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Found 466004 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:117859 (history)  Vaccinated:1998-12-04
Age:59.2  Onset:1998-12-04, Days after vaccination: 0
Gender:Female  Submitted:1998-12-08, Days after onset: 4
Location:South Carolina  Entered:1998-12-31, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: premarin, vitamins;Ginseng, herbs
Current Illness: NONE
Preexisting Conditions: sulfa, tetanus
Diagnostic Lab Data: NONE
CDC 'Split Type': SC98093
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09805800IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0871H0SCRA
Administered by: Other     Purchased by: Public
Symptoms: Hyperaesthesia, Injection site mass, Injection site oedema, Injection site pain, Myalgia, Pruritus, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: pt recv vax 4DEC98 & immed noticed warm feeling in rt arm;noticed pain, redness, swelling around 7-8PM;stated arm was so sore couldn''t stand to touch it;had h/a & generalized body aches;area warm, indurated, sore, itchy;

VAERS ID:117994 (history)  Vaccinated:1998-11-16
Age:59.8  Onset:1998-11-17, Days after vaccination: 1
Gender:Female  Submitted:1998-11-17, Days after onset: 0
Location:Georga  Entered:1999-01-11, Days after submission: 55
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: NONE
CDC 'Split Type': GA98123
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49882086IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1247H0IMLA
Administered by: Public     Purchased by: Public
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: Pt recv vax on 11/16/98; on 11/17/98 pt exp red, hot, edema, pain of LA; tx=Cortisone injection, Advil, moist heat

VAERS ID:118128 (history)  Vaccinated:1998-10-21
Age:59.0  Onset:1998-10-27, Days after vaccination: 6
Gender:Female  Submitted:1998-10-27, Days after onset: 0
Location:Massachusetts  Entered:1999-01-14, Days after submission: 79
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': MA9856
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0955780 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1541E IMRA
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES0950740 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Injection site pain, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 21OCT98 & initially lt arm felt hard, & sore to touch;26OCT98 observed welts, raised, red & hot;

VAERS ID:118610 (history)  Vaccinated:1998-12-14
Age:59.2  Onset:1999-01-11, Days after vaccination: 28
Gender:Female  Submitted:1999-01-19, Days after onset: 8
Location:Texas  Entered:1999-02-08, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': 99TX006
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1049H0 LA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Pt recv vax on 12/14/98; on 1/11/99 pt exp varicella rash

VAERS ID:118751 (history)  Vaccinated:1998-12-16
Age:59.5  Onset:1998-12-16, Days after vaccination: 0
Gender:Female  Submitted:1999-01-20, Days after onset: 35
Location:South Carolina  Entered:1999-02-09, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Combipatch
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG nl sinus rhythm
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09818200IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1247H0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Bradycardia, Hypotension, Myalgia, Myasthenic syndrome, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Malignancy related conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: syncopal episode;c/o nausea, lower extremity, weakness & generalized achiness 2hr p/vax;vitals @ time of syncopal episode BP 90/50, HR 50;p/ 750cc nl saline BP 128/70, HR 80;

VAERS ID:118798 (history)  Vaccinated:1999-01-08
Age:59.8  Onset:1999-01-08, Days after vaccination: 0
Gender:Female  Submitted:1999-01-11, Days after onset: 3
Location:Alaska  Entered:1999-02-09, Days after submission: 29
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: Borderline hypertension, Hx of COPD-mild
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4549560IMLA
Administered by: Public     Purchased by: Other
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt recv vax on 1/8/99; on same day pt exp diarrhea x 3 day

VAERS ID:119562 (history)  Vaccinated:1997-10-13
Age:59.0  Onset:1997-10-13, Days after vaccination: 0
Gender:Female  Submitted:1998-11-17, Days after onset: 400
Location:California  Entered:1999-02-26, Days after submission: 101
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': 7657
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81862   
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction
SMQs:
Write-up: Pt recv vax on 10/13/97; post vax pt exp local rxn from shoulder to wrist; vax was given SC rather than IM

VAERS ID:119646 (history)  Vaccinated:1997-11-13
Age:59.2  Onset:1997-11-20, Days after vaccination: 7
Gender:Female  Submitted:1998-11-19, Days after onset: 364
Location:New Hampshire  Entered:1999-02-26, Days after submission: 99
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': U199800200
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81930  LA
Administered by: Other     Purchased by: Other
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: Pt recv vax on 11/13/97; on 11/20/97 pt exp red, raised area of vax site-LA

VAERS ID:119914 (history)  Vaccinated:1998-05-22
Age:59.9  Onset:1998-05-26, Days after vaccination: 4
Gender:Female  Submitted:1999-03-01, Days after onset: 279
Location:Florida  Entered:1999-03-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES98060039
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0159E0IM 
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD. 0SC 
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES 0IM 
Administered by: Private     Purchased by: Private
Symptoms: Headache, Nausea, Neck pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Pt recv vax on 5/22/98; on 5/26/98 pt exp temple area headache, neck pain, nausea

VAERS ID:121299 (history)  Vaccinated:1999-04-13
Age:59.4  Onset:1999-04-14, Days after vaccination: 1
Gender:Female  Submitted:1999-04-14, Days after onset: 0
Location:New York  Entered:1999-04-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Norvasc, Imdur, Topol
Current Illness: NONE
Preexisting Conditions: Cardiac disease
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7H91839 IM 
Administered by: Other     Purchased by: Private
Symptoms: Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Pt recv vax on 4/13/99; on 4/14/99 pt exp body aches/ pains

VAERS ID:121738 (history)  Vaccinated:1998-07-15
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:1999-04-16
Location:California  Entered:1999-04-26, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp similar rxn w/hep b vax;
Other Medications:
Current Illness:
Preexisting Conditions: hepatitis, similar rxn w/hep b vaccine;
Diagnostic Lab Data: SSB negative;SSA negative;ANA nl;RF elevated;
CDC 'Split Type': 19980218551
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Dry mouth, Face oedema, Laboratory test abnormal, Salivary gland enlargement
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 15JUL98 & exp mouth & tongue dryness, white plaque-like oral surface & lip swelling;seen by ENT specialist;dx poss Sjorgren''s disease;

VAERS ID:121593 (history)  Vaccinated:1999-02-09
Age:59.0  Onset:1999-02-19, Days after vaccination: 10
Gender:Male  Submitted:1999-04-09, Days after onset: 48
Location:Iowa  Entered:1999-04-27, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, FBS, Lytes, BU- WNL; EMG/ NCV- mild prolonged latency of superficial peroneal sensory nerve; F-wave responses normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM572A60IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0989580 IMLA
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIES10605700SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt recv vax on 2/9/99; on 2/19/99 pt exp red/ swollen vax site on LA, peripheral neuropathy of numb arms &legs x 3-4 wk

VAERS ID:122112 (history)  Vaccinated:1999-04-29
Age:59.5  Onset:1999-05-01, Days after vaccination: 2
Gender:Female  Submitted:1999-05-05, Days after onset: 4
Location:Georga  Entered:1999-05-13, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4585820IMLA
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49981130IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax on 4/29/99; on 5/1/99 pt exp local rxn of warmth/ erythema/ induration

VAERS ID:122259 (history)  Vaccinated:1999-04-30
Age:59.1  Onset:1999-05-05, Days after vaccination: 5
Gender:Female  Submitted:1999-05-06, Days after onset: 1
Location:Washington  Entered:1999-05-20, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid;Premarin
Current Illness: NONE
Preexisting Conditions: hypothyrodidsm
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 0 RA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Oedema, Pain, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: pt recv vax 30APr99 & began having swelling & pruritus/pain 5MAY99;treated for cellulitis w/dicloxicillin;

VAERS ID:124043 (history)  Vaccinated:0000-00-00
Age:59.9  Onset:1998-09-27
Gender:Female  Submitted:1999-05-14, Days after onset: 229
Location:Hawaii  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: hydrochlorothiazide;Motrin;Potassium chloride;
Current Illness:
Preexisting Conditions: varicella;
Diagnostic Lab Data: 9/30/98 lab test PCR analysis: adequate specimen, negative for wild type
CDC 'Split Type': WAES98100459
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Dermatitis bullous, Pharyngitis, Rash maculo-papular
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Hypersensitivity (narrow)
Write-up: grandchild recv vax & grandparent devel 3 skin lesions d/t questionable secondary transmission;it was reported the lesions were vesiculopapular one of which was located on trunk & 2 rt arm;had sore throat & cough;

VAERS ID:125224 (history)  Vaccinated:1999-06-07
Age:59.9  Onset:1999-06-10, Days after vaccination: 3
Gender:Female  Submitted:1999-06-22, Days after onset: 12
Location:Florida  Entered:1999-06-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Effexor XR;Flexeril
Current Illness: NA
Preexisting Conditions: fibromyalgia
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0997390 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Somnolence, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: c/o pain, discomfort & swelling lt shoulder w/erythema, warm to touch & feeling very sleepy & tired;tx apply heat & take Viox;

VAERS ID:125293 (history)  Vaccinated:1999-06-07
Age:59.8  Onset:1999-06-07, Days after vaccination: 0
Gender:Female  Submitted:1999-06-21, Days after onset: 14
Location:Pennsylvania  Entered:1999-07-01, 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 fever, chills, soreness lt arm up into neck w/lyme vax #1;
Other Medications: Evista;Calcium
Current Illness: NONE
Preexisting Conditions: Lyme Disease SEPT97;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120G91IMRA
Administered by: Private     Purchased by: Private
Symptoms: Adverse drug reaction, Asthenia, Chills, Dizziness, Headache, Injection site hypersensitivity, Nuchal rigidity, Pruritus, Rash, Similar reaction on previous exposure to drug, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: p/vax evening bad h/a, stiff neck, arm, chills, dizziness @ times fatigue, hives, blotchy rash neck area;6/14/99 round ring & rash @ inj site;rash covers entire deltoid area;6/18/99 itchy rash nape of neck;

VAERS ID:126149 (history)  Vaccinated:1999-07-07
Age:59.6  Onset:1999-07-07, Days after vaccination: 0
Gender:Female  Submitted:1999-07-15, Days after onset: 8
Location:Delaware  Entered:1999-07-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19990169381
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY120G90IMLA
Administered by: Other     Purchased by: Other
Symptoms: Hypoxia, Nausea, Pyrexia, Respiratory disorder, Tremor
SMQs:, Acute pancreatitis (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: within 1hr p/vax pt devel severe nausea, fever & trembling;taken to ER; pt on ventilator;

VAERS ID:126519 (history)  Vaccinated:1999-03-29
Age:59.0  Onset:1999-03-30, Days after vaccination: 1
Gender:Female  Submitted:1999-04-27, Days after onset: 27
Location:New York  Entered:1999-07-30, Days after submission: 94
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: in pt; lymerrix, dose 1, enlarged node (neck)
Other Medications: phentermine;zoloft;tenuate;claradol;advil;premarin
Current Illness:
Preexisting Conditions: allergic to citrus, hay fever
Diagnostic Lab Data:
CDC 'Split Type': 1999007952
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120D91IMA
Administered by: Public     Purchased by: Other
Symptoms: Adverse drug reaction, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt exp itching & urticaria on upper torso; tx: medrol dosepak & benadryl; symptoms became worse & MD referred to allergist;

VAERS ID:126632 (history)  Vaccinated:1999-04-01
Age:59.0  Onset:1999-04-01, Days after vaccination: 0
Gender:Male  Submitted:1999-05-19, Days after onset: 47
Location:Pennsylvania  Entered:1999-07-30, 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:
Diagnostic Lab Data:
CDC 'Split Type': 1999011289
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1 A
Administered by: Other     Purchased by: Other
Symptoms: Anorexia, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: p/vax pt devel nausea & fever; could not eat;

VAERS ID:127124 (history)  Vaccinated:1998-01-12
Age:59.0  Onset:1998-01-27, Days after vaccination: 15
Gender:Female  Submitted:1999-07-10, Days after onset: 528
Location:California  Entered:1999-08-11, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none
Other Medications: premarin, provera
Current Illness: none
Preexisting Conditions: penicillan; erythromycin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.2357A21  
Administered by: Private     Purchased by: Private
Symptoms: Hyperthyroidism, Hypokinesia, Myasthenic syndrome, Myopathy, Pain
SMQs:, Rhabdomyolysis/myopathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hyperthyroidism (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: 15 days p/vax pt exp severe lower limb myopathy w/extreme pain; inability to walk; bedridden; muscles deteriorated; dx of Graves Disease

VAERS ID:127268 (history)  Vaccinated:1999-08-05
Age:59.7  Onset:1999-08-11, Days after vaccination: 6
Gender:Female  Submitted:1999-08-11, Days after onset: 0
Location:Washington  Entered:1999-08-17, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4630190 RA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0998960  LA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site inflammation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: p/vax pt arm red & inflamed @ site;

VAERS ID:127653 (history)  Vaccinated:1999-04-24
Age:59.0  Onset:1999-04-25, Days after vaccination: 1
Gender:Male  Submitted:1999-08-19, Days after onset: 116
Location:New Jersey  Entered:1999-08-27, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0420  
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Dizziness, Ear pain, Headache, Myalgia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: lethargic, sleepy, soreness of lt arm, dizziness, lt shoulder & neck, head & ear sore;cont x2 more days;

VAERS ID:128213 (history)  Vaccinated:1999-08-24
Age:59.2  Onset:1999-08-24, Days after vaccination: 0
Gender:Female  Submitted:1999-08-24, Days after onset: 0
Location:Arkansas  Entered:1999-09-13, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: trazadone
Current Illness: none
Preexisting Conditions: anaphvlacxic reactions to conpazine 1989; & pincillin (hx) 1969
Diagnostic Lab Data: none
CDC 'Split Type': AR9931
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2398B60IMLA
Administered by: Public     Purchased by: Other
Symptoms: Paraesthesia, Paraesthesia oral, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: p/vax pt devel pruritic welts (hives) at waistline; disseminating to lower abd/chest;neck over 60-90 min; lips & tongue began to tingle & numb; went to ER; Rx: Celestone; benadryl; home instruction;

VAERS ID:128413 (history)  Vaccinated:1999-09-15
Age:59.8  Onset:1999-09-16, Days after vaccination: 1
Gender:Female  Submitted:1999-09-17, Days after onset: 1
Location:Oklahoma  Entered:1999-09-21, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp rxn @ age 59 w/TD booster;
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic DPH actifed;antihistamines sulfa;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0137J1 LA
Administered by: Other     Purchased by: Other
Symptoms: Headache, 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: 9/16/99 deltoid area swollen 2in;no redness, no heat, T97.4;9/17/99 pt stated area became red-also had h/a;

VAERS ID:129312 (history)  Vaccinated:1999-10-05
Age:59.7  Onset:1999-10-06, Days after vaccination: 1
Gender:Male  Submitted:1999-10-13, Days after onset: 7
Location:Texas  Entered:1999-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: polycystic kidney, chronic renal failure
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982440IMRA
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: pt exp circumoral numbness & tingling to extremities the day p/vax;sx lasted for approx 4-6hr;no tx was sought by patient;

VAERS ID:129396 (history)  Vaccinated:1999-06-09
Age:59.6  Onset:1999-06-09, Days after vaccination: 0
Gender:Female  Submitted:1999-08-16, Days after onset: 68
Location:Minnesota  Entered:1999-10-15, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Oedema peripheral, Skin discolouration
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: arm began to swell w/in a few hr;3 days later it started turning colors-yellow & red & swelling lasted about a month or more; Pella, IA hosp prescribed Augmentin, DPH & Tagamet;

VAERS ID:129476 (history)  Vaccinated:1999-10-06
Age:59.9  Onset:1999-10-06, Days after vaccination: 0
Gender:Female  Submitted:1999-10-13, Days after onset: 7
Location:Virginia  Entered:1999-10-18, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Premarin;Progestrone;Prilosec;
Current Illness: NA
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC 'Split Type': VA99052
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P7IMRA
Administered by: Public     Purchased by: Public
Symptoms: Myalgia, Pharyngitis, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt devel hives approx 4hr p/vax which occurred intermittently through that noc & next day;took DPH & had no further hives;also had sore throat & was achy for 2 days;

VAERS ID:129604 (history)  Vaccinated:1999-10-11
Age:59.3  Onset:1999-10-11, Days after vaccination: 0
Gender:Male  Submitted:1999-10-12, Days after onset: 1
Location:Pennsylvania  Entered:1999-10-20, 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: novacaine & percocet allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Headache, Hyperhidrosis, Hypertonia, Hypokinesia, Personality disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt was not able to stand, broke out into extreme sweat then vomited several times;dizziness, severe h/a & cont to vomit;when lying down felt like are was flying;sx persist next day-not as severe but w/stiffness;

VAERS ID:129784 (history)  Vaccinated:1999-09-14
Age:59.5  Onset:1999-09-15, Days after vaccination: 1
Gender:Female  Submitted:1999-09-30, Days after onset: 15
Location:Louisiana  Entered:1999-10-25, Days after submission: 25
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: codeine allergy
Diagnostic Lab Data:
CDC 'Split Type': LA991004
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0871H0IMRA
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES 2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: c/o nausea & vomit beginning 9/15/99 approx 930AM @ work;unable to eat w/o vomiting;to ER 9/16/99 when still unable to keep food down;

VAERS ID:129804 (history)  Vaccinated:1999-10-13
Age:59.9  Onset:0000-00-00
Gender:Male  Submitted:1999-10-14
Location:New York  Entered:1999-10-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': NY599036
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P IMRA
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv flu vax in both arms in error;should have recv flu & pneumococcal vax;No adverse event;

VAERS ID:130056 (history)  Vaccinated:1999-10-15
Age:59.0  Onset:1999-10-17, Days after vaccination: 2
Gender:Female  Submitted:1999-10-25, Days after onset: 8
Location:Michigan  Entered:1999-10-29, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Lymphadenopathy
SMQs:, Hypersensitivity (narrow)
Write-up: p/24 to 48hr noticed a rash circling both arm pits;on upper of lt arm same arm vax given was another rash approx 1" x 3" in size;sx faded away 1wk;also exp sl resp sx in 48hr;

VAERS ID:130131 (history)  Vaccinated:1999-10-26
Age:59.1  Onset:1999-10-27, Days after vaccination: 1
Gender:Female  Submitted:1999-10-28, Days after onset: 1
Location:Massachusetts  Entered:1999-11-01, 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': MA9919
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 1 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: 4-8" red rxn on rt arm got pneumovax twice in 1yr by different hlth care provider;;

VAERS ID:130246 (history)  Vaccinated:1999-10-24
Age:59.5  Onset:1999-10-24, Days after vaccination: 0
Gender:Female  Submitted:1999-10-30, Days after onset: 6
Location:Arizona  Entered:1999-11-03, 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: Progesteron;Estrogen
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG, Blood work;monitored Bp
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Dehydration, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: n/v, diarrhea for sometime;dehydrated & transported to hosp by paramedic;

VAERS ID:130555 (history)  Vaccinated:1999-10-19
Age:59.3  Onset:1999-10-20, Days after vaccination: 1
Gender:Female  Submitted:1999-10-26, Days after onset: 6
Location:Michigan  Entered:1999-11-08, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: most ATB, animals, molds, grass, dust, citrus, detergents;
Diagnostic Lab Data:
CDC 'Split Type': MI99105
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P1 RA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dyspnoea, Injection site hypersensitivity, Nausea, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: site of inj warm & red-rash began on trunk of body;advised by MD to get DPH;seen in ER nauseated, SOB, weak, rash over entire body;02 given;

VAERS ID:130570 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:1999-10-20
Gender:Female  Submitted:1999-11-08, Days after onset: 19
Location:Georga  Entered:1999-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv Td vax
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Neck pain, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: pt exp pain from shoulder down into upper arm & side of neck & back of neck;cont to move down arm across back to finger tips persisting x 3 wk;rx edurmicin hydrocodone;numbness in fingers, palm;

VAERS ID:130605 (history)  Vaccinated:1999-10-07
Age:59.0  Onset:1999-10-08, Days after vaccination: 1
Gender:Female  Submitted:1999-11-03, Days after onset: 26
Location:Mississippi  Entered:1999-11-09, 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: Celestone, Ceftin, Proventil HAM, histex HC
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: surgical pathology from lt lung biopsy on 10/28/99-diffuse alveolar damage w/acute & chronic penumonitis, hyaline membrane formation, interstitial edema & early organization;
CDC 'Split Type': U199900836
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0065AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoxia, Pharyngitis, Pulmonary fibrosis, Pulmonary oedema, Respiratory disorder
SMQs:, Cardiac failure (narrow), Agranulocytosis (broad), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: p/vax pt exp a severe sore throat that became worse p/ATB;CXR revealed bilat pulmonary infiltrates;pt put on ventilator;pt had an open lung biopsy on10/28''/99;tissue samples show diffuse alveolar damage w/acute & chronic pneumonitis

