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Case Details (Sorted by Age)

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VAERS ID:120707 (history)  Vaccinated:1998-07-27
Age:58.2  Onset:1998-07-27, Days after vaccination: 0
Gender:Female  Submitted:1998-08-17, Days after onset: 21
Location:Nebraska  Entered:1999-03-29, Days after submission: 224
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': U199800473
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0944780   
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt recv vax on 7/27/98; on same day pt exp pain at vax site

VAERS ID:121022 (history)  Vaccinated:1998-10-01
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:1999-03-31
Location:Maryland  Entered:1999-04-08, 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: asthma;hay fever;
Diagnostic Lab Data: lyme test negative; ANA positive;
CDC 'Split Type': MPI982053
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.    
Administered by: Other     Purchased by: Other
Symptoms: Antinuclear antibody, Arthritis, Hypokinesia, Systemic lupus erythematosus
SMQs:, Systemic lupus erythematosus (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: pt recv vax & w/in 5 days pt devel arthritic pain in hands, hips & knees;consulted MD;Ibuprofen prescribed which provided only mild relief;treating MD to r/o Lupus;pt states arthritis sx worsening, having difficulty walking & writing

VAERS ID:121154 (history)  Vaccinated:1999-03-22
Age:58.2  Onset:1999-03-23, Days after vaccination: 1
Gender:Female  Submitted:1999-03-24, Days after onset: 1
Location:Mississippi  Entered:1999-04-12, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, Trival, Citracel, Premarin, KCL, Prilosec
Current Illness: NONE
Preexisting Conditions: Allergic to Penicillin, Sulfa
Diagnostic Lab Data: NONE
CDC 'Split Type': MS99015
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR I)MERCK & CO. INC.0957H0 LA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES0967100  RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Myalgia, Pruritus
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 (narrow)
Write-up: Pt recv vax on 3/22/99; on 3/23/99 pt exp swollen/ red/ knot/ itching/ pain at rt arm vax site

VAERS ID:121266 (history)  Vaccinated:1999-03-02
Age:58.6  Onset:0000-00-00
Gender:Female  Submitted:1999-04-07
Location:New York  Entered:1999-04-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD by Connaught lot# 246611 given 2MAR99
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: inc sed rate 60;inc platelets 423;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A20IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal pain, Nausea, Pain, Pyrexia, Red blood cell sedimentation rate increased, Thrombocythaemia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: immed p/vax x 6d tender skin, x 4d fever to 101.4, x6d nausea & severe abd pain;25d p/vax 4d fever 100.7 on & off, severe stomachache;

VAERS ID:121336 (history)  Vaccinated:1999-03-01
Age:58.4  Onset:1999-03-02, Days after vaccination: 1
Gender:Female  Submitted:1999-03-03, Days after onset: 1
Location:Tennessee  Entered:1999-04-20, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Pempro
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type': TN99005
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1542E0IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES09705203IMLA
Administered by: Public     Purchased by: Other
Symptoms: Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt recv vax on 3/1/99; on 3/2/99 pt exp LA pain at vax site, headache, nausea; tx=Esoteric, ice

VAERS ID:121731 (history)  Vaccinated:1998-07-06
Age:58.0  Onset:1998-07-09, Days after vaccination: 3
Gender:Female  Submitted:1998-08-07, Days after onset: 29
Location:Pennsylvania  Entered:1999-04-26, Days after submission: 262
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetylsalicylic acid
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 14JUL98 hepatitis A antibody positive;hepatitis C antibody screen 83;hepatitis A IGM-antibody positive;
CDC 'Split Type': 19980202591
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM548A40IMRA
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0PO 
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hepatic function abnormal, Infection, Jaundice, Malaise, Pruritus, Pyrexia, Urine analysis abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Hypersensitivity (broad)
Write-up: pt recv vax 6JUL98 & 9JUL98 pt seen in medical center feeling malaise w/tea-colored urine;14JUL98 sclera were yellow & was itching all over;had fever;15JUL98 hep a dx positive IGM;elevate liver enzymes;positive hep A antibody

VAERS ID:121791 (history)  Vaccinated:1999-04-05
Age:58.6  Onset:1999-04-16, Days after vaccination: 11
Gender:Female  Submitted:1999-04-26, Days after onset: 10
Location:Wisconsin  Entered:1999-04-30, 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: Premarin
Current Illness: NONE
Preexisting Conditions: Hay fever, heart related problems
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1359HH0SCLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Arthropathy, Osteoarthritis
SMQs:, Arthritis (broad)
Write-up: Pt recv vax on 4/5/99; on 4/16/99 pt exp joint swelling/ pain; 4/18/99 pt rt hand frozen stiff, pain behind lt knee &ankles; tx=Ibuprofen

VAERS ID:122343 (history)  Vaccinated:1998-07-24
Age:58.4  Onset:1998-07-31, Days after vaccination: 7
Gender:Female  Submitted:1998-07-31, Days after onset: 0
Location:Texas  Entered:1999-05-21, Days after submission: 294
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: premarin 0.9mg synthroid
Current Illness: none
Preexisting Conditions: last dose tetanus toxiod was administered 10 yrs ago
Diagnostic Lab Data:
CDC 'Split Type': 898215066A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES454678 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax, 7 days later devel inject site react by a 10-cm area of induration, warmth, rash & swelling. pt was seen by md

VAERS ID:122364 (history)  Vaccinated:1999-01-12
Age:58.0  Onset:1999-01-12, Days after vaccination: 0
Gender:Female  Submitted:1999-01-28, Days after onset: 16
Location:Pennsylvania  Entered:1999-05-21, Days after submission: 112
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: unknown
Other Medications: none
Current Illness: flu-like symptoms
Preexisting Conditions: allergic to demerol (agitation) & bee & wasp stings (anaphylactic shock)
Diagnostic Lab Data: unknown
CDC 'Split Type': 899029129A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES457829  LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt exp vax near underarm & within hours developed swelling & induration at inject site, extended from shoulder to elbow. then developed blister surrounded by rash, area painful & nodule size of quarter. tylenol no relief

VAERS ID:124882 (history)  Vaccinated:1998-10-26
Age:58.0  Onset:1998-10-27, Days after vaccination: 1
Gender:Female  Submitted:1999-05-27, Days after onset: 211
Location:Georga  Entered:1999-06-07, 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: premarin, conjugated, provera, medroxyprogesterone, synthroid, levothyroxine sodium tenormin, atenolol
Current Illness:
Preexisting Conditions: allergies: codiene & ceclor
Diagnostic Lab Data: none rpt
CDC 'Split Type': MPI981971
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.20218HB IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: the day following vax pt described react event size of silver dollar getting redness slightly itchy & tender & heavy, but not painful, on left arm inject site.

VAERS ID:125243 (history)  Vaccinated:1998-08-10
Age:58.5  Onset:1998-09-15, Days after vaccination: 36
Gender:Female  Submitted:0000-00-00
Location:Tennessee  Entered:1999-06-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp joint & muscle problems, walking problem, fatigue w/hep b #1;
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Unknown
Symptoms: Arthropathy, Asthenia, Hypokinesia, Myalgia, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: joint & muscle problems-serious to point had problem walking, normal function;much fatigue;seemed to accrue more p/2nd shot;

VAERS ID:125311 (history)  Vaccinated:1999-03-26
Age:58.7  Onset:1999-03-26, Days after vaccination: 0
Gender:Male  Submitted:1999-06-28, Days after onset: 93
Location:Massachusetts  Entered:1999-07-01, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp arthritic responsew/lymerix dose 2
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: arthritic response to lyme vax which has persisted since 2nd inj;mild rxn 2/26/99 2nd dose 3/26/99 severe did not recv 3rd dose of vax;

VAERS ID:126261 (history)  Vaccinated:1999-07-07
Age:58.7  Onset:1999-07-08, Days after vaccination: 1
Gender:Female  Submitted:1999-07-13, Days after onset: 5
Location:Iowa  Entered:1999-07-22, 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, multi vit.
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7258BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site hypersensitivity, Injection site oedema, Injection site pain, Nausea, Pyrexia, Vasodilatation
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), Hypersensitivity (narrow)
Write-up: day p/vax pt arm became very red, painful, swollen, warm, pt had low grade fever, nausea, headache. use ice pack, hydrocortisone cream, tylenol.

VAERS ID:126559 (history)  Vaccinated:1999-03-02
Age:58.6  Onset:1999-03-02, Days after vaccination: 0
Gender:Female  Submitted:1999-04-26, Days after onset: 54
Location:New York  Entered:1999-07-30, Days after submission: 95
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD, conn, #246611, rt arm, 0 prev doses
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: plate-423; sed rate elevat-60
CDC 'Split Type': 1999009356
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A20IMLA
Administered by: Public     Purchased by: Other
Symptoms: Abdominal pain, Hyperaesthesia, Nausea, Pain, Pyrexia, Red blood cell sedimentation rate increased, Thrombocythaemia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: p/vax pt exp tender skin; T101.4; nausea; severe abdominal pain; elevated sed rate & elevated platelets; symptoms lasted 6 days; 25day later pt exp T100.7 & severe stomach ache;

VAERS ID:126637 (history)  Vaccinated:1999-03-17
Age:58.0  Onset:1999-05-01, Days after vaccination: 45
Gender:Male  Submitted:1999-05-20, Days after onset: 19
Location:New Jersey  Entered:1999-07-30, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type': 1999011383
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1  
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: p/vax pt exp muscle/joint pain in elbows;no tx given;pt has not recovered yet;

VAERS ID:127075 (history)  Vaccinated:1999-07-24
Age:58.4  Onset:1999-07-24, Days after vaccination: 0
Gender:Male  Submitted:1999-08-02, Days after onset: 9
Location:Delaware  Entered:1999-08-10, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: lethargic, ringing in ears, rt shoulder pain Anthrax#1
Other Medications: Beta-optic, Mevacor
Current Illness: NONE
Preexisting Conditions: hyperlipidemia
Diagnostic Lab Data: CBC, sed rate, CPK, RF, RA, ANA, LFS
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0411 RA
Administered by: Military     Purchased by: Military
Symptoms: Adverse drug reaction, Headache, Pain, Similar reaction on previous exposure to drug, Somnolence, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (narrow)
Write-up: 7/24/99 extremely lethargic, cont ringing in both ears, entire rt arm hurts like toothache from wrist to axis;h/a & dizziness;

VAERS ID:128721 (history)  Vaccinated:1999-09-13
Age:58.6  Onset:1999-09-18, Days after vaccination: 5
Gender:Female  Submitted:1999-09-22, Days after onset: 4
Location:California  Entered:1999-09-28, Days after submission: 6
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: NKDA
Diagnostic Lab Data:
CDC 'Split Type': CA990105
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0010AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site reaction, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax pt c/o redness, swollen, tolerable pain; skin warm to touch site itchy;self treated;afeb;seen by MD 12cm red, center clearing tenderness;dx delayed localized rxn;tx Ibuprofen & cold compress;

VAERS ID:128870 (history)  Vaccinated:1999-09-16
Age:58.9  Onset:1999-09-22, Days after vaccination: 6
Gender:Female  Submitted:1999-09-24, Days after onset: 2
Location:Maryland  Entered:1999-10-04, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC w/diff, ESR (results pending)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)LEDERLE LABORATORIES4614250IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pruritus, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: p/vax pt devel 50mm area of erythema, warm & itchy @ site of inj lt deltoid;no fever or discharge;tx w/duracef & allegra;another area has devel approx 3.5 x 8cm;

VAERS ID:128912 (history)  Vaccinated:1999-08-08
Age:58.0  Onset:1999-08-08, Days after vaccination: 0
Gender:Male  Submitted:1999-08-31, Days after onset: 23
Location:Tennessee  Entered:1999-10-05, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0432SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain, Pruritus, Skin nodule
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: pt c/o bumps on lt side, initially painful when pressure applied;sl itchy;bumps noticed late same day recv vax;shot given in rt arm;symptoms abated after 6 wks.

VAERS ID:129190 (history)  Vaccinated:1999-10-05
Age:58.9  Onset:1999-10-05, Days after vaccination: 0
Gender:Male  Submitted:1999-10-05, Days after onset: 0
Location:North Carolina  Entered:1999-10-12, 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: ASA, alenolol;DPH
Current Illness: NONE
Preexisting Conditions: HTN, several TIA''s
Diagnostic Lab Data: pulse oximetry-nl;
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998228 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dysphagia, Laryngospasm
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dystonia (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: c/o throat feeling tight w/choking sensation;no wheezing or SOB, no hives;MD notified pt to ER;MD does not feel it was rxn to flu shot;took DPH as area red;pt doing well;

VAERS ID:129550 (history)  Vaccinated:1999-10-11
Age:58.8  Onset:1999-10-11, Days after vaccination: 0
Gender:Female  Submitted:1999-10-15, Days after onset: 4
Location:Michigan  Entered:1999-10-19, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONe
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02979P IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: p/vax pt devel welt @ site, size of quarter;then pt devel a red 2" x 1"-warm & hard lump;

VAERS ID:129940 (history)  Vaccinated:1999-10-16
Age:58.1  Onset:1999-10-17, Days after vaccination: 1
Gender:Female  Submitted:1999-10-18, Days after onset: 1
Location:California  Entered:1999-10-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0144AA0IMA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Injection site hypersensitivity, Injection site mass, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: woke @ 2AM to acute shoulder pain @ site of inj;discovered indurated area @ site of inj w/erythema;extremely hot to touch & deep pain;(induration seemed to proceed downward into tissue burning hot;fever;

VAERS ID:130005 (history)  Vaccinated:1999-10-22
Age:58.4  Onset:1999-10-23, Days after vaccination: 1
Gender:Female  Submitted:1999-10-25, Days after onset: 2
Location:California  Entered:1999-10-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: local 60mm induration
Preexisting Conditions: similar rxn to estrogen inj;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E33609KA1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: p/vax pt noticed tenderness & redness @ site;pt to employee hlth w/60mm induration, cool to touch;sent for eval by MD;

VAERS ID:130051 (history)  Vaccinated:1999-10-18
Age:58.1  Onset:1999-10-19, Days after vaccination: 1
Gender:Male  Submitted:1999-10-25, Days after onset: 6
Location:Michigan  Entered:1999-10-29, 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: Lopid;Flovent-allegra
Current Illness: NONE
Preexisting Conditions: timothy hay;asthma;high cholesterol
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER4998231   
Administered by: Other     Purchased by: Other
Symptoms: Ageusia, Dysphonia, Lung disorder, Lymphadenopathy, Parosmia, Rhinitis
SMQs:, Taste and smell disorders (narrow), Parkinson-like events (broad)
Write-up: extreme hoarseness;loss of taste;loss of smell;pain armpit lt arm;nasal & chest congestion;

VAERS ID:130119 (history)  Vaccinated:1999-10-21
Age:58.1  Onset:0000-00-00
Gender:Female  Submitted:1999-10-26
Location:Minnesota  Entered:1999-11-01, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES462361  LA
Administered by: Private     Purchased by: Unknown
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: local rxn w/itching & swelling;no fever;

VAERS ID:130128 (history)  Vaccinated:1999-10-06
Age:58.2  Onset:1999-10-17, Days after vaccination: 11
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1999-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': CA990119
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982161  
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Back pain, Chills, Hypertonia, Injection site hypersensitivity, Injection site pain, Myalgia, Nausea, Pyrexia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: p/vax pt achy, bones & muscles (in back, across shoulders & middle) cramp, cold chills, nausea, T101-102;nothing to eat x 2 days;arm inj site very sore 7 warm to touch;advil did not completely relieve sx;will see PMD if sx are not better;

VAERS ID:130216 (history)  Vaccinated:1999-10-14
Age:58.9  Onset:1999-10-18, Days after vaccination: 4
Gender:Female  Submitted:1999-10-26, Days after onset: 8
Location:Massachusetts  Entered:1999-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn in 1962 w/flu vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982212 RA
Administered by: Other     Purchased by: Private
Symptoms: Adverse drug reaction, Diarrhoea, Lymphadenopathy, Malaise, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: p/vax pt called in sick to work c/o rxn to flu shot;c/o lump in rt arm pit (?swollen gland) & uncontrollable nausea, vomiting & diarrhea which suddenly began on morning of 10/18/99;told to call MD;

VAERS ID:130220 (history)  Vaccinated:1999-11-01
Age:58.1  Onset:1999-11-01, Days after vaccination: 0
Gender:Female  Submitted:1999-11-02, Days after onset: 1
Location:California  Entered:1999-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Verpamil;Premarin;Maxide;Ibuprofen;
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998230 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: area w/generalized swelling w/some tenderness;not red, not hot;it taking Ibuprofen;declines medical eval;hx of some erythema p/PPD;

VAERS ID:130286 (history)  Vaccinated:1999-10-19
Age:58.2  Onset:1999-10-20, Days after vaccination: 1
Gender:Female  Submitted:1999-10-26, Days after onset: 6
Location:Illinois  Entered:1999-11-04, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Inderal, Hydrodiuril, Tagamet, claritan, entex, becanese
Current Illness: NONE
Preexisting Conditions: allergy to preservative used in allergy shots 10 year ago;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4561280IMRA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Injection site hypersensitivity, Injection site mass, Myalgia, Pyrexia, Skin striae, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: p/vax pt had a h/a, felt achy & had a fever;pt had a 3 3/5 inch red horizontal line 1 inch below inj site w/ 3 hive like dots;egg shaped, swollen, reddened & tender area bout 2.5in wide by 1.5 inch long about 3-4 inch below inj site;

VAERS ID:130831 (history)  Vaccinated:1999-11-02
Age:58.6  Onset:1999-11-02, Days after vaccination: 0
Gender:Female  Submitted:1999-11-10, Days after onset: 8
Location:Georga  Entered:1999-11-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt grandchild exp sx w/DTP;
Other Medications: synthroid
Current Illness: NONE
Preexisting Conditions: fibormyalgia, chronic fatigue, spinal stenosis;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Hallucination, Myalgia, Pain, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: p/vax pt began to feel nauseated 7 heaved 20min, chills, fever, vomit, diarrhea, aches, pain, hallucinations, T103;spoke to MD by phone;

VAERS ID:130973 (history)  Vaccinated:1999-10-13
Age:58.4  Onset:1999-10-13, Days after vaccination: 0
Gender:Male  Submitted:1999-11-11, Days after onset: 29
Location:California  Entered:1999-11-22, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Prilosec, Verpamil
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': FL72041199
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS03179P0 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1339H0 LA
Administered by: Private     Purchased by: Other
Symptoms: Anorexia, Asthenia, Headache, Malaise, Myasthenic syndrome, Nervousness, Oedema peripheral, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: lt arm swelled 2 times nl size-heaviness, restless during noc, fever, h/a, all over lousy feeling, loss of appetite & very painful lt arm;Md arm still quit swollen & weak & not nl self;

VAERS ID:130988 (history)  Vaccinated:1999-11-02
Age:58.0  Onset:1999-11-02, Days after vaccination: 0
Gender:Female  Submitted:1999-11-02, Days after onset: 0
Location:Tennessee  Entered:1999-11-22, 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: codeine
Diagnostic Lab Data:
CDC 'Split Type': TN99045
Vaccination
Manufacturer
Lot
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2935A40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: p/vax pt fainted;aroused;fainted again;transported to ER told by MD episode d/t HBV;

