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Found 551189 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:81724 (history)  Vaccinated:1994-06-01
Age:40.5  Onset:1994-06-01, Days after vaccination: 0
Gender:Female  Submitted:1995-08-31, Days after onset: 456
Location:Rhode Island  Entered:1995-10-13, Days after submission: 43
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt exp fatigue p/dose 1
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO5434
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX ID)PASTEUR MERIEUX INST.J11031 A
Administered by: Private     Purchased by: Unknown
Symptoms: Asthenia, Myalgia, Pruritus, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)
Write-up: constitutional fatigue, general weakness, achy, sore arm;not painful;had initial local itching;will probably not continue series & check titer;28JUN94 follow-up recovered

VAERS ID:81976 (history)  Vaccinated:1994-10-04
Age:40.4  Onset:1994-10-04, Days after vaccination: 0
Gender:Female  Submitted:1995-08-31, Days after onset: 331
Location:Pennsylvania  Entered:1995-10-17, 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: Cephalexin 10-14 days
Current Illness: cat bite
Preexisting Conditions: no allergy history
Diagnostic Lab Data:
CDC Split Type: CO5588
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K00653  
Administered by: Other     Purchased by: Private
Symptoms: Hyperhidrosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: noc sweats w/fever that was not measured;bitten by stray cat on 19SEP94 & recvd IV ATB, & Cephalexin for 10-14 days;

VAERS ID:78192 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Male  Submitted:1995-10-10
Location:Ohio  Entered:1995-10-18, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1341A0IM 
Administered by: Public     Purchased by: Public
Symptoms: Herpes zoster
SMQs:
Write-up: pt devel herpes zoster w/in 7 days of receiving 1st dose of HEB vax; dx''d & rx''d by PMD

VAERS ID:79302 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:1995-07-10
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1995-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95080149
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: a child recvd vax;child''s mom devel macular,vesicular lesions on the distal portion of the legs, proximal arms&in mouth;the oral lesions caused a difficulty eating;was noted that there was no documentation of the vaccinee devel lesions

VAERS ID:78654 (history)  Vaccinated:1995-10-13
Age:40.8  Onset:1995-10-13, Days after vaccination: 0
Gender:Female  Submitted:1995-10-25, Days after onset: 12
Location:California  Entered:1995-11-03, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS0057P  A
Administered by: Unknown     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt devel hives p/1st flu vax;

VAERS ID:78750 (history)  Vaccinated:1995-10-20
Age:40.2  Onset:1995-10-25, Days after vaccination: 5
Gender:Male  Submitted:1995-10-27, Days after onset: 2
Location:Minnesota  Entered:1995-11-07, 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: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: saw neurologist; neg stroke MS, Bell''s palsey atypical; MRI-tumor
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Hypokinesia, Injection site reaction, Paraesthesia, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: numbness on lt side top of head to waist arm;no loss of motor control x/face;felt hot/cold temps ok;problems in face have gotten worse arm is getting better;centered @ site of inj;

VAERS ID:78902 (history)  Vaccinated:1995-10-25
Age:40.8  Onset:1995-10-25, Days after vaccination: 0
Gender:Female  Submitted:1995-11-07, Days after onset: 13
Location:South Dakota  Entered:1995-11-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp same sxs as above @ 39yrs w/flu vax;sibling exp same rxn as above @ 44yrs
Other Medications: Wellbutrin;Naldecon;Desyerl
Current Illness: NONE
Preexisting Conditions: yearly allergies outside & inside, foods, wool, sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49580850 RA
Administered by: Private     Purchased by: Other
Symptoms: Anorexia, Hypokinesia, Injection site mass, Injection site pain, Myalgia, Nausea, Pyrexia, Similar reaction on previous exposure to drug, Thinking abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: exp burning sensation when fluid put in rt arm much bleeding;arm remained sore 2 firm knot @ site for several days;nauseaous, severe h/a, diarrhea (p/eating) several timeas a day;loss of appetite, fever 98.9-100.7;muscle & bone soreness;

VAERS ID:78944 (history)  Vaccinated:1995-10-16
Age:40.0  Onset:1995-10-17, Days after vaccination: 1
Gender:Male  Submitted:1995-11-02, Days after onset: 16
Location:Florida  Entered:1995-11-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Tagamet
Current Illness: NA
Preexisting Conditions: asthma
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F611341IMLA
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: day p/vax arm became very sore & was diff to move; c/o severe soreness off & on APAP controls sxs; seen by clinic MD;dx traumatic myalgia f/u w/PMD:

VAERS ID:81613 (history)  Vaccinated:1993-02-20
Age:40.0  Onset:1993-09-01, Days after vaccination: 193
Gender:Unknown  Submitted:1994-10-18, Days after onset: 412
Location:New York  Entered:1995-11-14, Days after submission: 392
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sudafed
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: SEP93 LDH approx 2X nl; SGOT approx 2X nl; SGPT approx 2X nl; GGT approx 2X nl; liver biopsy liver cell induction
CDC Split Type: 940094721
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Hepatic function abnormal, Hepatitis, Infection
SMQs:, Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Lack of efficacy/effect (narrow)
Write-up: pt recvd vax & 9 months later was found to have elevated liver enzymes;pt subsequently had a liver biopsy which was dx as liver cell induction

VAERS ID:81624 (history)  Vaccinated:1994-08-26
Age:40.0  Onset:1994-08-26, Days after vaccination: 0
Gender:Female  Submitted:1994-10-24, Days after onset: 59
Location:Louisiana  Entered:1995-11-14, Days after submission: 386
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: 940096981
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1374A40IMRA
Administered by: Other     Purchased by: Private
Symptoms: Diarrhoea, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax;10 hrs later,exp d,cramping & n;sx lasted for 48 hrs;

VAERS ID:81640 (history)  Vaccinated:1994-09-19
Age:40.0  Onset:0000-00-00
Gender:Male  Submitted:1994-11-07
Location:Unknown  Entered:1995-11-14, Days after submission: 372
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Blood work: POS liver abnm;
CDC Split Type: 940101431
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1374A42IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Hepatic function abnormal, Jaundice, Nausea, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recvd vax;following 3rd dose, exp inc fatigue,n,v & jaundice; dph given by MD;pt reports feeling very tired; cannot work a full day

VAERS ID:82119 (history)  Vaccinated:1995-01-24
Age:40.0  Onset:1995-01-24, Days after vaccination: 0
Gender:Female  Submitted:1995-02-01, Days after onset: 8
Location:Vermont  Entered:1995-11-14, Days after submission: 286
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aerobid;Albuterol
Current Illness:
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type: 950007921
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1437A40IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recvd vax & post vax exp a low grade temp & rash around the inj site extending across thorax & up neck;these symptoms were treated w/DPH;

VAERS ID:82283 (history)  Vaccinated:1995-03-14
Age:40.8  Onset:1995-03-27, Days after vaccination: 13
Gender:Female  Submitted:1995-05-17, Days after onset: 50
Location:Unknown  Entered:1995-11-14, Days after submission: 181
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: WBC 3apr95=3100 CUMM;RBC 3apr95:4.19 XMIL;MCH=31.5 PG 3apr95;MONO =9% 3apr95;HBSA nonreactive;NEUTHs 3apr95 57%; Lymph:32% 3apr95; X-Ray neg on 11apr95;
CDC Split Type: 950030371
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1441A40IMA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dysphonia, Influenza, Leukocytosis, Lymphadenopathy, Malaise, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: 2 days of tender mass or lymph node in lt neck,pain over lt side of face,low grade cough w/small amount of yellow,hoarseness;discomfort in lt ear when pt chewed;devel non-itching rash,awful w/no energy;flu;viral illness not related to vax;

VAERS ID:82304 (history)  Vaccinated:1995-04-18
Age:40.0  Onset:1995-04-18, Days after vaccination: 0
Gender:Male  Submitted:1995-04-24, Days after onset: 6
Location:Unknown  Entered:1995-11-14, Days after submission: 204
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 13-Mar-95 Engerix B, Lot #1307A6, flu like sxs
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 950035771
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1307A61  
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Similar reaction on previous exposure to drug
SMQs:
Write-up: pt recvd vax;exp flu like sx w/in a couple of hrs;

VAERS ID:82305 (history)  Vaccinated:1995-04-19
Age:40.0  Onset:1995-04-19, Days after vaccination: 0
Gender:Female  Submitted:1995-04-25, Days after onset: 6
Location:Unknown  Entered:1995-11-14, Days after submission: 203
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: in pt, feet & ankles swelled w/ 1 dose of engerix;
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes
Diagnostic Lab Data:
CDC Split Type: 950035781
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1307A61  
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Injection site oedema
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: pt recvd vax; felt dizzy & exp swelling at inject site;

VAERS ID:82487 (history)  Vaccinated:1995-06-05
Age:40.0  Onset:1995-06-06, Days after vaccination: 1
Gender:Female  Submitted:1995-06-27, Days after onset: 21
Location:Unknown  Entered:1995-11-14, Days after submission: 140
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: topical rxn to local antiseptic
Diagnostic Lab Data:
CDC Split Type: 950058551
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1591A40IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypertonia, Myasthenic syndrome, Myoclonus, Nuchal rigidity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt recvd vax & 1 days post vax reported neck stiffness;therapist suggested neck massage;during massage pt exp tingling down rt arm & flexion contractions of 3rd & 4th fingers;seen by MD who prescribed Xanax;weakness & tingling cont;