VAERS ID:130796 (history)  Vaccinated:1999-10-14
Age:59.3  Onset:1999-10-18, Days after vaccination: 4
Gender:Female  Submitted:1999-10-18, Days after onset: 0
Location:Georga  Entered:1999-11-15, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tomoxil;Glucocol;
Current Illness: NA
Preexisting Conditions: astham;breast surgery 3yr ago;
Diagnostic Lab Data: NA
CDC 'Split Type': GA99125
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU011AA0IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4557540IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: p/vax now exp tightness in chest;no s/o chest pain;c/o T100;;

VAERS ID:130830 (history)  Vaccinated:1999-11-09
Age:59.5  Onset:1999-11-09, Days after vaccination: 0
Gender:Female  Submitted:1999-11-10, Days after onset: 1
Location:Texas  Entered:1999-11-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen;Paxil;Celebrex;
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Injection site mass, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: hives size of orange below inj site;

VAERS ID:130875 (history)  Vaccinated:1998-11-30
Age:59.0  Onset:1998-11-30, Days after vaccination: 0
Gender:Female  Submitted:1999-11-10, Days after onset: 345
Location:Washington  Entered:1999-11-18, 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: unk
Current Illness: unk
Preexisting Conditions: unk
Diagnostic Lab Data: unk
CDC 'Split Type': 4754105NOV199
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Chest pain, Hypoxia, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: p/vax pt devel wheezing, chest tightness & facial flushing;tx w/DPH & epi & 02;sx resolved w/in 3min;this event is considered medically important;

VAERS ID:131616 (history)  Vaccinated:1999-11-17
Age:59.7  Onset:1999-11-17, Days after vaccination: 0
Gender:Female  Submitted:1999-11-18, Days after onset: 1
Location:Maryland  Entered:1999-12-01, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp red, warm knot @ age 59 w/flu vax #7;
Other Medications: Norvasc, Betapaste, Diazide, Premarin, Blipazide, Azulfidine;
Current Illness: NONE
Preexisting Conditions: heart disease, allergice cordarone, imdur, protamine, nitro persartine;
Diagnostic Lab Data:
CDC 'Split Type': MD99030
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1585H1 LA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Insomnia, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: arm that inj given became extremely sore 2hr p/vax; there is a warm, red knot the size of a quarter;arm hurt to the extent that it interfered w/sleep;

VAERS ID:131621 (history)  Vaccinated:1999-11-08
Age:59.8  Onset:1999-11-08, Days after vaccination: 0
Gender:Male  Submitted:1999-11-10, Days after onset: 2
Location:Michigan  Entered:1999-12-01, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: pt recv flu vax lot# 60126FA given 10/3/99;coumadin toppol lipator, topmax, paxil, levoxyl
Current Illness: NONE
Preexisting Conditions: hx stroke 96;NKA
Diagnostic Lab Data:
CDC 'Split Type': MI99126
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.4510  RA
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: c/o swelling starting 11/8/99 PM;ice pack applied;pt denies fever c/o area hot to the touch,, edeam dec today approx 3" diameter, tender to touch @ the elbow;

VAERS ID:132434 (history)  Vaccinated:1999-10-08
Age:59.0  Onset:1999-11-02, Days after vaccination: 25
Gender:Male  Submitted:1999-12-06, Days after onset: 34
Location:Wisconsin  Entered:1999-12-17, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN170A0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Coordination abnormal, Guillain-Barre syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow)
Write-up: Paresthesias in extremities and ataxia. Atypical Guillain-Barre Syndrome-s/p vax. Hosp 11-2-99, Disch 11-3-99. Pt now independent w/activities-daily living. Disch w/outpt phys and occupational therapy.

VAERS ID:132607 (history)  Vaccinated:1999-06-12
Age:59.0  Onset:1999-08-20, Days after vaccination: 69
Gender:Male  Submitted:1999-12-13, Days after onset: 115
Location:Delaware  Entered:1999-12-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Asprin daily
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC,Sed rate,CPK,UA,CXR,ANA,RF
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0430 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Arthropathy
SMQs:, Arthritis (broad)
Write-up: After 3rd Anthrax injection in Aug. 99, pt.''s left middle finger began aching, then deformity of joints began in middle and little fingers of left hand.Left ankle aches sporadically. As of follow up information received on 06/16/2000 member has retired from the USAF reserves. He will be followed by the veterans administration.

VAERS ID:132654 (history)  Vaccinated:1999-11-08
Age:59.0  Onset:1999-11-10, Days after vaccination: 2
Gender:Male  Submitted:1999-11-12, Days after onset: 2
Location:South Carolina  Entered:1999-12-20, 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: UNK
Diagnostic Lab Data:
CDC 'Split Type': SC99081
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0145BA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1095H SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0011AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Oedema peripheral, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 2 days after vaccination pt. reported redness,swelling,& pain in right arm.Pt. stated tx w/ Keflex by MD.

VAERS ID:132717 (history)  Vaccinated:1999-12-16
Age:59.7  Onset:1999-12-17, Days after vaccination: 1
Gender:Male  Submitted:1999-12-20, Days after onset: 3
Location:Michigan  Entered:1999-12-21, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ziac,Lipitor,Ultram
Current Illness: NONE
Preexisting Conditions: HBP,Stroke x 3, increased cholesterol
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 7IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Headache, Myalgia, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad)
Write-up: 12/17/99:Pt. experienced fever,chills,headache,cough productive of clear mucus,aching all over.Stomach was jittery but eating and drinking fluids normally & sore throat.

VAERS ID:132153 (history)  Vaccinated:1999-10-05
Age:59.9  Onset:1999-10-06, Days after vaccination: 1
Gender:Female  Submitted:1999-11-22, Days after onset: 47
Location:California  Entered:1999-12-28, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Delafan,Sudafed
Current Illness: NONE
Preexisting Conditions: severe environmental allergies, allergy to doxycycline;sulfa;& Benadryl
Diagnostic Lab Data: NONE
CDC 'Split Type': CA990144
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH499821610IMLA
Administered by: Other     Purchased by: Other
Symptoms: Ecchymosis, Nausea, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Severe swelling,soreness,bruising to lt elbow, & nausea w/i 24 hrs of injection.Seen by MD & tx w/ Solu-Medrol w/ fair relief.On 11/22/99,pt still experiencing a moderate degree of swelling.

VAERS ID:131833 (history)  Vaccinated:1999-04-11
Age:59.0  Onset:1999-04-12, Days after vaccination: 1
Gender:Female  Submitted:1999-11-03, Days after onset: 205
Location:Indiana  Entered:1999-12-29, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER454616 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Given a DT toxoid booster on 4/11/99 and developed an erythematous and painful area around injection site, no swelling.

VAERS ID:131842 (history)  Vaccinated:1999-10-19
Age:59.6  Onset:1999-10-19, Days after vaccination: 0
Gender:Female  Submitted:1999-10-29, Days after onset: 10
Location:North Dakota  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: Estrace, Tavist D, calcium, vitamins, flovent,serevent, allergy shots
Current Illness:
Preexisting Conditions: Allergits to IVP dye, ASA, Ibuprofen, foods
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1585H IMLA
Administered by: Private     Purchased by: Other
Symptoms: Headache, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Pt reported sore arms, headache and body aches for one day. She didn''t notify a physician.

VAERS ID:132882 (history)  Vaccinated:1999-10-20
Age:59.0  Onset:1999-10-20, Days after vaccination: 0
Gender:Female  Submitted:1999-12-20, Days after onset: 61
Location:Unknown  Entered:1999-12-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0431 LA
Administered by: Military     Purchased by: Public
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt states has hard nodule at injection site. 3 x 3 inches.

VAERS ID:132891 (history)  Vaccinated:1999-12-16
Age:59.0  Onset:1999-12-16, Days after vaccination: 0
Gender:Male  Submitted:1999-12-16, Days after onset: 0
Location:Michigan  Entered:1999-12-29, 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:
Preexisting Conditions: Paxil, No know allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02879P0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site haemorrhage, Injection site hypersensitivity, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt given .5cc Infuenza vax in L deltoid. Sm amt of bleeding occurred at site. Immediately, raised, reddened are appeared approx 1" dia. Applied cold compress. No respiratory problems noted.

VAERS ID:133294 (history)  Vaccinated:1999-10-15
Age:59.0  Onset:1999-10-15, Days after vaccination: 0
Gender:Female  Submitted:1999-11-24, Days after onset: 40
Location:Alaska  Entered:2000-02-01, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Sore arm for 2 yrs with getting Flu vaccine.
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': AK200008
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998203IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: C/o dull ache in L/deltoid area, off & on since receiving vax. Soreness started on 10/15. Denies swelling, redness in area at any time. Soreness goes away & reappears w/movement of arm, like when cleaning around home.

VAERS ID:133509 (history)  Vaccinated:1999-12-08
Age:59.0  Onset:1999-12-09, Days after vaccination: 1
Gender:Female  Submitted:2000-01-13, Days after onset: 35
Location:South Carolina  Entered:2000-02-01, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vasotec, Nolvadex, Prilosec, Vitamin-E & Vitamim-D
Current Illness: NONE
Preexisting Conditions: Hx/Breast CA, Mastectomy, Osteoporosis, Raynaud''s
Diagnostic Lab Data: NONE
CDC 'Split Type': SC00001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0205AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1095H0 LA
Administered by: Public     Purchased by: Other
Symptoms: Hypokinesia, Injection site hypersensitivity, Injection site pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Urticaria-2 cm wheals at site of each injection & below each site. L/arm very sore & painful to raise. MD recommended no repeat of these vaccines in the future.

VAERS ID:133961 (history)  Vaccinated:2000-01-26
Age:59.0  Onset:2000-01-28, Days after vaccination: 2
Gender:Female  Submitted:2000-01-29, Days after onset: 1
Location:Alaska  Entered:2000-02-15, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
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/WYETH4998302 IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site reaction
SMQs:
Write-up: Local rxn 3 days post vax; note per MD, delayed (TYPE II).

VAERS ID:134158 (history)  Vaccinated:1999-10-12
Age:59.0  Onset:1999-10-13, Days after vaccination: 1
Gender:Female  Submitted:1999-10-13, Days after onset: 0
Location:Michigan  Entered:2000-02-17, Days after submission: 127
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Chlortrimeton
Current Illness:
Preexisting Conditions: Asthma, allergy to environmental allergens
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 10IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 3" redness and slight swelling at inject site. Noticed approximately 19 hours after flu shot. Minimal itching.

VAERS ID:134260 (history)  Vaccinated:2000-01-25
Age:59.0  Onset:2000-01-31, Days after vaccination: 6
Gender:Female  Submitted:2000-02-16, Days after onset: 16
Location:Unknown  Entered:2000-02-29, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES467043 SCRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, 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: 1/25 rcv''d vax at ER post laceration. 1/31 redness, swelling, tenderness to R deltoid. Treated. Returned again w/ inc cellulitis to R shoulder. Admitted. Sx consistent w/ DT being given SQ. Documented 5/8" needle used for vax.

VAERS ID:134416 (history)  Vaccinated:1999-05-22
Age:59.0  Onset:1999-06-04, Days after vaccination: 13
Gender:Female  Submitted:2000-02-16, Days after onset: 257
Location:Maryland  Entered:2000-02-29, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: Hypothyroid
Preexisting Conditions: Hypothyroidism.
Diagnostic Lab Data: Neg for Lyme Disease
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Hypokinesia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Second vax produced lasting pain and limited range of motion in right arm progressing to include all joints and muscles of arms and legs.

VAERS ID:150198 (history)  Vaccinated:1999-11-25
Age:59.0  Onset:1999-12-03, Days after vaccination: 8
Gender:Male  Submitted:2000-02-14, Days after onset: 73
Location:New York  Entered:2000-03-17, 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: Vasotec
Current Illness: Hypertension
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES 2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Gait disturbance, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Pt notices head falls to his left, shoulder droops to left, gait uncertain beginning 8 days post vax and continuing to present.

VAERS ID:150573 (history)  Vaccinated:1999-05-18
Age:59.0  Onset:1999-08-01, Days after vaccination: 75
Gender:Male  Submitted:2000-01-19, Days after onset: 171
Location:Wisconsin  Entered:2000-03-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin
Current Illness:
Preexisting Conditions: hx of valve replacement
Diagnostic Lab Data:
CDC 'Split Type': 19990279961
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Approximately 3 months, post vax, in August, 1999, the pt began to experience arthralgia. His symptoms are in multiple joints. The most recent information, received on 11/23/99, reports the condition of the pt is ongoing.

VAERS ID:151892 (history)  Vaccinated:1999-05-01
Age:59.0  Onset:1999-05-01, Days after vaccination: 0
Gender:Female  Submitted:2000-04-21, Days after onset: 356
Location:New Jersey  Entered:2000-05-12, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The pt has no history of Lyme disease or any type of joint pain.
Diagnostic Lab Data:
CDC 'Split Type': 20000055251
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Rheumatoid arthritis
SMQs:, Arthritis (narrow)
Write-up: In April, 1999 and May, 1999, the pt received her 1st and 2nd dose of Lymerix vaccine and she immediately starting having pain in her right shoulder which then spread to her left shoulder and her hips. It was not clarified if these adverse events began after the 1st or 2nd injection. In the fall of 1999, the pt was dx''d with rheumatoid arthritis. Treatment includes Enbrel and Celebrex. Additional information has been requested.

VAERS ID:152232 (history)  Vaccinated:1999-07-13
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:New York  Entered:2000-05-23
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Private
Symptoms: Anxiety, Depression, Fatigue, Malaise, Mood swings, Panic reaction
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (narrow)
Write-up: General malaise, chronic fatigue, depression, anxiety mood changes, panic attacks and suicide thoughts.

VAERS ID:152751 (history)  Vaccinated:1998-11-02
Age:59.0  Onset:1998-11-09, Days after vaccination: 7
Gender:Male  Submitted:2001-08-21, Days after onset: 1015
Location:Iowa  Entered:2000-06-07, Days after submission: 440
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: Pollen type-hay fever
Diagnostic Lab Data: MRI-nml
CDC 'Split Type': U1999002330
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0968420 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow)
Write-up: It was reported, that a 59 year old male, post vax, approximately 1-2 weeks later, had a rash appear at injection site. It was a very slight rash which became itchy. About the same time, the pt developed an achy arm, shoulder and neck. The pt went back to the MD, one month later and was told that the vaccine had nothing to do with his pain. The pt had an MRI and was followed-up through another MD, but they (reportedly) cannot find anything (no significant additional findings were made). From additional information received, on 4/29/1999, it was reported, that the pt has not yet recovered from this experience. From follow-up info received on 04/19/2001, it was reported that the pt has not recovered. In addition, reporter and responsible physician information were also provided. No further information was provided from follow-up #2 corespondence returned to Aventis Pasteur Inc. On 08/20/01. No further information is anticipated, this case is closed.

VAERS ID:153389 (history)  Vaccinated:2000-05-04
Age:59.0  Onset:2000-05-04, Days after vaccination: 0
Gender:Female  Submitted:2000-05-09, Days after onset: 5
Location:Virginia  Entered:2000-06-09, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pepcid
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': VA00016
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4600252IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Headache, Injection site erythema, Injection site pain, Oedema, 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), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: The pt received vaccine on 5/4/00. Pt states pain in arm at site of injection on 5/4, redness and pain on 5/5, and swelling, pain and redness on 5/6. The pt states a headache and fever on 5/5 and 5/6, ice provided some relief. Erythema and edema extends past elbow and area of swelling still growing. Per phone conversation with health department, this sounded like a severe (and abnormal) local reaction. Pt had an appt with PMD, but was told if symptoms worsen go to ER. Follow up states the pt saw PMD was given Levaquin, Prednisone and instructed to apply ice. Was also instructed to never receive TD with animal growth again.

VAERS ID:153867 (history)  Vaccinated:1999-12-08
Age:59.0  Onset:1999-12-08, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2000-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol
Current Illness: NONE
Preexisting Conditions: Hypertension, grass allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2936A20IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Ache @ site and throughout body 1 - 2 days.

VAERS ID:154169 (history)  Vaccinated:1999-07-03
Age:59.0  Onset:1999-07-03, Days after vaccination: 0
Gender:Female  Submitted:2000-02-25, Days after onset: 237
Location:Idaho  Entered:2000-06-14, Days after submission: 109
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: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': 899189184A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988028/4988029 IM 
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt. developed an injection site reaction characterized by a 4 inch area of redness, swelling and itching.

VAERS ID:154327 (history)  Vaccinated:1999-04-15
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:1999-09-29
Location:New Jersey  Entered:2000-06-15, Days after submission: 260
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vasotec, Premarin, Provera
Current Illness:
Preexisting Conditions: chronic allergic rhinitis, hypertension
Diagnostic Lab Data: Western Blot test-positive
CDC 'Split Type': 19990185291
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM120591IM 
Administered by: Private     Purchased by: Private
Symptoms: Laboratory test abnormal, Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: At the end of May 1999, post vax, she developed myalgias, low grade fever, and a rash. She saw a physician on 6/11/99 with myalgias and low grade fever. She was treated with doxycycline. The pt has been on doxycycline for 5 weeks and is still not feeling great.

VAERS ID:154417 (history)  Vaccinated:1999-04-27
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:1999-09-29
Location:Pennsylvania  Entered:2000-06-15, Days after submission: 260
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor
Current Illness:
Preexisting Conditions: Allergic to pain medication containing narcotics and has elevated cholesterol
Diagnostic Lab Data: MRI-ruled out kidney problems. No herniated disc noted.
CDC 'Split Type': 19990204511
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Alcohol poisoning, Chills, Fatigue, Hyperhidrosis, Muscle spasms, Pain, Paraesthesia, Vertigo
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)
Write-up: This is a spontaneous report from a 59 year old male pt who received the 1st and 2nd dose of Lymerix on 3/23/99 and 4/27/99, respectively. Starting in June 1999, the pt experienced excruciating pain, tingly sensation, numbness and cramps (muscular) on the left side of his body. Additionally, he experienced chills, sweats, vertigo and fatigue. He has not driven a car in 6 weeks. He had one glass of wine and felt very drunk. He was seen by a physician and treated with ice packs, physical therapy, electro-stimulation, ultrasound therapy and ibuprofen. The most recent information received on 8/12/99, reports the condition of the pt as ongoing.

VAERS ID:154430 (history)  Vaccinated:1999-05-27
Age:59.0  Onset:1999-05-27, Days after vaccination: 0
Gender:Male  Submitted:1999-08-23, Days after onset: 88
Location:California  Entered:2000-06-15, Days after submission: 297
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tenormin, colchicine and possibly Keflex
Current Illness:
Preexisting Conditions: Allergic to Klonopin, Glucophage, Glucotrol, Hytrin, Indocin, sulfa and tetracycline.
Diagnostic Lab Data:
CDC 'Split Type': 19990212871
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM116A20IMLA
Administered by: Other     Purchased by: Other
Symptoms: Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: This is a spontaneous report from a nurse referring to a 59 year old male who, on 5/27/1999, received his 1st Lymerix shot and several hours later, he experienced nausea for several hours. The symptoms resolved on the same day. The most recent information, received on 8/20/99, reports the condition of the pt as resolved.

VAERS ID:154431 (history)  Vaccinated:1999-05-11
Age:59.0  Onset:1999-05-12, Days after vaccination: 1
Gender:Male  Submitted:1999-09-10, Days after onset: 121
Location:New York  Entered:2000-06-15, Days after submission: 279
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celebrex, Propulsid, Prilosec
Current Illness:
Preexisting Conditions: Allergic to crabs, lobster and shrimp (swelling) Had a hiatal hernia
Diagnostic Lab Data: MRI of the cervical spine and there was nothing pressing on C3. He has no muscle weakness.
CDC 'Split Type': 19990212941
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Musculoskeletal stiffness, Neck pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: This is a spontaneous report from a physician and from a 59 year old male pt who, on 3/2/99, received his 1st dose of Lymerix and 1 day later, he experienced a stiff neck, which resolved in 1 week. On 5/11/99, the pt received the 2nd dose of Lymerix, and 1 day later, he experienced a stiff neck, neck pain and tingling from ear lobe to his chin. He was treated with NSAIDS (nos). The most recent information, received on 9/10/99, reports the condition of the pt as unknown.