VAERS ID:130996 (history)  Vaccinated:1999-09-14
Age:58.2  Onset:1999-09-14, Days after vaccination: 0
Gender:Female  Submitted:1999-11-19, Days after onset: 66
Location:Michigan  Entered:1999-11-22, 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: Premarin
Current Illness: NONE
Preexisting Conditions: allergies: mold, citirus, scallops, dust & cust mites;
Diagnostic Lab Data: scratch tested
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2711A40 RA
Administered by: Private     Purchased by: Private
Symptoms: Laryngospasm, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Hypersensitivity (narrow)
Write-up: itching of hands & feet-5hr p/vax;hives, throat swelling 12hr p/vax;medrol dose pack & DPH given;pred burst given;sx cleared p/5 days;

VAERS ID:131058 (history)  Vaccinated:1999-09-22
Age:58.0  Onset:1999-09-27, Days after vaccination: 5
Gender:Female  Submitted:1999-09-30, Days after onset: 3
Location:Colorado  Entered:1999-11-23, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol, Progesterone, OHEA, Pamelo, Ibuprofen, Gucifenesin, synthroid & numerous herbs (Ginko, dandeion root, milk thistle, ect)
Current Illness: hep c, hypothyroid;
Preexisting Conditions: hep C, hypothyroidism, mult chem sensitivities & post traumatic stress disorder;
Diagnostic Lab Data: CBC, thyroid, liver function <11 normal
CDC 'Split Type':
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HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM615A41IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Agitation, Anorexia, Asthenia, Dizziness, Headache, Injection site hypersensitivity, Injection site pain, Lymphadenopathy, Myalgia, Nausea, Rhinitis, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: p/vax pt c/o having soreness @ inj site, whole arm ached, felt hyper, nauseated to the point of not being able to eat, h/a, dizziness, head congestion, fatigue & hives;welt type hives on arm/shoulder & @ inj site;saw MD;

VAERS ID:131491 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:1999-11-06
Gender:Female  Submitted:1999-11-16, Days after onset: 10
Location:Wisconsin  Entered:1999-11-29, 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: NONe
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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Manufacturer
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Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: dizziness-12AM-9AM;

VAERS ID:131500 (history)  Vaccinated:1999-11-04
Age:58.4  Onset:1999-11-05, Days after vaccination: 1
Gender:Female  Submitted:1999-11-10, Days after onset: 5
Location:Minnesota  Entered:1999-11-29, 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: NONE
Current Illness: NONE
Preexisting Conditions: adverse rxn to haprosyn-psuedo effudrine;allergic to cats;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998263 IMA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Chills, Diarrhoea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: chills 12noon 11/05;fever 101 11/05 evening;fever 101.6 11/06;abd cramping, diarrhea 10/06;no fever p/11/06;11/10 still sl diarrhea;

VAERS ID:131609 (history)  Vaccinated:1999-11-17
Age:58.2  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? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premarin
Current Illness: NONe
Preexisting Conditions: allergy-peanutbutter;
Diagnostic Lab Data:
CDC 'Split Type': MD99029
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1585H1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Myalgia, Oedema peripheral, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: p/vax inj arm started to feel hot & began to swell;in AM arm from shoulder to elbow & part of shoulder blade was 3X larger;redness present;devel achiness in legs & arms today;seen by MD advised DPH;

VAERS ID:131612 (history)  Vaccinated:1999-11-09
Age:58.7  Onset:1999-11-10, Days after vaccination: 1
Gender:Female  Submitted:1999-11-12, Days after onset: 2
Location:Michigan  Entered:1999-12-01, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Prevacid;synthroid;Paxil
Current Illness: epigastric 7 RUQ pain (abd)
Preexisting Conditions: PCn;smokes, HTn, hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type': MI99127
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4664450IMRA
Administered by: Public     Purchased by: Public
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: deltoid area became red & swollen w/discomfort & a white pimple @ inj site;

VAERS ID:132045 (history)  Vaccinated:1999-10-06
Age:58.3  Onset:1999-11-12, Days after vaccination: 37
Gender:Male  Submitted:1999-11-29, Days after onset: 17
Location:Nebraska  Entered:1999-12-03, 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: Coumadin;Propanalol;Cozar;Lasix;Lipitor;Baycid baby ASA;
Current Illness: NONE
Preexisting Conditions: HTN, CAD, hyperlipidemia;
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0064AA IMA
Administered by: Private     Purchased by: Other
Symptoms: Asthma, Bronchitis, Coronary artery disease, Drug ineffective, Dyspnoea, Infection, Influenza, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Hypersensitivity (broad)
Write-up: p/vax pt devel SOB, bronchitis approx 5wk p/vax;rapid antigen test for influenza A positive when adm to hosp;significantother devel some s/s but wa snot hosp;

VAERS ID:132208 (history)  Vaccinated:1999-11-04
Age:58.0  Onset:1999-11-08, Days after vaccination: 4
Gender:Male  Submitted:1999-11-30, Days after onset: 22
Location:D.C.  Entered:1999-12-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data: LP-nl;Nuclear magnetic resonance imaging-nl;Electroencephalogram-sl abn w/some slowing which is c/w encephalopathy;Ultrasound doppler-negative;
CDC 'Split Type': 6810129NOV199
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998274   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Aphasia, Delusion, Electroencephalogram abnormal, Encephalopathy, Paranoia
SMQs:, Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad)
Write-up: p/vax pt devel encephalopathy & expressive aphasia;pt hosp;while hosp pt exp a paranoid delusional episode;MD indicated that pthas no psychiatri hx;LP revealed nl cerebrospinal fluid, MRI nl;EEG sl abn w/some slowing c/w encephalopathy;

VAERS ID:132223 (history)  Vaccinated:1999-11-04
Age:58.0  Onset:1999-11-04, Days after vaccination: 0
Gender:Female  Submitted:1999-11-22, Days after onset: 18
Location:Maryland  Entered:1999-12-07, 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: unk
Preexisting Conditions: asthma NOS
Diagnostic Lab Data: unk
CDC 'Split Type': 6012218NOV199
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998245 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Condition aggravated
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: p/vax exp a severe episode of asthma;pt hosp for 2 to 3 days;

VAERS ID:132695 (history)  Vaccinated:1999-10-25
Age:58.8  Onset:1999-10-25, Days after vaccination: 0
Gender:Male  Submitted:1999-12-14, Days after onset: 50
Location:Illinois  Entered:1999-12-21, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0126FA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Muscle twitching, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Rt eye twitching to left upper lip twitching. Fatigue, achey.

VAERS ID:132730 (history)  Vaccinated:1999-11-11
Age:58.3  Onset:1999-11-11, Days after vaccination: 0
Gender:Male  Submitted:1999-12-16, Days after onset: 35
Location:Minnesota  Entered:1999-12-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Stool cultures-Neg. Flex Sig-Neg
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Diarrhoea, Eructation
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Within 1 hr of receiving flu shot, pt. began having severe gas that turned into diarrhea;which is still present 1 month after injection.

VAERS ID:132864 (history)  Vaccinated:1999-10-28
Age:58.4  Onset:1999-10-28, Days after vaccination: 0
Gender:Female  Submitted:1999-11-17, Days after onset: 20
Location:New Hampshire  Entered:1999-12-27, Days after submission: 40
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': NH9925
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998228 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain, Paraesthesia, Rash maculo-papular
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Started w/red,papular rash @ inj. site;spread to back of shoulder & down lt arm to elbow area.Pain scale 10 @ site;radiating down arm to fingers,numbness & tingling in fingers.Seen on 11/3 & still had rash,pain,& numbness.Tx w/Celestone

VAERS ID:132867 (history)  Vaccinated:1999-12-08
Age:58.0  Onset:1999-12-09, Days after vaccination: 1
Gender:Female  Submitted:1999-12-14, Days after onset: 5
Location:Connecticut  Entered:1999-12-27, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH467042 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt. states has redness, swelling, pain at injection site.

VAERS ID:132095 (history)  Vaccinated:1999-10-11
Age:58.7  Onset:1999-10-11, Days after vaccination: 0
Gender:Female  Submitted:1999-10-14, Days after onset: 3
Location:Texas  Entered:1999-12-28, Days after submission: 75
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: allergies
Diagnostic Lab Data: NONE
CDC 'Split Type': 99TX217
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0130AA6IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1094H1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Redness, swelling @ site spreading to axilla & lt breast area & then down inside of lt inner arm to elbow. Pt self administered oral Benadryl & used Benadryl ointment on site & reaction.

VAERS ID:131866 (history)  Vaccinated:1999-10-11
Age:58.7  Onset:1999-10-23, Days after vaccination: 12
Gender:Female  Submitted:1999-10-26, Days after onset: 3
Location:Illinois  Entered:1999-12-29, 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: Estrace, Fosamax, Provera, Tagamet
Current Illness:
Preexisting Conditions: Allergy to Morphine, Keflex, Iodine
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)PFIZER/WYETH49981990IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM598A60IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria rash along the back, arms, and chest.

VAERS ID:131876 (history)  Vaccinated:1999-11-15
Age:58.3  Onset:1999-11-16, Days after vaccination: 1
Gender:Female  Submitted:1999-11-22, Days after onset: 6
Location:New York  Entered:1999-12-29, Days after submission: 37
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
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982450IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Skin nodule, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Red - itchy - lump on 11/16/99.

VAERS ID:131960 (history)  Vaccinated:1999-11-01
Age:58.1  Onset:1999-11-02, Days after vaccination: 1
Gender:Female  Submitted:1999-11-05, Days after onset: 3
Location:New York  Entered:1999-12-29, Days after submission: 54
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: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0065AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cough, Dyspnoea, Vasodilatation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Woke up around midnight, vomiting, hot & flushed, coughing & dyspnea. Symptoms subsided when went outside in cold air. Cough lingered into the next day.

VAERS ID:132911 (history)  Vaccinated:1999-11-17
Age:58.0  Onset:1999-11-17, Days after vaccination: 0
Gender:Female  Submitted:1999-12-06, Days after onset: 19
Location:New York  Entered:1999-12-29, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Klonopin
Current Illness: NONE
Preexisting Conditions: anxiety disorder, hx of intermittent GI malabsorption
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM639B60IM 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR007410IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anxiety, Malabsorption, Pain, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow)
Write-up: 12-24 hrs after injection, pt developed raised,red macules over face,chest,forearms,upper back.Pt also has itchy, burning sensation.Tx w/ Benadryl.

VAERS ID:133162 (history)  Vaccinated:1999-12-08
Age:58.0  Onset:1999-12-08, Days after vaccination: 0
Gender:Female  Submitted:1999-12-10, Days after onset: 2
Location:Georga  Entered:2000-01-08, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Borderline B/P, Penicillin allergy
Diagnostic Lab Data: EKG-Poss Atrial enlargement,
CDC 'Split Type': GA99180
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS01989P0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Pt states, 2-3 hrs after vax, her L/arm started swelling from shoulder down to her fingertips & light swelling around her neck. Seen by Dr on 12/9/99 & her B/P was elevated, 180/100. As of 12/10/99, sx''s gone, except for swelling of L/hand.

VAERS ID:133357 (history)  Vaccinated:1999-11-01
Age:58.0  Onset:1999-11-15, Days after vaccination: 14
Gender:Female  Submitted:1999-12-27, Days after onset: 42
Location:Arizona  Entered:2000-01-19, 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: Inderal
Current Illness: NONE
Preexisting Conditions: Tetracycline allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998230 IMLA
Administered by: Private     Purchased by: Other
Symptoms: Pain
SMQs:
Write-up: Within t weeks after vaccine developed sub deltoid bursitis type pain in vaccination arm.

VAERS ID:133555 (history)  Vaccinated:1999-12-21
Age:58.0  Onset:1999-12-21, Days after vaccination: 0
Gender:Male  Submitted:1999-12-28, Days after onset: 7
Location:Oklahoma  Entered:2000-02-01, Days after submission: 35
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: NKDA
Diagnostic Lab Data:
CDC 'Split Type': OK9967
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKDALE PHARMACEUTICALS02089P0IMRA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER1611H0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypertonia, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: He received 2 shots in R/deltoid. Today he is c/o muscle spasms & pain in that shoulder since he has received the injections.

VAERS ID:133570 (history)  Vaccinated:1999-10-21
Age:58.0  Onset:1999-12-21, Days after vaccination: 61
Gender:Male  Submitted:2000-01-17, Days after onset: 27
Location:California  Entered:2000-02-01, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4998216 IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site abscess
SMQs:
Write-up: 12/21/99, presented w/lump on L/deltoid "from Flu shot" received 10/21/99. On 1/14/00, recheck of arm shows increased size & tenderness. I & D of sterile Abscess done w/wick placement. On 1/17/00, replaced wick. To return in 2 days to check

VAERS ID:150084 (history)  Vaccinated:1999-06-17
Age:58.0  Onset:1999-06-17, Days after vaccination: 0
Gender:Male  Submitted:2000-02-29, Days after onset: 257
Location:Delaware  Entered:2000-03-15, Days after submission: 15
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV0412SCLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Neck pain, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Minor neck and shoulder pains. Itching at rash on lower face, left and right side following third shot. Itchy rash on left temple area following fourth shot. Follow up 05/30/2000: "Patient recovered from adverse event."

VAERS ID:150252 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:1999-10-14
Gender:Female  Submitted:2000-03-08, Days after onset: 146
Location:New Jersey  Entered:2000-03-21, 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: PCN allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Face oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Brawny edema of face, quite intense. Ruled out superior vena cava syndrome, blood clot and malignancy. Dermatology consult identified no specific etiology. Treated symptomatically with fluid removal. Recently vaccinated with influenza. 60 day follow-up dated 09/27/00 provided no additional data.

VAERS ID:150337 (history)  Vaccinated:2000-03-13
Age:58.0  Onset:2000-03-13, Days after vaccination: 0
Gender:Male  Submitted:2000-03-14, Days after onset: 1
Location:Utah  Entered:2000-03-23, 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: Pepcid AC
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3351D60IMLA
Administered by: Public     Purchased by: Private
Symptoms: Balance disorder, Dizziness, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Pt experienced dizziness, balance disturbance, rapid heart rate, beginning approximately 10 hours post vax. Still persists.

VAERS ID:151854 (history)  Vaccinated:2000-04-25
Age:58.0  Onset:2000-04-26, Days after vaccination: 1
Gender:Female  Submitted:2000-04-27, Days after onset: 1
Location:New York  Entered:2000-05-12, 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: Premarin, PPD
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4653190IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Headache, Injection site inflammation, Injection site oedema, Injection site pain, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Post vax, the pt developed fevers, chills, generalized malaise, myalgias, arthralgias, and extreme fatigue. Left arm was extremely inflamed, swollen, and tender. She also experienced intense headaches.

VAERS ID:151901 (history)  Vaccinated:1999-05-21
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2000-04-21
Location:New York  Entered:2000-05-12, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 20000064971
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1  
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Injection site warmth, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: On 8/9/99, the pt received her first injection of Lymerix with no apparent ill effects. On 5/21/99, the pt received the second dose and sometime thereafter experienced nausea, vomiting, pain and warmth at the injection site. The information received on 3/6/00 reports the symptoms as resolved.

VAERS ID:151989 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2000-03-07
Location:Florida  Entered:2000-05-16, Days after submission: 69
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES99011576
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Multiple sclerosis
SMQs:, Optic nerve disorders (broad), Demyelination (narrow)
Write-up: In approximately 1994, this 58-year-old female received vax. The pt noted that she was ''formerly a nurse''s assistant working around Hepatitis B infected pts.'' In approximately 1997 the pt was dx with multiple sclerosis. The pt sought unspecified medical attention. Additionally it was noted that the pt considered his condition life threatening and disabling. Additional information has been requested.

VAERS ID:152013 (history)  Vaccinated:1999-11-10
Age:58.0  Onset:1999-11-15, Days after vaccination: 5
Gender:Female  Submitted:2000-05-25, Days after onset: 191
Location:Texas  Entered:2000-05-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: History of glaucoma, hypothyroidism and a hysterectory.
Diagnostic Lab Data: Electromyography, lumbar puncture - both consistent with neuropathy.
CDC 'Split Type': MPU2000000540
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.  IM 
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Coordination abnormal, Neuropathy, Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Report received from a neurologist concerning a pt who experienced peripheral neuropathy 5 days post vax. Reported date of vax and reaction start date were approximate. Case reassessed to be serious on receipt of follow-up information form the neurologist. This pt developed neuropathy and loss of coordination and reflex strength. The vaccinee was also reported as ''dysesthetic poor''. The vaccinee was treated with steroids. Symptoms were stated by the reporter to be disabling/incapacitating. No stop date was given for the symptoms. Numerous labs and tests were consistent with neuropathy.

VAERS ID:152107 (history)  Vaccinated:2000-05-04
Age:58.0  Onset:2000-05-05, Days after vaccination: 1
Gender:Male  Submitted:2000-05-16, Days after onset: 11
Location:California  Entered:2000-05-19, 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: glucosamine, multi-vitamins, nicotinic acid, pancrelipase
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES00050991
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0043J0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site pain, Pruritus, Skin irritation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: The following day post vax, the pt presented to a physician with right arm painful, irritated, and red. The pt''s temperature was normal. The following day, the pt presented to an ER with cellulitis and swelling twice the normal size from the injection site to below the elbow. The pt was treated with Rocephin. On 5/8/00, the pt was seen in the physician''s office and his arm was still red, swollen, and itchy. Subsequently the pt recovered.

VAERS ID:152746 (history)  Vaccinated:1997-06-06
Age:58.0  Onset:1997-06-13, Days after vaccination: 7
Gender:Female  Submitted:1999-12-10, Days after onset: 910
Location:Ohio  Entered:2000-06-07, Days after submission: 179
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES99091400
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Other
Symptoms: Abdominal pain, Dizziness, Fatigue, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Information has been received from an RN concerning a 58 year old female who, post vax, experienced nausea, diarrhea, vomiting, aches, fatigue, dizziness, fever, abdominal pain and cramps. The pt sought unspecified medical treatment and subsequently, recovered from diarrhea, vomiting, aches and fatigue. The pt''s nausea persisted. For the past 2 years, the pt has experienced bouts of nausea that she did not have prior to vaccination. The nausea

VAERS ID:153078 (history)  Vaccinated:1999-12-17
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2000-03-10
Location:Nevada  Entered:2000-06-08, Days after submission: 89
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CT/Ultrasound
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIESU0135AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling (10cm X 10cm) and erythema at IZ site that persists. Slightly decreased with prednisone and Augmentin.

VAERS ID:153739 (history)  Vaccinated:2000-05-19
Age:58.0  Onset:2000-05-20, Days after vaccination: 1
Gender:Female  Submitted:2000-05-22, Days after onset: 2
Location:Rhode Island  Entered:2000-06-09, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to yeast
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES4653080IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Feeling hot, Injection site pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: L upper arm cellulitis (erythema, warmth and tenderness over L deltoid region) @ injection site noted 1 day after receiving the vax, started on Cipro 500mg po bid on 5/22/2000. Scheduled for re-evaluation on 5/26/00.

VAERS ID:154006 (history)  Vaccinated:1999-11-01
Age:58.0  Onset:1999-11-07, Days after vaccination: 6
Gender:Female  Submitted:1999-12-07, Days after onset: 30
Location:Ohio  Entered:2000-06-13, Days after submission: 188
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': HQ5152110NOV1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Within 6 days post vax, the pt developed flu-like symptoms, described as headache, fever of 102, arthralgia, myalgia, and nausea.

VAERS ID:154125 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:1999-12-21
Location:Indiana  Entered:2000-06-13, Days after submission: 174
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': HQ8682515DEC1999
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49982721IM 
Administered by: Other     Purchased by: Other
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Subsequently post vax, the pt developed some itching. The pt recovered.