VAERS ID:82502 (history)  Vaccinated:1995-04-06
Age:40.8  Onset:1995-04-07, Days after vaccination: 1
Gender:Male  Submitted:1995-08-17, Days after onset: 132
Location:Unknown  Entered:1995-11-14, Days after submission: 89
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zestril, Zestoretic, Norvasc, K-dur
Current Illness: NONE
Preexisting Conditions: HTN, smoker, tuberculosis;pt had stab wound to lt forearm resulting in diff w/extension of the fingers
Diagnostic Lab Data: 7APR95 PE-lt facial droop, dec taste on anterior 2/3 of tongue, hyperacusis of lt ear & ?blurred, lt optic disk;BP 160/112;7APR95 ophthalmic exam: vision was 20/30 in both eyes;inability to close lt eye;
CDC Split Type: 950048091
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1437A42IMRA
Administered by: Private     Purchased by: Other
Symptoms: Ageusia, Blindness, Conjunctivitis, Eye disorder, Facial palsy, Hyperacusis, Hypertension, Keratitis
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Corneal disorders (narrow), Retinal disorders (broad), Hearing impairment (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: pt recvd vax & 16hrs p/vax pt noted lt facial palsy w/drooling, paralysis of facial nerve, hyperacusis of lt ear, dec taste;dx bell''s palsy;BP 160/112;c/o lt eye irritation & dec vision;poss bell''s palsy w/keratitis 2ndary to exposure;

VAERS ID:82539 (history)  Vaccinated:1994-05-10
Age:40.6  Onset:1994-05-14, Days after vaccination: 4
Gender:Male  Submitted:1995-07-17, Days after onset: 429
Location:Unknown  Entered:1995-11-14, Days after submission: 120
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp bronchitis w/dose 1 of Engerix-B;& stuffy nose w/dose 2 of Engerix-B
Other Medications: sinus pills;Rocephin;
Current Illness:
Preexisting Conditions: allerg to chicken feathers, bronchitis;pt had bronchitis since childhood;
Diagnostic Lab Data:
CDC Split Type: 950065301
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1099A42  
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Agitation, Asthenia, Chills, Diarrhoea, Hyperhidrosis, Paraesthesia, Sinusitis
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recvd vax 10MAY94 & 4 days post vax exp chills,sweats,tingling in arms,diarrhea,cramps,irritability,fatigue,& chronic sinusitis;sx principally fatigue & chronic sinusitis cont

VAERS ID:82554 (history)  Vaccinated:1995-07-25
Age:40.0  Onset:1995-07-25, Days after vaccination: 0
Gender:Female  Submitted:1995-08-02, Days after onset: 8
Location:Connecticut  Entered:1995-11-14, Days after submission: 104
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type: 950071421
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1540A41IMA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & w/in hrs exp hives; An ER or MD visit was required & pt was treated w/an antihistamine;

VAERS ID:79060 (history)  Vaccinated:1995-10-26
Age:40.9  Onset:1995-10-26, Days after vaccination: 0
Gender:Female  Submitted:1995-11-01, Days after onset: 6
Location:Ohio  Entered:1995-11-15, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rxn 1967 w/flu vax inc temp, rash, projective vomiting x 3 days
Other Medications:
Current Illness:
Preexisting Conditions: allergies PCN, ASA, Darvocet, Codeine, IVP dye, tetanus toxoid; hx of pneumonia 7 asthmatic bronchitis in past several yrs, chronic epstein-Barr virus
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958078 SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Back pain, Chills, Headache, Hypertonia, Nausea, Pyrexia, Rash, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax 250PM 26OCT95 & 7PM-730PM severe back & joint pain, h/a, chills, fever;1145PM stiff neck, backache;27OCT95 red rash, (disappeared in 24hrs), palms of hands red, skin felt like sandpaper, t104 w/chills, severe nausea;

VAERS ID:79022 (history)  Vaccinated:1995-10-11
Age:40.5  Onset:1995-10-12, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1995-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp fever, joint pain, n,v @ 39yrs old w/MMR SEP94 booster
Other Medications: Plaquirol, Synthroid, Calan, phenobarb acthylchlorthiazide
Current Illness: SLE no recen flares
Preexisting Conditions: allergies PCN (fever, hives); SLE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: fever 101-102 & emesis 12 hrs p/vax;duration 2 days; also myalgias, arthralgia; pt has hx SLE, no recent flares;

VAERS ID:79104 (history)  Vaccinated:1994-11-14
Age:40.9  Onset:1994-11-14, Days after vaccination: 0
Gender:Female  Submitted:1995-10-30, Days after onset: 350
Location:Washington  Entered:1995-11-17, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: unk
Current Illness: NONE
Preexisting Conditions: unk
Diagnostic Lab Data: NONE
CDC Split Type: WA951176
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51024 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Chills, Conjunctivitis, Cough, Dyspnoea, Hyperhidrosis, Pain, Vasodilatation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: 7PM-had coughing fit from deep inside; got home, relaxed;face got red, not hot; eyes felt like sand in them really dry; sweating but chilled & hot; chest felt tight/breathless/shallow;arm real sore; states took APAP q 3hrs;tightness in ches