VAERS ID:154434 (history)  Vaccinated:1999-03-02
Age:59.0  Onset:1999-05-13, Days after vaccination: 72
Gender:Male  Submitted:1999-08-27, Days after onset: 106
Location:Wisconsin  Entered:2000-06-15, Days after submission: 293
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: NONE
Diagnostic Lab Data: Lupus testing was neg.
CDC 'Split Type': 19990220111
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Hypokinesia, Pain
SMQs:, Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: This is a spontaneous report from a registered pharmacist referring to a male who received his 1st dose of Lymerix on 2/2/99 and his 2nd dose on 3/2/99, respectively. On 5/13/99, while jogging, the pt experienced arthritis-like pain of both knees. He could not drive his car. He was seen by a physician and was treated with ibuprofen. As of 8/24/99, his pain has slowly abated. He still has some discomfort. The most recent information, received on 8/24/99, reports the condition of the pt is ongoing. The most recent information received on 5/31/00 reports the condition of the pt as resolved.

VAERS ID:154459 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:1999-09-13
Location:Missouri  Entered:2000-06-15, Days after submission: 276
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': 19990241511
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Influenza like illness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: One week following the 3rd dose of Lymerix, the pt experienced flu-like symptoms, myalgias and arthralgias. The most recent information received on 9/3/99, reports the pt made a full recovery.

VAERS ID:154901 (history)  Vaccinated:1998-09-29
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:1998-12-22
Location:Missouri  Entered:2000-06-21, Days after submission: 546
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: Mitral Valve Prolapse
Diagnostic Lab Data:
CDC 'Split Type': U199800719
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR09817900  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Injection site erythema, 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)
Write-up: It was reported that a 59 year old female received Fluzone SV 98-99 USP on Sep 29.1998. Reportedly sometime after the vaccination the pt experienced a fever and a swollen, red arm. From additional information received on Nov 16, 1998 it was reported that the pt also experienced chills after receiving the vaccination.

VAERS ID:154902 (history)  Vaccinated:1998-09-29
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:1998-12-22
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: NONE
Preexisting Conditions: Mitral Valve Prolapse
Diagnostic Lab Data:
CDC 'Split Type': U199800720
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR0981790   
Administered by: Private     Purchased by: Unknown
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: It was reported that a 59 year old female received Fluzone SV 98-99 USP on Sep 29, 1998. Reportedly sometime after the vaccination the pt experienced an aching, swollen, red arm. From additional information received on Nov 16, 1998 it was reported the pt recovered from this experience.

VAERS ID:154914 (history)  Vaccinated:1998-05-08
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2000-04-21
Location:Pennsylvania  Entered:2000-06-21, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: blood pressure (nos)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 1999016491
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Private     Purchased by: Private
Symptoms: Alopecia
SMQs:
Write-up: Case reference number 199901649411, is a spontaneous report from 59year of female pt /physician assist. The pt is allergic to oral codeine (GI SX and NSAIDS) She is hypertensive and takes blood pressure medications (NOS). ON 05/08/98, the pt received her first dose of Havrix for prophylaxis of Hep A. During the summer of 1998, she began to lose her hair. She lost 2/3 of hair volume . A doctor visit was required. She was treated with biotin 300mg/ day and zinc 200 mg / BID. Havrix was discontinued. The most recent information receivid on 07/01/99 reports the condition of the pt is not yet recovered.

VAERS ID:154975 (history)  Vaccinated:1999-04-05
Age:59.0  Onset:1999-04-09, Days after vaccination: 4
Gender:Female  Submitted:1999-12-20, Days after onset: 255
Location:North Carolina  Entered:2000-06-21, Days after submission: 183
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Abrasion, contusion on lower leg
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': 899263034A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4978249 IM 
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site oedema, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: A nurse reported that a 59 year old female inadvertently received an injection of DT on 4/5/99 after sustaining an abrasion and contusion on her lower leg. On 4/9/99, 4 days post vax, pt developed an injection site reaction characterized by itching and an angry looking 8.8 X 6.2 cm area of redness, warmth and swelling described as cellulitis; she was seen by the physician. On 4/19/99, she was seen by the physician who noted that the area of redness was "resolving nicely''.

VAERS ID:155154 (history)  Vaccinated:1998-11-19
Age:59.0  Onset:1998-11-21, Days after vaccination: 2
Gender:Female  Submitted:1998-12-17, Days after onset: 26
Location:Wisconsin  Entered:2000-06-21, Days after submission: 551
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Provera, Premarin
Current Illness: NONE
Preexisting Conditions: allergy to erythromycin, tetanus, high blood pressure
Diagnostic Lab Data:
CDC 'Split Type': U1998008410
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0989920 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: On 11/21/98, the pt experienced a local reaction at the injection site. Pt had an approximately 14 cm irregular redness in a circle around injection site. This resolved in a couple of days.

VAERS ID:155155 (history)  Vaccinated:1998-10-26
Age:59.0  Onset:1998-10-26, Days after vaccination: 0
Gender:Female  Submitted:1998-12-15, Days after onset: 50
Location:Wisconsin  Entered:2000-06-21, Days after submission: 553
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, sulfa, Voltaren
Current Illness: bladder infection
Preexisting Conditions: arteritis
Diagnostic Lab Data: NONE
CDC 'Split Type': U1998008450
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES0980560 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: Within a half an hour post vax, the pt experienced a slight metallic taste in her mouth. Reportedly by 10/30 the taste was very strong, like sucking on a rusty spoon.

VAERS ID:155256 (history)  Vaccinated:1999-08-04
Age:59.0  Onset:1999-08-05, Days after vaccination: 1
Gender:Female  Submitted:2000-01-28, Days after onset: 176
Location:Virginia  Entered:2000-06-22, Days after submission: 145
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NON
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': 899221141A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4998114 IMLA
Administered by: Private     Purchased by: Other
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: One day post vax, this pt developed injection site reaction with redness, swelling and induration. Treated with Benadryl and an unspecified steroid and recovered.

VAERS ID:155601 (history)  Vaccinated:1999-03-02
Age:59.0  Onset:1999-09-26, Days after vaccination: 208
Gender:Male  Submitted:2000-06-20, Days after onset: 268
Location:Connecticut  Entered:2000-06-28, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: sore arm;FLU (Mfr not specified); ;.00;In Patient
Other Medications: Proscar, Hytrin singular
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: HLA-neg, ANA, ASO, CRP, Lyme-abn
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Groin pain, Hypokinesia, Laboratory test abnormal, Neck pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Joint pain in hips, groin, left shoulder, and both wrists.60 day follow-up dated 09/29/00 states the pt has pain in back of neck. Pain hampers walking and driving an automobile. The annual follow-up states neck pain, loss of flexibility in both wrists and weakness. Also, the right shoulder pain and much groin pain.

VAERS ID:155650 (history)  Vaccinated:1999-10-08
Age:59.0  Onset:1999-10-08, Days after vaccination: 0
Gender:Female  Submitted:1999-11-01, Days after onset: 24
Location:South Carolina  Entered:2000-06-28, Days after submission: 239
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor, Flavix
Current Illness: NONE
Preexisting Conditions: stroke, polydipsia
Diagnostic Lab Data:
CDC 'Split Type': U1999008130
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998223 IMLA
HIBV: HIB (ACTHIB)CONNAUGHT LABORATORIES  IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0003BA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: On 10/8/99, the pt''s right deltoid and right upper inner arm was red with a whelp. The symptoms persisted for seven days. Treated with Claritan.

VAERS ID:155661 (history)  Vaccinated:1999-08-08
Age:59.0  Onset:1999-08-11, Days after vaccination: 3
Gender:Female  Submitted:2000-01-27, Days after onset: 169
Location:West Virginia  Entered:2000-06-28, Days after submission: 152
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Laceration to left thumb.
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': U1999010360
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7341BA IM 
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Three days post vas, this pt developed cellulitis, a temperature of 99.3 F and swelling of the left upper arm and elbow.

VAERS ID:156476 (history)  Vaccinated:2000-05-26
Age:59.0  Onset:2000-05-26, Days after vaccination: 0
Gender:Female  Submitted:2000-07-01, Days after onset: 36
Location:Unknown  Entered:2000-07-13, 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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988176   
Administered by: Other     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt experienced swelling and pain at injection site, fever for three days. Pt also experienced nausea and vomiting for one day.

VAERS ID:157269 (history)  Vaccinated:1999-07-02
Age:59.0  Onset:1999-07-17, Days after vaccination: 15
Gender:Female  Submitted:2000-05-16, Days after onset: 304
Location:California  Entered:2000-07-19, 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: Xenical
Current Illness:
Preexisting Conditions: obesity
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES99071265
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Subsequent to receiving one dose of varicella virus vaccine live the pt developed a low grade fever for 6 - 10 days, myalgia, headache, and rash of about 40 pimples on both arms and upper torso.

VAERS ID:157781 (history)  Vaccinated:1999-04-11
Age:59.0  Onset:1999-04-12, Days after vaccination: 1
Gender:Female  Submitted:2000-02-24, Days after onset: 318
Location:Indiana  Entered:2000-07-21, Days after submission: 147
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': 899264001L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES454616 IM 
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: One day post vax pt developed an injection site reaction characterized by redness and pain.

VAERS ID:157916 (history)  Vaccinated:2000-06-29
Age:59.0  Onset:2000-07-01, Days after vaccination: 2
Gender:Female  Submitted:2000-07-21, Days after onset: 20
Location:Minnesota  Entered:2000-07-25, 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: Prilosec, Premarin, Citracel, Vioxx, Coumadin
Current Illness:
Preexisting Conditions: cardiac valve disease; codeine allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES471038 IM 
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Oedema, Pruritus
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), Hypersensitivity (broad)
Write-up: Pt experienced redness at injection site (3 - 4 inches) with itching, swelling and warmth.

VAERS ID:157997 (history)  Vaccinated:2000-07-14
Age:59.0  Onset:2000-07-15, Days after vaccination: 1
Gender:Female  Submitted:2000-07-21, Days after onset: 6
Location:Connecticut  Entered:2000-07-27, 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: Atenolol, Timoptic, Xeletin
Current Illness: NONE
Preexisting Conditions: high blood pressure
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES471039 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt experienced localized erythema and edema approximately 2/3 of upper arm and fever. Rash described as pruritic. Temperature at time of recheck was 98.1

VAERS ID:158042 (history)  Vaccinated:2000-04-29
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-19
Location:New York  Entered:2000-07-27, Days after submission: 69
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prinizide
Current Illness:
Preexisting Conditions: hypertension
Diagnostic Lab Data:
CDC 'Split Type': 20000146401
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Pain
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Post first vax with no untoward effects. Post second dose sometime thereafter, experienced arthritic pain in his lower back, spine, hands, and shoulder. Treatment included Advil.

VAERS ID:158056 (history)  Vaccinated:2000-05-18
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2000-05-30
Location:New Jersey  Entered:2000-07-27, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;Lyme (LYMErix);1;59;In Patient
Other Medications: Hyzaar, Flonase, Verapamil
Current Illness: UNK
Preexisting Conditions: sinus problems, hypertension, Lyme disease in October 1999, Thymus irradiation (2 months), bull''s eye rash, Surgical history included three unspecified breast procedures.
Diagnostic Lab Data: Lyme tst (05/11/2000) positive
CDC 'Split Type': 20000158631
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM136B91IMRA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site pain, Malaise, Pain, Upper respiratory tract infection
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Post 2nd dose of vax, She experienced pain at the injection site, overall body aches, general malaise, and headache. Additionally, she experienced bilateral calf pain and feet pain in May 2000. She stated that a doctor visit was required, and she was treated for an upper respiratory infection with Levoguin. Received 10/19/2000: "The vaccinee has no allergies, reportedly. Her medical history includes thymus irradiation at age two months, sinus problems (NOS), hypertension, and Lyme disease in October 1999. She had a bull''s eye rash and was treated with doxycycline for two weeks. The vaccinee stated that she did not have blood work done in October 1999, to check for Lyme disease, but was told by her physician that "she had it". Concomitant medications include verapamil, hydrochlorothiaside/losartan potassium (Hysaar), and fluticasone propionate (Flonase). She had no illness at the time of vaccination. On 04/18/2000, the vaccinee received her first IM-right deltoid dose of Lymerix Post-vaccination, starting on 04/18/2000, she experienced pain at the injection site. A few days post-vaccination, she experienced overall body aches, general malaise, and headaches. On 05/01/2000 she experienced arthralgias of the knees, ankles, and wrists. This last adverse event was considered mild in intensity, possibly related to Lymerix and ongoing. On 05/16/2000, she received her second IM-right deltoid dose of Lymerix. Following dose 2 of Lymerix, she continued to experience her dose 1 adverse events. Additionally, she experienced bilateral calf pain and feet pain in May 2000. she stated that a doctor visit was required, and she was treated for an upper respiratory infection with Levoquin 500mg once daily starting on 05/08/2000. Lymerix was discontinued "at present". The most recent information, received on 10/16/2000, reports the condition of the vaccinee as ongoing. This case is considered incapacitating/disabling by the responsible physician and therefore ICM serious. A 15-day follow up report received 01/18/20

VAERS ID:158073 (history)  Vaccinated:1999-04-01
Age:59.0  Onset:1999-05-01, Days after vaccination: 30
Gender:Male  Submitted:2000-06-19, Days after onset: 415
Location:Massachusetts  Entered:2000-07-27, 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: thyroid medications, replacement therapy
Current Illness:
Preexisting Conditions: Lyme disease, thyroid disorder
Diagnostic Lab Data:
CDC 'Split Type': 20000172721
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Diabetes insipidus, Pituitary tumour benign
SMQs:
Write-up: Approximately one month post vax, the vaccinee developed diabetes insipidus and a tumor on his pituitary gland. The vaccinee is receiving replacement therapy for his pituitary tumor.

VAERS ID:158130 (history)  Vaccinated:1999-06-01
Age:59.0  Onset:2000-03-01, Days after vaccination: 274
Gender:Male  Submitted:2000-06-15, Days after onset: 105
Location:Connecticut  Entered:2000-07-28, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, colchicine
Current Illness:
Preexisting Conditions: Allergic to codeine and it''s derivatives, Darvon and PO Erythromycin. Has gout.
Diagnostic Lab Data: Blood work was performed, including sedimentation rate and test for Lyme disease (no results were provided)
CDC 'Split Type': 20000178161
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: "Approximately 1 year ago", the pt received his 1st, 2nd and 3rd doses of Lymerix. About 4-5 months ago, he experienced muscle and joint pain. This included right shoulder bursitis-type pain, pain in the back of his legs from his heels up to middle upper calf, and aching feet from time to time. A doctor visit was required. Physician told the pt that he "did not have arthritis". The most recent information, received on 6/5/00, reports the condition of the vaccinee is ongoing.

VAERS ID:158267 (history)  Vaccinated:2000-07-18
Age:59.0  Onset:2000-07-19, Days after vaccination: 1
Gender:Female  Submitted:2000-07-21, Days after onset: 2
Location:California  Entered:2000-08-02, 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: hypertension, hypercholesterolemia
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)LEDERLE LABORATORIES471039 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 3.0 cm induration with erythema locally. She also complained of pain for 72 hours, dull constant to left axilla.

VAERS ID:158392 (history)  Vaccinated:1999-06-14
Age:59.0  Onset:1999-06-28, Days after vaccination: 14
Gender:Female  Submitted:2000-07-29, Days after onset: 397
Location:Connecticut  Entered:2000-08-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamin E, Centrum Silver vitamins
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY123A91IM 
Administered by: Private     Purchased by: Other
Symptoms: Carpal tunnel syndrome, Pain
SMQs:
Write-up: Two weeks post vax, the bone in the palms of both hands hurt when putting pressure on them. It continues to this day. Three months post vax, the pt woke up in the middle of the night with both hands frozen in claw-like position. When sleeping this happens every 2-4 hours. They hurt and I have to work them back to normal. They continue to do this and they swell up too. The pt was treated for carpal tunnel syndrome but orthopedic doesn''t think that is all of her problems. She went to a rheumatologist that did a lot of blood work but nothing shows. The follow up letter received on 10/5/00 states, "the pt presents today for follow up evaluation. The pt is followed for hand discomfort and presents today for a check. She has been using her splits at night. Her carpal tunnel sympptoms appear to be improved although she still has some discomfort about her hypothenar eminences. She has been using Motrin without significant relief. On examination from today the pt does have some discomfort about her hypothenar eminences. No significant discomfort in her fingers. Impression and plan: overall the pt at this point seems somewhat improved. We will continue conservatively. If she has increasing pain and discomfort we will re-evaluate her. We will see her back as needed."

VAERS ID:158814 (history)  Vaccinated:1999-04-19
Age:59.0  Onset:1999-11-25, Days after vaccination: 220
Gender:Male  Submitted:2000-08-09, Days after onset: 257
Location:New York  Entered:2000-08-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dioxan
Current Illness: NONE
Preexisting Conditions: High blood pressure.
Diagnostic Lab Data: Labs - Lyme disease.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abasia, Arthropathy, Bacterial infection, Night sweats, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: I became immobilized, couldn''t walk or stand, high fever, night sweats, all joints affected, in wheelchair/ walker for 1.5 months, palpitations. The annual follow-up states that he still has "flat feet" little ankle motion during the morning hours and some night sweats and others.

VAERS ID:159006 (history)  Vaccinated:1997-01-01
Age:59.0  Onset:1997-11-07, Days after vaccination: 310
Gender:Male  Submitted:2000-08-07, Days after onset: 1003
Location:California  Entered:2000-08-21, 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:
Preexisting Conditions: Diabetes, hypertension, elevated triglycerides. Allergic to eggs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC. 1IM 
Administered by: 0     Purchased by: 0
Symptoms: Pancreatitis
SMQs:, Acute pancreatitis (narrow)
Write-up: The pt developed pancreatitis after receiving 1st dose of hepatitis vaccine in 1997.

VAERS ID:159318 (history)  Vaccinated:2000-06-01
Age:59.0  Onset:2000-06-28, Days after vaccination: 27
Gender:Male  Submitted:2000-08-28, Days after onset: 61
Location:New Jersey  Entered:2000-08-30, 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: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 20000257341
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Private     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: On 6/28/00, the pt experienced a persistent headache. He was treated with Naprosyn.

VAERS ID:159559 (history)  Vaccinated:2000-06-16
Age:59.0  Onset:2000-06-22, Days after vaccination: 6
Gender:Female  Submitted:2000-06-23, Days after onset: 1
Location:Arkansas  Entered:2000-09-11, Days after submission: 80
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': AR0036
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0162AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: 35mm X 60mm red area at left arm, warm to touch, complained of itching.

VAERS ID:159993 (history)  Vaccinated:2000-09-15
Age:59.0  Onset:2000-09-16, Days after vaccination: 1
Gender:Female  Submitted:2000-09-19, Days after onset: 3
Location:Unknown  Entered:2000-09-22, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergy
Diagnostic Lab Data: WBC-9.47
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0265AA IMLA
Administered by: 0     Purchased by: 0
Symptoms: Injection site erythema, Injection site oedema, Injection site vesicles, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 24 hours post vax, the pt experienced upper arm erythema with increased warmth, swelling, blisters around injection site.

VAERS ID:160353 (history)  Vaccinated:1999-05-01
Age:59.0  Onset:1999-06-25, Days after vaccination: 55
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2000-10-05
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: Lyme Western Blot-positive
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Other
Symptoms: Contusion, Erythema, Infection, Oedema peripheral, Pruritus, Vasculitis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vasculitis (narrow), Hypersensitivity (broad)
Write-up: On 6/25/99, the pt developed a red, itchy spot on right arm. On 7/18, she had developed numerous spots on extremities; easy to bruise. On 8/5, her left leg was swollen. On 8/24, she was dx with leukocytoplastic vasculitis. Treated with oral antibiotics. .

VAERS ID:161694 (history)  Vaccinated:2000-02-23
Age:59.0  Onset:2000-02-24, Days after vaccination: 1
Gender:Female  Submitted:2000-03-27, Days after onset: 32
Location:Texas  Entered:2000-10-06, Days after submission: 192
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: UNK
Preexisting Conditions: Bronchiectasis NOS, Pneumonia
Diagnostic Lab Data: UNK
CDC 'Split Type': 1303101032000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4681351IM 
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt developed a fever of 100 degrees and a severe injection site reaction characterized by swelling and redness extending past the elbow. The pt was treated symptomatically the symptoms resolved. The pt medical history includes residual lung scarring.

VAERS ID:161803 (history)  Vaccinated:1999-10-26
Age:59.0  Onset:1999-10-27, Days after vaccination: 1
Gender:Female  Submitted:2000-02-16, Days after onset: 112
Location:Kentucky  Entered:2000-10-06, Days after submission: 232
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ4916208NOV1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4566910IM 
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Injection site pain, Injection site rash, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: On 10/27/99, pt developed paresthesias, weakness and an injection site reaction characterized by a rash and pain that extended down her arm and up into her neck. She recovered from the rash and paresthesia; however, as of 11/5/99, the pain and weakness persisted.