VAERS ID:154337 (history)  Vaccinated:1999-05-27
Age:58.0  Onset:1999-05-30, Days after vaccination: 3
Gender:Female  Submitted:1999-09-29, Days after onset: 122
Location:Connecticut  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: Klonopin
Current Illness:
Preexisting Conditions: hx of mitral valve prolapse, Lyme disease x 2
Diagnostic Lab Data:
CDC 'Split Type': 19990149701
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Musculoskeletal discomfort, Oedema peripheral, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 4/29/99, the pt received her first (IM-Left Deltoid) dose of Lymerix for prevention of Lyme disease. One week later on 5/6/99, the pt experienced a muscle pull behind the knee. This adverse event resolved. On 5/27/99, the pt received her second dose of Lymerix. Approximately 3 days later, on 5/30/99, the pt experienced severe pain after walking. He left leg was swollen, she was seen by an orthopedist and Motrin was prescribed. Aching persists. The most recent information received on 6/23/99, reports the condition of the pt is ongoing.

VAERS ID:154368 (history)  Vaccinated:1999-07-01
Age:58.0  Onset:1999-07-02, Days after vaccination: 1
Gender:Female  Submitted:1999-08-31, Days after onset: 60
Location:Minnesota  Entered:2000-06-15, Days after submission: 289
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 19990192871
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Influenza like illness, Pain
SMQs:, Arthritis (broad)
Write-up: On approximately 6/3/99, the pt received her first dose of Lymerix. On 7/1/99, the pt received her second dose of Lymerix. The following day, on 7/2/99, she felt as if she had a 24-hour flu. She experienced achiness and soreness in hips/legs that felt like arthritis. An MD visit was required. The pt was treated with Medrol. FU states she experienced extremem joint and muscle pain all over her body. She stated she felt like she had "went from 58 to 85". In Sept 1999 she was hospitalized as she could not move her legs.

VAERS ID:154423 (history)  Vaccinated:1999-05-03
Age:58.0  Onset:1999-06-10, Days after vaccination: 38
Gender:Female  Submitted:1999-09-29, Days after onset: 111
Location:Virginia  Entered:2000-06-15, Days after submission: 260
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol changed to Norvasc
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood work negative for Lyme disease.
CDC 'Split Type': 19990206311
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY120F91IM 
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: This is a spontaneous report from a RN referring to a 58 year old female who received her 1st dose of Lymerix on 4/1/99 and 2nd dose on 5/03/99, respectively. 37 days after 2nd dose, on 6/10/99, and 70 days after 1st dose, the pt reported that she had experienced fatigue and dyspnea. She was seen by a physician, who changed her treatment with atenolol to Norvasc. The most recent information, received on 8/17/99, reports the condition of the pt is recovered.

VAERS ID:154539 (history)  Vaccinated:2000-06-12
Age:58.0  Onset:2000-06-12, Days after vaccination: 0
Gender:Female  Submitted:2000-06-14, Days after onset: 2
Location:Unknown  Entered:2000-06-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0061AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt presented to ER after receiving Tetanus/Diptheria injection. There is a large area of tenderness and redness on the left deltoid area.

VAERS ID:154849 (history)  Vaccinated:2000-06-12
Age:58.0  Onset:2000-06-13, Days after vaccination: 1
Gender:Female  Submitted:2000-06-14, Days after onset: 1
Location:Virginia  Entered:2000-06-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0061AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt experienced an injection site reaction characterized by a swollen and reddened shoulder. Pt was treated with Tagamet and Benadryl.

VAERS ID:155114 (history)  Vaccinated:1998-10-26
Age:58.0  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: Synthroid
Current Illness: NONE
Preexisting Conditions: Allergies, perfumes, food preservatives, ASA, Asthma
Diagnostic Lab Data:
CDC 'Split Type': U1998007680
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES09805602IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: About 5 minutes, post vax, the pt experienced a metallic taste in her mouth, which lasted about 1/2 hour and resolved. The pt recovered from this experience. From additional information received on 12/15/1998, it was reported, "reviewed, no additional information at this time; 12/12/98.

VAERS ID:155409 (history)  Vaccinated:1999-06-30
Age:58.0  Onset:1999-06-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:2000-06-26
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
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A2   
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Influenza like illness, Myalgia, Paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad)
Write-up: Pt developed flu-like symptoms, muscle ache, and joint pain. Eventual paralysis requiring hospitalization. Treated with prednisone and fosomak. Still experiencing pain and soreness, especially in chest, thighs, arms, and back.60 day follow-up dated 01/29/00 states the pts symptoms are ongoing. Per doc 195954,patient still has symptoms and he is taking medications with prednisone otherwise would not be able to function.

VAERS ID:155772 (history)  Vaccinated:1999-06-14
Age:58.0  Onset:2000-03-01, Days after vaccination: 261
Gender:Female  Submitted:2000-06-28, Days after onset: 118
Location:California  Entered:2000-06-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen, Premarin, Prem-Pro, Tetracycline, aspirin, multiple vitamins
Current Illness:
Preexisting Conditions: Allergy to Amidol, thimerosal, Novocaine. Had Dengue fever in 1974, mild arthuritis, sciatia, considerably low thyroid studies, and rosacea. In the past the pt was bitten by a Lyme positive tick but tested negative for Lyme disease.
Diagnostic Lab Data: Chest X-ray, Thyroid studies, LP, Anti-Nuclear Antibodies, Parvo Virus, Lyme Titre, Thyroid stimulating hormone, Cat Scan of head, Creatine Phosphokinase, ESR, RF
CDC 'Split Type': 20000147911
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM104A21IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Confusional state, Fatigue, Hypoaesthesia, Joint swelling, Malaise, Musculoskeletal stiffness, Myalgia, Nausea, Night sweats, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: On 5/1499, the pt received her 1st shot with Lymerix with no untoward effects. In June 1999, she received her 2nd dose of Lymerix and about 8 months later, in February 2000, the pt had experienced malaise, stiff neck, muscle aches, nausea, night sweats, confusion, fever and in about April 2000, she experienced numbness in her great toes. She went to the ER on 4/13/2000 and her complaints were muscle pain, numbness, and a stiff neck. She was admitted to the hospital for joint pain, fatigue (weakness), and for a neurological evaluation. A physician exam revealed swollen shoulder joints, left wrist, and swollen cervical spine. She was dx''d with polymyalgia rheumatica and was treated with prednisone. She was discharged from the hospital after 3 days on sulfemethoxazole and trimethoprim 2 X/day (Septra DS), paracetamol and Vicodin and a prednisone taper. The most recent information received on 6/21/2000, reported the symptoms resolved.

VAERS ID:155855 (history)  Vaccinated:2000-05-04
Age:58.0  Onset:2000-06-01, Days after vaccination: 28
Gender:Male  Submitted:2000-06-24, Days after onset: 23
Location:Wisconsin  Entered:2000-06-30, 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: glucosamine
Current Illness:
Preexisting Conditions: spring allergies
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY144B90IMRA
Administered by: Public     Purchased by: Private
Symptoms: Back pain, Headache, Malaise, Musculoskeletal stiffness
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Pt developed malaise, back pain, neck stiffness, and headaches. Self treated and acupuncture to come.

VAERS ID:157377 (history)  Vaccinated:2000-07-07
Age:58.0  Onset:2000-07-17, Days after vaccination: 10
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:2000-07-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cardizem,; Tenormin; Laritan; Vioxx; Premarin; Nitroglycerin
Current Illness: NONE
Preexisting Conditions: arthritis; hayfever; heart pt
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7345AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Within 3 hours post vax pts arm was extremely sore, red, hot and a huge lump appeared. Pt was treated with Benadryl, Diprolene, Tylenol, and ice.

VAERS ID:157767 (history)  Vaccinated:2000-02-28
Age:58.0  Onset:2000-03-04, Days after vaccination: 5
Gender:Female  Submitted:2000-03-27, Days after onset: 23
Location:California  Entered:2000-07-21, Days after submission: 115
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol;Serevent; Theophylline
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ1782623MAR2000
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES468868 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Four days post vax pt developed an injection site reaction characterized by an itchy rash. Pt was treated with steroids, anti-inflammatories and a topical cortisone cream. Follow up states patient recovered. .

VAERS ID:158036 (history)  Vaccinated:2000-03-20
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-05
Location:New York  Entered:2000-07-27, Days after submission: 83
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: Pt has benign prostate hypertrophy, degenerative arthritis in shoulder, allergies not specified. Has had Lyme meningitis.
Diagnostic Lab Data:
CDC 'Split Type': 2000012887
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: "Shortly after" the first vax, he has experienced fatique, headache, myalgias and arthralgias. Reportedly there was no tenderness, swelling, effusions or tenosynovitis. There was no neurological problems or Lyme arthritis. No treatment was given. Lymerix was discontinued. Most recent information reports the condition as ongoing. On 3/20/00, the pt received his first Im injection of LYMErix. He also developed right shoulder pain. Initially, the pt had no neurological problems; however, on follow up, the physician indicated that the pt was experiencing neuropsychiatric symptoms consisting of difficulty with memory, thinking, concentration, and calculation. Relevant lab tests included a sed rate of 33mm/h, rheumatoid factor <20, negative antinuclear antibody, and a negative HLA-H27 antigen. Joint fluid was not obtained. Reportedly, the pt is going to bee seen by an orthpopedic physician. The events of headache, shoulder pain, arthralgias, and neuropsychiatric symptos do not meet serious criteria but are being submitted expeditiously for informational purposes.

VAERS ID:158039 (history)  Vaccinated:2000-04-13
Age:58.0  Onset:2000-04-13, Days after vaccination: 0
Gender:Female  Submitted:2000-05-30, Days after onset: 47
Location:New York  Entered:2000-07-27, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nasal spray, Excedrin
Current Illness:
Preexisting Conditions: clindamycin allergy, hormone replacement therapy, migraine headaches and sulfa allergy
Diagnostic Lab Data:
CDC 'Split Type': 20000130141
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Chills, Dizziness, Injection site pain
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)
Write-up: Post first vax, two hours later, pt experienced flu like symptoms with chills, weakness, dizziness, and tiredness. She also had severe injection site upper arm pain. Psot second dose same day her entire arm was hurting and muscle hurting. She was treated with Advil.

VAERS ID:158088 (history)  Vaccinated:1999-06-01
Age:58.0  Onset:1999-07-01, Days after vaccination: 30
Gender:Male  Submitted:2000-07-27, Days after onset: 392
Location:Unknown  Entered:2000-07-28, 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: buspirone HCL, irbesartan.
Current Illness:
Preexisting Conditions: hypertension
Diagnostic Lab Data: X-ray bilateral heels - to R/O Bilateral Spurs - results not provided.
CDC 'Split Type': 20000222721
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Joint stiffness, Pain
SMQs:, Arthritis (broad)
Write-up: One month post vax, the pt experienced joint stiffness, mild bilateral hand and heel pain, and mild right hip pain. He describes his mild pain as arthritic-like. He reports he had no joint swelling or warmth. Pt has been evaluated by a physician who has drawn lab work. Pt received no treatment for the events.

VAERS ID:158557 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:2000-07-27
Location:Iowa  Entered:2000-08-02, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES99110269
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0774J0  
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Post vax, the pt developed cellulitis at the injection site. The pt sought unspecified medical attention.

VAERS ID:158565 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2000-07-27
Location:Iowa  Entered:2000-08-02, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES99110761
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0774J0  
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Post vax, the pt developed cellulitis at the injection site. The pt sought unspecified medical attention.

VAERS ID:158647 (history)  Vaccinated:2000-06-26
Age:58.0  Onset:2000-06-26, Days after vaccination: 0
Gender:Male  Submitted:2000-08-08, Days after onset: 43
Location:New Jersey  Entered:2000-08-09, 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: Lotensin, HCTZ
Current Illness:
Preexisting Conditions: hypertension
Diagnostic Lab Data:
CDC 'Split Type': 20000236241
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Bursitis, Hypokinesia, Joint swelling, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: On 6/26/00, the pt received his first IM - left deltoid dose of Lymerix. Within one week post vax, he experienced severe left shoulder pain and swelling. During the first few days, the pt "could not move" his shoulder. He can move his shoulder now but has constant pain. He thought it was more muscle pain than joint pain. An MD visit was required and the pt was treated with an analgesic/anti-inflammatory combination. The pt had difficulty identifying whether his pain was in the shoulder joint or in the deltoid area of his left arm. He was unable to determine whether the pain was myalgia or arthralgia. He reported that on a scale of 1-10, his pain was a "9" in the mid-day to evening and a "3" in the morning. He reported that his pain was worse if the weather changed to rain. He reported that the pain is primarily "in his shoulder". He was seen by a physician about 5-7 days after the pain started. He reported that his physician noted redness and swelling and the diagnosis of bursitis was given. His joint complaints have been evaluation by a physician. A swollen left shoulder joint has been documented on physical exam. Joint fluid was not obtained. On FU pt states within 2 hours post-vaccination he experienced severe left shoulder pain and swelling. He was "almost totally immobilized for about a week or two thereafter. The pt reported that the physician wanted to treat the pt with cortisone injection, but the pt declined. The pt took the meds for one week but discontinued it as it caused drowsiness and nausea. As of 8/02/00, the pt reported that there had been slow and gradual improvement and he can extend his left arm "up to shoulder level" but it continued to be painful. He was unsure if there was redness or swelling now. The events of left shoulder pain, left shoulder swelling, bursitis, and shoulder stiffness do not meet ICH serious criteria, but are being submitted expeditiously for information purposes.

VAERS ID:158934 (history)  Vaccinated:2000-06-26
Age:58.0  Onset:2000-06-27, Days after vaccination: 1
Gender:Male  Submitted:2000-08-08, Days after onset: 42
Location:New York  Entered:2000-08-16, 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: UNK
Preexisting Conditions: Historical Condition contact with or exposed to rabies. Previously vax, with pre exposure series of rabies vax, 1984 received post exposure rabies treatment with state licensed vax.
Diagnostic Lab Data:
CDC 'Split Type': EM20000292
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION2330110IM 
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt developed bilateral lymphadenopathy post vax, for post exposure prophylaxis. Following day he complained of itchiness of the right and left axillary areas left more than right, as well as swelling unilaterally in axilla. On June 30, 2000 the pt received Benadryl and Solu-Medrol prior to 2nd dose. No reaction, reporter assessed the event as related to RabAvert.

VAERS ID:159581 (history)  Vaccinated:1999-08-05
Age:58.0  Onset:1999-08-06, Days after vaccination: 1
Gender:Male  Submitted:2000-01-07, Days after onset: 154
Location:Idaho  Entered:2000-09-10, Days after submission: 246
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Diabeta, Glucophage, thyroid
Current Illness: NONE
Preexisting Conditions: Adult Onset Diabetes Mellitus
Diagnostic Lab Data: NONE
CDC 'Split Type': U1999005610
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.P0914503IM 
Administered by: Private     Purchased by: Private
Symptoms: Eyelid oedema, Injection site erythema, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: It was reported that a pt (no specifics provided) received a 4th post-exposure dose of Rabies Imovax IM vaccine (actual vaccination date not provided). Reportedly, sometime, post vax, the pt complained of swelling at the injection site and swelling of the eyes. Additional information is expected. From additional information received, the same day, the patient, vaccine, reporter and responsible physician information was provided. Reportedly, the pt recovered from this experience. Additional information was received on 8/12/99. This correspondence provided the date of vaccination as 8/5/99. The adverse event was also described as, "redness and swelling in arm with eyelid swelling." No additional information was available as reported on 10/25/99.

VAERS ID:159514 (history)  Vaccinated:2000-04-14
Age:58.0  Onset:2000-04-28, Days after vaccination: 14
Gender:Female  Submitted:2000-08-29, Days after onset: 123
Location:New Jersey  Entered:2000-09-11, 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: Hyzaar, verapamil
Current Illness: hypertension
Preexisting Conditions: hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY136B91IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Headache, Joint swelling, Pain in extremity, Upper respiratory tract infection
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: The pt experienced swelling in the right ankle, pain on side of right foot, headaches, joint pain. The pt was dx with URI.

VAERS ID:159637 (history)  Vaccinated:2000-07-31
Age:58.0  Onset:2000-08-02, Days after vaccination: 2
Gender:Male  Submitted:2000-09-07, Days after onset: 36
Location:Florida  Entered:2000-09-12, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3231A60IM 
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM661C60IM 
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0194AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Blister, Erythema, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt received 3 vax on 7/31/2000 and 2 days later had redness & broke out with multiple blisters on palms and soles. Very itchy palms and soles have persisted though the blisters healed over one week. No other rash or sx, still mildly symptomatic.

VAERS ID:160275 (history)  Vaccinated:2000-05-03
Age:58.0  Onset:2000-05-04, Days after vaccination: 1
Gender:Female  Submitted:2000-10-03, Days after onset: 152
Location:New Jersey  Entered:2000-10-04, 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: Estrogen, L-Thyroxine
Current Illness:
Preexisting Conditions: hypothyroidism
Diagnostic Lab Data: hearing test-nml
CDC 'Split Type': 20000279561
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Disorientation, Ear discomfort, Meniere's disease, Nausea, Tinnitus
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow)
Write-up: Next day post vax, the pt experienced an extreme rushing sound and an episode of extreme pressure in her right ear. This pressure clouded her hearing temporarily and caused her profound disorientation. The pressure was also associated with high-pitched cadence and accompanied by nausea but with no vomiting. The episode reoccurred two to three more times that day, lessening in severity each time. She reports that she has since experienced approximately seven more episodes as described above. Each episode renders her feeling raw and unable to function and she treats the episode by lying down and resting for one to three days. She has been examined by an internist who has given her a dx of precursor to Meniere''s syndrome. The most recent information received indicates that the events are intermittently ongoing.

VAERS ID:161696 (history)  Vaccinated:1999-09-20
Age:58.0  Onset:1999-09-21, Days after vaccination: 1
Gender:Female  Submitted:2000-02-04, Days after onset: 136
Location:California  Entered:2000-10-06, Days after submission: 244
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium with Vit D & Premarin
Current Illness: NONE
Preexisting Conditions: Drug Hypersensitivity; Hypothyroidism; Seborrhoea
Diagnostic Lab Data:
CDC 'Split Type': 1480106101999
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES459838 IM 
Administered by: Private     Purchased by: Other
Symptoms: Feeling hot, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On September 21, 1999 she developed an injection site reaction characterized by extreme redness, warmth and swelling which extended to the elbow. The pt was treated with Benadryl and prednisone; she recovered. This is of 2 patients from this facility who developed an injection site reaction following receipt of vax. Additional information states pt was treated with Medrol dose pack.

VAERS ID:160400 (history)  Vaccinated:1999-03-22
Age:58.0  Onset:1999-03-23, Days after vaccination: 1
Gender:Male  Submitted:2000-10-04, Days after onset: 560
Location:Connecticut  Entered:2000-10-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: arthritis, gout
Diagnostic Lab Data: Lyme disease test
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM  IM 
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Dizziness, Insomnia, Joint stiffness, Pain, Pyrexia, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: The pt experienced a fever, stiff joints, insomnia, severe back and leg pain, dizziness and blurred vision. No treatment was required. A follow up report received 1/8/2001 adds: Update per phone call from pt: states he is getting worse in that he has trouble walking and has a good deal of pain in feet, legs, knees, and now hips. He is concerned because the symptoms are "moving upwards" and he plays piano. These symptoms are "unlike Lyme Disease". The antibiotic tx did help decrease the fatigue and dizziness about 50%. He has no fever or sweats, but still has blurred vision. He remains on Voltarin and also takes glucosamine and milk thistle (homeopathic treatment from nutritionist). He has consulted with a specialist in Lyme Disease who believes he did have Lyme Disease for about 9 months with minor symptoms of slightly stiff neck and occasional fever. The tests for Lyme came back negative then positive s/p first dose of vaccine. He then had two positive testings s/p dose two of vaccine. Follow up 10/30/2000: "Patient does not know lot #."