VAERS ID:79521 (history)  Vaccinated:1995-10-13
Age:40.6  Onset:1995-10-13, Days after vaccination: 0
Gender:Female  Submitted:1995-10-16, Days after onset: 3
Location:Texas  Entered:1995-11-20, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type: TX95208
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F611450IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dyspnoea, Pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: devel diff breathing & trachael discomfort w/in 1 hr; referred to MD who gave Decadron & Medrol dose pak

VAERS ID:79573 (history)  Vaccinated:1995-09-29
Age:40.0  Onset:1995-09-29, Days after vaccination: 0
Gender:Male  Submitted:1995-10-11, Days after onset: 12
Location:New York  Entered:1995-11-20, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~0.00~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to PCN
Diagnostic Lab Data: NONE
CDC Split Type: BAB036
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESSC71140 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oedema peripheral, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: high fever, swollen arm & pain

VAERS ID:79714 (history)  Vaccinated:1995-10-23
Age:40.0  Onset:1995-10-24, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:1995-11-27
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: person verbalized problems w/eggs in the past;did not state had problems w/eggs when recvd vax, though info was provided to her
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958081 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Injection site hypersensitivity, Malaise
SMQs:, Hypersensitivity (narrow), Arthritis (broad)
Write-up: aching joints, large reddened rxn @ inj site;person felt awful for 2 days;states eat eggs occassionally but suspects that has been sick from eating eggs in the past;suspicion that maybe allerg to eggs

VAERS ID:82713 (history)  Vaccinated:1994-10-07
Age:40.9  Onset:1994-10-07, Days after vaccination: 0
Gender:Female  Submitted:1995-09-20, Days after onset: 348
Location:Texas  Entered:1995-11-29, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Synthyroid
Current Illness: NONE
Preexisting Conditions: no allergy history
Diagnostic Lab Data:
CDC Split Type: CO5602
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES4F51074   
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site reaction, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: large local rxn w/numbness on rt side of head & whole lt side of body w/in5mins of vax;treated w/DPH & completely resolved w/in 3 days;

VAERS ID:79796 (history)  Vaccinated:1995-10-05
Age:40.6  Onset:1995-10-05, Days after vaccination: 0
Gender:Male  Submitted:1995-10-26, Days after onset: 21
Location:Oregon  Entered:1995-12-01, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958075 IMRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5F1086 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: muscle soreness began a few hrs p/inj;pt discovered about 1wk later had dec strength lt arm;pt able to quantify this as lifts weights on a regular basis;began to notice tingling, esp thumb & fore finger lt hand

VAERS ID:79801 (history)  Vaccinated:1995-11-14
Age:40.1  Onset:1995-11-14, Days after vaccination: 0
Gender:Male  Submitted:1995-11-22, Days after onset: 8
Location:Idaho  Entered:1995-12-01, Days after submission: 9
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) (FLUSHIELD)PFIZER/WYETH08480110 RA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: pain in joint of rt elbow 1 hr p/inj & cont to get worse for a wk;spread to lt elbow for 3 days;rt elbow appear to be improving slowly but still painful

VAERS ID:79802 (history)  Vaccinated:1995-11-08
Age:40.0  Onset:1995-11-13, Days after vaccination: 5
Gender:Female  Submitted:1995-11-27, Days after onset: 14
Location:Arizona  Entered:1995-12-01, 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: NONE
Current Illness: NNE
Preexisting Conditions: MVP, horse serum allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0776A0SC 
Administered by: Private     Purchased by: Public
Symptoms: Arthralgia, Osteoarthritis, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: rash, followed by severe joint;swelling & aches;mving from joint to joint-settled in wrist & hands

VAERS ID:79820 (history)  Vaccinated:1995-10-16
Age:40.7  Onset:1995-10-18, Days after vaccination: 2
Gender:Female  Submitted:1995-10-23, Days after onset: 5
Location:Pennsylvania  Entered:1995-12-04, Days after submission: 42
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NA
Current Illness: NONE
Preexisting Conditions: seasonal allergies
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F611002 RA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Laryngospasm, Pruritus, Rash, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: total body rash, swelling of nasal passages, swelling of throat-ER tx included IV Solumedrol 125mg;IV DPH;IV Pepcid;Epi;Tagamet, Pred;sx included local swelling, redness, itch @ site