VAERS ID:160505 (history)  Vaccinated:2000-08-31
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2000-10-10
Location:Maryland  Entered:2000-10-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma, elevated cholesterol, irritable bowel syndrome
Diagnostic Lab Data:
CDC 'Split Type': 20000297761
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM146A90IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Joint swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: The pt experienced fever, chills, aches, redness (injection site) and swelling (joint). As of 10/5/00, the outcome of the events is resolved.

VAERS ID:160839 (history)  Vaccinated:2000-10-18
Age:59.0  Onset:2000-10-19, Days after vaccination: 1
Gender:Male  Submitted:2000-10-23, Days after onset: 4
Location:Arizona  Entered:2000-10-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir
Current Illness: Herpes
Preexisting Conditions: Herpes
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0337AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Post Flu injection experienced welts on head, chest, back of neck, and one on face. Pt did not have any swelling of eyes, lips nor any wheezing or difficulty breathing.

VAERS ID:160895 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2000-10-18
Location:New Hampshire  Entered:2000-10-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CPK-37
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1960J IMRA
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY144B9 IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: 2 days post vax, the pt developed significant myalgias which slowly resolved over 6 months.

VAERS ID:161372 (history)  Vaccinated:2000-09-27
Age:59.0  Onset:2000-10-06, Days after vaccination: 9
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:2000-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl, Premarin, Kortone, Augestin, Allegra, Lipitor
Current Illness:
Preexisting Conditions: ragweed pollen allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4653171SCLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: The pt developed cellulitis of left arm at vax site. Symptoms started approximately 1 week after vax. The problem was reported approximately 9 days post vax. Was sent to the ER and received Ancef followed by oral Keflex.

VAERS ID:162438 (history)  Vaccinated:2000-10-18
Age:59.0  Onset:2000-10-19, Days after vaccination: 1
Gender:Male  Submitted:2000-11-08, Days after onset: 20
Location:Kansas  Entered:2000-11-21, 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: allergy to Cipro, chemicals in sunscreen
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E59240GA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Angioneurotic oedema, Diarrhoea, Erythema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: The pt experienced diarrhea, huge hive on right size as big as an egg, bright red and swollen.

VAERS ID:162600 (history)  Vaccinated:2000-11-20
Age:59.0  Onset:2000-11-22, Days after vaccination: 2
Gender:Female  Submitted:2000-11-22, Days after onset: 0
Location:Illinois  Entered:2000-11-27, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fever, aches;UNK. POLIOVIRUS LIVE ORAL TRIVALENT;3;.00;In Patient
Other Medications: Vitamins, Prempro, Xanax
Current Illness: NONE
Preexisting Conditions: allergy to cough medicines
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0414BB0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0690K0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: The pt experienced 3 red spots, one the size of a quarter and 2 the size of dimes, 2 to 3 inches below the injection site on the left arm and the pneumonia vax. Not itchy or painful, flat not raised.

VAERS ID:163153 (history)  Vaccinated:2000-10-27
Age:59.0  Onset:2000-11-06, Days after vaccination: 10
Gender:Female  Submitted:2000-11-29, Days after onset: 23
Location:Massachusetts  Entered:2000-12-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Triest/prog
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 3SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Erythema, Joint stiffness, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: This patient is non-immune to rubella by titer. Ten days after a dose of MMR reports wide, red band across the top of her feet and both wrists, swollen fingers, joint stiffness. The patient did not present for treatment. She was seen 3 weeks later, still reports joint aches. The patient denies history of fever, rash or any other symptoms.

VAERS ID:163472 (history)  Vaccinated:2000-03-01
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:2000-12-04
Location:New Jersey  Entered:2000-12-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: MRI of brain and neck - nml
CDC 'Split Type': 20000349091
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: On 10/16/00 the pt was diagnosed with "spastic motor skills" by a neurologist. Onset from time of immunization was not provided. A 15-day follow up report received 11/14/2001 adds: Report 2000034909-1 describes Creutzfeldt-Jakob disease in a 58-year-old male who received Lyme disease vaccine (Lymerix). Concurrent medical conditions included hypertension, coronary artery disease, hypercholesterolemia, chronic constipation, and a kidney stone "removed some years ago". The vaccine provider indicated that there were no concurrent medications at the time of immunization. The pt received his first 2 injections of Lymerix on 03/18/1999 and 04/16/1999, respectively. No adverse events were reported following receipt of these 2 injections. The pt received his 3rd injection of Lymerix on 03/20/2000. In May 2000 approximately 2 months post-immunization, he experienced severe tiredness and developed a moderately unbalanced gait with some paresthesia. He gradually worsened over time and was referred to a neurologist. The pt was seen by the neurologist on 10/06/2000. The pt reported that he "had trouble walking for the past few months. He loses his balance and falls backwards or forwards. He states his handwriting is scribbly but not small." At the time of the consult, the pt was taking nortriptyline (Pamelor) for unspecified pain, verapamil (Calan), stenolol (Tenormin) and fluvastatin (Lescol). On physical examination, the neurologist noted that the pt "has widened palpebral fissures bilaterally and a questionable lid lag...There is increased tone with spastic paraparesis bilaterally." The neurologist''s impression was "spastic paraparesis etiology unknown." An MRI of the cervical spine, with and without contrast, performed 10/11/2000 revealed "Two tiny foci of signal abnormality in the spinal cord at the T1 level, seen only on the proton density images." The neurologist saw the pt on 10/13/2000. At that time, the pt reported that "he has had an episode of incontinence on occasion." Physical examination revealed "a spastic

VAERS ID:163566 (history)  Vaccinated:2000-12-01
Age:59.0  Onset:2000-12-02, Days after vaccination: 1
Gender:Male  Submitted:2000-12-04, Days after onset: 2
Location:Pennsylvania  Entered:2000-12-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daypro
Current Illness: NONE
Preexisting Conditions: Fibromyalgia; lower back pain (chronic)
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Dry mouth, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fever, nausea (severe), chills, aches/pains, dry mouth. Took Tylenol/aspirin for 2 1/2 days. Also had stomach pain.

VAERS ID:163702 (history)  Vaccinated:2000-11-28
Age:59.0  Onset:2000-11-29, Days after vaccination: 1
Gender:Female  Submitted:2000-12-04, Days after onset: 5
Location:California  Entered:2000-12-13, 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: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008180 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Pt developed 6cm-7cm area of erythema. Pt states "felt itchy" immediately.

VAERS ID:163905 (history)  Vaccinated:2000-12-07
Age:59.0  Onset:2000-12-07, Days after vaccination: 0
Gender:Female  Submitted:2000-12-14, Days after onset: 7
Location:Texas  Entered:2000-12-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, Norvasc, K-Dur, Synthroid
Current Illness: NONE
Preexisting Conditions: Allergic to ASA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40091800IMRA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Erythema, Hypertension, Nausea, Pallor, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: 20 minutes, post vax, pt became dizzy, slightly nauseated and skin color was pale, fingers tingling, red hot. BP 139/80, P 76, no SOB. Benadryl 25mg po given and pt felt better after 10 minutes. At 14:40, 20 minutes after Benadryl, pt ready, no dizziness, no tingling and felt good. BP 130/80 and P 66.

VAERS ID:164369 (history)  Vaccinated:1999-05-19
Age:59.0  Onset:1999-06-01, Days after vaccination: 13
Gender:Female  Submitted:2002-07-03, Days after onset: 1128
Location:New York  Entered:2001-01-03, Days after submission: 545
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: folic acid; Premarin; Prilosec; prednisone; omaprarole; Ammonium lactate; Halobetasol propionate; Clobetasol propionate; Triamcinolone acetonide; Cephalexin; Salmetearol kinafoate; Fluticasone propionate; Flurandrenolone; Botamethasone dipr
Current Illness: UNK
Preexisting Conditions: Foot pain, earache, sinus congestion, sore throat, swollen glands and cough, asthma, high Epstein-Barr titers on 4/19/99, spot on heel dx''d as carpal tunnel disease operated on in 1991, Raynaud''s disease since 1991 (after surgery), hiatal hernia, increased bruisability and hypothyroidism. Over the past year, has had fatigue, headaches and light-headedness associated with nausea. 10
Diagnostic Lab Data: Western Blot for Lyme on 3/20/00 was positive for IgG at 18, 41, 45, 58, 66 and 93 kilodalton bands; antinuclear antibody-neg but this was elevated to 8 (<7.5) on 8/23/99. Epstein-Barr virus-IGM-VCA-positive; SGPT-elevated; Bun-elevated; LD
CDC 'Split Type': 20000368281
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM123A71IMLA
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Alopecia, Antinuclear antibody positive, Arthralgia, Blood lactate dehydrogenase increased, Blood urea increased, Depression, Dizziness, Ecchymosis, Fatigue, Headache, Immunoglobulins increased, Infection, Insomnia, Malaise, Nausea, Purpura, Rheumatoid arthritis, Skin disorder, Spine malformation, Urticaria, Vasculitis, Weight increased
SMQs:, Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Congenital, familial and genetic disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Vasculitis (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (narrow), Tumour lysis syndrome (broad)
Write-up: On 4/19/99, the pt received her 1st Lymerix vaccination with no untoward effects. On 5/19/99, she received her 2nd dose. After 2-3 weeks, she experienced a rash which worsened. The rash was hive-like, ecchymotic, purpuric, burned and was eventually biopsied on 8/24/99. She was dx''d with leucocytoblastic vasculitis and was treated with a shot of cortisone and a 6 day supply of prednisone. After the corticosteroid therapy ended, her condition worsened. She was given prednisone. "In general, she felt more fatigued and had malaise more than usual". She did not improve much but developed joint pain on 9/15/99. She was dx''d with rheumatoid arthritis in 9/99. Prednisone was increased to 60mg/day and hydroxychloroquine 400mg was started. Prednisone was tapered to 20mg/day, hydroxychloroquine was stopped and methotrexate 7.5mg/week was begun on 10/29/99. Her rash returned while on 30mg of prednisone and she still had sever joint pain. The methotrexate was increased to 15mg/week. She still had pain in her knees, ankles, knuckles, wrists, elbows and fingers. A rheumatology consult on 5/12/00, revealed the pt''s joint symptoms were improving, but she still had a return of small spots of vasculitis on her arms and legs. The pt reported to the rheumatologist that she was told by a Lyme disease specialist, "she had a vaccine induced vasculitis but the Western Blot suggested Lyme disease as well". The pt was placed on Biaxin 500mg 2X/day. The information received reported the symptoms were ongoing. The adverse event of leucocytoblastic vasculitis is considered "Medically Serious". F/U report revealed degenerative changes most marked C4-5 and C5-6 with disc space narrowing, 3/10/97 MRI revealed herniation of the nucleus pulposus and reversal of the normal lordotic curvature of the spine at C4-5. The chircopracter''s diagnosis were cervical subluxation, degeneration of cervical intervertebral disc, cervical sprain/strain, radicultitis. The pt was treated with hot/cold packs, electric muscle stimulation and chiropractic adjusting.F/

VAERS ID:164929 (history)  Vaccinated:2000-12-20
Age:59.0  Onset:2000-12-21, Days after vaccination: 1
Gender:Female  Submitted:2000-12-22, Days after onset: 1
Location:Pennsylvania  Entered:2001-01-19, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Proventil inhaler, Prempro, Celebrex
Current Illness: passed out at work
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': PA0113
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008224 IMRA
Administered by: Other     Purchased by: Public
Symptoms: Face oedema, Feeling hot, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: One day post vax, the pt started itching which lasted most of the day. It itched like dry skin, the pt used lotion. The next day, the pt woke up with itching with hives on the buttocks, sides and back, abdomen and top of legs and waist line. Ears were hot and swollen. Took Benadryl. Hives lightened. Was taken to the ER.

VAERS ID:165271 (history)  Vaccinated:2000-11-04
Age:59.0  Onset:2000-11-05, Days after vaccination: 1
Gender:Female  Submitted:2000-11-07, Days after onset: 2
Location:New York  Entered:2001-01-29, 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: estrogen therapy
Current Illness: NONE
Preexisting Conditions: allergy to sulfates and some foods
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0415AA5IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1217J0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Lymph node pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: The pt experienced body aches, severe soreness in the right armpit, slight elevated temp, tiredness, took Tylenol and was better the next day.

VAERS ID:165434 (history)  Vaccinated:2000-11-18
Age:59.0  Onset:2000-11-19, Days after vaccination: 1
Gender:Female  Submitted:2000-12-20, Days after onset: 31
Location:Colorado  Entered:2001-01-31, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zantac, Acyclovir, Premarin
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ4156228NOV2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Private     Purchased by: Other
Symptoms: Dysphagia, Hypotension, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow)
Write-up: The same day of the vax, the pt developed hives. She was treated with antihistamines. The next day she experienced difficulty swallowing and a drop in her diastolic BP to 60. The pt was admitted to the hospital and treated with prednisone and epinephrine. As of 11/27/00 the pt had been discharged from the hospital. Follow-up information received 12/18/00 indicated that the pt was seen in the ER and then hospitalized for 5 days. Follow-up information also included the state and county of the vaccine administration and the correct phone number of the reporter.

VAERS ID:165655 (history)  Vaccinated:2000-12-05
Age:59.0  Onset:2000-12-05, Days after vaccination: 0
Gender:Female  Submitted:2000-12-12, Days after onset: 7
Location:Kansas  Entered:2001-02-07, Days after submission: 57
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': KS200030
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081900 RA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Fatigue, Headache, Pain, Paraesthesia, Peripheral coldness, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: This patient began feeling achy within 5 hours after receiving vaccine. The patient also noticed headache, chills; within 2 more hours hands felt tingly, and hands and feet felt cold. Her temperature was 100.5 the next AM and then 2 days later 101.3 in the AM, it resolved by the 3rd day. The patient still felt drug out and fatigued.

VAERS ID:165732 (history)  Vaccinated:2001-01-08
Age:59.0  Onset:2001-01-08, Days after vaccination: 0
Gender:Female  Submitted:2001-01-16, Days after onset: 8
Location:Texas  Entered:2001-02-09, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Esterol, Lipitro
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': TX01003
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008226 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pharyngeal oedema, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: On Monday, 01/08/01, at 9 PM, the patient had a rash on her body. On Tuesday, 01/09/01, the patient experienced itching, hives and throat swelling. The doctor administered Cortizone treatment lasting 7 days. The patient stated by Thursday, 01/11/01, she had no signs of hives, itching, rash or throat swelling

VAERS ID:165992 (history)  Vaccinated:2000-12-27
Age:59.0  Onset:2001-01-01, Days after vaccination: 5
Gender:Female  Submitted:2001-01-04, Days after onset: 3
Location:South Carolina  Entered:2001-02-20, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BP medicine and Estrogen
Current Illness: NONE
Preexisting Conditions: HTN
Diagnostic Lab Data: NONE
CDC 'Split Type': SC0101
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0439DA IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0267AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Pt noticed, 3 days ago, that right arm deltoid muscle area began itching. Has 2 areas approx. 2 1/2" below site of Tetanus that is red and slightly warm feeling and "looks better than they did; were almost red". Possible allergic reaction to TD vaccine.

VAERS ID:166123 (history)  Vaccinated:2000-10-03
Age:59.0  Onset:2000-10-04, Days after vaccination: 1
Gender:Unknown  Submitted:2000-10-26, Days after onset: 22
Location:Idaho  Entered:2001-02-22, Days after submission: 119
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: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1938109OCT2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4998128 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Parotid gland enlargement
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: A physician reported that a 59 year old pt received an injection of Tetanus Toxoid Adsorbed, Ultrafined on 10/3/00. The next day, the pt developed left parotid gland swelling.

VAERS ID:166243 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:1997-09-10
Gender:Female  Submitted:2001-02-07, Days after onset: 1246
Location:New York  Entered:2001-03-01, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM  IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: The pt developed arthritis in September of 1997. The pt was in a testing group for a vaccine for Lyme Disease.

VAERS ID:166494 (history)  Vaccinated:2000-05-26
Age:59.0  Onset:2000-05-27, Days after vaccination: 1
Gender:Female  Submitted:2000-10-06, Days after onset: 132
Location:New York  Entered:2001-03-05, Days after submission: 150
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ8834321JUL2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4988176   
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain, Injection site reaction, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A pharmacist reported a pt received a vaccine on 5 26/00, the next day she developed a fever of 103 deg F and an injection site reaction characterized by pain and swelling. She recovered after 3 days

VAERS ID:166975 (history)  Vaccinated:2001-02-13
Age:59.0  Onset:2001-02-14, Days after vaccination: 1
Gender:Male  Submitted:2001-02-28, Days after onset: 14
Location:Michigan  Entered:2001-03-12, 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
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESV0361AA IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Itchy rash Locally, left arm.

VAERS ID:167074 (history)  Vaccinated:1999-12-13
Age:59.0  Onset:1999-12-19, Days after vaccination: 6
Gender:Female  Submitted:1999-12-20, Days after onset: 1
Location:North Carolina  Entered:2001-03-13, Days after submission: 449
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught, lot #251711
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: PPD
CDC 'Split Type': NC99105
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site erythema, Injection site oedema, Injection site warmth, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: The pt experienced a swollen right deltoid that was hard, red in color and warm to the touch. The pt complained of pain with touch and movement. No treatment to date. Symptoms began on 12/19/99. The vaccine was a PPD. No other vaccine was listed.

VAERS ID:168197 (history)  Vaccinated:2001-03-19
Age:59.0  Onset:2001-03-26, Days after vaccination: 7
Gender:Female  Submitted:2001-03-27, Days after onset: 1
Location:Pennsylvania  Entered:2001-04-03, 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: Metformin, calcium,Lipitor, Cozaar, hctz, Claritin
Current Illness:
Preexisting Conditions: HTN, DM II, Hypercholesterolemia, osteoarthritis, allergic rhinitis
Diagnostic Lab Data: peak flow=250
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0368AA IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site induration, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 8 days post vaccine, pt presented with 1 day h/o wheezing and local induration at site of injection.

VAERS ID:169354 (history)  Vaccinated:2000-12-01
Age:59.0  Onset:2000-12-01, Days after vaccination: 0
Gender:Female  Submitted:2001-04-18, Days after onset: 137
Location:New York  Entered:2001-05-01, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness: UNK
Preexisting Conditions: Dry throat; hypercholesterolemia; hysterectomy NOS; Peripheral neuropathy NEC
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ5599005JAN2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Private     Purchased by: Other
Symptoms: Condition aggravated, Dry throat, Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Within 1 hour post vax, the pt experienced periodic neuropathy in her feet and hands. She stated that this felt like pins and needles that moved around a bit, then resolved. The reporter also noted that she developed peripheral neuropathy in summer of 2000 while taking Baycol. Baycol was stopped and the symptoms resolved. It was also noted that the pt had taken Mevacor for 10 years and stopped, then restarted in 09/2000 as an alternative to Baycol and experienced a strange dry feeling in her throat. She stopped taking Mevacor and symptoms were resolving as of 01/04/2001.

VAERS ID:169641 (history)  Vaccinated:2001-04-16
Age:59.0  Onset:2001-04-20, Days after vaccination: 4
Gender:Female  Submitted:2001-04-23, Days after onset: 3
Location:Tennessee  Entered:2001-05-09, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC sinus meds; Meds for HTN; Meds for Lupus
Current Illness:
Preexisting Conditions: Lupus; Sinus infection (3 weeks ago); HTN
Diagnostic Lab Data:
CDC 'Split Type': TN01016
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM671A40IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0194AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Injection site erythema, Rash macular
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt called on 4/20/01 at 10:30 and stated her right arm was red and blotched and complaining of mild difficulty breathing. She was told to see MD. She stated she was going to MD and was to call clinic with results. Also, given another telephone # to call. Tried to call pt on 10/23/01 and only answering machine picked up, so left a message for her to call clinic.

VAERS ID:169666 (history)  Vaccinated:2001-01-03
Age:59.0  Onset:2001-01-04, Days after vaccination: 1
Gender:Female  Submitted:2001-01-19, Days after onset: 15
Location:New York  Entered:2001-05-10, Days after submission: 110
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: High blood pressure.
Diagnostic Lab Data: NONE
CDC 'Split Type': NYS21010
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081770 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: On 01/04/01, this patient became light headed and nauseated 24 hours after receiving Influenza vaccine. It lasted for several hours. Called PCP, and went to the Health Dept, was told to go to PCP or walk-in. The patient felt better and did not go, called PCP and made an appointment for 01/10/01. On 01/10/01, the patient was seen by PCP, he told her it sounded like a reaction, she is fine now.