VAERS ID:162538 (history)  Vaccinated:1999-10-19
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:2000-05-03
Location:New York  Entered:2000-10-13, Days after submission: 163
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': U2000002790
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES  IM 
Administered by: Other     Purchased by: Other
Symptoms: Neuropathy, Peroneal nerve palsy
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: Approximately 10 hours post vax, the pt developed neuropathy of his left leg with foot drop of the left side. Additional information is being requested. No further information is available.

VAERS ID:160627 (history)  Vaccinated:2000-07-21
Age:58.0  Onset:2000-08-03, Days after vaccination: 13
Gender:Female  Submitted:2000-10-06, Days after onset: 64
Location:Michigan  Entered:2000-10-18, 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: UNK
Current Illness: NONE
Preexisting Conditions: allergic to Talvoin
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1720J SCLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Joint swelling, Rash
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: On 8/3/00, the pt noted joint discomfort in both knees, right ankle, and left MCP joint of index finger. Also developed rash, described as red spots, over chest and abdomen. On exam, few scattered small slightly erythematous circular spots on chest and back. Slight swelling of MCP joint of left hand. Pt felt symptoms were fairly mild and was tx with Tylenol and Motrin.

VAERS ID:162914 (history)  Vaccinated:2000-04-01
Age:58.0  Onset:2000-04-01, Days after vaccination: 0
Gender:Male  Submitted:2000-07-26, Days after onset: 115
Location:New Jersey  Entered:2000-10-26, Days after submission: 92
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: High blood pressure
Diagnostic Lab Data:
CDC 'Split Type': 20000225551
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Diarrhoea, Unevaluable event
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Subsequent to receiving first dose of Lymerix, the pt experienced diarrhea which resolved approximately 8 hours later. Within a few hours of receiving second dose of Lymerix, the pt again experienced diarrhea which resolved 8 hours later. No treatment was given. The most recent information reports the outcome of the event as resolved.

VAERS ID:161746 (history)  Vaccinated:2000-10-26
Age:58.0  Onset:2000-10-26, Days after vaccination: 0
Gender:Male  Submitted:2000-10-26, Days after onset: 0
Location:Tennessee  Entered:2000-11-09, 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: Takes allergy shots
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E59270CA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dysgeusia, Hypoaesthesia oral
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Pt was with another pt her to get flu shots. His friend complained of "bad taste in mouth" "metal taste" and was triaged out assessed. 30 minutes later, pt complained of numbness and tingling at the end of his tongue and mouth. Pt waited 15 minutes and symptoms resolved.

VAERS ID:163247 (history)  Vaccinated:1999-09-14
Age:58.0  Onset:1999-09-14, Days after vaccination: 0
Gender:Female  Submitted:1999-11-18, Days after onset: 65
Location:Michigan  Entered:2000-11-14, Days after submission: 362
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness:
Preexisting Conditions: bad back with spur; allergic to citrus, mold, pepper, scallops; arthritis; hay fever; hysterectomy; ulnar nerve transplant
Diagnostic Lab Data:
CDC 'Split Type': 19990249221
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2711A40IMRA
Administered by: Private     Purchased by: Private
Symptoms: Angioneurotic oedema, Arthralgia, Diarrhoea, Dysphagia, Erythema, Fatigue, Feeling jittery, Headache, Oesophageal spasm, Somnolence
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: The evening subsequent to receiving vax, the pt developed diarrhea, and giant hives the size of silver dollars which started on her lower back, then spread to arms, legs, hands and bottoms of feet. Her face was red but had no hives. She was jittery and had a headache. The pt was seen by a physician who treated her with an injection of Donnatal and prednisone. She was also given liquid Benadryl. It was noted that there was no swelling at the injection site. After she finished the prednisone treatment, the rash resolved. Medications were stopped. The pt reported having esophageal spasms which consisted of difficulty swallowing in the muscular part of the throat, which resolved. She had no problems breathing. The pt was seen by a dermatologist. Her clothing causing her discomfort and caused break-out hives. The dermatologist prescribed prednisone5 mg X 7 daily to be tapered over 10 days. After the therapy was completed the pt noticed throbbing joint aches in hands, knees, feet and back. The pt believed that these joint aches had started shortly after vax but had been masked by steroid therapy. This symptom is ongoing. Additionally the pt feels tired and is sleeping more. On 10/04/1999 the pt felt itching at the bottom of her back. On 10/28/1999 she was seen by an allergist who found that the pt is allergic to Engerix B. The most recent information received reports the condition of the pt is not resolved.

VAERS ID:163376 (history)  Vaccinated:2000-03-20
Age:58.0  Onset:2000-03-20, Days after vaccination: 0
Gender:Female  Submitted:2000-04-28, Days after onset: 38
Location:Texas  Entered:2000-11-14, Days after submission: 200
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Uniphyl, Pravachol, Flovent, Verapamil, Glucophage
Current Illness:
Preexisting Conditions: diabetes, asthma
Diagnostic Lab Data:
CDC 'Split Type': 20000119391
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2888A40IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow)
Write-up: Five hours post vax, the pt''s hands began to itch, then arms, then all over. She took Benadryl that night and stayed home the next day. On 3/23/00, the itching got worse. Where she scratched she had large welts. Saw physician who dx her as having an allergic reaction and gave her an unspecified injection. Symptoms completely resolved by 3/26/00.

VAERS ID:161956 (history)  Vaccinated:2000-10-26
Age:58.0  Onset:2000-11-03, Days after vaccination: 8
Gender:Female  Submitted:2000-11-06, Days after onset: 3
Location:Iowa  Entered:2000-11-15, 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: multivitamins, vitamin C, Glucophage
Current Illness: NONE
Preexisting Conditions: Hypertension, DM Type II
Diagnostic Lab Data:
CDC 'Split Type': IA00017
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)LEDERLE LABORATORIES466550 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, 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: On Friday, 11/3/00, left upper arm developed itching (felt like that around leg insect bite) by that evening, arm was aching, slightly swollen and warm to touch. Arm continues to be swollen, red and sore.

VAERS ID:161977 (history)  Vaccinated:2000-10-27
Age:58.0  Onset:2000-10-28, Days after vaccination: 1
Gender:Female  Submitted:2000-11-09, Days after onset: 12
Location:Iowa  Entered:2000-11-15, 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: Lanoxin, Vasotec, Coumadin, Coreg, Demadex, Vancenase
Current Illness: UTI
Preexisting Conditions: CHF, atrial fibrillation, cardiomyopathy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0410AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Back of left arm very red and redness going down to her elbow and forearm area. Warm packs to area and take Benadryl.

VAERS ID:162490 (history)  Vaccinated:1999-10-06
Age:58.0  Onset:1999-10-07, Days after vaccination: 1
Gender:Female  Submitted:2000-01-07, Days after onset: 92
Location:New York  Entered:2000-11-22, Days after submission: 320
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: Codeine allergy.
Diagnostic Lab Data: + ANA screen ANA titer 80, C reactive protein 14.2. ESR 50.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0010AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Antinuclear antibody positive, Blood creatine phosphokinase increased, Malaise, Myalgia, Nausea, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: No adverse event at time of vax. Symptoms within 24 hours of myalgia, malaise, transient nausea. Used over-the-counter anti-inflamatories, prescription zyrtec / medrol dose pack (steroid). Tapering prednisone 11/99. Referred to rheumatology.

VAERS ID:162575 (history)  Vaccinated:2000-10-12
Age:58.0  Onset:2000-10-12, Days after vaccination: 0
Gender:Female  Submitted:2000-11-17, Days after onset: 36
Location:Vermont  Entered:2000-11-24, 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: Premarin, Fosamax, ibuprofen, amitriptyline
Current Illness: Medial epicondylitis
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0194AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site swelling, Type III immune complex mediated reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swollen arm, Arthus, Type II

VAERS ID:162620 (history)  Vaccinated:2000-11-07
Age:58.0  Onset:2000-11-13, Days after vaccination: 6
Gender:Female  Submitted:2000-11-15, Days after onset: 2
Location:Pennsylvania  Entered:2000-11-27, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hytrin, vitamin E
Current Illness: NONE
Preexisting Conditions: hypertension, hyperlipidemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0298AA IMLA
Administered by: Private     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: 7 days post vax, the pt had pain, redness, and swelling at injection site. Given antibiotics for cellulitis.

VAERS ID:163487 (history)  Vaccinated:2000-12-01
Age:58.0  Onset:2000-12-01, Days after vaccination: 0
Gender:Female  Submitted:2000-12-01, Days after onset: 0
Location:Massachusetts  Entered:2000-12-08, 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: Hep-C
Diagnostic Lab Data: BP-132/78
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008192 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Hypertension, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Pt reported being nauseous and light-headed. BP remained 132/78, soon after she stated she felt a lot better and shortly thereafter, she stated she was ok. On 12/2/00 per telephone conversation with pt, she stated she is fine.

VAERS ID:163559 (history)  Vaccinated:2000-12-05
Age:58.0  Onset:2000-12-06, Days after vaccination: 1
Gender:Male  Submitted:2000-12-08, Days after onset: 2
Location:Pennsylvania  Entered:2000-12-11, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008180 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Post vax, the pt developed rash and redness, started itching on 12/6/00. Applied ointment on 12/7/00.

VAERS ID:163572 (history)  Vaccinated:2000-11-15
Age:58.0  Onset:2000-11-16, Days after vaccination: 1
Gender:Male  Submitted:2000-11-20, Days after onset: 4
Location:South Carolina  Entered:2000-12-11, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HTN medication
Current Illness: NONE
Preexisting Conditions: Allergy to penicillin
Diagnostic Lab Data: NONE
CDC 'Split Type': SC00069
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E66350HA9IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4691330IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0266BA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left arm, at site of injection, with 3" X 3" reddened area, hot to touch, non-tender. No other symptoms or complaints stated. Event began 1 day, post vax. Referred client to PMD. Client was to see MD that afternoon.

VAERS ID:163761 (history)  Vaccinated:2000-12-06
Age:58.0  Onset:2000-12-07, Days after vaccination: 1
Gender:Female  Submitted:2000-12-07, Days after onset: 0
Location:California  Entered:2000-12-14, 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: valium, estrace
Current Illness: NONE
Preexisting Conditions: environmental allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008197 IM 
Administered by: Other     Purchased by: Other
Symptoms: Decreased appetite, Dizziness, Feeling hot, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: The pt experienced dizziness, then got very hot, and nauseous, laid on the cool bathroom floor for 2 hours. Every time the pt stood up she would get dizzy/hot/nauseous again. This continued for about 8 hours then she felt a little better. Could not eat, but could drink water.

VAERS ID:163842 (history)  Vaccinated:2000-11-15
Age:58.0  Onset:2000-11-15, Days after vaccination: 0
Gender:Male  Submitted:2000-11-21, Days after onset: 6
Location:South Carolina  Entered:2000-12-18, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, Coumadin, Glucotrol
Current Illness: NONE
Preexisting Conditions: Heart valve replaced 1992; High BP; High Cholesterol
Diagnostic Lab Data: CBC-WBC-11,100; po 73%, lymphs 18%, monocytes 6%, eosinephils 2%, Hgb-15.2, HcT-45, PT-18.8 and NR 2.9
CDC 'Split Type': SC00078
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0417AA8IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES469133 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, 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: Developed pain at injection site within 1 hour. 11/16/00 AM, redness and swelling at injection site, progressively increasing with increased temperature to 99.7F. Called doctor and ordered Benadryl and cold compresses. 11/17/00, increased swelling, redness and warmness from 5" above elbow to wrist with increased temperature to 100F. Used warm compresses and Benadryl. Went to ER at 20:00 on 11/17/00. Rx''d Unisom IV, Augmentin po. 11/20/00, decreased swelling of arm. 11/21/00, decreased swelling hand.

VAERS ID:164386 (history)  Vaccinated:2000-03-27
Age:58.0  Onset:2000-05-27, Days after vaccination: 61
Gender:Male  Submitted:2000-12-28, Days after onset: 215
Location:New Jersey  Entered:2001-01-03, 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: NONE
Current Illness:
Preexisting Conditions: coronary artery disease, hypertension
Diagnostic Lab Data: MRI of brain and neck normal
CDC 'Split Type': 20000349091
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 2IM 
Administered by: Private     Purchased by: Other
Symptoms: Fatigue, Gait disturbance, Muscle spasticity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: The pt received his 1st 2 injections of Lymerix on 3/15/99 and 4/16/99. He received his 3rd Lymerix and 3/17/00 and approximately 2 months post vax the pt experienced severe tiredness and developed a moderately unbalanced gait with some paresthesia. Pt gradually worsened over time and was referred to a neurologist. The neurologist made a diagnosis of "spastic motor skills". An MRI of the brain and neck was interpreted as normal. The vax provider considered the tiredness, unbalanced gait and paresthsia to be possibly related to Lymerix administration. The neurologist stated that the "spastic motor skills" were possibly related to Lymerix administration. The tiredness, unbalanced gait, paresthesia, and spastic motor skills persisted as of 12/19/2000.

VAERS ID:164497 (history)  Vaccinated:2000-10-30
Age:58.0  Onset:2000-10-31, Days after vaccination: 1
Gender:Female  Submitted:2000-11-29, Days after onset: 29
Location:New York  Entered:2001-01-08, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Zyrtec, Vitamins, Minerals, and Herbs
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0408CA3IM 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Asthenia, Diarrhoea, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: The patient has epigastric pain, nausea, shakiness, chills, and weakness for about 6 hours (started 18 hours approximately after injection). The patient had some lower abdominal cramping, and slight diarrhea the second day after her shot.

VAERS ID:164894 (history)  Vaccinated:2000-12-01
Age:58.0  Onset:2000-12-01, Days after vaccination: 0
Gender:Female  Submitted:2000-12-08, Days after onset: 7
Location:California  Entered:2001-01-18, Days after submission: 41
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': CA000159
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0330AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dermatitis allergic, Injection site erythema, Injection site reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: The pt experienced pruritis, allergic dermatitis at the site of injection (left deltoid) with redness and itching.

VAERS ID:165328 (history)  Vaccinated:2001-01-22
Age:58.0  Onset:2001-01-22, Days after vaccination: 0
Gender:Female  Submitted:2001-01-25, Days after onset: 3
Location:Minnesota  Entered:2001-01-30, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0455AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: The pt had a rash, was treated with Benadryl and Medrol dose pack. MD thinks the reaction was due to preservative thimerosal.

VAERS ID:165837 (history)  Vaccinated:2001-01-16
Age:58.0  Onset:2001-01-18, Days after vaccination: 2
Gender:Male  Submitted:2001-01-21, Days after onset: 3
Location:New Mexico  Entered:2001-02-13, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40082046IMLA
Administered by: Public     Purchased by: Public
Symptoms: Ear pain, Gingival pain, Neck pain, Pain, Peritonitis, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation (narrow), Gingival disorders (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: On 1/18/01, begin having right ear and neck pain. At noon, started getting leg aches. PCP Rx''s with antibiotic Zithromax X 5 days; beginning swelling and again went to PCP. Dx''d peritonitis and Rx''d another antibiotic but got GI symptoms. Rx''d with steroid for swelling; stayed swollen for 4 days. Saw PCP again on 1/23/01. On 1/18/01 had fever and chills. Went to dentist for cleaning on 1/3/01 and complained of gum discomfort on left side, 5 days later.

VAERS ID:165885 (history)  Vaccinated:2000-12-05
Age:58.0  Onset:2000-12-06, Days after vaccination: 1
Gender:Female  Submitted:2000-12-11, Days after onset: 5
Location:Wisconsin  Entered:2001-02-14, Days after submission: 65
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Inderal, Prozac, Ketrofen.
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WI0113
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40081930IMRA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4674150SCRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Headache, Injection site hypersensitivity, Injection site induration, Oedema, Pain, 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 (narrow)
Write-up: On 12/05/00, Wednesday night, the patient''s body ached, headache, arms red, swollen. Took Ibuprofen, Doxycycline ordered by the PMD. Today arm red all away around, swollen, itchy, painful encouraged to recall HCP. On 12/19/00 the patient states arm much better, less red and swollen, but still firm and itching at the injection site. To call for an appt with HCP when road conditions improve.

VAERS ID:166212 (history)  Vaccinated:2001-02-20
Age:58.0  Onset:2001-02-21, Days after vaccination: 1
Gender:Male  Submitted:2001-02-21, Days after onset: 0
Location:Florida  Entered:2001-02-28, Days after submission: 7
Life Threatening? No
Died? Yes
   Date died: 2001-02-21
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: CHF; CHD; IDDM
Diagnostic Lab Data: UNK
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM684B60IMLA
Administered by: Public     Purchased by: Other
Symptoms: Atherosclerosis, Cardiovascular disorder, Diabetes mellitus, Hypertension, Obesity, Unevaluable event
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: Pt was given Hep-A vaccine at 18:00-18:15. He was a chaplain with the Police Dept and was riding with a Police Officer. The Police Officer took the pt home at 23:30. States that the pt had no complaints at that time. At 02:15, the Police Dept was informed by the pt''s wife that he had been sent to the hospital and died. Autopsy states cause of death as atherosclerotic cardiovascular disease. Other significant conditions: diabetes, hypertension, obesity.

VAERS ID:166439 (history)  Vaccinated:2000-12-15
Age:58.0  Onset:2000-12-15, Days after vaccination: 0
Gender:Female  Submitted:2001-02-08, Days after onset: 55
Location:Illinois  Entered:2001-03-05, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0454AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0710K IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt experienced redness, pain, swelling and warmth on left upper and lower arm, the night of the injection. RN was notified the next morning. Instructed pt to take ibuprofen and consult MD. On 12/18/00, she saw MD and was dx''d with cellulitis and placed on Keflex. Contact made on 12/20/00 and condition is much improved.

VAERS ID:166440 (history)  Vaccinated:2000-12-15
Age:58.0  Onset:2000-12-15, Days after vaccination: 0
Gender:Female  Submitted:2001-02-08, Days after onset: 55
Location:Illinois  Entered:2001-03-05, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0454AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0710K IMRA
Administered by: Other     Purchased by: Private
Symptoms: Eye oedema, Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pronounced edema, redness and itching at injection site on right arm. Ice applied. Refused antihistamine. Arm checked in 30 minutes; at 45 minutes had swelling of right eye. Chlo-Amine tablets (4) given. Arm slowly improved. Continued with ice. Instructed to take Benadryl at home and call MD if condition worsens. At 16:00, arm checked and was much improved.

VAERS ID:166700 (history)  Vaccinated:2001-02-07
Age:58.0  Onset:2001-02-07, Days after vaccination: 0
Gender:Female  Submitted:2001-02-21, Days after onset: 14
Location:Michigan  Entered:2001-03-07, 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: Patient states she is on several meds including antidepressant.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM671A41IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cachexia, Coordination abnormal, Depression, Dysphonia, Influenza like illness, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (narrow)
Write-up: This patient received TD and Hep A on 07/05/00, at her county health dept. She called them to report "severe flu-like symptoms" that evening. She was told it was like due to the TD. The patient received her 2nd Hep A vaccine on 02/07/01 at another county health dept. Within in hours she developed "worse state of depression she''s ever had", also complained of weakness, shaking, and dropping things. She developed a hoarse voice which she still has. The patient walked into the Health dept today to report all of this, she did not call there or her private physician.