VAERS ID:79901 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1995-11-07
Location:California  Entered:1995-12-07, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E2805HC IM 
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Insomnia
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: sleeping poorly, Saturday nite, dizzy still feeling dizzy

VAERS ID:80219 (history)  Vaccinated:1995-11-03
Age:40.0  Onset:1995-11-20, Days after vaccination: 17
Gender:Female  Submitted:1995-12-06, Days after onset: 16
Location:North Carolina  Entered:1995-12-22, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: zoloft
Current Illness:
Preexisting Conditions: pt had flu immun in the past yr;
Diagnostic Lab Data:
CDC Split Type: 895347005L
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958079 IMA
Administered by: Private     Purchased by: Private
Symptoms: Dysuria, Guillain-Barre syndrome, Influenza, Leukocytosis, Myalgia, Urinary tract infection
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recvd vax;was adm to hosp w/ dx of a "mild case" of GBS;pt hosp for 5 days & was discharged w/ urinary catheter;

VAERS ID:80582 (history)  Vaccinated:1995-10-26
Age:40.6  Onset:1995-11-09, Days after vaccination: 14
Gender:Female  Submitted:1995-11-27, Days after onset: 18
Location:North Carolina  Entered:1996-01-02, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unable to get info
Other Medications: unable to get info
Current Illness: NONE
Preexisting Conditions: unable to get info from pt
Diagnostic Lab Data: NONE
CDC Split Type: NC95129
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61023 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: rash all over 2wks p/shot;rash itched;MD felt this was related to flu shot

VAERS ID:80964 (history)  Vaccinated:1995-10-20
Age:40.4  Onset:1995-10-21, Days after vaccination: 1
Gender:Female  Submitted:1996-01-04, Days after onset: 75
Location:New Hampshire  Entered:1996-01-19, 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: TINE
Current Illness:
Preexisting Conditions: cashews-hives
Diagnostic Lab Data:
CDC Split Type: NH95033
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5H711423  
Administered by: Private     Purchased by: Public
Symptoms: Oedema, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: red & swollen;hurt lasted 5-6 days;

VAERS ID:81114 (history)  Vaccinated:1995-01-04
Age:40.4  Onset:1995-01-05, Days after vaccination: 1
Gender:Female  Submitted:1996-01-08, Days after onset: 368
Location:New Mexico  Entered:1996-01-22, Days after submission: 14
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: asthmatic/allergic to nuts-perioral edema, + PPD
Diagnostic Lab Data:
CDC Split Type: NM96001
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5C7114 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Hypersensitivity, Oedema, Pain, Pruritus, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 5cm redness, warmth, swollen, painful & itchy;pt states rxn has dec;pt advised to use cold compresses to relieve allergic rxn;4 days-had not resolved as of 8SEP95

VAERS ID:81092 (history)  Vaccinated:1995-10-23
Age:40.9  Onset:1995-10-24, Days after vaccination: 1
Gender:Female  Submitted:1995-10-26, Days after onset: 2
Location:New Hampshire  Entered:1996-01-28, Days after submission: 94
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recvd Rabies vax 6NOV95 by MI DEPT of hlth
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NH95037
Vaccination
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Site
RAB: RABIES (NO BRAND NAME)MICHIGAN DEPT PUB HLTH1395B1IM 
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: p/vax on 23OCT95 pt had swelling of the inj site, soreness, burning, itching, & redness in color;pt exp no sxs w/1st Rabies vax 10OCT95;

VAERS ID:83201 (history)  Vaccinated:1995-09-01
Age:40.2  Onset:1995-11-14, Days after vaccination: 74
Gender:Male  Submitted:0000-00-00
Location:Wisconsin  Entered:1996-01-31
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: 30AUG95 indirect antiglobulin neg; 14NOV95 complement fixation neg;
CDC Split Type: WAES95111372
Vaccination
Manufacturer
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0403B0SC 
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recvd vax 1SEP95 & lab eval on 14NOV95 revealed complement fixation studies neg;no further details were provided;

VAERS ID:83356 (history)  Vaccinated:1995-11-17
Age:40.0  Onset:1995-12-01, Days after vaccination: 14
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:1996-01-31
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: neutropenia;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95120615
Vaccination
Manufacturer
Lot
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax 17NOV95 & 1DEC95 pt noticed 1 lesion on lower extremity;# of lesions had gradually inc & now had several hundred;1DEC95 MD nicked hand while performing surgery & had cellulitis around it;extensive vesicular lesions

VAERS ID:81711 (history)  Vaccinated:1995-11-06
Age:40.7  Onset:1995-11-06, Days after vaccination: 0
Gender:Female  Submitted:1995-11-28, Days after onset: 22
Location:Nebraska  Entered:1996-02-01, Days after submission: 65
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: unk
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896053009L
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958118 IMA
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt devel gen hives