VAERS ID:169705 (history)  Vaccinated:2001-02-19
Age:59.0  Onset:2001-03-20, Days after vaccination: 29
Gender:Female  Submitted:2001-05-09, Days after onset: 49
Location:New Jersey  Entered:2001-05-11, 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:
Current Illness:
Preexisting Conditions: Allergic to caines, Darvon, IV pyelogram dye.F/U reportedly she had no medical history and rec''d conjugated estrogens (Premarin). Her surgical history include total abdominal hysterectomy, oophrectomy and appendectomy.
Diagnostic Lab Data: 03/20/01 - CT - Abdomen "Nml". Ultrasound - abdomen "Nml". Occult Blood (stools) - 0. Thyroid - 0. 3/19/01 colonoscopy - hemorrhoids.
CDC 'Split Type': 20010113981
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0 LA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Dehydration, Diarrhoea, Fatigue, Haemorrhoids, Headache, Influenza like illness, Muscle disorder, Myalgia, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Report 2001021398-1 described dehydration due to diarrhea in a 59 year old female who received Lyme disease vaccine OspA recombinant (Lymerix) for prophylaxis of Lyme disease. This report was received from the vaccinee and has not been verified by a physician or other health care professional. Reportedly, the vaccinee was allergic to IV pyelogram dye, dextropropoxyphene hydrochloride (Darvon), and "caines", chocolate and nuts. Reportedly, she had no medical history and took no concomitant medications. Reportedly, she was never diagnosed with Lyme disease. On 02/19/01, the vaccinee received her 1st left arm dose of Lymerix. Reportedly, 36 hours later, she developed diarrhea, which got progressively worse. On 03/05/2001, two weeks post-immunization, she was experiencing diarrhea which reportedly occurred six to eight times daily. Additionally, at this time, she reported that she developed flu-like symptoms, headaches, and muscle pain in the cervical area. The muscle pain in the cervical area would resolve, and the muscle pain would move to the thighs. Reportedly, she never experienced joint pain. She was treated with anti-diarrhea medications and a BRAT (bananas, rice, applesauce and toast) diet with no no results. An ultrasound of the abdomen was performed. The results were reportedly "normal". A gastroenterologist admitted the patient into the hospital on 03/20/01. Reportedly, inpatient testing consisted of stools for occult blood, thyroid levels and "other labs" (results unknown). CT of the abdomen was reportedly "normal". She was treated with IV antibiotics. The patient reported that a diagnosis of dehydration due to diarrhea was made. She was discharged from the hospital on 03/22/01. Her weight decreased from 126 lbs to 108 lbs in one month. She was scheduled to have a "H.D.D.A Scan (3) abdominal" on 05/07/01. As of 05/07/01, reportedly, her diarrhea persisted (she was having three to six bowel movements per day), she was fatigued, and she experienced muscle loss in her thighs and arms due to weight loss. The

VAERS ID:170532 (history)  Vaccinated:1998-06-01
Age:59.0  Onset:2000-11-18, Days after vaccination: 901
Gender:Male  Submitted:2002-05-28, Days after onset: 555
Location:Unknown  Entered:2001-05-31, Days after submission: 362
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage, Diovan.
Current Illness:
Preexisting Conditions: Diabetes mellitus NOS,Hypertension NOS.
Diagnostic Lab Data: Abnormal labs from 11/20/00 included glucose; 204 mg/dl; alkalinf phosphates 460; U/L; SGOT: 81 U/L; SGPT: 150 U/L; T Bilirubin: 7.3 mg/dL; anti-Hav AB:positive: Computed Axial: 11/??/00- Normal -liver/ spleen scan; Blood glucose-11/20/00-2
CDC 'Split Type': WAES00112142
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1037E   
HEPA: HEP A (VAQTA)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Cholestasis
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Biliary tract disorders (narrow)
Write-up: The patient developed Hepatitis A. The patient sought unspecified medical attention. IN FOLLOW-UP information, the reporter stated "that the patient was treated and recovered, however he couldn''t confirm if the patient had Hepatitis A". FOLLOW-UP information from the medical records, dated 12/18/00, indicated that the patient was a 59- year old female whoi has longstanding diabetes and was taking glimepirade (Amaryl) and Metformin hydrochloride(Glucophage). It was also indicated that she recntly had an area in breast taken out which showed a caricinoma in situ and was getting "tamoxifen" as a prophylaxis. Her liver enzymes were all normal on 03/20/00.The physician indicated that the patient developed some sort of "ill understood" syndrome of fever, chills and jaundice around 11/18/00. The patient''s bilirubin went up to 10.3 mg/dl. Her alkaline phosphatases were up to around 460 U/L on 11/20/00 and her SGPT and SGOT were at 150 and 81 U/L respectively. Her Hepatitis panel was unremarkable, just showing an old proctective IgG antibody to help Hepatitis A virus but no acute antibody. Her liver enzymes gradually drifted down to normal by 12/04/00. Her alkaline phosphatases were down to 175 and SGOT and SGPT were normal. Her bilirubin was back down to 1.5. She never had any pain and never had any pruritus. she only had the fever and chills for a couple days. She was not taking any new medications during this period of time. The patient had a liver/spleen scan which showed a normally functioning and normal sized liver and spleen with no filling defects. The patient had a CT scan done on 11/20/00 , to rule out obstruction, and the liver and spleen were both normal in size, and no focal abnormalities were seen. There were some coincidental radiologic abnormality (possible artifact) was seen with some dilated tortuous veins around the spleen, and these were confluent with the left gonadal veins on the iliac crest. The physician indicated that the patient''s physical examination revealed no sclerae icterus and a normal

VAERS ID:171110 (history)  Vaccinated:2001-05-29
Age:59.0  Onset:2001-06-05, Days after vaccination: 7
Gender:Female  Submitted:2001-06-05, Days after onset: 0
Location:Massachusetts  Entered:2001-06-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Seasonal/environmental allergies.
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM658A4 IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R06922 SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt received TD in left arm by IM on 5/29/01. On 6/5/01, a "rash developed". Area is lateral aspect of left arm, 16cm X 8cm, at it''s largest point, blotchy erythema, warm to touch and 3cm below site of injection. Husband is a retired dermatologist. Treated at this time with cortisone cream.

VAERS ID:173540 (history)  Vaccinated:2001-07-10
Age:59.0  Onset:2001-07-11, Days after vaccination: 1
Gender:Female  Submitted:2001-07-19, Days after onset: 8
Location:Ohio  Entered:2001-07-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Did not fell well;ENGERIX-B;1;59.00;In Patient
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5144A21IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Fatigue, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: The patient experienced dizziness, vomiting and fatigue.

VAERS ID:173673 (history)  Vaccinated:1998-10-23
Age:59.0  Onset:1998-10-24, Days after vaccination: 1
Gender:Female  Submitted:1998-11-12, Days after onset: 19
Location:Texas  Entered:2001-07-27, Days after submission: 987
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: High blood pressure
Diagnostic Lab Data: CT Scan, lumbar puncture neuro eval
CDC 'Split Type': SA98D
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Headache, Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Post vax patient experienced chills, fever, headache and neck pain.

VAERS ID:174130 (history)  Vaccinated:2000-11-16
Age:59.0  Onset:2000-11-16, Days after vaccination: 0
Gender:Female  Submitted:2001-07-30, Days after onset: 255
Location:Minnesota  Entered:2001-08-07, 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: Atenolol, Lipitor, Prevacid
Current Illness:
Preexisting Conditions: Medical history: cholecystic surgery, concurrent conditions: Amoxicillin allergy, hypercholesterolemia, and atherosclerosis
Diagnostic Lab Data:
CDC 'Split Type': WAES00112116
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081800IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0690K0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Information has been received concerning a pt who post vaccination experienced a severe local reaction, the entire upper arm was very swollen,red, hot, tight and severely painful. On 11/17/00 it was reported the pt had dizziness and unspecified medical attention was sought. The pt recovered from her experience on 11/20/2000.

VAERS ID:174583 (history)  Vaccinated:2001-08-09
Age:59.0  Onset:2001-08-09, Days after vaccination: 0
Gender:Female  Submitted:2001-08-09, Days after onset: 0
Location:Maryland  Entered:2001-08-22, Days after submission: 13
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: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.476952 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling, Injection site warmth, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt received routine Pneumovax to deltoid area in AM. Returned approximately 51/2 hours later with complaints of swollen, warm, tender right upper arm. Pt also complained of nausea. Slight pain remains at site on 08/15/2001.

VAERS ID:174600 (history)  Vaccinated:2001-07-25
Age:59.0  Onset:2001-07-27, Days after vaccination: 2
Gender:Female  Submitted:2001-08-15, Days after onset: 19
Location:Kansas  Entered:2001-08-22, 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: TB skin test; Synthroid; Triestroges cream; Progesterone cream;
Current Illness: NONE
Preexisting Conditions: Thyroid
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM684061IMLA
Administered by: Public     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Post vax, the patient developed hives which started under the left arm and continued to spread until her body was covered. The patient saw a physician on 07/27/2001 through 08/01/2001 each day.

VAERS ID:174877 (history)  Vaccinated:2001-08-06
Age:59.0  Onset:2001-08-07, Days after vaccination: 1
Gender:Female  Submitted:2001-08-27, Days after onset: 20
Location:Maryland  Entered:2001-08-31, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Complained of lack of energy
Preexisting Conditions: NONE
Diagnostic Lab Data: CT test-nml; Blood work showed AST and ALT were very high; lymphs were high and polys were low; Glucose serum 114 (high); Alkaline phosphatase, serum-314 (high)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0603L2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Blood alkaline phosphatase increased, Blood glucose increased, Headache, Hyperhidrosis, Laboratory test abnormal, Rash
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: On 8/4/01, pt had lack of energy; on 8/5/01, she went for a hike and thinks she got dehydrated so she drank water; later afternoon she had a fever of 102F and took aspirin and felt much better by 20:00. On 8/6/01, she felt good; got hepatitis B #3 vaccine in the morning; on 8/7/01, pt had a headache in the evening, rather strong so she took ibuprofen. She also had profuse sweating from head/neck/chest area at night. On 8/8/01, she had strong headache in the evening and woke up with a strong headache at 03:00 so she took ibuprofen and Tylenol and still had profuse sweating from head/neck/chest area at night. On 8/9/01, still with same symptoms so on 8/10/01 she saw MD in Infectious Diseases in the afternoon and he ordered a battery of tests, blood work and a CT of head. On 8/11/01, had a very mild headache at midday so took Advil. On 8/12/01, felt ok; on 8/13/01, felt ok and had blood work done which showed Alkaline phosphatase, AST and ALT were very high. On 8/14/01, she felt ok but a rash had appeared on her abdomen on either side of the midline and the area was about 2 X 4, they were eruption, not blisters, slowly disappeared over the next 3 days and by 8/17/01, they were gone; rash was not itchy. On 8/15/01, no other symptoms. On 8/22/01, saw MD and CT test returned as normal; he ordered an abdominal sonogram to make sure gallbladder, liver and pancreas are OK; sonogram scheduled for 8/28/01; he ordered liver function enzymes to be redone and I will redo that on 8/27/01.

VAERS ID:175001 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:2000-09-27
Gender:Female  Submitted:2000-12-20, Days after onset: 84
Location:West Virginia  Entered:2001-09-05, Days after submission: 258
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: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ2802826OCT2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES466788   
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: A physician reported that a 59 year old female received an injection of Pnu-Imune 23. On 09/27/00, she developed an injection site reaction characterized by a large red welt, swelling, heat, and achiness.

VAERS ID:176686 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:2001-08-20
Gender:Female  Submitted:2001-10-17, Days after onset: 58
Location:Texas  Entered:2001-10-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Prednisone
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1070K0IM 
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Edema, redness, swelling of arm, developing to cellulitis. Treated with cephalosporin antibiotic.

VAERS ID:176708 (history)  Vaccinated:1999-04-28
Age:59.0  Onset:1999-05-01, Days after vaccination: 3
Gender:Male  Submitted:2003-02-14, Days after onset: 1385
Location:Kentucky  Entered:2001-10-24, Days after submission: 478
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor and ibuprofen
Current Illness:
Preexisting Conditions: Allergic to bees and penicillin. Back and cervical problems. Cervical problems.
Diagnostic Lab Data:
CDC 'Split Type': 2001021620
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1  
Administered by: Public     Purchased by: Private
Symptoms: Fatigue, Pernicious anaemia
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: A 61 year old male received Lymerix. Reportedly, the pt was allergic to penicillin and bees. Also the pt''s medical history included cervical and back problems. Reportedly on 28-APR-1999, the pt received his first dose of Lymerix. Reportedly three days later he experienced fatigue. On 28-MAY-1999, the pt received his second dose of Lymerix. Reportedly post vaccination his fatigue continued and he was found to have pernicious anemia. Reportedly, he was treated with Nascobal Nasal gel one squeeze per week and his fatigue and anemia subsequently "resolved". Reportedly, on 28-APR-2000, the pt received his third dose of Lymerix without adverse event. "Follow up labs taken on 23-AUG-2000 were all normal". As of 05-SEP-2001, the adverse event had reportedly resolved. The follow up states on 1/22/02, the responsible physician reported that the vaccinee had experienced tiredness in August 1999 which was moderate in intensity and possibly related to LYMErix. The vaccinee''s vitamin B12 level in 1999 was reported aa 168pg/ml. Responsible physician stated that the vaccinee was subsequently found to have pernicious anemia.

VAERS ID:176710 (history)  Vaccinated:1999-05-28
Age:59.0  Onset:1999-08-09, Days after vaccination: 73
Gender:Female  Submitted:2003-02-14, Days after onset: 1285
Location:Kentucky  Entered:2001-10-24, Days after submission: 478
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamisil (Terbinafine), Vitamin E, Calcium, Folic Acid, Acetylsalicylic Acid, Hormone Replacement (NOS), Sporanox (Itraconazole), Iron.
Current Illness:
Preexisting Conditions: Allergic to Ampicillin, allergic to Darvocet, Intermittent Anemia. Reportedly, the vaccine had anemia (NOS at times. The vaccinee received iron as needed, hormone replacement (NOS), vitamin E, acetylsalicylic acid, calcium, folic acid, terbinafine (Lamisil), and itraconazole (Sporanox).
Diagnostic Lab Data: Examination - Occult Blood, result Text: NORMAL, EGD result Text: NORMAL. Exam Date: 08/1999, Examination, Colonoscopy, Exam Date: 08/1999, Result Text: NORMAL
CDC 'Split Type': 2001021704
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Anaemia
SMQs:, Haematopoietic erythropenia (broad)
Write-up: Described anemia (NOS) in a 59-year-old female who received Lyme disease vaccine recombinant OspA (LYMErix). This report was received from the vaccinee and has not been verified by a [hysician or other health care professional. Reportedly, the vaccinee was allergic to ampicillin, and dextropropropoxcyphene (Darvocet). Vaccinee had anemia (NOS) at times. The follow up states the vaccinee had lactose intolerance beginning in 1999. The vaccinee reported that she received her first left deltoid dose of LYMErix on 4/28/99. Three days later she felt fatigued. Reportedly, on 5/28/99, the vaccinee received her second left deltoid dose of LYMErix. She reported that, on 6/6/99, she experienced a drop in red blood cell and hematocrit counts. Her fatigue continued. Reportedly, on 8/9/99 and 8/10/99, repeat lab tests showed continued decrease in red blood cells, white blood cells, and hematocrit. The vaccinee stated that a diagnosis of anemia was made "because I had low RBC, WBC, and HCT counts. Her "B12" was normal, reportedly. She stated that she underwent three occult blood tests, esophagogastroduodenoscopy, and colonoscopy. These tests were reportedly normal. Reportedly, on 9/2/99, lab tests were repeated: WBC was normal, and RBC and HCT were "almost normal." Reportedly, on 10/25/99, WBC, RBC and HCT were all "dropping." No treatment was given. Reportedly, 4/13/00, all lab values were normal. On 1/20/02, the reporting physician stated that on 8/10/99, the vaccinee reported fatigue to him. Lab analyses performed in August 1999 showed HCT 30%, WBC 3300/cumm, and platelet count of 141,000/cumm. Reporting physician stated htat the fatigue was moderate in intensity and was possibly related to LYMErix. Reportedly on 4/28/00, the vaccinee received her third left deltoid dose of LYMErix. oN 8/23/00, her WBC was "low," and her RBC and HCT were normal. In February 2001, all labs were reportedly normal. As of 9/5/01, the vaccinee''s symptoms had resolved.

VAERS ID:176859 (history)  Vaccinated:2001-10-09
Age:59.0  Onset:2001-10-10, Days after vaccination: 1
Gender:Female  Submitted:2001-10-22, Days after onset: 12
Location:Kansas  Entered:2001-10-30, 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: Diarrhea
Preexisting Conditions: Fragrance, Niacin, Nizeral, Cipro and ploclyco, Morphine and Thirmersol.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Public
Symptoms: Diarrhoea, Headache, Malaise, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Had diarrhea, vomiting, muscle aches more severe and headache. Nauseated, ill feeling. Went to Dr. on 10/17/2001 and he gave me Cedox (antibiotic for sinus infection).

VAERS ID:177153 (history)  Vaccinated:2001-10-02
Age:59.0  Onset:2001-10-02, Days after vaccination: 0
Gender:Male  Submitted:2001-10-28, Days after onset: 26
Location:New Mexico  Entered:2001-11-05, Days after submission: 8
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA
Current Illness: NONE
Preexisting Conditions: High BP; ASHD; Hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE02761HA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Confusional state, Dizziness, Erythema, Hypotension, Lethargy, Nausea
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Around 11:30 on 10/2/01, he called his son and said he was dizzy and nauseated and was brought to MD''s office with erythema, confusion and lethargy. His BP was 54/40, then 74/30. He was given epinephrine, SC, steroids and IV fluids in ER with full recovery. He also had taken 1 aspirin at 10:00. He is not allergic to eggs. He had taken flu vaccine on 1/11/01 without problem and previous aspirin also.

VAERS ID:177495 (history)  Vaccinated:2000-11-10
Age:59.0  Onset:2000-11-11, Days after vaccination: 1
Gender:Female  Submitted:2001-01-21, Days after onset: 71
Location:Ohio  Entered:2001-11-09, Days after submission: 292
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': U200100173
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0423AA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Lymphadenopathy
SMQs:
Write-up: It was reported that a female patient received a Fluzone SV vaccination on 11/10/2000. Reportedly within the next day or two the patient developed swollen lymph glands under her arms. Further information is requested.

VAERS ID:177613 (history)  Vaccinated:2001-10-29
Age:59.0  Onset:2001-10-30, Days after vaccination: 1
Gender:Male  Submitted:2001-10-31, Days after onset: 1
Location:Wisconsin  Entered:2001-11-12, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin, Prevacid, Vitamin E
Current Illness:
Preexisting Conditions: Aortic Valve Replacement
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0678EA1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0945K SCLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis
SMQs:
Write-up: The patient developed cellulitis one day post vax.

VAERS ID:177750 (history)  Vaccinated:2001-11-04
Age:59.0  Onset:2001-11-04, Days after vaccination: 0
Gender:Female  Submitted:2001-11-05, Days after onset: 1
Location:Washington  Entered:2001-11-15, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Other     Purchased by: Private
Symptoms: Discomfort, Heart rate increased, Myalgia, Pyrexia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pt had fever of 100.3 10 hrs after injection. Hives(swollen red spots size of quarter or half dollar) 24 hrs after injection. Racing heart beat and general discomfort. Muscles aches 10 hrs after injection.

VAERS ID:177840 (history)  Vaccinated:1999-08-13
Age:59.0  Onset:1999-11-05, Days after vaccination: 84
Gender:Male  Submitted:0000-00-00
Location:Maryland  Entered:2001-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY130B9 IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: The patient experienced arthritis like symptoms.

VAERS ID:177946 (history)  Vaccinated:2001-11-09
Age:59.0  Onset:2001-11-10, Days after vaccination: 1
Gender:Female  Submitted:2001-11-12, Days after onset: 2
Location:California  Entered:2001-11-19, 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: HCTZ
Current Illness: Cellulitis of the right hand.
Preexisting Conditions: Hypertension.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES00368AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site rash, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 11/12/2001 the patient experienced local erythema of the left arm in an area 12cm x 15cm. The patient was treated with Benadryl for itching, TAC cream and cool compresses.