VAERS ID:167145 (history)  Vaccinated:2001-02-05
Age:58.0  Onset:2001-02-07, Days after vaccination: 2
Gender:Female  Submitted:2001-02-12, Days after onset: 5
Location:Oregon  Entered:2001-03-14, 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: Asthma, Perennial allergies
Diagnostic Lab Data: NONE
CDC 'Split Type': OR200105
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3352A40IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0945K1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Returned to clinic on 2/7/01 with redness and swelling in upper left arm. Also had swollen upper lip that AM but this resolved.

VAERS ID:167221 (history)  Vaccinated:2001-02-19
Age:58.0  Onset:2001-02-20, Days after vaccination: 1
Gender:Female  Submitted:2001-03-06, Days after onset: 14
Location:Texas  Entered:2001-03-16, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40082334IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1197K1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blister, Contusion, Injection site pain, Injection site reaction, Malaise, Pruritus, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 2/20/01 pt had fever 102F and "feeling out of it" and had a red, local reaction at the injection site. On 2/21/01, more of the same. Very sick with rash on arm. On 2/22/01, too sick to see doctor but he talked her into being seen on 2/23/01. Had severe reaction on arm. Started on prednisone X 4 days and felt 80% better. On 2/24/01, reaction started getting better.

VAERS ID:167740 (history)  Vaccinated:2001-03-12
Age:58.0  Onset:2001-03-12, Days after vaccination: 0
Gender:Male  Submitted:2001-03-15, Days after onset: 3
Location:D.C.  Entered:2001-03-23, 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: Many-get from pt
Current Illness: NONE
Preexisting Conditions: Get from pt or LMD
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM670B60IM 
YF: YELLOW FEVER (YF-VAX)CONNAUGHT LABORATORIESUA728AA0IM 
Administered by: Private     Purchased by: Private
Symptoms: Dysgeusia, Fatigue, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Received yellow fever and Hep-A on 3/12/01. About 19:00, felt very tired and went to bed. Woke up with vomiting, weakness, headache and metallic taste. No specific Rx taken. Felt improved but weak on 3/13/01.

VAERS ID:168169 (history)  Vaccinated:2000-07-25
Age:58.0  Onset:2000-07-25, Days after vaccination: 0
Gender:Female  Submitted:2001-03-21, Days after onset: 239
Location:Ohio  Entered:2001-04-03, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type': OH0011
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)SMITHKLINE BEECHAMLY130B91IMLA
Administered by: Public     Purchased by: 0
Symptoms: Fatigue, Headache, Pain
SMQs:
Write-up: Tired- headache- achy 1st day, 2nd day exhausted & aches everywhere, missed work. Extreme fatigue like never before.

VAERS ID:168383 (history)  Vaccinated:2000-12-11
Age:58.0  Onset:2000-12-13, Days after vaccination: 2
Gender:Male  Submitted:2001-01-16, Days after onset: 34
Location:Wisconsin  Entered:2001-04-06, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': WI0119
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40082076IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: States in mid December and same last year; began with macular scattered rash on entire arms, posterior popliteal to calves and lateral abdomen. Changes to papular; pruritic; open after scratched. No fever. Ruhuli gel decreases pruritus. On 2/1/01, saw MD and was put on prednisone.

VAERS ID:168628 (history)  Vaccinated:1999-08-01
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2001-04-04
Location:Unknown  Entered:2001-04-12, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: progressive arthritis
Diagnostic Lab Data: sed rate - 34, Lyme WB - pos, Igm - 23, IgG - 18,23,39,41, HLA, ANA - neg
CDC 'Split Type':
Vaccination
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM  IM 
Administered by: 0     Purchased by: 0
Symptoms: Arthritis, Condition aggravated, Laboratory test abnormal, Red blood cell sedimentation rate increased
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: The pt received the Lyme vaccine through Yale study 1994-1998 with a history of Lyme arthritis in 1992. Since receiving the vax she has had progressive worsening of the arthritis in her knees with symptoms unresponsive to both PO and IV antibiotics. The reporter feels there is a correlation with this progressive arthritis and the Lyme vaccine.

VAERS ID:168947 (history)  Vaccinated:2001-04-09
Age:58.0  Onset:2001-04-12, Days after vaccination: 3
Gender:Female  Submitted:2001-04-13, Days after onset: 1
Location:Minnesota  Entered:2001-04-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions: allergy to Sulfa
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0365AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The pt experienced a 4"x3" area of redness and warmth at the injection site. The doctor prescribed cold compress, and Tylenol for discomfort and Allegra (antihistamine) as needed.

VAERS ID:169004 (history)  Vaccinated:2001-03-13
Age:58.0  Onset:2001-03-13, Days after vaccination: 0
Gender:Female  Submitted:2001-03-16, Days after onset: 3
Location:Colorado  Entered:2001-04-24, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions: Allergy to codeine; history of renal calculi
Diagnostic Lab Data: BP 124/78; Pulse 64; Resp 12; Temperature 98.9F; Pulse OX 97%
CDC 'Split Type':
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1266K1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Conjunctivitis, Cough, Headache, Hypertension, Hypoventilation, Injection site erythema, Injection site oedema, Injection site pain, Pain, Pyrexia
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: Seen today, after vaccination on 3/13/01 into left deltoid for local erythema, edema, tenderness, generalized body aches, headache, low-grade fever, chills, dry hack-like cough and bilateral conjunctivitis.

VAERS ID:169351 (history)  Vaccinated:2000-11-27
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2001-04-03
Location:Unknown  Entered:2001-05-01, 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: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ6994508FEB2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4008183 IM 
Administered by: Private     Purchased by: Other
Symptoms: Hypoaesthesia, Injection site reaction, Skin atrophy
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Subsequent to receiving vax, the pt developed an injection site reaction characterized by focal fatty atrophy in the subcutaneous tissue and numbness.

VAERS ID:169525 (history)  Vaccinated:2001-04-11
Age:58.0  Onset:2001-04-14, Days after vaccination: 3
Gender:Male  Submitted:2001-04-17, Days after onset: 3
Location:North Carolina  Entered:2001-05-07, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': NC01047
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3375A40IMRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: The pt states that on 4/14/01 he developed itching, red whelps that began on torso and spread to the head, arms legs. Referred to his PMD. He was seen and given medication. The diagnosis was hives. Probably not due to vaccine.

VAERS ID:169694 (history)  Vaccinated:2001-04-24
Age:58.0  Onset:2001-04-25, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:2001-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergies to PCN, Compazine
Diagnostic Lab Data: NONE
CDC 'Split Type': TX0105
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1454K0IMRA
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM667A60IMLA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.R034620SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0316AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Approx. 26 hours, post vax, pt had nausea, diarrhea, abdominal cramping and low-grade fever began. Seen by MD on 4/26/01 at 13:00. Rx''d Pepto-Bismol and had gradual and steady improvement. Completely "better" by 4/30/01. Only site of injection complaint was redness.

VAERS ID:169846 (history)  Vaccinated:2000-11-03
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2001-05-07
Location:Michigan  Entered:2001-05-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM3214A4 IM 
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Pruritus
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad)
Write-up: The pt had prickly itching from elbows to shoulders on both arms, spreading to chest, neck. Has "sores" from scratching. Pressure in chest lately.

VAERS ID:170103 (history)  Vaccinated:2001-05-10
Age:58.0  Onset:2001-05-11, Days after vaccination: 1
Gender:Female  Submitted:2001-05-14, Days after onset: 3
Location:New Jersey  Entered:2001-05-22, 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: Ginko Biloba, Centrum Silver, Caltrate
Current Illness: Laceration to base of left thumb
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4998302 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Back pain, Balance disorder, Blister, Blood pressure increased, Diarrhoea, Feeling hot, Influenza like illness, Injection site erythema, Injection site swelling, Periorbital oedema, Tachycardia
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Friday at 18:00, 48 hours, post vax, had backache, joints, equilibrium, diarrhea X 1 and periorbital edema on 5/12/01. Took Benadryl po on 5/12/01 PM and it helped with the flu-like symptoms. On 5/14/01, pt with swelling, redness at site with blisters-open/closed. Left arm edema from deltoid; left anticubital area warm to touch. Vital signs 97-64-18 BP 130/80.

VAERS ID:171088 (history)  Vaccinated:2001-05-23
Age:58.0  Onset:2001-05-30, Days after vaccination: 7
Gender:Female  Submitted:2001-06-06, Days after onset: 7
Location:Michigan  Entered:2001-06-12, 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: Avista
Current Illness:
Preexisting Conditions: Tylenol III allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0382AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain at injection site for 2-3 days, 7 days, post vax.

VAERS ID:173040 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:2001-07-03
Location:Unknown  Entered:2001-07-09, 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: Glipizide, Metformin, Metoprolol, Nitro-Bid, Omeprazole, Quinine
Current Illness: UNK
Preexisting Conditions: hypertension, chronic obstructive airway disease, diabetes mellitus
Diagnostic Lab Data: Hemoglobin-11.7; blood lactate dehydrogenase-inc; platelet count-13000 cells/mm3; BUN and serum creatinine-inc; ANA-1:160 titer; non-drug dependent IgM pos; all other laboratory/diagnostic tests were normal or negative.
CDC 'Split Type': HQ2574727JUN2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IM 
Administered by: Other     Purchased by: Other
Symptoms: Anaemia, Antinuclear antibody positive, Autoantibody positive, Blood creatinine increased, Blood lactic acid increased, Blood urea increased, Extensor plantar response, Fatigue, Immune system disorder, Immunoglobulins increased, Mental impairment, Oliguria, Paralysis flaccid, Petechiae, Rash, Tachycardia, Thrombocytopenia, Thrombotic thrombocytopenic purpura
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, arterial (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Renovascular disorders (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad)
Write-up: Post vaccination pt presented with mental status changes and oliguria following a several day history of feeling fatigued. He also had a rash on his shins. He was admitted to the hospital approximately 2 weeks post immunization. He was afebrile but tachycardic. PE showed flaccid paralysis, decreased deep tendon reflexes and bilateral Babinski signs. A petechial rash was noted on both shins. The event was managed with plasmapheresis and hemodialysis. The pt has since recovered. It was noted that "it is likely that the influenza vaccine triggered the antibody formation and immune complex deposition and led to the development of TTP."

VAERS ID:173401 (history)  Vaccinated:2001-06-27
Age:58.0  Onset:2001-06-30, Days after vaccination: 3
Gender:Female  Submitted:2001-07-09, Days after onset: 9
Location:California  Entered:2001-07-18, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucophage; Immune Globulin
Current Illness: NONE
Preexisting Conditions: Diabetes
Diagnostic Lab Data: NONE
CDC 'Split Type':
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Manufacturer
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Dose
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HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM671A40IMLA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Fatigue, Headache, Injection site erythema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 3 days post-vax the patient developed a red and sore arm, anorexia, chills, a possible fever, fatigue and a headache. The patient had these symptoms 4-5 days. The patient''s headache was severe enough to use medication every 2-4 hours.

VAERS ID:173833 (history)  Vaccinated:2001-07-20
Age:58.0  Onset:2001-07-21, Days after vaccination: 1
Gender:Male  Submitted:2001-07-24, Days after onset: 3
Location:California  Entered:2001-08-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)CONNAUGHT LABORATORIESR112120IMLA
Administered by: Public     Purchased by: Private
Symptoms: Delirium, Influenza like illness, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: Day 1 pt developed soreness at site which slowly crept over whole body in the next 24 hours, "like the flu." Day 2 pt stated body sore and muscle aches. Day 3 pt had high temperature and felt delirious. Day 4 pt continued with temp to 103. Day 5 Temp broke in early AM only to return but milder by mid-day. Pt had no nausea, vomiting, diarrhea, cough or headache.

VAERS ID:174447 (history)  Vaccinated:2000-11-01
Age:58.0  Onset:2000-11-04, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2001-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0408EA1IM 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Oedema peripheral, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Systemic lupus erythematosus (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: Within 48 hours after the vaccine, I started having joint pains in my hips and shoulders, the pain went down to my elbows, and in after a few weeks the pain moved down to my hands. The pain in my elbows and shoulders has let up but my fingers are getting worse, with some swelling. It is getting difficult to do things like open jars with out alot of pain. I have never had pain like this before. There is nothing listed in the vaccine handout that gives any warnings about arthritis being a side effect of the vaccine.

VAERS ID:174959 (history)  Vaccinated:1976-10-01
Age:58.0  Onset:1977-10-01, Days after vaccination: 365
Gender:Female  Submitted:2002-05-10, Days after onset: 8987
Location:Rhode Island  Entered:2001-09-05, Days after submission: 247
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Klonopin, Lopressor
Current Illness: NONE
Preexisting Conditions: Mastectomy NOS
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ2638128JUN2001
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: A 58 year old female received an injection of influenza virus vaccine in 10/76. One year, post vax, she developed hypersensitivity to the following; sulfa products, penicillin, Floxin, Cipro, codeine, clindamycin, Macrobid, generic Klonopin, blue dye, red dye #40, yellow dye FC #5 and #6, eggs, beef, bacitracin, proparacaine, lidocaine, Tobrex, fluoracaine, Acular, Ocuflox, Vexol and chlorine in the drinking water. Her hypersensitivity symptoms include: nausea and diarrhea. FOLLOW-UP information received fromthe patient on 08/27/01, indicated that she also developed a hypersensitivity to Bactorban and band-aids glue. FOLLOW-UP informationreceived from the patient on 05/09/02 indicated that her symptoms have not related.

VAERS ID:175029 (history)  Vaccinated:2000-09-14
Age:58.0  Onset:2000-09-14, Days after vaccination: 0
Gender:Female  Submitted:2001-03-09, Days after onset: 176
Location:Florida  Entered:2001-09-05, Days after submission: 179
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ambien, Darvocet-N, Ditropan.
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': HQ6276123JAN2001
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4630151IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A medical assistant reported that a 58 year old female received an injection of Pnu-Imune 23 on 09/14/00. Within a few hours of vaccine administration, she developed an injection site reaction characterized by heat, redness, pain, and swelling. It was also reported that this patient had received a dose of Pnu-Imune 23 on 10/20/94. This is 1 of 3 patients from this facility who had an adverse experienced following receipt of Pnu-Imune 23 lot 463-015. Follow-up info received from the physician on 03/06/01, indicated that the patient recovered.

VAERS ID:175741 (history)  Vaccinated:2001-09-06
Age:58.0  Onset:2001-09-07, Days after vaccination: 1
Gender:Female  Submitted:2001-09-21, Days after onset: 14
Location:Massachusetts  Entered:2001-09-26, 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: Verapamil, Premarin, dicyclomine, Lasix, Lipitor, ASA and vitamins
Current Illness: NONE
Preexisting Conditions: hypertension, high cholesterol
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD745IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The pt experienced swelling of the left arm from the shoulder to elbow, with redness, hot to the touch, tenderness and unknown if pt had a fever.

VAERS ID:175748 (history)  Vaccinated:2001-08-27
Age:58.0  Onset:2001-08-29, Days after vaccination: 2
Gender:Female  Submitted:2001-09-18, Days after onset: 20
Location:Florida  Entered:2001-09-26, 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: Ziac
Current Illness:
Preexisting Conditions: diet controlled diabetes, HBP
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Public     Purchased by: Other
Symptoms: Movement disorder, Myalgia, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Extreme muscle pain started in neck and back by late Wednesday Evening. The pt could hardly lift arms over head. The pt experienced hip and buttock pain and then the legs were affected.

VAERS ID:176102 (history)  Vaccinated:2001-09-12
Age:58.0  Onset:2001-09-28, Days after vaccination: 16
Gender:Female  Submitted:2001-10-04, Days after onset: 6
Location:Ohio  Entered:2001-10-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cozmar, Estrogen, Indopanide, Xalatin, Betopic, and Acordra.
Current Illness: NONE
Preexisting Conditions: Hypertension, Glaucoma, allergies to strawberries and Macrobid.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0597L0SC 
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Headache, Lymphadenopathy, Neck pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Began with pea sized swelling of left parotid gland 09/28/2001 which way by 10/01/2001 had progressed to gross swelling of left side of face, low grade temp, headache and neck pain. As of 10/04/2001 swelling and temp have almost resolved HIA "better". Treated with Arigment arophylactically by ENT who saw pt.

VAERS ID:176338 (history)  Vaccinated:2001-10-02
Age:58.0  Onset:2001-10-03, Days after vaccination: 1
Gender:Female  Submitted:2001-10-13, Days after onset: 10
Location:Kansas  Entered:2001-10-16, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Achey;Vaccine not specified;;56;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergies to MS, PCN.
Diagnostic Lab Data: CPK-247; WBC-11.2; Sed Rate-42 and all other values were WNL.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0675AB0IMRA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Blood creatine phosphokinase increased, Feeling abnormal, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: The day after vaccine was given, the pt had a fever, weakness, joint aches (states she could barely move) and "felt funny". She did miss 2 1/2 days from work but did not see a doctor and did not call a doctor''s office. A follow up report received 11/1/2001 adds: Reporter states that pt did have labs drawn but didn''t see her physician. She has subsequently recovered. She had no other vaccine at this visit and no other in the previous 4 weeks. She did report "achy" 2 years ago with flu shot then but no severe effects.

VAERS ID:176343 (history)  Vaccinated:2001-10-04
Age:58.0  Onset:2001-10-04, Days after vaccination: 0
Gender:Male  Submitted:2001-10-10, Days after onset: 6
Location:Indiana  Entered:2001-10-16, 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: Viodex, Ativan, Prilosec
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1456K0IM 
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site pain, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt c/o 3 X3 red, rash area, very warm to touch, whole upper arm aches. Advised oral Benadryl-topical hydrocortisone.

VAERS ID:177014 (history)  Vaccinated:2001-10-19
Age:58.0  Onset:2001-10-21, Days after vaccination: 2
Gender:Male  Submitted:2001-10-25, Days after onset: 4
Location:Oregon  Entered:2001-11-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0688AA IM 
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Discomfort, Headache, Myalgia, Nasal congestion, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: The patient developed knots in his legs 2 days after receiving the flu shot. The knots were gone by the next day. The patient started with a fever, headache, chills, and congestion that evening. The patient has alot of muscle and joint soreness at the present time.

VAERS ID:177127 (history)  Vaccinated:2001-10-26
Age:58.0  Onset:2001-10-27, Days after vaccination: 1
Gender:Female  Submitted:2001-10-31, Days after onset: 4
Location:Virginia  Entered:2001-11-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celebrex, Singulair, Premarin, Accupril, Medroxyprogesterone
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1448K   
Administered by: Other     Purchased by: Other
Symptoms: Chills, Dizziness, Erythema, Joint range of motion decreased, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: The patient had chills and dizziness. The patient''s arm was red and hot with fever. The patient could not raise her arm for 2 days. The patient slept all day Saturday and Sunday and was sore on Monday from laying around. It is now Wednesday and my arm is still red, hurts and has a fever.

VAERS ID:177212 (history)  Vaccinated:2001-09-28
Age:58.0  Onset:2001-09-28, Days after vaccination: 0
Gender:Female  Submitted:2001-10-02, Days after onset: 4
Location:California  Entered:2001-11-06, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO592AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Insomnia, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen arm 15 minutes after administration of vaccine. Bad headaches 4 days, disrupting sleep and work.