VAERS ID:81878 (history)  Vaccinated:1995-01-11
Age:40.1  Onset:1995-01-12, Days after vaccination: 1
Gender:Male  Submitted:1995-04-11, Days after onset: 88
Location:Wisconsin  Entered:1996-02-05, Days after submission: 300
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WI95009
Vaccination
Manufacturer
Lot
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1378A12IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Pain
SMQs:
Write-up: 16FEB95 c/o pain lt shoulder to MD;apparently expressed to MD-poss from hep B inj;

VAERS ID:81888 (history)  Vaccinated:1995-03-30
Age:40.1  Onset:1995-03-30, Days after vaccination: 0
Gender:Female  Submitted:1995-04-10, Days after onset: 10
Location:Wisconsin  Entered:1996-02-05, Days after submission: 301
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Atenonol;Trimethoprin
Current Illness: NONE
Preexisting Conditions: react adversly to IVP dye & sulfa
Diagnostic Lab Data: NONE
CDC Split Type: WI95027
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4H61119  LA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Injection site hypersensitivity, Injection site oedema, Malaise, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), 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), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: inj 30MAR95;that PM c/o nausea & chills & aching arm that PM;31MAR95 achy, flushed, nausea, arm hurt, hand burning;fever 100.6 orally, rash around inj site, inc swelling on 1APR95;pt went to hosp 31MAR95-was so sick;

VAERS ID:82416 (history)  Vaccinated:1995-12-15
Age:40.9  Onset:1995-12-16, Days after vaccination: 1
Gender:Female  Submitted:1996-02-05, Days after onset: 51
Location:New York  Entered:1996-02-13, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none
Other Medications: none
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES   LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Neck pain, Nuchal rigidity, Oedema peripheral, Pruritus, Skin nodule, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt recvd vax;16dec95 arm swollen from elbow to arm pit;arm was grossly edematous, hard, red & itchy;inject site was oozing yellow fluid;also painful & stiff neck;to er on 17dec95;tx w/ duricef & ancef;

VAERS ID:82975 (history)  Vaccinated:1996-02-15
Age:40.9  Onset:1996-02-15, Days after vaccination: 0
Gender:Female  Submitted:1996-02-20, Days after onset: 5
Location:Oregon  Entered:1996-02-23, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: poss allergy to yeast in beer, HA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1725A40 LA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Migraine, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recvd vax; w/in 1 hr devel severe migraine HA; violent n & v;

VAERS ID:83981 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1995-10-11
Location:Wisconsin  Entered:1996-02-26, Days after submission: 138
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Traiphasil
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type: 895307013L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958078 IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax; devel inject site rxn characterized by swelling, itching, erythema, warmth;

VAERS ID:84249 (history)  Vaccinated:1995-10-17
Age:40.7  Onset:1995-10-18, Days after vaccination: 1
Gender:Female  Submitted:1995-11-08, Days after onset: 21
Location:Colorado  Entered:1996-02-26, Days after submission: 110
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:
Diagnostic Lab Data:
CDC Split Type: 895353002L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958115 IMA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Chills, Influenza, Myalgia, Pyrexia, Respiratory disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 17OCT95 & w/in 12hrs devel a fever (100 fahrenheit),chills,& flu-like sx,characterized by aches & resp sx;

VAERS ID:84291 (history)  Vaccinated:1995-10-24
Age:40.8  Onset:1995-10-24, Days after vaccination: 0
Gender:Female  Submitted:1995-10-27, Days after onset: 3
Location:Nebraska  Entered:1996-02-26, Days after submission: 122
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:
Diagnostic Lab Data:
CDC Split Type: 896039029L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4958137 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 12-24 hrs devel an inj site rxn characterized as red,raised,warm & 3 inches in circumference

VAERS ID:84374 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Connecticut  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: no relevant data;
CDC Split Type: WAES95020834
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Other     Purchased by: Other
Symptoms: Coordination abnormal, Muscle spasms, Pain
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax in 1990 & shortly p/3rd dose pt devel some cramping & pain in lower legs;sx persisted & pt devel ataxia;pt seen by several MD''s w/no clear dx;FEB95 sx persisted;f/u info from MD indicated that no knowledge of exposure to hep B

VAERS ID:84619 (history)  Vaccinated:1994-03-02
Age:40.1  Onset:1994-03-06, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1996-02-27
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: blood culture neg; culture staph aureus,beta LAC pos; X-ray elbow nl''
CDC Split Type: WAES95071321
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Infection, Lymphadenopathy, Myalgia, Osteoarthritis, Pyrexia, Serum sickness
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax;joint pains;fever 100.6;weakness,fatigue,swollen glands;painful swelling elbow;redness,tenderness;infect;erythematous elbow;purulent paronychia on 4th finger;dx: serum sickness muscles aches,backache,n;tx pred;