VAERS ID:177950 (history)  Vaccinated:2001-10-16
Age:59.0  Onset:2001-10-16, Days after vaccination: 0
Gender:Female  Submitted:2001-11-09, Days after onset: 24
Location:Kentucky  Entered:2001-11-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Flu like symptoms;FLU (Mfr not specified);1;19.00;In Patient
Other Medications: Metoprolol, Dilantin, Zestril, Prazosin, Lasix, Clonidine, Norvasc and Folic Acid.
Current Illness:
Preexisting Conditions: Polycystic disease of the kidneys and liver, enlarged thyroid, also some seizure activity. Implanted pacemaker in 2000.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0574AA IM 
Administered by: Other     Purchased by: 0
Symptoms: Chills, Lymphadenopathy
SMQs:
Write-up: Mid-afternoon, the day of the vaccination, the patient experienced swelling and tenderness of the glands under each ear and down the side of the throat towards the thyroid. The patient did not have a fever but by mid-afternoon the next day the patient had chills for about 3 hours.

VAERS ID:178261 (history)  Vaccinated:2001-10-22
Age:59.0  Onset:2001-10-22, Days after vaccination: 0
Gender:Female  Submitted:2001-10-30, Days after onset: 8
Location:Ohio  Entered:2001-11-27, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: Hypothyroid
Diagnostic Lab Data: NONE
CDC 'Split Type': OH0059
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0856L1IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Neck pain, Pyrexia, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Pt developed pain at approximately 4 PM that started at left deltoid injection site and travelled into left shoulder and into left side of neck to just below left ear. On 10/23/01, pt developed fever and chills. She took one dose of Tylenol. She experienced chills for 2 days. On 10/29/01, the pain in shoulder began to subside but is a little more noticeable again on 10/30/01.

VAERS ID:178342 (history)  Vaccinated:2001-11-16
Age:59.0  Onset:2001-11-17, Days after vaccination: 1
Gender:Male  Submitted:2001-11-20, Days after onset: 3
Location:Arizona  Entered:2001-11-28, 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: Lipitor and Claritin.
Current Illness:
Preexisting Conditions: Hyperlidpidemia and smoker.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0695AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: The following morning after receiving the vaccines, the patient''s arm hurt and turned red for 3 days. The patient''s temperature was 101F for 2 days and his whole body ached for 2 days. All symptoms were resolved after 3 days.

VAERS ID:178392 (history)  Vaccinated:2001-11-19
Age:59.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Female  Submitted:2001-11-19, Days after onset: 0
Location:Nevada  Entered:2001-11-28, 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: Premarin, Mobic, Sudafed, ASA
Current Illness: NONE
Preexisting Conditions: Allergy to sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM52112C62IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM705A61IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T081620IMLA
Administered by: Other     Purchased by: Public
Symptoms: Anorexia, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Pt developed dizziness, nausea and anorexia.

VAERS ID:178759 (history)  Vaccinated:2001-11-02
Age:59.0  Onset:2001-11-13, Days after vaccination: 11
Gender:Male  Submitted:2001-11-19, Days after onset: 6
Location:Oregon  Entered:2001-12-10, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Discharge summary indicates pt has history of smoking/tobacco addiction.
Diagnostic Lab Data: CSF fluid with increased protein.
CDC 'Split Type': OR200147
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO688AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, CSF test abnormal, Coordination abnormal, Fatigue, Feeling abnormal, Guillain-Barre syndrome, Paraesthesia, Sepsis, Urinary tract infection
SMQs:, Agranulocytosis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Arthritis (broad)
Write-up: Pt got the flu shot on 11/2/01. "A couple of days later", he felt joint aches and was "feeling bad". On 11/13/01 at 14:00, he began to feel numbness and tingling in his feet and hands. Also was losing coordination. GBS? Still in ICU. 60 day follow-up information states on 1/21/03 T.V. with medical RN and client.l Under care of neurologist for GBS which occurred 2 weeks after flu vaccine 11/2/01. On Soc Sec because uncalbe to return to job as machinist. Able to ambulate now without care. Very fatigued/no stamina, feet hypersensitive and sore; numbness and tingling in fingers and left side of face and forehead. Discharge summary states GBS, sepsis, and URI. Follow up on 11/04/2003: "Vaccine recipient did not recover from the adverse event. See attached updated report based on 10/30/2003. Telephoned client regarding her present health states and treatment."

VAERS ID:178844 (history)  Vaccinated:2001-11-07
Age:59.0  Onset:2001-11-09, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:2001-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0681AA IM 
Administered by: Other     Purchased by: Private
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: The pt complained of soreness at the site of the injection. She called on 12/31/01 and said that she had difficulty in raising her arm. She was vaccinated on 11/7/01.

VAERS ID:178942 (history)  Vaccinated:2001-11-13
Age:59.0  Onset:2001-11-14, Days after vaccination: 1
Gender:Female  Submitted:2001-12-08, Days after onset: 24
Location:New York  Entered:2001-12-12, 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: Verapamil, glucophase and liptor
Current Illness: NONE
Preexisting Conditions: DM-2, dyslipidemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1469K0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Swelling, erythema right arm. Treated with cold compresses, resolved less than 2 weeks.

VAERS ID:179079 (history)  Vaccinated:2001-11-28
Age:59.0  Onset:2001-11-28, Days after vaccination: 0
Gender:Female  Submitted:2001-12-03, Days after onset: 5
Location:Michigan  Entered:2001-12-17, 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:
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018043 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site swelling, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt states 1st day hot hot, hard & itchy and 2nd day hives under L axilla and spread to breast & legs. 3rd day arm very swollen, could not bend, hot to touch and very red. Went to ER 12/1/01. Given Benadryl, Solumedrol, Prednisone packet and cortisone cream. Instructed pt to call her family Dr to make him aware, and not to get flu vaccine in the future. Pt stated she has had flu vaccine for 10 yrs except for last year when there was a shortage.

VAERS ID:179153 (history)  Vaccinated:2001-12-03
Age:59.0  Onset:2001-12-04, Days after vaccination: 1
Gender:Female  Submitted:2001-12-06, Days after onset: 2
Location:Georga  Entered:2001-12-18, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN, Erythromycin, Recently recovered from pneumonia
Diagnostic Lab Data: On 12/06/01, the patient saw Dr., who feels that the Adverse Event was a systemic reaction. He recommended anti-inflammatory treatment, in the form of Tylenol and heat. He also recommended that the patient not receive the pneumonia vaccine in the future.
CDC 'Split Type': GA01112
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE05221KA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1071K0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Client received pneumonia vaccine on 12/03/2001 around 11:30 in the morning. Approximately three hours later, she started experiencing chills and a fever. The latter reached 102 and lasted for twenty-four hours. A swollen area of redness was noted about two inches below the injection site. The underside of the left arm was also tender to the touch. This tenderness lasted for two days after the vaccination.

VAERS ID:179289 (history)  Vaccinated:2001-11-13
Age:59.0  Onset:2001-11-13, Days after vaccination: 0
Gender:Female  Submitted:2001-12-17, Days after onset: 34
Location:New Jersey  Entered:2001-12-20, 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: Fosama
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0687EA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Headache, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 11/13/2001 *:00 am-Awakened with a headache, took two Advil tablets 8:30 headache 3:00 pm received the Flu vaccine 3:30 pm took two Tylenol tablets 6:30 pm while changing clothes had red, very raised blotched areas from armpit and below, nipple line to neckline 7:00 pm took Benedryl 8:30 pm asleep to 11/14/2001 at 7:00 am, without rash.

VAERS ID:179440 (history)  Vaccinated:2001-11-29
Age:59.0  Onset:2001-11-29, Days after vaccination: 0
Gender:Female  Submitted:2001-12-21, Days after onset: 22
Location:Virginia  Entered:2001-12-27, 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: Stomach Virus
Preexisting Conditions: NONE
Diagnostic Lab Data: Atrial fibrillation labs and Halter monitor.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018027 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Stomach discomfort
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: On 10/29/2001 at 10:30 AM administered vaccine (flu). By 10:55 AM pt became sick to stomach, weak, diarrhea, no vomiting. By 11 AM weak, warm, diaphoretic, quite pink all over. Unable to hear BP. No respiratory distress, no hives, no localized reaction at site. Poorly responsive. Sent to ER via ambulance.

VAERS ID:179671 (history)  Vaccinated:2001-12-06
Age:59.0  Onset:2001-12-09, Days after vaccination: 3
Gender:Male  Submitted:2001-12-21, Days after onset: 12
Location:Oklahoma  Entered:2002-01-03, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUO704AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Tingling in index and second finger in left hand. Fells like fingers are asleep.

VAERS ID:179704 (history)  Vaccinated:2001-11-15
Age:59.0  Onset:2001-12-10, Days after vaccination: 25
Gender:Male  Submitted:2001-12-14, Days after onset: 4
Location:California  Entered:2002-01-04, 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: Atendol Glucotral
Current Illness: NONE
Preexisting Conditions: HTN diabetes
Diagnostic Lab Data:
CDC 'Split Type': CA-01-0139
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU05922A IM 
Administered by: Other     Purchased by: Public
Symptoms: Pulmonary congestion, Rhinorrhoea
SMQs:, Cardiac failure (broad)
Write-up: 12/10/2001-Onset of congestion and runny nose. No fever, no sore throat, no malaise, no muscle aches. The patient went to the doctor because they were "very prone to bronchitis" He was told that he had a cold and was prescribed Ampicillin. The patient is aware that the vaccination doesn''t protect against URI. He just followed CDC''s info on us (VAERS)

VAERS ID:179709 (history)  Vaccinated:2001-11-30
Age:59.0  Onset:2001-12-07, Days after vaccination: 7
Gender:Female  Submitted:2001-12-12, Days after onset: 5
Location:Unknown  Entered:2002-01-04, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Patient experienced a rash on left arm, a fever and soreness for a day and a half.

VAERS ID:179725 (history)  Vaccinated:2001-11-13
Age:59.0  Onset:2001-11-13, Days after vaccination: 0
Gender:Female  Submitted:2001-12-26, Days after onset: 43
Location:Wisconsin  Entered:2002-01-07, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: As the nurse was giving me the shot, a severe pain went creeping down my arm. When it reached my hand, it felt like an explosion going off. I have had a very painful arm for the past six weeks. At first, I had to carry my arm around. It does seem to be getting better.

VAERS ID:179842 (history)  Vaccinated:2001-10-08
Age:59.0  Onset:2001-10-09, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2002-01-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Meloxicam; Rantidine
Current Illness: NONE
Preexisting Conditions: Gout and osteoarthritis
Diagnostic Lab Data:
CDC 'Split Type': PJP2002000110
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES  IM 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Pancreatitis
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: A 59 year old male pt experienced severe abdominal pain and pancreatitis, which resulted in prolonged hospitalization one day after receiving the Fluvirin vaccine on 08-OCT-2001. At the time of reporting the pt was recovering. There was insufficient information to determine the reporter''s causality assessment.

VAERS ID:180662 (history)  Vaccinated:2001-12-07
Age:59.0  Onset:2001-12-07, Days after vaccination: 0
Gender:Female  Submitted:2001-12-11, Days after onset: 4
Location:Pennsylvania  Entered:2002-01-29, Days after submission: 49
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aciphex, Singulair, Advair, Xanax, Anacin
Current Illness: NONE
Preexisting Conditions: "Environmental" Asthma, GURD
Diagnostic Lab Data: NONe
CDC 'Split Type': PA0201
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4018029 IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4749360IMRA
Administered by: Public     Purchased by: 0
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Approx. 4 hours after vaccine, right arm started to ache. By 8:30 pm, she was unable to move her right arm. Movement of the arm got extremely painful to move from 12/07/01 pm thru 12/09/01. No treatment.

VAERS ID:180818 (history)  Vaccinated:2000-03-14
Age:59.0  Onset:2000-03-15, Days after vaccination: 1
Gender:Female  Submitted:2000-04-14, Days after onset: 29
Location:Georga  Entered:2002-02-04, Days after submission: 661
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrace; Calcium
Current Illness: NONE
Preexisting Conditions: Codeine allergy; mitral valve abnormality
Diagnostic Lab Data:
CDC 'Split Type': U200000158
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0147AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: It was reported that a female pt received a TD Adult on 3/14/00. Reportedly, on 3/15/00, the pt complained of right deltoid redness, itchiness, tenderness and right extremity swelling. The pt received Keflex and Prednisone as treatment. Reportedly, the symptoms have subsided. From correspondence received on 4/10/00, additional pt, vaccine and responsible physician information was provided.

VAERS ID:180909 (history)  Vaccinated:2001-10-24
Age:59.0  Onset:2001-11-29, Days after vaccination: 36
Gender:Male  Submitted:2002-01-28, Days after onset: 60
Location:Michigan  Entered:2002-02-05, 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:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0600AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Joint range of motion decreased, Pain
SMQs:, Arthritis (broad)
Write-up: Client c/o shoulder hurting and not being able to move aem, i.e lift without aches. Arm never red or swollen, was advised to see MD

VAERS ID:180972 (history)  Vaccinated:2000-11-07
Age:59.0  Onset:2000-11-10, Days after vaccination: 3
Gender:Female  Submitted:2001-01-22, Days after onset: 73
Location:Maryland  Entered:2002-02-06, Days after submission: 380
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': U200100194
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0316AA   
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: It was reported that a female pt received a TD Adult vaccination on 11/07/2000. Reportedly on 11/10/2000, the pt developed a local reaction of redness and soreness at the injection site. A physician evaluated the pt; no prescribed medication was given.

VAERS ID:181277 (history)  Vaccinated:2002-02-01
Age:59.0  Onset:2002-02-01, Days after vaccination: 0
Gender:Female  Submitted:2002-02-06, Days after onset: 5
Location:New York  Entered:2002-02-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1056J2IMLA
Administered by: Other     Purchased by: Private
Symptoms: Eye oedema, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt called stating that after receiving Hep-B vaccine #3 on 2/1/02 and arriving home, she noticed left eye swelling and a rash on left wrist. She did not seek medical treatment. At the time of call, on 2/4/02, she was with swelling and advised to follow-up with PMD.

VAERS ID:181697 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:0000-00-00
Gender:Male  Submitted:2002-02-22
Location:Unknown  Entered:2002-02-26, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Glibemolamide, Valsartan, Metoformin hydrochloride, Troglitazone, Sildenafil citrate, Frusemids, Allepurinol, Testosterone, Simvastatin, Gababpentin
Current Illness: UNK
Preexisting Conditions: Asbestosis, Ataxia, Bells Palsy, carpel Tunnel syndrome, ellulitis of lower extremity, Detached retina, Diabetic Neuropathy, enlarged heart, enlarged prostate, ?, erectile dysfunction, Gliosis, head injury, headache, hydrocels, hyperlifidemia, hypertension, hyperuricemia, ? nerve pasly, increased glycosylated hemoglobin A, joint pain, kidney stone, knee injury, knee pain, leg edema
Diagnostic Lab Data: Chest x-rays and computed tomogram, 2/12/98: "Body thorax: moderate osteoarthritis of the thoracic spine. Heart size: at the upper limit of normal in its transveres diameter. Aorta: widened. Lung parenchyma: diffucse coarse linear ? through
CDC 'Split Type': A0359651A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM  IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Diabetes mellitus, Dyspnoea, Fatigue, Neck pain, Obesity, Obstructive airways disorder, Paraesthesia, Pharyngitis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: The vaccinee reportedly received Lymerix; the number of injections administered was not reported. In a statement of injuries, his attorney alleged that the pt "suffers from joint pain in his hands, fingers, knees, hips, elbows and neck. He also suffers from fatigue, diabetes and asbestosis lung disease". Following the reported onset of asbestosis, diabetes, fatigue, and joint pain, the vaccinee experienced hypertonia, parafoveal metamorphopsia, increased concentration of asparate sminotransferase, decreased concentration of testosterone, and leg cellulites requiring hospitalization. These events 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. The vaccinee received three injections of LYMErix, the only injection documented in the medical records was the third injection, administered on 5/25/00(lot# not recorded). In a Statement of Injuries, his attorney alleged that the vaccinee "suffers from joint pain in his hands, fingers, knees, hips, elbows and neck. He also suffers from fatigue, diabetes and asbestosis lung disease." Time to onset following immunization was not specified. The vaccinee was seen by a pulmonologist on 7/28/98. The pulmonologist indicatedt that he had reviewd records and reports from three physicians who had examined the vaccinee in 1997 and 1998. The pulmonologist noted taht during the vaccinee''s employment, he "had extensive direct contact and airborne uprotected exposure to asbestos. He was also exposed in varying degrees to fly ash dust, welding fumes, nuclear radiation...and other occupational dusts and fumes....He has greater than twenty years of heavy asbestos exposure". At the time of the evaluation, the vaccinee reported that "he plans to stop working by December 1998 becuase of his breathing problems. (His) present respiratory symptoms are: Daily dry cough; shortness of breath at res, on minimal and on ordinary exertion, and very easy fati

VAERS ID:182446 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:2002-03-01
Gender:Female  Submitted:2002-03-07, Days after onset: 6
Location:Nebraska  Entered:2002-03-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fever;Td, Adsorbed, Adult (Mfr not specified);1;21.00;In Patient
Other Medications: Acifex, Premarin, Lipitor
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.0536L0SCRA
Administered by: Private     Purchased by: 0
Symptoms: Lymphadenopathy
SMQs:
Write-up: Sub occipital lymph nodes-one; large one on the left, 2 smaller ones on right.

VAERS ID:182489 (history)  Vaccinated:2001-10-02
Age:59.0  Onset:2001-10-07, Days after vaccination: 5
Gender:Male  Submitted:2002-03-07, Days after onset: 151
Location:Texas  Entered:2002-03-14, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01111680
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1749K0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a registered nurse concerning a 59 year old male who on 10/02/2001 at 10:15am and 11/07/2001 at 11am was vaccinated with the first and second dose of hep b vaccine recombinant IM. Five days after the first dose the pt developed chills, fever, and headache. It was reported that the pt "took hot shower" and the symptoms disappeared by the next day. Four days after the second dose the pt experienced the same symptoms. The pt sought unspecified medical attention. It was reported that the pt recovered. No further info is expected.

VAERS ID:182853 (history)  Vaccinated:2002-02-26
Age:59.0  Onset:2002-03-04, Days after vaccination: 6
Gender:Male  Submitted:2002-03-15, Days after onset: 11
Location:Illinois  Entered:2002-03-26, 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: Dilacor, Lescol
Current Illness: NONE
Preexisting Conditions: high blood pressure, high cholesterol
Diagnostic Lab Data:
CDC 'Split Type': IL02011
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS217A40IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0386AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pruritus, Rash macular, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Redness on backs of hands progressing to bumps on the head near hairline. On 03/06/2002 took Benadryl which didn''t help. On 03/07/2002, hands swollen, 03/08/2002 nickle size blotches on wrists, on 03/10/2002 swelling down, 03/13/2002 bumps on back of head itching, on 03//14/2002 MD ordered doxepin and allegen. At midnight hives all over body and in throat, went to ER started on methylprednisone. on 03/15/2002 morning, symptoms resolving.

VAERS ID:184199 (history)  Vaccinated:2002-04-22
Age:59.0  Onset:2002-04-23, Days after vaccination: 1
Gender:Female  Submitted:2002-04-24, Days after onset: 1
Location:Colorado  Entered:2002-05-03, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0518AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Chest pain, Hypokinesia, Injection site pain, Musculoskeletal stiffness
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: On the day after vaccination, the pt developed arm tenderness. Post 36 hrs, lower back and chest achy. Post 48 hrs, lower back and chest achy, lower neck stiff, and limited ability to lift left arm.

VAERS ID:184384 (history)  Vaccinated:2002-04-11
Age:59.0  Onset:2002-04-11, Days after vaccination: 0
Gender:Female  Submitted:2002-05-03, Days after onset: 22
Location:Michigan  Entered:2002-05-09, 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: Heart problems, hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0267AA1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site mass, Pain, Paraesthesia, Skin discolouration
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: The pt was bit by a dog at left eye on 04/11/2002. The pt received a Td shot on the right upper arm. She complained of dark in color, and painful knot since 04/11/2002. Also developed 2 small knots and loss of feeling on right hand. On 05/06/2002 no swelling but had sore arm (applied ice). Started on Cipro 500 mg, Kelfinist 250 mg, and Ceptin on 05/02.

VAERS ID:184732 (history)  Vaccinated:2001-02-20
Age:59.0  Onset:2001-03-26, Days after vaccination: 34
Gender:Female  Submitted:2002-05-15, Days after onset: 414
Location:Unknown  Entered:2002-05-16, 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: aspirin, Lipitor, Zestril, Lopressor
Current Illness:
Preexisting Conditions: Allergic to Ceclor, pcn, cephalexin, and Ceftin
Diagnostic Lab Data:
CDC 'Split Type': WAES01041035
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1614K   
Administered by: Other     Purchased by: Other
Symptoms: Skin ulcer
SMQs:
Write-up: Information has been received from a registered nurse concerning a 59 year old female with Ceclor allergy, pcn allergy, cephalexin allergy and Ceftin allergy who on 02/20/2001 was vaccinated with varicella vaccine. Concomitant therapy included Lipitor, Zestril, Lopressor and aspirin. On approximately 03/26/2001, the pt developed two lesions, both 0.5 inches in diameter that were slightly red and cracked. The first lesion was on the front of bicep and the second lesion was below the pt''s clavicle. The second lesion has totally resolved. Unspecified medical attention was sought. Additional info has been requested.