VAERS ID:177215 (history)  Vaccinated:2001-10-18
Age:58.0  Onset:2001-10-18, Days after vaccination: 0
Gender:Female  Submitted:2001-10-25, Days after onset: 7
Location:California  Entered:2001-11-06, 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: HCTZ 25mg and potassium supplement.
Current Illness: NONE
Preexisting Conditions: Seasonal allergies, no medical conditions.
Diagnostic Lab Data:
CDC 'Split Type': CA010121
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO684AA IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES476951 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Injection site oedema, Pyrexia, Vasodilation procedure
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: High fever, joint aches, chills (next day), left arm edema, redness, hot to touch and edema great enough to hide elbow. One week later pt still feels tired.

VAERS ID:177318 (history)  Vaccinated:2001-10-17
Age:58.0  Onset:2001-10-19, Days after vaccination: 2
Gender:Female  Submitted:2001-10-23, Days after onset: 4
Location:Wisconsin  Entered:2001-11-07, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0670AA IMLA
Administered by: Private     Purchased by: 0
Symptoms: Diarrhoea, Fatigue, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Post vax, the patient developed a fever, fatigue, myalgia, nausea, loose stools and chills.

VAERS ID:177584 (history)  Vaccinated:2001-10-18
Age:58.0  Onset:2001-10-19, Days after vaccination: 1
Gender:Male  Submitted:2001-11-06, Days after onset: 18
Location:New York  Entered:2001-11-12, 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: aspirin; Tenormin; hydrochlorothiazide; Zestril
Current Illness:
Preexisting Conditions: Asbestos exposure; Coronary artery disease; hyperlipidemia
Diagnostic Lab Data:
CDC 'Split Type': WAES01104569
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0944K1IM 
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Hypokinesia, Injection site erythema, Injection site swelling
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: Information has been received from a woman in a physician''s office concerning a 58 year old Caicasian male pt with hyperlipidemia and coronary artery disease and no known allergies and a history of asbestos exposure who on 10/18/2001 was vaccinated in the right arm with a second dose of pneumococcal vaccine 23 polyvalent. Concomitant vaccinations on 10/18/01 included a second dose in the right arm of Fluvirin. Other concomitant therapy included atenol, lisinopril, aspirin and hydrochlorothiazide. Subsequently, the patient developed erythema with 3+ edema. The affected area was from the injection site(deltoid)to his wrist, affecting his upper arm and forearm. It was reported that his arm was so bad that he couldn''t touch his head. He was started on prednisone over the weekend (on approximately 10/20/20010. The condition was reported to not be resolving so that patient was started on amoxicillian trihydrate (+)Clavulanate potassium 875 mg twice daily for cellulitis. The reporter indicated that she thought the patient was improving because their office had not heard anything further from him. The reporter expressed a concern with the lot since 3 patients received the vaccine and "have had reaction". FOLLOW-UP information from a physician indicated that the patient developed swelling, erythema, pain of right arm from injection site to wrist, with a fever of 101. The patient was treated with antibiotics with resolutiuon of symptoms over approximately 10 days. No further information is availble.

VAERS ID:177617 (history)  Vaccinated:2001-10-04
Age:58.0  Onset:2001-10-04, Days after vaccination: 0
Gender:Male  Submitted:2001-10-04, Days after onset: 0
Location:Michigan  Entered:2001-11-12, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, Lasix, Toprol, Celebrex, Imdur, Captopril, Neurontin, ASA
Current Illness: CAD, Smoker, Hyperlipidemia, S/P Stent Placement
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': MI2001084
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0574AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad)
Write-up: Ten minutes post vax the patient complained of feeling shakey and his throat feels tight. The patient was treated with Benadryl.

VAERS ID:177999 (history)  Vaccinated:2001-10-18
Age:58.0  Onset:2001-10-18, Days after vaccination: 0
Gender:Female  Submitted:2001-11-13, Days after onset: 26
Location:Georga  Entered:2001-11-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO595AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Bacterial infection, Dysgeusia, Musculoskeletal stiffness, Neck pain
SMQs:, Taste and smell disorders (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Taste of formaldehyde for two days. Extreme pain in neck. Could not lift or turn head. Strep throat.

VAERS ID:178109 (history)  Vaccinated:2001-10-29
Age:58.0  Onset:2001-10-29, Days after vaccination: 0
Gender:Female  Submitted:2001-11-05, Days after onset: 7
Location:Texas  Entered:2001-11-21, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vasotec, daily
Current Illness:
Preexisting Conditions: HTN; Allergic to PCN and ASA; No birth defects
Diagnostic Lab Data:
CDC 'Split Type': TX01172
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0675AB2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Per pt, she states that about 20 minutes, post vax, she had onset of pain (severe) to left arm which lasted through the night. Pain subsided by the AM, the next day (10/30/01). No pain today. Also had slight swelling which has subsided since she started using warm packs.

VAERS ID:178128 (history)  Vaccinated:2001-11-01
Age:58.0  Onset:2001-11-02, Days after vaccination: 1
Gender:Male  Submitted:2001-11-07, Days after onset: 5
Location:Alaska  Entered:2001-11-21, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: bronchitis, pneumonia, other respiratory problems
Diagnostic Lab Data: NONE
CDC 'Split Type': AK200170
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0680AA IMLA
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES474936 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: One day post vax left upper arm became pink, swollen and warm to touch from shoulder to elbow. Treated with oral Benadryl and ice. Pt seen by ER physician to make sure it was not cellulitis. Pt continued to treat with oral Benadryl and swelling started to decrease. Six days post vax the pt is doing much better but still some swelling present.

VAERS ID:178406 (history)  Vaccinated:2001-08-15
Age:58.0  Onset:2001-08-20, Days after vaccination: 5
Gender:Female  Submitted:2001-11-20, Days after onset: 92
Location:Unknown  Entered:2001-11-29, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of primary biliary cirrhosis with jaundice and ascities.
Diagnostic Lab Data: No surface antibody titers of Hep-B were checked; apparently, it is routine to re-vaccinate pts for Hep-A and Hep-B prior to transplant.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: 0     Purchased by: 0
Symptoms: Feeling hot, Lethargy, Myalgia, Polyarthritis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (narrow)
Write-up: Pt was given a repeat series of Hep-B vaccine in preparation for a liver transplant. This ADR (adverse drug reaction) occurred following the 2nd injection of the repeat series. Symptoms included: fever to 102.7F, polyarthritis, warm and red knee and ankle joints, myalgias and lethargy.

VAERS ID:178727 (history)  Vaccinated:2001-11-29
Age:58.0  Onset:2001-11-30, Days after vaccination: 1
Gender:Female  Submitted:2001-12-13, Days after onset: 13
Location:Pennsylvania  Entered:2001-12-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Prevacid
Current Illness: NONE
Preexisting Conditions: None except arthritis, lumbar spine
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0713AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Oedema, Pain, Paraesthesia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Pain, swelling in upper arm. Pain, numbness in left 5th finger (1 day after injection. Still persisting on day four.

VAERS ID:178765 (history)  Vaccinated:2001-11-08
Age:58.0  Onset:2001-11-08, Days after vaccination: 0
Gender:Female  Submitted:2001-11-12, Days after onset: 4
Location:Kansas  Entered:2001-12-10, 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: Actos 15 mg QD, Accupil 10 mg QD
Current Illness:
Preexisting Conditions: Feline
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0672AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt called 7 days within flu shot voiced that she had a rash all over her body.

VAERS ID:178913 (history)  Vaccinated:2001-12-04
Age:58.0  Onset:2001-12-04, Days after vaccination: 0
Gender:Male  Submitted:2001-12-07, Days after onset: 3
Location:Maryland  Entered:2001-12-12, 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: NONE
Current Illness: NO
Preexisting Conditions: Hay fever
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0591CA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1071K IMRA
Administered by: Public     Purchased by: 0
Symptoms: Bursitis, Cellulitis, Injection site erythema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Cellulitis of R upper arm, bursitis of R elbow, low grade fever. Redness evening of vaccine within 24 hrs of vac. Rx duracef 1gm x 2 days 500mg BID x 8 days 12/12 - feeling much better.

VAERS ID:178924 (history)  Vaccinated:2001-12-03
Age:58.0  Onset:2001-12-03, Days after vaccination: 0
Gender:Female  Submitted:2001-12-06, Days after onset: 3
Location:Illinois  Entered:2001-12-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Toprol XL, Estrates, Levsin Aciphex
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO708AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site inflammation, Vasodilation procedure
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Left deltoid (site of injection0 red, inflamed, tender to touch. treated with erythromycin 333 TID for 5 days.

VAERS ID:179000 (history)  Vaccinated:2001-11-29
Age:58.0  Onset:2001-12-06, Days after vaccination: 7
Gender:Female  Submitted:2001-12-07, Days after onset: 1
Location:Virginia  Entered:2001-12-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Hypertension
Diagnostic Lab Data: NONE
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0385AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Oedema, Superficial injury of eye, Vasodilation procedure
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Hypersensitivity (narrow)
Write-up: Pt was scratched by her cat in the eye (right). MD advised TD. Given and reaction occured 12/06/2001. Left deltoid area with redness, slightly swollen.

VAERS ID:179082 (history)  Vaccinated:2001-12-05
Age:58.0  Onset:2001-12-06, Days after vaccination: 1
Gender:Female  Submitted:2001-12-07, Days after onset: 1
Location:Massachusetts  Entered:2001-12-17, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;UNK. INFLUENZA VACCINE;;.00;In Sibling
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': MA0105
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0676AA IM 
Administered by: Private     Purchased by: Other
Symptoms: Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Rec''d flu vaccine 12/5/01 4:30pm. Developed fever, chills, headache. 11am 12/6 Tx with tylenol - Sx free as of 9pm 12/6/01.

VAERS ID:179123 (history)  Vaccinated:2001-12-03
Age:58.0  Onset:2001-12-05, Days after vaccination: 2
Gender:Female  Submitted:2001-12-12, Days after onset: 7
Location:Texas  Entered:2001-12-17, 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: HTN meds and oral agents for DM
Current Illness: NONE
Preexisting Conditions: Diabetes Type II and HTN
Diagnostic Lab Data:
CDC 'Split Type':
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.19600J2 LA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Pyrexia, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 1.5 days after injection fever 100-102, 3rd or 4th day post injection, red rash over neck, arms, back and legs. Given steroid shot and cortico steroids by MD on 4th day after injection. Fever did not go away until 8 days after vaccine. Blisters on tongue, gums and oral cavity.

VAERS ID:179364 (history)  Vaccinated:2001-11-26
Age:58.0  Onset:2001-11-26, Days after vaccination: 0
Gender:Female  Submitted:2001-12-17, Days after onset: 21
Location:South Carolina  Entered:2001-12-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO673GA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Oedema, Pain, Rash maculo-papular
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: After injection, approximately 6 hours, left deltoid began hurting, then turned red and swollen at site, raised 1/4", not hard, centered, it stayed about 18 hours. Client did not apply ice or any treatment, thereafter it went away without difficulty.

VAERS ID:179666 (history)  Vaccinated:2001-12-01
Age:58.0  Onset:2001-12-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Oklahoma  Entered:2002-01-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroid
Current Illness: NONE
Preexisting Conditions: Thyroid
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER4018024  LA
Administered by: Public     Purchased by: 0
Symptoms: Hypokinesia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient c/o very sore left arm. she states that she can''t lift it without pain.

VAERS ID:179736 (history)  Vaccinated:2001-11-15
Age:58.0  Onset:2001-11-25, Days after vaccination: 10
Gender:Female  Submitted:2002-01-04, Days after onset: 40
Location:New Jersey  Entered:2002-01-07, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical history, concurrent conditions, and concurrent medications were not specified
Diagnostic Lab Data: NONE
CDC 'Split Type': 2001030469-1
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0IM 
Administered by: Public     Purchased by: Other
Symptoms: Arthritis, Conjunctivitis, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: On 11/15/2001, the vaccine received an injection of the Lyme vaccine. It wasn''t known if she had received previous injection of the vaccine. On 11/25/2001, 10 days post vaccination, she experienced conjuctivitis, rash and arthritis. She was seen by the physician. the diagnosis of arthritis was based on the unspecified symptoms experienced by the vaccinee, no laboratory analyses were performed. Treatment was not specified. The events persisted as of 12/21/2001.

VAERS ID:179777 (history)  Vaccinated:2001-10-18
Age:58.0  Onset:2001-10-20, Days after vaccination: 2
Gender:Female  Submitted:2001-12-27, Days after onset: 68
Location:Unknown  Entered:2002-01-09, 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: Premarin; Flonase; Claritin
Current Illness:
Preexisting Conditions: Hysterectomy 1998; osteoarthritis of right knee; menopause; glaucoma within the last year
Diagnostic Lab Data:
CDC 'Split Type': PJP2002000010
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE06731KA IM 
Administered by: Other     Purchased by: Other
Symptoms: Aneurysm, Carotid artery thrombosis, Hemiparesis
SMQs:, Ischaemic cerebrovascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)
Write-up: The pt received a flu vaccine on 11/5/99 without incidence. On 10/18/01 or 10/19/01, the pt received a Fluvirin vaccine on her deltoid muscle. Within 48 hours, 10/20/01, the pt was dx''d with a cerebral thrombosis and was admitted to a hospital. The pt experienced cerebral thrombosis, MCA with right hemiparesis and aneurysm on the left carotid artery. The pt was discharged on 10/29/01 and at the time of the report was undergoing rehabilitation therapy. The reporter has stated that the pt''s family doctor believed that there was a possible relationship with Fluvirin. The pt did not have a risk factor for stroke per her family physician. The left carotid aneurysm found on exam was a risk factor already present, although unknown. Also, the concomitant use of Premarin would have increased the pt''s risk of cardiovascular events. It is more likely that the combination of the aneurysm and the use of Premarin resulted in this event rather than the vaccination with Fluvirin. Further information regarding the other risk factors will be requested from the reporter.

VAERS ID:179971 (history)  Vaccinated:2000-06-19
Age:58.0  Onset:2000-08-20, Days after vaccination: 62
Gender:Male  Submitted:2002-01-14, Days after onset: 512
Location:New York  Entered:2002-01-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Meds for BP
Current Illness: NONE
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM14689   
Administered by: Private     Purchased by: 0
Symptoms: Difficulty in walking, Pain
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: 8/2000 Knees started bothering me-problems walking, some aching. Has had knees injected 07/19/2001. Had surgery on left knee 10 yaers ago.

VAERS ID:180146 (history)  Vaccinated:2002-01-04
Age:58.0  Onset:2002-01-05, Days after vaccination: 1
Gender:Male  Submitted:2002-01-08, Days after onset: 3
Location:Texas  Entered:2002-01-18, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
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TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESU0154AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: On 1/8/02, the client reported that on 1/5/02, he noted swelling and redness under his left arm. Advised client to see doctor and he declined.

VAERS ID:180759 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:2001-10-15
Gender:Male  Submitted:2002-01-23, Days after onset: 100
Location:Unknown  Entered:2002-01-31, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CVA; HTN; Hypercholesterolemia stabilized on long term Warfarin therapy for RUE DVT.
Diagnostic Lab Data: INR-increased
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Prothrombin level increased
SMQs:
Write-up: Drug interaction: Hypoprothrombinemia. Pt had received influenza vaccine 1 week earlier; INR was therapeutic before influenza vaccine. DX: elevated prothrombin time due to flu vaccine administration (probable). Treatment: Warfarin hold until INR decreased. Diagnosed with interaction between warfarin and influenza vaccine.

VAERS ID:181261 (history)  Vaccinated:2002-01-04
Age:58.0  Onset:2002-01-11, Days after vaccination: 7
Gender:Male  Submitted:2002-02-01, Days after onset: 21
Location:Idaho  Entered:2002-02-12, 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: flu/4018054/IM/RD/0
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': ID02005
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS217A40IMRA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURT1464 IMLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0138BA IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURT1229Z0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0228L0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Malaise, Pharyngolaryngeal pain, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Generalized malaise, sore throat, rash on body starting 7 days after vaccines given. Lasting 1 week +.

VAERS ID:181423 (history)  Vaccinated:2002-01-23
Age:58.0  Onset:2002-01-24, Days after vaccination: 1
Gender:Female  Submitted:2002-02-15, Days after onset: 22
Location:Virginia  Entered:2002-02-15
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:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Myalgia, Pyrexia, Swelling, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Took shot on Wednesday. Started to get ill on Thursday by midnight, temp 103, vomiting, diarrhea all night, swelling in the arm to elbow and very sore. All day on Friday, some what better.

VAERS ID:181453 (history)  Vaccinated:2001-01-17
Age:58.0  Onset:2001-01-20, Days after vaccination: 3
Gender:Male  Submitted:2001-02-02, Days after onset: 13
Location:Massachusetts  Entered:2002-02-15, Days after submission: 378
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': QC0103
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TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD70 IMRA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt received Td on 01/17/2001. Pt returned on 01/19/2001 for red and swollen injection site, and was given Benadryl. On 01/20/2001 pt went to ER complaining of pain and increased swelling and redness at injection site. He was sent home with a dose of Ceftriaxone. Later same day pt returned to ER and was admitted to the hospital. On 01/22/2001 pt was discharged with full resolution of cellulitis, and was given dicloxacillin. No other medications were being taken at the time of the vaccination and no underlying disease conditions were reported.