VAERS ID:84777 (history)  Vaccinated:1995-10-16
Age:40.3  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estraderm
Current Illness: none
Preexisting Conditions: allergy,sulfa;
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES95101527
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1528W0IM 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Diarrhoea, Headache, Influenza, Injection site pain, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax;devel flu like sx;n,stiff neck;f/u:md reported pt exp n,HA,lt neck soreness,v for 1 day & tender at infect site;tx w/ meds;pt still exp sx at time of rpt;

VAERS ID:84835 (history)  Vaccinated:1995-09-18
Age:40.7  Onset:1995-09-19, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Louisiana  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tenoretic, Slow K
Current Illness:
Preexisting Conditions: high blood pressure
Diagnostic Lab Data: BP 142/42;
CDC Split Type: WAES95110182
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Public     Purchased by: Public
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 recv vax on 29SEP95 pt exp nausea & dizziness when got up;MD reported that the pt exp no problems while on therapy w/antenololchlorthalidone & potassium cl;pt''s BP was sl elevated to 142/72;

VAERS ID:84863 (history)  Vaccinated:1995-11-29
Age:40.0  Onset:1995-11-29, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: 1DEC95 CXR neg;
CDC Split Type: WAES95120308
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1382B0SC 
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 29NOV95 instead of TB skin test & 30NOV95 pt devel a 10cm skin rxn @ the test site w/a 5cm raised red center & a 1cm hard core in the center of the lesion;exp sl itching but no pain or burning;pt recovered;

VAERS ID:84880 (history)  Vaccinated:1995-11-06
Age:40.3  Onset:1995-11-06, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Kansas  Entered:1996-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: sore throat
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES95121578
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Public     Purchased by: Public
Symptoms: Headache
SMQs:
Write-up: pt recv vax 6NOV95 & exp h/a 4hr post vax;h/a was successfully treated w/APAP & the pt was able to remain @ work the rest of the day

VAERS ID:83824 (history)  Vaccinated:1996-02-28
Age:40.0  Onset:1996-02-29, Days after vaccination: 1
Gender:Female  Submitted:1996-02-29, Days after onset: 0
Location:Michigan  Entered:1996-03-22, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MI96021
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1853A43IMRA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt woke up @ approx 7AM 29FEB noted raised hive like spots on face;states they were also warm to touch;states noted spots for a few hrs; MD notified 24FEB96 3PM;

VAERS ID:85254 (history)  Vaccinated:1995-03-13
Age:40.0  Onset:1995-03-15, Days after vaccination: 2
Gender:Male  Submitted:1995-03-21, Days after onset: 6
Location:North Carolina  Entered:1996-04-01, Days after submission: 377
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: none
CDC Split Type: 895100002S
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4938224 IM 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Chills, Injection site hypersensitivity, Injection site mass, Injection site pain, Pruritus, Pyrexia, Serum sickness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;devel erythema,induration,warmth & pain at inject site on lt arm;rxn spread distally to elbow & proximal forearm accompanied by fever,chills,fatigue;"serum sickness type of rxn";almost resolved but pruritic over area involved;

VAERS ID:85266 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1995-06-12
Location:New York  Entered:1996-04-01, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 895215005L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958001 IM 
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site inflammation, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax;cellulitis;very large area of redness(elbow to shoulder),inflammation&hardness dx as cellulitis;pt responding to massive doses of Ceftin;tx in ER;

VAERS ID:85268 (history)  Vaccinated:1995-07-08
Age:40.4  Onset:1995-07-09, Days after vaccination: 1
Gender:Female  Submitted:1995-07-11, Days after onset: 2
Location:Missouri  Entered:1996-04-01, Days after submission: 265
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: 895257015L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958004 IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax; exp swelling & erythema at inject site;also exp n,v & fever of 101;seen by MD;

VAERS ID:84331 (history)  Vaccinated:1995-12-29
Age:40.7  Onset:1996-01-13, Days after vaccination: 15
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:1996-04-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt''s daughter exp hives @ 12yrs w/MMR
Other Medications: seldane
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: MN95035
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.1111A0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Osteoarthritis, Pain
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: gen arthritis starting 2wks p/rubella vax;swelling & pain both hands, both shoulders, & both knees;given rx for naproxen

VAERS ID:84787 (history)  Vaccinated:1996-03-15
Age:40.3  Onset:1996-03-15, Days after vaccination: 0
Gender:Female  Submitted:1996-03-18, Days after onset: 3
Location:Michigan  Entered:1996-04-10, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: fish/iodine in x-ray;some nuts walnuts, cashews
Diagnostic Lab Data:
CDC Split Type: MI96027
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MICHIGAN DEPT PUB HLTHTD6132B1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Injection site oedema, Oedema peripheral, Skin striae, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 15MAR96 & stated last Td 9-10yrs ago no prev rxn;pt began having warm,swollen arm @ inj site rt deltoid;warmth & swelling progressed down arm to forearm on 16MAR & 17MAR;c/o chills & felt cold;noticed red streaks on rt arm