VAERS ID:184771 (history)  Vaccinated:2002-04-16
Age:59.0  Onset:2002-04-16, Days after vaccination: 0
Gender:Male  Submitted:2002-04-17, Days after onset: 1
Location:Georga  Entered:2002-05-17, 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': GA02034
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEURT086324IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Blood pressure increased, Feeling abnormal, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow)
Write-up: Pt RTC 4/17/02, approx. 10:35, complaining of nausea, weakness and vomiting to the point of dry heaves. He states, I took my last rabies shot yesterday and about 2 hours later, I began to feel real bad with nausea and vomiting. I drank 2 beers and thought I would feel better but I continued to feel bad with mild tremors noted. BP 132/80, P-74. Referred to MD.

VAERS ID:186016 (history)  Vaccinated:2002-05-17
Age:59.0  Onset:2002-05-23, Days after vaccination: 6
Gender:Female  Submitted:2002-05-28, Days after onset: 5
Location:Connecticut  Entered:2002-06-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ;Influenza (unknown mfr);1;51;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': CT200204
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1265L0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Headache, Pain, Pyrexia, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: The pt developed swelling left arm pit, left breast, left neck, body aches, headache, fever, rash on legs on 05/23 and all over by 05/29, red/pink rash with individual "bumps" larger then pinpoint.

VAERS ID:186766 (history)  Vaccinated:2002-06-04
Age:59.0  Onset:2002-06-05, Days after vaccination: 1
Gender:Female  Submitted:2002-06-05, Days after onset: 0
Location:Wisconsin  Entered:2002-06-19, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0517AA1 LA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Red, raised welt, warm to touch 3 1/2 by 4 inch. Treatment, ice and Motrin. Cleared up 06/09/02.

VAERS ID:187025 (history)  Vaccinated:2002-06-19
Age:59.0  Onset:2002-06-19, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Virginia  Entered:2002-06-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0352L0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Feeling abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)
Write-up: Vaccine administered 06/19/02. 06/21/02 he reported that two hours post hot given he felt dizzy and "not right" until he went to bed. He awoke the next day "feeling fine." Reported incident ot Doctor who ordered to see PMD for problems and not to repeat hep B shots if risk.

VAERS ID:187258 (history)  Vaccinated:1998-10-08
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2002-07-03
Location:Pennsylvania  Entered:2002-07-08, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Conjugated estrogens; Fluoxetine hydrochloride; Aspirin
Current Illness: UNK
Preexisting Conditions:
Diagnostic Lab Data: Unk
CDC 'Split Type': A0303842A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 1  
Administered by: Private     Purchased by: Other
Symptoms: Alopecia, Anaemia, Drug toxicity, Ear pain, Glossodynia, Infection, Mucous membrane disorder, Myalgia, Polyarthritis, Sjogren's syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Drug abuse and dependence (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Lacrimal disorders (narrow), Arthritis (narrow)
Write-up: Report A0303842A describes possible mercury poisoning in a 59 year old female who received hep B vaccine recombinant after sustaining a needle stick injury. This report was received from the vaccinee, who is a nurse and has not been verified by a physician. The vaccinee reported that she had no allergies or medical history. However, she also reported that she took conjugated estrogens (Premarin), Prozac and baby aspirin. The vaccinee reported that she received the first and second doses of Engerix B on 09/08/1998 and 10/08/1998, respectively. She reported that "within one to two weeks" of receiving the second injection of Engerix B, three-fourths of her hair fell out and was "coming off from the follicle." She also reported that her hair became limp. She stated that she also experienced "occasional "earaches, "occasional" sinus infectious, anemia (manifested by decreased hemoglobin concentration, decreased hematocrit, and decreased total protein concentration), polyarthritis, muscle pain, "thumb not in joint," and "beginning in late May 2002 or early June 2002, her "tongue has sores and is very red." She started that she "thinks" that she has "mercury poisoning" because she received thimerosal in the Engerix B injections in 1998. She also stated that she experienced dryness of "all mucous membranes" and that she "now has" Sjogren''s syndrome. She considered the "mercury poisoning" and Sjogren''s syndrome to be possibly related to Engerix B administration. The most recent info received on 06/19/02, indicated that all the reported events were ongoing. This report of "mercury poisoning" is considered medically serious.

VAERS ID:187705 (history)  Vaccinated:2002-06-28
Age:59.0  Onset:2002-06-28, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2002-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Keflex 500 mg po qid x 7 days
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0526AA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site oedema, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Localized edema, cellulitis to left arm.

VAERS ID:187716 (history)  Vaccinated:2002-06-04
Age:59.0  Onset:2002-06-20, Days after vaccination: 16
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2002-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD, Thyroid Rx
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3355A40IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1209L SCLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Hypoaesthesia, Joint swelling, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: MMR given 06/04/02. Joint pain and swelling in knees and large joints began 06/20/02. Now has numbness, pain and swelling in hands.

VAERS ID:187779 (history)  Vaccinated:2002-07-03
Age:59.0  Onset:2002-07-03, Days after vaccination: 0
Gender:Female  Submitted:2002-07-12, Days after onset: 9
Location:West Virginia  Entered:2002-07-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multiple
Current Illness:
Preexisting Conditions: Ceclor allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)CONNAUGHT LTD.U05111IMLA
Administered by: Private     Purchased by: Other
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Itching without skin eruption. RX: Motrin and Allegra.

VAERS ID:188117 (history)  Vaccinated:2002-06-06
Age:59.0  Onset:2002-06-10, Days after vaccination: 4
Gender:Male  Submitted:2002-07-12, Days after onset: 32
Location:Unknown  Entered:2002-07-29, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor; Niacin 1000mg; Zeotril; Toprol; Zantac;Eratrin danul
Current Illness:
Preexisting Conditions: Heart attack; rheumatoid arthritis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM719C6 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hepatitis A vaccine #1 given 06/06/02 (lot VHA719C6). Facial swelling and lips swelled 4 days later 06/10/02. Cleared by steroid therapy ordered by family physician. Advised to consult with him prior to second dose due 12/02.

VAERS ID:188206 (history)  Vaccinated:2002-07-02
Age:59.0  Onset:2002-07-10, Days after vaccination: 8
Gender:Male  Submitted:2002-07-15, Days after onset: 5
Location:Oregon  Entered:2002-07-30, 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:
Current Illness: Arthritis
Preexisting Conditions: Reiter''s Syndrome
Diagnostic Lab Data:
CDC 'Split Type': OR200226
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0125M SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypokinesia, Insomnia, Musculoskeletal stiffness, Neck pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Pain in arm, neck, leg 8 days out. Difficulties sleeping, lower mobility, stiffness. Also, pain at injection site 8 days out. NSAIDS helped immensely. He will taper off them in next few days.

VAERS ID:188390 (history)  Vaccinated:2001-11-08
Age:59.0  Onset:2001-11-10, Days after vaccination: 2
Gender:Female  Submitted:2002-07-30, Days after onset: 261
Location:Illinois  Entered:2002-08-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES01111416
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1197K IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a woman in a doctor''s office and an RN concerning a 59 year old Caucasian female RN who on 11/8/01, at 18:00, was vaccinated in the left deltoid with a dose (1st number 635892/1197K) of pneumococcal vaccine 23 polyvalent. There were no illnesses at the time of vaccination. On 11/10/01, sometime in the AM, (also reported as within 12 hours of administration of the vaccine), the pt developed an injection site reaction with an enlarged, raised, reddened area, that was hot to the touch and very painful (12" X 4", deltoid to elbow, also reported as 10" X 4"). The pt was treated with ice and acetaminophen (+) caffeine (Excedrin). The pharmacist who supplied the physician''s office with the pneumococcal vaccine 23 polyvalent was worried about using the last vial. Follow-up information received from the female RN indicated that although there was no visible evidence, the area of injection was still painful to the touch. She reported the outcome of the events as recovered. The records of testing prior to release of this lot (635892/1197K) have been checked by GMP Compliance and found to be satisfactory. This lot complies with the standards of the Center for Biologics Evaluation and Research and was released. No further information is available.

VAERS ID:188910 (history)  Vaccinated:2002-01-28
Age:59.0  Onset:2002-01-30, Days after vaccination: 2
Gender:Male  Submitted:2002-07-30, Days after onset: 180
Location:Virginia  Entered:2002-08-14, Days after submission: 15
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: Concurrent: Diabetes mellitus NOS, Hyperlipidaemia NOS, Hypertension NOS
Diagnostic Lab Data:
CDC 'Split Type': WAES0202USA01653
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1448K0IM 
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Information has been received from a registered nurse concerning a 59 year old Caucasian male with hypertension, hyperlipidemia and diabetes who on 01/28.02 was vaccinated IM in the left deltoid with a first dose of pneumococcal vaccine 23 polyvalent (lot # 637263/1448K). The nurse reported that the patient was well at the time of vaccination. On 01/30/02, the patient called his physician''s office and reported that the injection site was red and he had a rash and a sore at the site. The physician ordered diphenhydramine hydrochloride (Benadryl) cream to the area and to call back if the symptoms worsened. On 01/31/02, the patient saw his physician and complained of the injection site being red and hard to touch. A diagnosis of cellulitis was made and the patient was treated with amoxicillin (Augmentin) 875 mg BID for 10 days. The patient was seen again in the office on 02/06/02 and the physician noted marked improvement in the cellulitis but still some redness at the site. The patient was considered to be recovered as of 02/06/02. The reporter also reported thata 26 year old male developed cellulitis after vaccination with pneumococcal vaccine 23 polyvalent (MSD) (lot # 641114/1387L) (WAES0202USA02499). The reporter stated a concern about the particular lot of vaccine. The records of testing prior to release of this lot have been checked and found to be satisfactory. The lot complies with the standards and was released. No further information is available.

VAERS ID:189087 (history)  Vaccinated:2002-08-08
Age:59.0  Onset:2002-08-08, Days after vaccination: 0
Gender:Female  Submitted:2002-08-09, Days after onset: 1
Location:California  Entered:2002-08-20, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0994L1IMLA
Administered by: Private     Purchased by: Other
Symptoms: Feeling hot, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient presented to clinic 1 day after pneumovax injection, left deltoid area. Grossly swollen, pain, hot, and red. Patient evaluated by provider.

VAERS ID:189197 (history)  Vaccinated:2002-08-06
Age:59.0  Onset:2002-08-07, Days after vaccination: 1
Gender:Male  Submitted:2002-08-09, Days after onset: 2
Location:Arizona  Entered:2002-08-22, Days after submission: 13
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
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1353L0SCLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0526AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Increased pain in left shoulder, low grade fever, arm hot to touch and red at site. Pt stated he noticed it on Tuesday night.

VAERS ID:189526 (history)  Vaccinated:1999-12-01
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2002-08-27
Location:Pennsylvania  Entered:2002-08-29, 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: NONE
Current Illness: UNK
Preexisting Conditions: The subject had no relevant medical history and received no medications at the time of immunization. She had experienced no adverse events following previous immunizations. She mentioned "pulling ticks off her during Lyme season".
Diagnostic Lab Data: Western blot - 08/07/02:" Dalton band 41; immunoglobulin was 1.''
CDC 'Split Type': A0377929A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 1IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthritis, Headache
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: This report describes arthritis in a 49 year old female who was vaccinated with Lyme disease vaccine recombinant OspA (Lymerix) for prophylaxis. The subject had no relevant medical history and received no medications at the time of immunizations. She mentioned "pulling ticks off her during Lyme season". In approximately12/99, the subject received her second injection of Lymerix. Approximately two weeks later, she began to experience arthritis with joint pain that was "so bad that she could not hold a bag". She also began to experience "frequent headaches that are really bad". The subject was seen by her physician. The arthritis symptoms were treated with rofecoxib (Vioxx) 25 mg as needed. After one year of vioxx therapy, her symptoms have improved and are now experienced "off and on". The Lymerix immunization series was discontinued. On 08/07/02, a Western blot was performed. "It revealed Dalton band 41.the immunoglobulin was 1." the reporter stated that the subject''s symptoms were probably related to Lymerix administration.

VAERS ID:190215 (history)  Vaccinated:2002-09-05
Age:59.0  Onset:2002-09-07, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2002-09-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5312C61IMLA
Administered by: Public     Purchased by: Private
Symptoms: Oedema peripheral, Pain, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: After initial dose, had subtle itching and hives which developed 2 weeks after dose and subsided .After 2nd dose, symptoms developed with in 48 hrs and required ER trip. Dx with reaction to vaccine and given Hydroxyzine 25 mg & Famotidine 20 mg on 09/09/2002, Saw pt 09/11/02, Hives persisting as well as swelling and pain in toes, fingers, Advised to defer further vaccine.

VAERS ID:190238 (history)  Vaccinated:2002-08-12
Age:59.0  Onset:2002-08-15, Days after vaccination: 3
Gender:Female  Submitted:2002-08-30, Days after onset: 15
Location:Arizona  Entered:2002-09-17, Days after submission: 18
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: NKA
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO526AA   
Administered by: Public     Purchased by: Public
Symptoms: Injection site reaction
SMQs:
Write-up: Significant local reaction reaction w/signs of infections several days after Td immunization, Rx with antibiotics.

VAERS ID:190241 (history)  Vaccinated:2002-08-29
Age:59.0  Onset:2002-09-01, Days after vaccination: 3
Gender:Male  Submitted:2002-09-06, Days after onset: 5
Location:Massachusetts  Entered:2002-09-17, 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: Diabetes
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0923L   
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Cellulitis at site requiring treatment

VAERS ID:190339 (history)  Vaccinated:2002-09-13
Age:59.0  Onset:2002-09-14, Days after vaccination: 1
Gender:Female  Submitted:2002-09-17, Days after onset: 3
Location:Alaska  Entered:2002-09-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: none
Preexisting Conditions: no known allergies, medical conditions
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO521AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Joint range of motion decreased, Oedema, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Received vaccine 9/13/02 L deltoid. 9/14 arm sore ; 9/15 swollen and sore shoulder to elbow, couldn''t move arm, went to ER, unsucessful attempt to drain possible abscess. 9/16: more pain, edema, erythema, febrile. Saw personal MD: IM rocephin and now on oral antibiotics and activity restriction x 6 days. 9/17: still red, sore, edema is decreasing, afebrile.

VAERS ID:190405 (history)  Vaccinated:2002-08-12
Age:59.0  Onset:2002-08-16, Days after vaccination: 4
Gender:Female  Submitted:2002-09-06, Days after onset: 21
Location:Unknown  Entered:2002-09-19, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD82   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site oedema, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 59 female received continued Td vaccination on 8/12/02. Next day noted pain/swelling at site. Seen four days later and found to have 10x10cm area of erythema and induration consistent with local reaction and cellulitis. Treated with po antibiotics.

VAERS ID:191008 (history)  Vaccinated:2002-09-18
Age:59.0  Onset:2002-09-20, Days after vaccination: 2
Gender:Female  Submitted:2002-10-02, Days after onset: 12
Location:Connecticut  Entered:2002-10-04, 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: Right middle finger laceration
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0745AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Large, localized reaction in left deltoid region with itching and redness.

VAERS ID:191575 (history)  Vaccinated:2002-09-24
Age:59.0  Onset:2002-09-26, Days after vaccination: 2
Gender:Female  Submitted:2002-10-17, Days after onset: 21
Location:Washington  Entered:2002-10-21, 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: Estrace, ASA, Synthyroid
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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DTAP: DTAP (TRIPEDIA)AVENTIS PASTEURU0816AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site inflammation, Injection site mass, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Very sore, inflamed red lump. Persistent several days.

VAERS ID:191642 (history)  Vaccinated:2002-10-16
Age:59.0  Onset:2002-10-16, Days after vaccination: 0
Gender:Female  Submitted:2002-10-21, Days after onset: 5
Location:California  Entered:2002-10-22, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium, Premarin, Thypoxine
Current Illness: NONE
Preexisting Conditions: Asthma as a child
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE30422GA   
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.O165M   
Administered by: Private     Purchased by: Private
Symptoms: Chills, Hyperhidrosis, Hypoaesthesia, Injection site oedema, Injection site pain, Injection site warmth, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Chills. Arm (left) continues to swell down to elbow and around inside arm-almost completely circles arm. Arm extremely sore to touch where swollen. Swollen area of arm very hot. Thurs. was freezing and by afternoon had the shakes. I was so cold, my hands were numb. Took bath to get warm. Took my temperature-it was 104. Had sweats. Missed work on 10/18/02.

VAERS ID:192079 (history)  Vaccinated:2002-10-17
Age:59.0  Onset:2002-10-17, Days after vaccination: 0
Gender:Female  Submitted:2002-10-22, Days after onset: 5
Location:Georga  Entered:2002-10-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0875AA  RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0111M  LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Significant redness, swelling and fever at injection site (left shoulder/arm).

VAERS ID:192104 (history)  Vaccinated:2002-10-21
Age:59.0  Onset:2002-10-22, Days after vaccination: 1
Gender:Female  Submitted:2002-10-22, Days after onset: 0
Location:Washington  Entered:2002-10-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ?
Current Illness:
Preexisting Conditions: Codeine, walnut, Wijonex, Loictab, asthma, R.A., chronic pain
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0358M IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 10/21/02-pt rec''d pneumococcal vaccine .5cc Rt arm IM approx 11am. SHe had the influenza vaccine week ago. 10/22/02 presented to office with tenderness and redness at injection site with fever of 100.9. Advised to go to hospital she refused. Dr started Keflex 500mg q 6 hrs x 10 days with f/u 10/25/02-fever gone, feeling be4tter, cont. Keflex.

VAERS ID:192265 (history)  Vaccinated:2002-10-28
Age:59.0  Onset:2002-10-29, Days after vaccination: 1
Gender:Female  Submitted:2002-10-30, Days after onset: 1
Location:Massachusetts  Entered:2002-10-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Anemia, depression
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Feeling hot, Pain
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt c/o redness and pain, hot to touch.

VAERS ID:192355 (history)  Vaccinated:2002-10-30
Age:59.0  Onset:2002-10-31, Days after vaccination: 1
Gender:Male  Submitted:2002-10-31, Days after onset: 0
Location:D.C.  Entered:2002-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor Prevacid Doxicyline Urocit-K
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN0IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Chills
SMQs:
Write-up: Time: 13 hours after administration of flu vaccine. Patient awoke 1 hour after going to sleep and experienced episode of extreme full-body shivering. Went on for about 1/2 to 1 hour or so and then subsided.

VAERS ID:192786 (history)  Vaccinated:2002-10-17
Age:59.0  Onset:2002-10-17, Days after vaccination: 0
Gender:Female  Submitted:2002-11-05, Days after onset: 19
Location:Ohio  Entered:2002-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown, had just completed antibiotic for URI, received flu shot sometime later that afternoon, but symptoms had started while was waiting in line.
Current Illness: Denies illness or fever
Preexisting Conditions: Denies allergy to medications contraindicated by pnemovax vaccine and denied problems with previous pneumonia shot given more than seven years previously.
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.F0376M1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Insomnia
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection given Left Deltoid without incident or complaint. Pt. left health department and traveled to Walmart where she received a flu shot in her Right Deltoid (this vaccine information is not available). Approximately 30 to 60 minutes later, the pt''s left arm began to hurt and became red at the injection site. The symptoms progressed to swelling, then the area became hard and warm to touch. Patient states she had difficulty sleeping that night because of the pain. Pt. also states the area had a "welt" like appearance at the injection site; denied respiratory difficulties. States that after two sleepless night, due to the arm discomfort, symptoms diminished. States by the third day, she has full functioning and mobility of the arm, denies any residual numbness or pain. This was the patient''s second shot, previous one was seven years prior, so it is not necessary for the injection to be repeated in the future. Patient did not see her physician for these complications.

VAERS ID:192726 (history)  Vaccinated:2002-10-28
Age:59.0  Onset:2002-10-28, Days after vaccination: 0
Gender:Female  Submitted:2002-10-29, Days after onset: 1
Location:California  Entered:2002-11-06, 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: Codeine & Sulta
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0875AA3IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Complain of arm hurting and sore red hot area approximately 4cm. Prescription for medrol dose. Use benedryl oral care.