VAERS ID:181713 (history)  Vaccinated:2000-04-13
Age:58.0  Onset:0000-00-00
Gender:Female  Submitted:2002-08-28
Location:New York  Entered:2002-02-26, Days after submission: 182
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Valaciclovir hydrochlorid, Aspirin, Cefuroxine axatil, Tolterodine tartrate Cancer chemotherapy, Ocutradial, multivitamin, *Cetirizine hydrochloride, magnesium salt, ascorbic acid, triamcinoIone acetonide, Malobetasol propionate
Current Illness: UNK
Preexisting Conditions: Medical history included metastatic *poorly differentiated, high-grade adenocarcinoma *consistent with mammary ductal cancer, with right axillary adenopathy but no detectable primary breast mass (i.e. statge TON2, or IIIA; 1996) treated with doxoprubicin, cyclophosphamids, radiation therapy to the chest, and bone marrow transplantation (1998). Medical history also included multiple
Diagnostic Lab Data: Cranial nerves exam and romber testing-normal; Audiogram-mild high-frequency only, sensorineural hearing loss. Bone scan June 2002 X-ray 18 Nov 1998 left distal traperial has single tiny sour. X-ray 21 AUg 1999 stage II on first NC. Antinu
CDC 'Split Type': A0359642A
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS144B92IM 
Administered by: Private     Purchased by: Other
Symptoms: Anxiety, Arthralgia, Arthritis, Bone disorder, Depressed level of consciousness, Fatigue, Headache, Hearing impaired, Hyperacusis, Injury, Otitis media, Pain, Paraesthesia, Rash, Rhinitis, Sinusitis, Sleep disorder, Tinnitus, Urinary incontinence
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: The pt reportedly received Lymerix; the number of injections administered was not reported. In a Statement of Injuries, her attorney alleged that the pt "suffers from severe osteoarthritis in her left hand, resulting in severe, constant pain, especially in her left thumb. In addition, (she) suffers from fatigue, rashes and tinnitus, greatly impeding her ability to work (and enjoy) playing music". Time to onset following immunization, treatment and outcomes of the alleged events were not reported. The fatigue, rashes and tinnitus are considered disabling because they allegedly are "greatly impeding her ability to work". The follow up states the pt is a 58 year old female. Medical history included metastatic *differentiated, high-grade* adenocarcinoma *consistent w/ductal cancer, w/right axillary adenopathy but not detectable primary breast mass (i.e. stage T0N2, or stage IJIA; 1996) treated with doxoprubicin, cyclophosphamids, radiation therapy to the chest, and bone marrow transplantation (1998). Medical history also included multiple nevi including a melanocytic nevus (1998), deviated nasal septus, bronchitis, pneumonia, herpes simplex virus infection, acromiocclavicular joint degeneration (1998), right thumb pain treated by an surgeon with an injection or unspecified medication (1998), paresthesias, chest pain, irregular heartbeat, flatulence, gastroesophageal reflux disease, two uterine fibroids, nummular dermatitis, heel hyperkeratosis, and marijuana use. The vaccinee was allergic to sulfa and had lactose intolerance. Surgical history included removal of a lymph node in the right axilla (1996), two myonectomies, oophorectomy, and unspecified knee cartilage surgery. Following the administration of the third injection of LYMErix, the vaccinee experienced *''bladder prob''s (frequency)'' treated w/tolterodine (Datxol), ptosis of both eyes,* dyspnea on exertion, viral upper respiratory tract infection, multiple abrasions and contusions after a fall, concussion after a fall, *inability to turn her neck and arm after

VAERS ID:181894 (history)  Vaccinated:2000-12-04
Age:58.0  Onset:2000-12-04, Days after vaccination: 0
Gender:Female  Submitted:2002-02-25, Days after onset: 448
Location:Montana  Entered:2002-03-04, 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: Premarin .625
Current Illness:
Preexisting Conditions: Possible Latex allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 6 RA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: About 10 hours post injection, the pt developed redness from the injection site to her elbow with moderate swelling @ injection site and very warm to touch. Redness and no swelling from 3" below injection site to elbow. symptoms lasted about 6 days. No other symptoms. No treatment other than an ice pack to swollen site Has had this reaction for the last three years. But has gotten worse each year

VAERS ID:182639 (history)  Vaccinated:2001-08-17
Age:58.0  Onset:2001-08-17, Days after vaccination: 0
Gender:Female  Submitted:2001-09-05, Days after onset: 19
Location:Kentucky  Entered:2002-03-19, Days after submission: 195
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: well butrin
Current Illness:
Preexisting Conditions: seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
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HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Influenza like illness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: The day of the vaccination, the pt developed extreme dizziness that lasted 36 hrs with nausea and flu-like symptoms that lasted three days.

VAERS ID:182788 (history)  Vaccinated:2002-03-06
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:2002-03-14
Location:California  Entered:2002-03-25, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0423K1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0996L IMRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red arm rule out cellulitis.

VAERS ID:182849 (history)  Vaccinated:2002-03-11
Age:58.0  Onset:2002-03-12, Days after vaccination: 1
Gender:Female  Submitted:2002-03-22, Days after onset: 10
Location:Louisiana  Entered:2002-03-26, 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: Glaucoma
Diagnostic Lab Data: NONE
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PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness at site of injection entire arm looked flush, no swelling or other irritation.

VAERS ID:182950 (history)  Vaccinated:2000-12-07
Age:58.0  Onset:2001-01-07, Days after vaccination: 31
Gender:Male  Submitted:2002-03-22, Days after onset: 439
Location:Massachusetts  Entered:2002-03-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin E; Multi-vitamins
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1161K SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Polyarthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Employee received MMR on 12/07/2000 at the employer health center. On 03/22/2002 he called the center to report that 1 month after the vaccination he began having inflammatory polyarthritis which still persists. He is being prescribed Prednisone, Vioxx, and plaquinil.

VAERS ID:183607 (history)  Vaccinated:2001-11-19
Age:58.0  Onset:2001-11-19, Days after vaccination: 0
Gender:Female  Submitted:2002-04-11, Days after onset: 142
Location:Mississippi  Entered:2002-04-17, 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: Tylenol, Accolate, Flexeril, Albuterol prn
Current Illness:
Preexisting Conditions: Bursitis right arm, smoker with lung problems
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Nasal congestion, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Pt to ER with fever, sob started on 11/19/2001 afternoon. Congestion, headache, left arm swollen and red around injection site. Pt given Prednisone, Lortab and discharged.

VAERS ID:184634 (history)  Vaccinated:2002-04-25
Age:58.0  Onset:2002-04-28, Days after vaccination: 3
Gender:Female  Submitted:2002-05-03, Days after onset: 5
Location:Michigan  Entered:2002-05-15, 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: Premarin; Progesterone Cream
Current Illness: NONE
Preexisting Conditions: States "post polio"; asthma
Diagnostic Lab Data: NONE
CDC 'Split Type':
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS711A60IMLA
Administered by: Public     Purchased by: Private
Symptoms: Anorexia, Arthralgia, Asthenia, Asthma, Condition aggravated, Dyspnoea, Feeling hot, Nausea, Pallor, Pruritus, Tremor
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: On 4/28/02 had joint pain, "feverish" feeling, pale, anorexia, nausea, weakness, shaking, difficulty breathing (has asthma), which continued until 4/30/02. On 4/30/02, had itching on arms but no rash. On 5/3/02, client recovered, when event reported.

VAERS ID:185639 (history)  Vaccinated:2002-02-20
Age:58.0  Onset:2002-02-21, Days after vaccination: 1
Gender:Female  Submitted:2002-04-05, Days after onset: 43
Location:Tennessee  Entered:2002-05-30, Days after submission: 54
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: Hypothyroid, hyperlipidemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.O9956 IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Dehydration, Pneumonia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Eosinophilic pneumonia (broad)
Write-up: The pt developed pneumonia which required hospitalization from the pneumonia vaccine.

VAERS ID:186816 (history)  Vaccinated:2001-11-20
Age:58.0  Onset:2001-11-20, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2002-06-21
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': PJP200200354
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER760041 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)
Write-up: An anonymised single pt print was received on 06/17/2002 concerning a 58 year old male pt, who experienced myocardial infarction 4 hrs after receiving FluVirin on 11/20/2001. At the time of reporting, the pt had recovered. There was insufficient info to determine the reporter''s causality assessment.

VAERS ID:186820 (history)  Vaccinated:2001-02-08
Age:58.0  Onset:2001-02-10, Days after vaccination: 2
Gender:Female  Submitted:2001-07-11, Days after onset: 150
Location:Michigan  Entered:2002-06-21, Days after submission: 345
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogen NOS, Provera, multivitamins
Current Illness: NONE
Preexisting Conditions: Drug hypersensitivity (allergy sulfa)
Diagnostic Lab Data: NONE
CDC 'Split Type': BIT010024
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV048B4SCLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Headache, Injection site erythema, Injection site oedema, Injection site warmth, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: Subject BIT010024, a 58 year old female with a medical history of allergy to sulfa drugs, received the 5th dose of Anthrax vaccine (lot FAV048B) on 02/08/2001. No other vaccines were given on this date. Concomitant medications at the time of the event included Estrogen, Provers, and dailty multiple vitamins. The pt did not have an illness at the time of vaccination and has no history of reactions to previous vaccinations. Two days post vaccination, the pt experienced a red, swollen, hot to touch area on the upper arm, five and one half to six inches in diameter. The redness continued for six days. Dizziness occurred on the third and fourth day post immunization. Ringing in he ears occurred on the third and fourth day, which was the most severe. While the ringing continued as of 02/22/2001, it is improving. The pt also experienced headaches that were treated with Tylenol from 02/11/2001 to 02/17/2001. While mild headaches continued as of 02/22/2001, the pt had discontinued the use of Tylenol to treat them. The pt noted increased sinus secretions associated with the headaches. Additional info received on 03/08/2001 indicated the headaches resolved b 03/02/2001. The outcome of the other events is unknown.

VAERS ID:186897 (history)  Vaccinated:1999-07-24
Age:58.0  Onset:1999-07-25, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Delaware  Entered:2002-06-25
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: Glaucoma; hypertension; GERD
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 1SC 
Administered by: Military     Purchased by: Military
Symptoms: Bursitis, Fatigue, Pain, Tinnitus
SMQs:, Hearing impairment (narrow)
Write-up: Right shoulder pain continues from time of shot to present. No has migrated to right arm and hand. Tinnitus continues at a level 6/10 and unresolving fatigue. Right subacromial bursitis. Pain has increased since last seen in 2001. Has pain when raises right arm; pain awakens him from sleep if he rolls on affected side, pain includes right hand and 1st finger. Takes no medication. tinnitus-rates intensity at 6/10, which increased immediately after receiving AVA #2.

VAERS ID:187676 (history)  Vaccinated:2002-07-12
Age:58.0  Onset:2002-07-12, Days after vaccination: 0
Gender:Female  Submitted:2002-07-16, Days after onset: 4
Location:Florida  Entered:2002-07-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5299A40IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS720A40IMRA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURAPU0380AB1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Injection site hypersensitivity, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Swelling, pain, red, and hot to the touch left deltoid @ injection site 9 hours after injection.

VAERS ID:188604 (history)  Vaccinated:2001-12-17
Age:58.0  Onset:2001-12-18, Days after vaccination: 1
Gender:Female  Submitted:2002-07-30, Days after onset: 223
Location:Unknown  Entered:2002-08-07, 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: Unk
Current Illness:
Preexisting Conditions: Hypertension NOS
Diagnostic Lab Data:
CDC 'Split Type': WAES0112USA02152
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1051L   
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a physician''s assistant concerning a 58 year old female patient with hypertension who on 12/17/01 was vaccinated with a dose of pneumococcal vaccine 23 polyvent (lot number 641027/1051L). On 12/18/01, the patient developed pruritus and urticaria (site not reported). The patient took diphenhydramine (BENADRYL) for symptoms. The patient was to be seen in the office on 12/19/01. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:188696 (history)  Vaccinated:2002-06-28
Age:58.0  Onset:2002-06-28, Days after vaccination: 0
Gender:Female  Submitted:2002-07-12, Days after onset: 14
Location:Oregon  Entered:2002-08-12, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil, Flonase, Prempro, Atenolol, Allegra, Vioxx
Current Illness: flu sinusitis
Preexisting Conditions: Pen UK
Diagnostic Lab Data:
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO381AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Painful, hot, red area @ site of injection lasting 8-10 days.

VAERS ID:189131 (history)  Vaccinated:2002-08-07
Age:58.0  Onset:2002-08-08, Days after vaccination: 1
Gender:Male  Submitted:2002-08-09, Days after onset: 1
Location:Minnesota  Entered:2002-08-20, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0527AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Had Td on 8/7/02. On 8/8/02 developed streaking, discomfort, increased pain and itching, low grade temp, myalgia into neck, flu-like sx. Started on Vioxx 25mg qd on 8/8/02.

VAERS ID:189279 (history)  Vaccinated:2002-08-12
Age:58.0  Onset:2002-08-12, Days after vaccination: 0
Gender:Female  Submitted:2002-08-13, Days after onset: 1
Location:California  Entered:2002-08-23, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cozaar, Amaril, Lipitor , Ostrace, Provera
Current Illness: NONE
Preexisting Conditions: HCN, NIDOM, HYPERLIPIDEMIA
Diagnostic Lab Data: Fever- to 100.8
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.12510L  RA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Flushing, Injection site erythema, Myalgia, Pyrexia, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Fever, chills, myalsias, facial flushing,redness and tenderness at arm. Treated with rest, Vicodin, and Benadryl.

VAERS ID:189803 (history)  Vaccinated:2002-08-12
Age:58.0  Onset:2002-08-15, Days after vaccination: 3
Gender:Male  Submitted:2002-08-23, Days after onset: 8
Location:Colorado  Entered:2002-09-05, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Puncture wound R index finger to FB removal
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0526AA1 LA
Administered by: Private     Purchased by: Public
Symptoms: Joint range of motion decreased, Musculoskeletal stiffness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: 8/12/02 seen for puncture wound R index finger with retained metal FB. Td given Rx Keflex 500mg po qid #20. Pt referred to hand specialist for FB removal performed 8/13/02 with nerve block. At 8/20/02 FU appt pt c/o side effect to Td which became very stiff, sore, unable to move arm through weekend and stayed home from work 8/19/02. Sx (-) N/T. Finger resolved. Td injection site (-) erythema/edema. Still resolving 8/23/02.

VAERS ID:190044 (history)  Vaccinated:2002-09-09
Age:58.0  Onset:2002-09-10, Days after vaccination: 1
Gender:Female  Submitted:2002-09-10, Days after onset: 0
Location:Pennsylvania  Entered:2002-09-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hot flush, Hyperhidrosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Hot flushes, sweating, sensation over neck and shoulders. Hot feeling and running a temperature.

VAERS ID:190307 (history)  Vaccinated:2002-08-13
Age:58.0  Onset:2002-08-14, Days after vaccination: 1
Gender:Female  Submitted:2002-09-11, Days after onset: 28
Location:North Carolina  Entered:2002-09-18, 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: Altace, Glucovance, Serzone, Allegra, KCL, Oxaprozin, Triamterene HCL
Current Illness: None
Preexisting Conditions: Aspirin, Prednisone, Diabetes, Depression, Arthritis, Penicillin Sulfa Drug, Hypertension, Allergies
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1159L1 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site swelling, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Day after shot, left arm swollen and hot. Week later, injection site swollen to size of quarter and hot. Diminished to dime size 10 days later with hard scab. Month later diminished to size of green pea with hard scab and redness. Still hot and swollen. Treated with Tylenol.

VAERS ID:190360 (history)  Vaccinated:2001-11-26
Age:58.0  Onset:2001-11-27, Days after vaccination: 1
Gender:Female  Submitted:2001-11-28, Days after onset: 1
Location:Washington  Entered:2002-09-19, Days after submission: 294
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin- well batrin
Current Illness: NONE
Preexisting Conditions: Sulfa, Codiene
Diagnostic Lab Data: NONE
CDC 'Split Type': WA011806
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0593AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction
SMQs:
Write-up: Local reaction 5cm diameter

VAERS ID:190794 (history)  Vaccinated:2001-05-03
Age:58.0  Onset:2001-05-03, Days after vaccination: 0
Gender:Male  Submitted:2001-07-03, Days after onset: 61
Location:North Carolina  Entered:2002-09-30, Days after submission: 454
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': U200100713
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3375A40IM 
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS671AH0IM 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURR11210IM 
Administered by: Private     Purchased by: Unknown
Symptoms: Malaise, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: It was reported that a male patient received a Typhim VI and a Hepatitis A vaccination on 05/03/01. Reportedly that same day, the patient developed general malaise and a rash on his arms. A physician did not evaluate the patient. From mailed correspondence received on 06/18/01, it was reported that the patient recovered from this experience. Additional patient, vaccine, responsible physician and vaccine administrator information was provided. This case is closed.

VAERS ID:190936 (history)  Vaccinated:2002-09-18
Age:58.0  Onset:2002-09-19, Days after vaccination: 1
Gender:Female  Submitted:2002-09-24, Days after onset: 5
Location:Ohio  Entered:2002-10-02, 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: Allergic to soft shell crabs, asthma.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1160L1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Injection site inflammation, Pruritus, Pyrexia, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Soreness in entire arm. 9/19/02 PM Fever 101 F, redness at injection site and very warm to touch. 09/20 AM Increase in area of inflammation and now hot to touch. Very sore. Took Tylenol. 9/20/02 PM Elevated temperature 101 F. Injection site inflammation up to softball size. 9/21/02 No fever, inflammation continues at injection site. 9/24/02 Feels much better but arm still sore to touch; still slightly warm, beginning to itch and some skin beginning to slough off. Has used ice pack to arm throughout course.

VAERS ID:191254 (history)  Vaccinated:2002-10-03
Age:58.0  Onset:2002-10-05, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2002-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acipenix, Flexiril,Aleve
Current Illness: Lip Injury
Preexisting Conditions: Hypoglycemic
Diagnostic Lab Data: Returned to visit to hospital on 10/05/02, visit to Primary physician on 10/07/02
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURUO530AA0  
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Injection site erythema, Injection site swelling, Myalgia, Pruritus
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), Arthritis (broad)
Write-up: Large swelling at point of injection (red & itchy) All joints in bodyached muscular aches extreme tiredness symptoms appeared sudenly came on in secondary, treating w/ vicopin & Ibuprofen to ease symptoms

VAERS ID:191319 (history)  Vaccinated:2002-07-29
Age:58.0  Onset:2002-07-29, Days after vaccination: 0
Gender:Male  Submitted:2002-10-06, Days after onset: 69
Location:Virginia  Entered:2002-10-15, 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: Glucomol, Dionad, Avandia, Tercor
Current Illness:
Preexisting Conditions: Diabetes
Diagnostic Lab Data:
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0736AA1IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Arm pain in upper muscle rt arm since vaccine was given. Did not have redness or swelling. No nodes noted. Point tenderness on deltoid area. Radiology report-no radiographic, abnormality rt humerlis. Treatment-Ibuprofen 400-600mg tid with food 1 month.

VAERS ID:191607 (history)  Vaccinated:2002-09-25
Age:58.0  Onset:2002-09-27, Days after vaccination: 2
Gender:Female  Submitted:2002-10-17, Days after onset: 20
Location:Washington  Entered:2002-10-22, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Breast Cancer, lacerated index finger
Preexisting Conditions: Right mastectomy for breast cancer and cellulitis of mastectomy site
Diagnostic Lab Data:
CDC 'Split Type': U200200829
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU0520AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: Information has been received on 10/14/02 from a nurse concerning a 58 year old female patient with a history of right mastectomy for breast cancer and cellulitis on the right mastectomy site who on 9/25/02, was vaccinated with a dose of TD ADS Adult in the right deltoid after a lacerated index finger. The lot number is U01520AA. Patient developed a recurrent cellulitis at the mastectomy site on 9/27/02. No injection site reaction was noted. The patient was hospitalized for 3 days on antibiotics.

VAERS ID:191875 (history)  Vaccinated:2001-10-18
Age:58.0  Onset:2001-12-24, Days after vaccination: 67
Gender:Male  Submitted:2002-05-24, Days after onset: 150
Location:Illinois  Entered:2002-10-23, 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: zocor
Current Illness:
Preexisting Conditions: Non-smoker, Does not work in high risk environment, Has been taking flu vaccine for7 years.
Diagnostic Lab Data:
CDC 'Split Type': U200101327
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURVOB81AA  LA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Hyperhidrosis, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: From mailed correspondence received on 03/11/02 regarding a 59 year old received Influenza (Fluzone SV ''01-''02) vaccine on 10/18/01 at 4 pm, it was reported by the patient that on 12/24/01 he developed rapid onset flu symptoms consisted of 103.5 degree F fever, chills, sweats. Patient did not see a physician. Strain of Flu was not confirmed by culture. These symptoms are currently unresolved. Patient receive vaccine at local Osco drug store. Additional information received on 03/11/02 from mailed correspondence patient reported that he developed flu symptoms on 12/2/01. He developed fever (103 degrees F orally), chills, sweat, body aches, light cough and no nasal discharge. Symptoms lasted above 4 days easing. Flu not confirmed by culture. Patient recovered. The case is closed.

VAERS ID:191908 (history)  Vaccinated:2002-10-18
Age:58.0  Onset:2002-10-20, Days after vaccination: 2
Gender:Female  Submitted:2002-10-23, Days after onset: 3
Location:Illinois  Entered:2002-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on chest near breast bone and on right shoulder. First appeared two days following shot and continue presently. Have taken antihistimine

VAERS ID:192312 (history)  Vaccinated:2002-10-18
Age:58.0  Onset:2002-10-19, Days after vaccination: 1
Gender:Male  Submitted:2002-10-24, Days after onset: 5
Location:Missouri  Entered:2002-11-01, 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: Chest x-ray, urinalysis, blood work-wnl
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0903AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pain, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Felt well at time of injection. Next AM woke up with whole body aching esp shoulders. by 4pm very hot, early AM cold and shaking. The next day hot and cold. Temp 103 to MD 10/21. Doxycycline 50 BID prescribed. 10/24/02 better "best day" since shot.

VAERS ID:192458 (history)  Vaccinated:2002-10-08
Age:58.0  Onset:2002-10-08, Days after vaccination: 0
Gender:Male  Submitted:2002-10-21, Days after onset: 13
Location:Unknown  Entered:2002-11-04, 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: Zocor, Lotral
Current Illness:
Preexisting Conditions: BP high and cholesterol
Diagnostic Lab Data: CRP normal, mic an, RF and ANA normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0910AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthritis, Injection site oedema
SMQs:, Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: 58 year old white male who received Influenza vaccine 10 days prior who developed non-painful swelling of left ankle that has persisted. pt has had influenza vaccine from various manufacturers without side effects. Non painful arthritis. Probably post infections. As per acknowledgement letter: arthritis resolved on own after 6 weeks

VAERS ID:192461 (history)  Vaccinated:2002-10-29
Age:58.0  Onset:2002-10-30, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:2002-11-04
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: Diabetes
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0675M   
Administered by: Private     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: 12 hrs after injection noted pain in deltoid muscle and inability to raise arm without assistance.

VAERS ID:192688 (history)  Vaccinated:2002-10-28
Age:58.0  Onset:2002-10-29, Days after vaccination: 1
Gender:Female  Submitted:2002-10-29, Days after onset: 0
Location:Kansas  Entered:2002-11-06, 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: ASA, Compazine, Anti-Inflamm, Steroids, Percocet, Asthma, Diabetes, Osteoarthritis
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0882AA0 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709M0 RA
Administered by: Private     Purchased by: Other
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: Red, swollen, warm to touch left arm.

VAERS ID:192856 (history)  Vaccinated:2002-10-07
Age:58.0  Onset:2002-10-12, Days after vaccination: 5
Gender:Male  Submitted:2002-11-07, Days after onset: 26
Location:Georga  Entered:2002-11-08, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Respiratory asthma. Achiness which went away.

VAERS ID:193007 (history)  Vaccinated:2002-11-07
Age:58.0  Onset:2002-11-07, Days after vaccination: 0
Gender:Female  Submitted:2002-11-10, Days after onset: 3
Location:Colorado  Entered:2002-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO920AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Patient received her flu shot prior to her appointment for a screening mammography. She has received flu shots yearly without problems. During her mammogram procedure, she suddenly felt lightheaded and nausea. Thought she was going to get sick. She sat for a few minutes, drank some juice and then felt better. Client did not appear to be anxious about her mammogram. Vital signs were normal. Spoke to patient today 11/10, she is feeling fine. Denies any symptoms or adverse affects today. VAERS form submitted due to the sudden onset on feeling light headed and nausea.

VAERS ID:192941 (history)  Vaccinated:2002-10-25
Age:58.0  Onset:2002-10-26, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Idaho  Entered:2002-11-11
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020018 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0735M IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Fatigue, Injection site pain, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt was very fatigued the day after she received the pneumo shot. On Sunday, 2 days after receiving the shot she woke up with severe hives, fatigue, very sore arm and believed shortness of breath. Md advised and steroid shot was given after no success with Benadryl.

VAERS ID:193121 (history)  Vaccinated:2001-11-13
Age:58.0  Onset:2002-01-01, Days after vaccination: 49
Gender:Female  Submitted:2002-11-06, Days after onset: 309
Location:Wisconsin  Entered:2002-11-13, 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: Euista
Current Illness:
Preexisting Conditions: Allergic to Sulfa/Dx Osteoarthritis, Raynauds, Minimal Arthritis
Diagnostic Lab Data: UA-nl, CPK. ESR.AIK PNOS, TSH, CBC, FT4, RA, GLU CA - ANK, Cat Scan, Lumbar spine-neg, Pelvis- neg, Bone scan- neg
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0683BA  RA
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Apprx. 1 month following vaccine- thighs, upper arms, lower buttocks hurt. Comes and goes.

VAERS ID:193240 (history)  Vaccinated:2002-10-28
Age:58.0  Onset:2002-10-28, Days after vaccination: 0
Gender:Female  Submitted:2002-10-30, Days after onset: 2
Location:California  Entered:2002-11-14, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Redness/Achiness left arm;Influenza (Fluzone);;57;In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: PCN, Novacaine
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0883AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Body temperature decreased, Feeling hot, Headache, Injection site erythema, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left arm 3" below site of injection. 3" red area warm to touch, sore; started 10/28/02 increasing. Complained of body aches, headache, temperature 97.5. Ibuprofen given. Ice pack to arm.

VAERS ID:193356 (history)  Vaccinated:2002-10-24
Age:58.0  Onset:2002-10-26, Days after vaccination: 2
Gender:Female  Submitted:2002-11-08, Days after onset: 13
Location:Colorado  Entered:2002-11-15, 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: Aspirin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER40200253 LA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on back, scalp, face, arm, chest and ears. Began on second day after shot. Took 150mg benadryl 5 days until hives did not reoccur.

VAERS ID:193415 (history)  Vaccinated:2002-10-29
Age:58.0  Onset:2002-10-30, Days after vaccination: 1
Gender:Female  Submitted:2002-11-01, Days after onset: 2
Location:New York  Entered:2002-11-18, 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: Flexor, Claridine, Olsakid
Current Illness: NOne
Preexisting Conditions: Hay fever, Sulfa, PCN
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR00311AA2SCLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site erythema, Injection site induration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 10cm erythema, warmth, slight induration. Left upper arm from shoulder to elbow swollen. Treatment: cool compresses, elevation, Clarinex, Prednisone

VAERS ID:193501 (history)  Vaccinated:2002-10-22
Age:58.0  Onset:2002-10-24, Days after vaccination: 2
Gender:Male  Submitted:2002-11-04, Days after onset: 11
Location:North Carolina  Entered:2002-11-19, 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:
Current Illness: NONE
Preexisting Conditions: CABG- HL- HBP- COPD-Thyroid disease
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH40200160 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1448K0 RA
Administered by: Private     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Both arms 4x swollen, red, warmth at site if flu and pneumovax right left site

VAERS ID:193632 (history)  Vaccinated:2002-11-13
Age:58.0  Onset:2002-11-13, Days after vaccination: 0
Gender:Male  Submitted:2002-11-14, Days after onset: 1
Location:Missouri  Entered:2002-11-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Taking accutane for 3 months prior for oily skin
Diagnostic Lab Data:
CDC 'Split Type': MO2002039
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4020022 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash bil forearms, slightly raised small bumps, no itching but rash feels hot to touch. Also has same rash on left side of neck.

VAERS ID:193647 (history)  Vaccinated:2002-11-04
Age:58.0  Onset:2002-11-05, Days after vaccination: 1
Gender:Female  Submitted:2002-11-13, Days after onset: 8
Location:New Jersey  Entered:2002-11-20, 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: Calcium
Current Illness: None
Preexisting Conditions: Osteopenia
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0922AA1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Joint stiffness, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Stiffness in hips, knee, and generalized body aches; felt like arthritis and frozen joints in hips and knees. Patient walked three miles at 1 PM. She normally walks 3 miles a day. Symptoms resolved 11/7/02.

VAERS ID:193946 (history)  Vaccinated:2002-11-19
Age:58.0  Onset:2002-11-19, Days after vaccination: 0
Gender:Female  Submitted:2002-11-19, Days after onset: 0
Location:California  Entered:2002-11-26, 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: Extra Strength Tylenol, Buspar (mg)
Current Illness: Headache
Preexisting Conditions: Asthma, Migraines
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: Unknown
Symptoms: Asthenia, Dizziness, Heart rate increased, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Paleness, weakness, fast heartbeat, Dizziness

VAERS ID:194094 (history)  Vaccinated:2002-06-24
Age:58.0  Onset:2002-06-24, Days after vaccination: 0
Gender:Male  Submitted:2002-11-26, Days after onset: 155
Location:Utah  Entered:2002-11-27, 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: Simvastatin, Lansoprazole
Current Illness: UNK
Preexisting Conditions: Gastroesophageal reflux, hypercholesterolemia
Diagnostic Lab Data: UNK
CDC 'Split Type': A0387170A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Other     Purchased by: Other
Symptoms: Demyelination, Difficulty in walking, Diplopia, Guillain-Barre syndrome, Hemiparesis, Nystagmus, Paraesthesia, Peroneal nerve palsy, Weight decreased
SMQs:, Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow)
Write-up: This report describes the occurrence of chronic inflammatory demyelinating polyneuropathy in a male between 65 and 70 years of age who was vaccinated with hep A inactivated and hep B recombinant vaccine (Twinrix) for prophylaxis. The subject''s medical histroy, concurrent conditions, and concurrent medications were unknown. The subject received his third injection of Twinrix on 6/24/02. While traveling approximately four months post-immunization, between mid-October and mid-November 2002, he was reportedly told that he had developed Guillain-Barr‚ syndrome. He returned to home, where a neurologist made a diagnosis of CIDP and prescribed prednisone. His physician considered Twinrix to be the cause of the CIDP. As of 11/19/02, the CIDP persisted, but had improved. This report of CIDP is considered medically serious (OMIC). The follow up received on 1/8/03 states that the subject''s medical history included hypercholasterolemia and gastroesophageal reflux disorder. Concurrent medications included Zocor and Prevacid. The subject received injections of Twinrix on 3/27/02, 4/26/02, and 6/24/02; lot numbers were not provided. The third injection was administered three months after the first injection, rather than the recommended interval of six months. The subject also received a booster injection of tetanus and diphtheria toxoids (manuf unk) on 3/27/02. The subject left "shortly after" receiving the third injection of Twinrix. While traveling approximately four months post-immunization, he was reportedly told that he had developed Guillain-Barre syndrome. He returned home, where he was evaluated by a neurologist on 10/25/02. The subject presented with "weight loss, dyaesthesia and weakness most pronounced in the left lower extremity." The subject reported that "shortly" after receiving the third injection of Twinrix, he began to exeprience weight loss and tingling in his feet and fingers. On a separate form, the neurologist recorded the onset date as 6/24/02. The subject reported that "over a three month period he has h

VAERS ID:194112 (history)  Vaccinated:2002-10-22
Age:58.0  Onset:2002-10-23, Days after vaccination: 1
Gender:Female  Submitted:2002-10-24, Days after onset: 1
Location:Alaska  Entered:2002-11-27, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cut finger, right hand, middle finger
Preexisting Conditions: NKA, Hard of hearing
Diagnostic Lab Data: Picture taken and sent via Tele Med to MD in Bethel
CDC 'Split Type': AK200249
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUO885AA1 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1161L1 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Rec''d Pneumovac RD on 10/22/02, Return to clinic today 10/24/02 presenting with warm, pink, painful area measuring 12.0 cm X 4.0 cm + is 4.0 cm below injection site. Also has right middle finger with infection (no streak)

VAERS ID:194213 (history)  Vaccinated:2002-11-13
Age:58.0  Onset:2002-11-15, Days after vaccination: 2
Gender:Female  Submitted:2002-11-27, Days after onset: 12
Location:New Mexico  Entered:2002-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Unknown
Symptoms: Asthenia, Blister, Erythema, Headache, Oedema, Pain
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: A flu and pneumonococoal vaccine were administered in the upper left arm on 11/13/02. The arm became red swollen with pain. Pt experiened a burning sensation from the elbow and up into my shoulder area. Returned to the Dr. who administered the shot on 11/18/02 and was told that it was a reaction to the pneumonococoal vaccine. The arm had developed a large bluish and odd yellowish white blister looking area. Understand it was not a blister but sort of reminded me of what a small pox vaccine sort of looked like. No culture was ever taken. Pt was given an antibiotic and cortisone shot in the hips on this date and began taking 500 mg doses of Cephalexin orally. Pt was to return on 11/20 for a follow up. The arm continued to bother pt. Pt returned to Dr. on 11/20. Dr. said it looked better (to pt it did not). Dr. said to return on 11/25 if not better and he would refer pt to a specialist. Pt was feeling badly and explained this to him. Pt had a headache and felt weak. Pt told him pt didn''t know if this was from the shots or if it was sinus. He gave me alegra samples. Pt felt very weak at this point and spend the day in bed after taking an Alegra tablet. Arising once to eat some soup. Around 4-4:30 p.m. Pt called his office to report that pt was really feeling badly. Pt spoke with his medical assistant who had administerd the shot and again explaned I didn''t know what it was but I just felt very very weak. I was told by the medical assistant that I was thinking to much about the injections. I assurd her that I would not bother them again. The following day, I made an appointment at another medical clinic here and saw a CN. She increased the Cephlaxen dosage to 4 times and instructed me to apply moist heat 3 times a day for about 30 minutes each time. I was to return on Monday, 11/25. The office receptionist informed me that the Dr. (CN) I had seen would not be there on 11/25. So an appointment was made for 11/26. On 11/25/02, I was feeling very - Nov 12. Called clinic regarding flu shot. I w

VAERS ID:194284 (history)  Vaccinated:2002-11-07
Age:58.0  Onset:2002-11-08, Days after vaccination: 1
Gender:Male  Submitted:2002-11-25, Days after onset: 17
Location:Ohio  Entered:2002-12-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Accupril, Cardura, Proscar
Current Illness: NONE
Preexisting Conditions: Hypertension, Benign Prostate Hyperplasia
Diagnostic Lab Data: EKG and Blood tests normal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0922AA0 LA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Dizziness, Flushing, Headache, Heart rate increased, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Nausea, muscle aches, chills, lightheadedness, flushing (warm) feeling, headache, increased heart rate. Intermittent and varying symptoms for the last 18 days.

VAERS ID:194524 (history)  Vaccinated:1999-03-17
Age:58.0  Onset:1999-04-19, Days after vaccination: 33
Gender:Male  Submitted:2002-11-26, Days after onset: 1317
Location:Pennsylvania  Entered:2002-12-04, Days after submission: 8
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin; Arthuris; Blood Pressure;Zoloft, Glucophage, Mellaril, Cogentin
Current Illness: None
Preexisting Conditions: "Nervous breakdown" in early 1960''s
Diagnostic Lab Data: Blood testing - HLA-DR4; HLA DR2
CDC 'Split Type':
Vaccination
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Lot
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LYME: LYME (LYMERIX)SMITHKLINE BEECHAM 0  
Administered by: Private     Purchased by: Private
Symptoms: Arthritis, Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arthritis (narrow)
Write-up: Flu like symptoms. BIP machine used for breathing with oxygen. Take arthritis medicine. Follow up note states the lot number was not recorded. Follow-up report on 02/19/2003: PT states, "Lots of pain in body and fever. Fine a crue pain." Annual follow up on 12/23/03: "Vaccine recipient has not recovered from adverse events that were reported for this vaccination. Have a lot of pain, take lot of pain pill and have to use oxygen."

VAERS ID:194617 (history)  Vaccinated:2002-11-17
Age:58.0  Onset:2002-11-17, Days after vaccination: 0
Gender:Female  Submitted:2002-11-22, Days after onset: 5
Location:Ohio  Entered:2002-12-06, 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: Potassium, Vitamin E, Multivitamin (Centrum, HZT 25 mg, Adalat CC
Current Illness: Cough, Congestion
Preexisting Conditions: Cough congestion, Upper Respiratory illness
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: Other
Symptoms: Injection site inflammation, Injection site oedema, Pain, 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: Fever & aches developed around 2 pm, Lasted thru 9 pm approx. Injection site inflammed and swollen. took Ibuprophen for fever, liquids to flush system, sleep & rest.

VAERS ID:194930 (history)  Vaccinated:2002-11-21
Age:58.0  Onset:2002-11-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2002-12-13
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 (Was just in for check up 11/?/02 + checked out perfect)
Diagnostic Lab Data: Chest X-ray taken in Dr''s office showed asthma
CDC 'Split Type':
Vaccination
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Lot
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERICD90  
Administered by: Other     Purchased by: Unknown
Symptoms: Asthma, Cough, Dyspnoea, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Difficulty breathing the evening of 11/21/02. The next day, developed into wheezing without a cough. At 1st, thought, it was just nasal drainage, a bad case of it. But after I got into see my doctor, it was asthma + he gave Augmentin script to fill. I haven''t had a bout of asthma alone for years. I need to call doctor again and see what else he wants me to be on.

VAERS ID:195049 (history)  Vaccinated:2002-11-22
Age:58.0  Onset:2002-11-23, Days after vaccination: 1
Gender:Female  Submitted:2002-11-25, Days after onset: 2
Location:Illinois  Entered:2002-12-17, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ultracet; Multi-vitamin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': IL02066
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0946AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0111M0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Joint range of motion decreased
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Patient complained of 4 inch diameter of redness, edema encircling entire upper arm and it includes axilla, weakness, and states, "couldn''t move arm for 2 days." Patient currently taking Ibuprofen and is seeing some slight daily improvements.

VAERS ID:195050 (history)  Vaccinated:2002-12-05
Age:58.0  Onset:2002-12-05, Days after vaccination: 0
Gender:Female  Submitted:2002-12-09, Days after onset: 4
Location:Illinois  Entered:2002-12-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 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 MANUFACTURER1026M0IMLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURERE6592KA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Cellulitic type reaction in right arm 6cm proximal to 8cm distal to injection site. Neatly circumferential.

VAERS ID:195092 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Utah  Entered:2002-12-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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HEPAB: HEP A + HEP B (TWINRIX)SMITHKLINE BEECHAM218B61 LA
Administered by: Other     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: UNK

VAERS ID:195170 (history)  Vaccinated:0000-00-00
Age:58.0  Onset:0000-00-00
Gender:Male  Submitted:2002-12-12
Location:New Jersey  Entered:2002-12-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabet
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Azotaemia, Bacterial infection, Balance disorder, Hypertension, Myalgia, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypertension (narrow), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Chronic kidney disease (narrow)
Write-up: Blurred vision, muscle soreness, off balance.

VAERS ID:195385 (history)  Vaccinated:2002-11-01
Age:58.0  Onset:2002-11-08, Days after vaccination: 7
Gender:Male  Submitted:2002-12-10, Days after onset: 32
Location:New York  Entered:2002-12-26, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Liptor, Altace
Current Illness: NONE
Preexisting Conditions: Spinal fusion for (unknown)6/14/01; Hx 6th nerve palsy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0934CA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Diplopia, Headache, Influenza
SMQs:, Ocular motility disorders (broad)
Write-up: One week after influenza vaccination, developed headache, flu-like symptoms and double vision. Seen by op

VAERS ID:195910 (history)  Vaccinated:2002-11-13
Age:58.0  Onset:2002-11-15, Days after vaccination: 2
Gender:Male  Submitted:2002-11-22, Days after onset: 7
Location:Massachusetts  Entered:2003-01-08, 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: Allopurinol, Zestrie, Lipitor
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES0923L  LA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received PPV 23 to left arm 11/13/2002. Pt stated that pm 11/15/2002, he saw white aurafor 3-4 hours. He also had chills, at site of injection, pt c/o increase redness and swelling. At time of my injection 11/22/2002. no redness or swelling.

VAERS ID:196069 (history)  Vaccinated:2002-12-18
Age:58.0 &nbs