VAERS ID:192955 (history)  Vaccinated:2002-10-28
Age:59.0  Onset:2002-10-28, Days after vaccination: 0
Gender:Male  Submitted:2002-11-04, Days after onset: 7
Location:Michigan  Entered:2002-11-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 0 LA
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Staring
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Dizziness, Fainting feeling, Could not focus eyes for 2-3 min

VAERS ID:193104 (history)  Vaccinated:2002-11-06
Age:59.0  Onset:2002-11-06, Days after vaccination: 0
Gender:Female  Submitted:2002-11-08, Days after onset: 2
Location:Ohio  Entered:2002-11-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid, Detrol, Macrobid, Le dose Antibiotic per QD
Current Illness: NONE
Preexisting Conditions: Hypertension
Diagnostic Lab Data: TB Mantoux C0833AA Lt Fa
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0925AA  RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0165M1 LA
Administered by: Public     Purchased by: Private
Symptoms: Feeling hot, 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: Pneumoccal vaccine given 11/06/2002. Within 5 mins site at right deltoid- throbbed, continued to hur that day. Arm swelled by that evening, 9-10 hours later, decrease pain and swelling on Thursday. Area of arm near elbow, front and back- red, warm, entire arm painful. Went to MD 11/08/2002

VAERS ID:193244 (history)  Vaccinated:2002-11-06
Age:59.0  Onset:2002-11-06, Days after vaccination: 0
Gender:Male  Submitted:2002-11-07, Days after onset: 1
Location:Ohio  Entered:2002-11-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0881AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Face oedema, Hypoaesthesia, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Received flu vacine 8A-215P developed numb lips, swollen lips and tough-scratchy throat-felt like it was closing. Rx ER steroids and antihistamines.

VAERS ID:193484 (history)  Vaccinated:2002-10-23
Age:59.0  Onset:2002-10-24, Days after vaccination: 1
Gender:Female  Submitted:2002-10-28, Days after onset: 4
Location:South Carolina  Entered:2002-11-19, 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: Substitue for Ogen, Atenolol, HcT2
Current Illness: NONE
Preexisting Conditions: increase blood pressure
Diagnostic Lab Data:
CDC 'Split Type': SC0250
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40200211 LA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0524AA  RA
Administered by: Public     Purchased by: Other
Symptoms: Feeling hot, Injection site erythema, Injection site induration, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received Td 10/23/2002. Next day pt noticed pain, redness, swelling right deltoid area that spread down right arm over next few days. Seen MD on 10/28/2002 to evaluate reaction. Right upper arm was warmer than left with redness and induration over middle 1/3 of upper arm. Had taken Benadyl.

VAERS ID:193804 (history)  Vaccinated:2002-10-12
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2002-11-16
Location:California  Entered:2002-11-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Chills, Injection site mass, Injection site oedema, Injection site warmth, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: About 30 minutes after injection, started getting sick to my stomach. By the evening, I felt real chilled and running low grade fever. My arm had a huge knot where the injection had been given. My arm swelled all around and real real hot. Temp in arm. Used cold compress arm was very painful. See my MD on 11/07/2002. Still had and still have a knot in arm. MD said a reaction to the vaccine. Arm still hurts.

VAERS ID:193817 (history)  Vaccinated:2002-11-11
Age:59.0  Onset:2002-11-12, Days after vaccination: 1
Gender:Female  Submitted:2002-11-18, Days after onset: 6
Location:Pennsylvania  Entered:2002-11-22, 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: Premarin, Atenalol
Current Illness: NONE
Preexisting Conditions: NKA-hypertension,Hypertriglyceremia
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO528AA0 RA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site erythema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Received dt on11/11/02 and within a few days she developed pain redness and pruritis in the right upper arm, she also developed a frontal HA. I prescribed Benadryl 50 mg PO QID for the Pruritis . Cool compresses and recheck in two days sooner if necessary.

VAERS ID:193931 (history)  Vaccinated:2002-11-21
Age:59.0  Onset:2002-11-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Indiana  Entered:2002-11-26
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: DM type II
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blindness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: Loss of vision in left eye-partial loss in Rt eye. Sight is blurry but not good. Has not seen Dr yet. Additional information: Unaware that pt had RxN. No on e by the name works here to have reported this.

VAERS ID:194115 (history)  Vaccinated:2002-10-03
Age:59.0  Onset:2002-10-04, Days after vaccination: 1
Gender:Female  Submitted:2002-10-08, Days after onset: 4
Location:Alaska  Entered:2002-11-27, Days after submission: 50
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: NKA
Diagnostic Lab Data:
CDC 'Split Type': AK200242
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO885AA1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1161L1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen,red area, size of grapefruit on left arm, fever, area was tight and red, saw FNP, dx sterile cellulitis, abx rxd, r/t fever, 5/8'' needle used for IM injections. I was notified by the pt about the Dr visit and the FNP has called

VAERS ID:194537 (history)  Vaccinated:0000-00-00
Age:59.0  Onset:0000-00-00
Gender:Female  Submitted:2002-11-27
Location:Utah  Entered:2002-12-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Childhood allergy to eggs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0953AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Developed area of redness, warm to touch, elevated area approximately 3 inch diameter. Referred to PCP for treatment.

VAERS ID:194543 (history)  Vaccinated:2002-11-22
Age:59.0  Onset:2002-11-22, Days after vaccination: 0
Gender:Female  Submitted:2002-11-25, Days after onset: 3
Location:Illinois  Entered:2002-12-04, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0955M IMLA
Administered by: Private     Purchased by: Public
Symptoms: Anxiety, Cough, Dizziness, Hyperhidrosis, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: 10 minutes after injection was admin. pt c/o lightheadedness, throat scratchy and kind of closing up. cough, diaphoresis, alert anxious. Pt was given a nebulizer. Treatment place on O2 and called 911 and taken to ER. Follow up; pt recovered.

VAERS ID:194655 (history)  Vaccinated:2002-11-08
Age:59.0  Onset:2002-11-14, Days after vaccination: 6
Gender:Female  Submitted:2002-12-01, Days after onset: 17
Location:Kentucky  Entered:2002-12-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cardizen, Premarin, ASA, Prilosec, Zoloft, Xanax, Pepcid, Sleeping Pill, Prednisone
Current Illness: Lupus
Preexisting Conditions: PCN, Tetracycline, Latex
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0886AA0 LA
Administered by: Public     Purchased by: Public
Symptoms: Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Patient called 1 week after receiving injection, started experiencing pain and tingling in left arm, lower back and left hip and leg. Received steroid Rx from physician and symptoms are still persisting at this time.

VAERS ID:194894 (history)  Vaccinated:2002-11-13
Age:59.0  Onset:2002-11-14, Days after vaccination: 1
Gender:Female  Submitted:2002-11-19, Days after onset: 5
Location:Massachusetts  Entered:2002-12-12, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Augmentin, Claritin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': MA0207
Vaccination
Manufacturer
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Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES0358M0 LA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Joint range of motion decreased
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: 11/14/02 pt c/o upper pain, upper edema, limited ROm to L arm after receiving pneumonia vaccination 11/13/02. Pt advised to call MD apply warm clothes to affected area and elevate extremity. 11/15/02 pt now c/o redness to area. She saw MD 11/15/02 and wasput on Cepro.

VAERS ID:194988 (history)  Vaccinated:2002-11-18
Age:59.0  Onset:2002-11-18, Days after vaccination: 0
Gender:Female  Submitted:2002-11-26, Days after onset: 8
Location:Wisconsin  Entered:2002-12-16, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergy to bee and wasp stings
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE31902HA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Myalgia, Oedema
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: 11/18/02 Employee received flu shot and had an adverse reaction 1 hour later. She returned to the flu clinic "complained of swelling, intense aching of left arm where flu shot was administered. Employee sent to occupational health services and seen by RN who sent employee to ER for further treatment. No SOB or respiratory problems were present. Area was ? free of redness or firmness. Sent home after treated without further problems.

VAERS ID:195771 (history)  Vaccinated:2002-11-25
Age:59.0  Onset:2002-11-26, Days after vaccination: 1
Gender:Female  Submitted:2002-12-27, Days after onset: 31
Location:Massachusetts  Entered:2003-01-06, 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: Fosamax 70mg weekly, Paxil 30mg po qd
Current Illness:
Preexisting Conditions: Wellbutrin, depression
Diagnostic Lab Data: WBC 34,300; 80 polys, 10 bands
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0932DA  LA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Cellulitis, Chills, Injection site induration, Injection site oedema, Injection site pain, Nausea, Pain, Pyrexia, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain swelling induration at injection site diagnosed as cellultiis. Negative blood cultures temp 100 deg-101.8 deg F. Clinically toxic. Treated with IV Kefzol. Discharged on Augmentin. The discharge summary states chills, anorexia, nausea, and pain.

VAERS ID:196026 (history)  Vaccinated:2002-10-25
Age:59.0  Onset:2002-10-25, Days after vaccination: 0
Gender:Female  Submitted:2003-01-02, Days after onset: 69
Location:Tennessee  Entered:2003-01-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium; Xanax; Aspirin Free/ Excedrin
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: EMG, Neuropahty Paripheral
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0910AA  LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0735M0 RA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: 10/25/02 Date of vaccine: loss of feeling in right arm all the way to right hand; loss of feeling in left hand 2 days later; Increased anxieties. (No treatment by that physician.) Ongoing loss of feeling. The follow up states "my right arm continues to ache and have loss of feeling as well as my left hand and the back of my right leg and the balls of my feet are sensitive and ach. This is not getting any better 1/22/03.

VAERS ID:196100 (history)  Vaccinated:2002-11-07
Age:59.0  Onset:2002-11-07, Days after vaccination: 0
Gender:Female  Submitted:2003-01-11, Days after onset: 65
Location:Oklahoma  Entered:2003-01-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None A pain medication (Darvocet) was prescribed when I visited my doctor to help me sleep at night. However, I was not on any medication when I received the shot.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER90658/VO4.91IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Haematoma, Insomnia, Movement disorder, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Shot was quite painful and swelling was within 30 minutes. Swelling continued until a large area in the muscle developed. After approximately 2 weeks, my arm was nearly paralyzed. I couldn''t lift it away from my body. It continued to worsen. I couldn''t sleep at night because of the severe pain. I finally went to my doctor and he thought it might be a hemmatoma. However, an ultra sound test did not confirm that. I am presently in physical therapy to regain use of my arm. The swelling is still there, but it has subsided. I still experience pain and have a prescription that I find it necessary to use at night. I did report this to the VNA

VAERS ID:196345 (history)  Vaccinated:2002-10-14
Age:59.0  Onset:2002-10-15, Days after vaccination: 1
Gender:Male  Submitted:2003-01-16, Days after onset: 93
Location:New Jersey  Entered:2003-01-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020023 IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0819M IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain and swelling in the left arm for 5 days. He did yard work after episode.

VAERS ID:196501 (history)  Vaccinated:2002-12-04
Age:59.0  Onset:2002-12-04, Days after vaccination: 0
Gender:Male  Submitted:2003-01-10, Days after onset: 37
Location:Utah  Entered:2003-01-21, 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: Vitamins
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0981AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0955M0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Anaphylactic reaction, Fatigue, Injection site pain, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Noon shot; went back to work. Arm was sore and I was tired. Went home and went to bed. Had fever and shakes the next morning at 09:00. Went to doctor''s office and fever was 104F but shakes had stopped. Benadryl, Celebrex and Bextra given by doctor. Pt improved. DX: Anaphylactic/allergy to either Pneumonia or Infanrix.

VAERS ID:196804 (history)  Vaccinated:2000-07-21
Age:59.0  Onset:2000-09-13, Days after vaccination: 54
Gender:Female  Submitted:2002-12-05, Days after onset: 813
Location:Pennsylvania  Entered:2003-01-27, Days after submission: 53
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins; calcium
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood work-neg; EKG-nml; CXR, UA, arm and thumb X-ray, Sed Rate-48; all normal
CDC 'Split Type':
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALSLY128A22IMRA
Administered by: Private     Purchased by: Private
Symptoms: Haemoglobin decreased, Oedema peripheral, Polyarthritis, Red blood cell abnormality
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: Swollen ankles. Went to MD and received phone call from office saying I was to report to ER. Red blood count was 6.2 at ER. Found HGB to be 5.9. Received 4 pints of blood and severe arthritis on right thumb and left elbow.

VAERS ID:197157 (history)  Vaccinated:2002-12-30
Age:59.0  Onset:2002-12-31, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:Unknown  Entered:2003-02-04
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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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0922AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Local area erythematous, warm to the touch.

VAERS ID:197412 (history)  Vaccinated:2002-10-21
Age:59.0  Onset:2002-10-21, Days after vaccination: 0
Gender:Female  Submitted:2003-01-28, Days after onset: 99
Location:South Carolina  Entered:2003-02-07, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: MRI-neg, labs-neg.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0908AA7IMLA
Administered by: Military     Purchased by: Other
Symptoms: Injection site pain, Joint range of motion decreased, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: C/O L arm pain post flu shot. C/O decreased ROM and pain into shoulder and neck. Took Advil without relief. Refused Medrol dose pack. Referred to neurologist. Ordered Mobic and MRI, labs. Never had MRI. Thinks shot was given "too high."

VAERS ID:197862 (history)  Vaccinated:2002-10-14
Age:59.0  Onset:2002-10-15, Days after vaccination: 1
Gender:Female  Submitted:2003-02-05, Days after onset: 113
Location:Washington  Entered:2003-02-19, 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: Metoprolol, hctz, zestril
Current Illness: NONE
Preexisting Conditions: Hyzaar-rash, Tiazac - red face; HBP
Diagnostic Lab Data: N/A
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0883AA IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: More pain than usual at inject site. Persistent pain 3.5 mts later. Site looks ok. No abnormality palpable.

VAERS ID:198237 (history)  Vaccinated:2002-11-06
Age:59.0  Onset:2002-11-12, Days after vaccination: 6
Gender:Female  Submitted:2003-01-06, Days after onset: 55
Location:South Carolina  Entered:2003-02-25, Days after submission: 50
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': SC0270
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0935AA3 RA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0820AA0 LA
Administered by: Public     Purchased by: Public
Symptoms: Contusion, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: PT received flu and Td vaccines on 11/6/02. Had pain x 6 days. Return to HD on 11/12/02. Swelling and bruising noted on left arm (had Td in left arm, flu in right arm) and pain. To MD on 1/6/03, light swelling and bruising gone but still having pain. To be treated with anti inflammatory x 2 wks and return to PMD in 2 wks.

VAERS ID:198978 (history)  Vaccinated:2003-02-26
Age:59.0  Onset:2003-03-02, Days after vaccination: 4
Gender:Female  Submitted:2003-03-06, Days after onset: 4
Location:Florida  Entered:2003-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Increased WBC dilantin phenobaiblev-is off
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH402007  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Decreased appetite, Pain, Pyrexia, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: By day 3 reports of chills, fever, aches, decreased appetite-saw MD 3/3 off work 3/4-3/6, hospitalized 3/6? RO rash.

VAERS ID:199284 (history)  Vaccinated:2003-03-22
Age:59.0  Onset:2003-03-28, Days after vaccination: 6
Gender:Male  Submitted:2003-03-04, Days after onset: 24
Location:Unknown  Entered:2003-03-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Resolve Acute Viral Labyrinthitis
Diagnostic Lab Data: NONE
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020071/8022361  LA
Administered by: Other     Purchased by: Private
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 6 days post vaccination, pt presented to clinic with scattered rash on lower legs. Relates rash is pruritic but not exudative. Pt given Allegra 180mg every day.

VAERS ID:199396 (history)  Vaccinated:2002-08-07
Age:59.0  Onset:2002-08-08, Days after vaccination: 1
Gender:Male  Submitted:2003-02-27, Days after onset: 203
Location:New Jersey  Entered:2003-03-12, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension
Diagnostic Lab Data: UNK
CDC 'Split Type': A0377268A
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS720841  
Administered by: Other     Purchased by: Other
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Report A0377268A describes the occurrence of "feeling crummy" in a 59 year old male who received hep A vaccine. This report was received from a nurse. The vaccinee''s relevant concurrent condition included hypertension. The vaccinee''s concomitant medications include Avapro. On 8/7/02, the vaccinee received the second injection of Havrix. Later that same day, the vaccinee developed a fever of 101.5 deg. and he reportedly "feels crummy." Reporter stated that the vaccinee apparently was already starting to feel bad before his Havrix injection, but didn''t tell anyone. Therefore, the reporter is not sure if the vaccinee had a reaction to the vaccine or was just getting sick. No adverse event was reported following the first Havrix injection, therefore, she noted the events could possibly be related to Havrix. The most recent info received on 8/8/02 reports the events to be unresolved; it is unknown if the Havrix immunization series will continue.

VAERS ID:199428 (history)  Vaccinated:2003-03-07
Age:59.0  Onset:2003-03-10, Days after vaccination: 3
Gender:Female  Submitted:2003-03-12, Days after onset: 2
Location:Texas  Entered:2003-03-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ??? Advair, Skelaxin
Current Illness: NONE
Preexisting Conditions: PCN
Diagnostic Lab Data: Biopsy
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Erythema multiforme - appeared 3 days post smallpox vax on forearm of vax''d arm. Prescribed steroid creme.

VAERS ID:199696 (history)  Vaccinated:2003-01-16
Age:59.0  Onset:2003-01-22, Days after vaccination: 6
Gender:Male  Submitted:2003-03-07, Days after onset: 44
Location:Ohio  Entered:2003-03-17, 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: Concurrent medications were not specified, NKDA
Current Illness:
Preexisting Conditions: Hypercholesterolemia; nephrolithiasis
Diagnostic Lab Data: Liver function test- elevated
CDC 'Split Type': A0395709A
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS  IM 
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR  SC 
Administered by: Public     Purchased by: Other
Symptoms: Chromaturia, Hepatitis, Jaundice, Lethargy, Liver function test abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Hepatitis, non-infectious (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: It was reported a occurrence of elevated liver enzymes in a pt who was vaccinated with hepatitis A inactivated and hepatitis B recombinant vaccine (Twinrix) for prophylaxis. There were no known allergies. On 1/16/03, the pt rec''d an injection of Twinrix; the number of previous injections of Twinrix was not specified. On the same day, the subject also rec''d typhoid vaccine (manufacturer unknown) and yellow fever vaccine (YF-Vax, Aventis Pasteur). On 1/22/03 6 days post immunization, the subject developed elevated liver enzyme (NOS), jaundice, lethargy, and dark urine. The pt was seen by his physician. As of 2/6/03, the events had improved. The reporter considered the events to be possibly related to Twinrix administration. The jaundice in this report is considered GSK medically serious. Follow-up information received on 5/14/2003 states: On ? January 2003, concentrations of alkaline phosphate, total and direct bilirubin, asparte amniotransferase, ?alanin aminotransferase were found to be increased. Please see laboratory data section. The physician made a diagnosis of chemical hepatitis. The physcian considered made diagnosis of chemical hepatitis. The physician considered the chemical hepatitis to be related to Twinrix administration. The chemical hepatitis resolved on 27 March 2003. Hepatitis is considered medically serious (OMIC).

VAERS ID:199972 (history)  Vaccinated:2003-03-10
Age:59.0  Onset:2003-03-18, Days after vaccination: 8
Gender:Female  Submitted:2003-03-14, Days after onset: 4
Location:Maryland  Entered:2003-03-20, 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: Synthroid, Effexor, ASA,Cytomel, Elavil
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771SCLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site reaction, Lymphangitis
SMQs:
Write-up: Cellulitis around injection site (vaccinia vaccine) with lymphangitis and tender L axillary L arm scant drainage from vaccination site. Treated with Z-pack.

VAERS ID:200071 (history)  Vaccinated:2003-02-27
Age:59.0  Onset:2003-03-08, Days after vaccination: 9
Gender:Female  Submitted:2003-03-12, Days after onset: 4
Location:California  Entered:2003-03-24, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fosamax, Vioxx
Current Illness: NONE
Preexisting Conditions: Arthritis, osteoporosis
Diagnostic Lab Data:
CDC 'Split Type':
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 3/12/03. Pt reports headweak, ? by phone (works at clinic). "Feels like back of head will lift off." T 98.5, no relief with any Advil 2-3x ? contacted MD by phone. 3/13/03 con''t to have headache. 3/14 headache, going to md.

VAERS ID:200289 (history)  Vaccinated:2003-03-17
Age:59.0  Onset:2003-03-18, Days after vaccination: 1
Gender:Female  Submitted:2003-03-19, Days after onset: 1
Location:New York  Entered:2003-03-26, 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: Pravachol Protonix; Celebrex; methotrexate
Current Illness: NONE
Preexisting Conditions: Rheumatoid arthritis; hyperlipidemia; reflux; diverticulitis
Diagnostic Lab Data: NONE
CDC 'Split Type':