VAERS ID:85020 (history)  Vaccinated:1996-03-26
Age:40.1  Onset:1996-03-27, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Washington  Entered:1996-04-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: AODM
Preexisting Conditions: NKDA:hx HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNU-IMUNE)LEDERLE LABORATORIES4319260IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Bursitis, Cellulitis, Infection, Myalgia, Oedema peripheral, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pain, redness & swelling of lt arm 1 day p/vax given;began oral amoxicillin 2 days p/inj;had spread to entire lt arm;30MAR-1APR hosp-adm to hosp for IV ATB followed by oral dicloxicillin;staph bursitis & cellulitis distal to inj

VAERS ID:85839 (history)  Vaccinated:1996-01-30
Age:40.7  Onset:1996-01-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1996-04-23
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: Mitral valve prolapse; Sinusitis,chronic;allergy erythromycin;allergy biaxin;
Diagnostic Lab Data: no relevant data
CDC Split Type: WAES96020881
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site inflammation, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax; exp itching all over body;exp inflam & redness at inject site;inflam & redness resolved by 7feb96 and itching by 9feb96;

VAERS ID:85652 (history)  Vaccinated:1996-04-29
Age:40.4  Onset:1996-04-30, Days after vaccination: 1
Gender:Female  Submitted:1996-05-01, Days after onset: 1
Location:New York  Entered:1996-05-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1420B SCRA
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958237 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Hypokinesia, Injection site hypersensitivity, Injection site oedema, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: devel pain, swelling, redness in inj site-lt deltoid area;the next day devel fever, gen body aches & chills;limitation ROM of the lt arm;

VAERS ID:85887 (history)  Vaccinated:1996-04-15
Age:40.3  Onset:1996-04-15, Days after vaccination: 0
Gender:Female  Submitted:1996-04-17, Days after onset: 2
Location:Georgia  Entered:1996-05-10, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Premrin;PPD by Parke Davis lot# 01475P
Current Illness: NONE
Preexisting Conditions: diabetes, sickle cell trait
Diagnostic Lab Data:
CDC Split Type: GA96045
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0883B SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71095  LA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: dizziness began around 12noon on date vax recv began having nausea & vomiting @ 8PM which cont off & on throughout noc;cont to have nausea, no vomiting on 16APR96;also weakness & dizziness;was seen @ ER 16APR96

VAERS ID:86150 (history)  Vaccinated:1995-10-23
Age:40.2  Onset:1995-10-24, Days after vaccination: 1
Gender:Female  Submitted:1995-12-14, Days after onset: 51
Location:Iowa  Entered:1996-05-13, Days after submission: 150
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: unk
CDC Split Type: 0010150950281
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS01595P IMLA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Diarrhoea, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 23OCT95 & 24OCT95 w/in 3 hr of vax pt devel nausea, vomiting, fever, diarrhea, & weakness;pt recovered;

VAERS ID:86160 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:1995-12-01
Gender:Female  Submitted:1995-12-14, Days after onset: 13
Location:Maryland  Entered:1996-05-13, Days after submission: 150
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: none reported
CDC Split Type: 0010150950296
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS    
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & inj site became red, hot, tender, itchy & hard;pt has not yet recovered;

VAERS ID:86170 (history)  Vaccinated:1995-10-02
Age:40.0  Onset:1995-10-03, Days after vaccination: 1
Gender:Female  Submitted:1995-10-18, Days after onset: 15
Location:New York  Entered:1996-05-13, Days after submission: 208
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: unk
Diagnostic Lab Data: unk
CDC Split Type: 0010150960002
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00885P0IM 
Administered by: Public     Purchased by: Other
Symptoms: Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 2OCT95 & 24hr p/vax devel h/a, fever, myalgia;

VAERS ID:86173 (history)  Vaccinated:1995-11-03
Age:40.1  Onset:1995-11-03, Days after vaccination: 0
Gender:Female  Submitted:1995-11-03, Days after onset: 0
Location:Washington  Entered:1996-05-13, Days after submission: 191
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: NONE reported
CDC Split Type: 0010150960006
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS 0IMA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Nausea, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: pt recv vax 3NOV95 & 1hr following vax pt exp dizziness, shaking, nausea, vomiting;pt reported sx to the MD;

VAERS ID:87071 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:1996-06-05
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: no relevant data;
CDC Split Type: WAES96032347
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Eye disorder
SMQs:, Corneal disorders (broad), Retinal disorders (broad)
Write-up: nurse was gave pt vax & pt moved & nurse got some of the vax in eyes & on skin; nurse stated that eyes stung a bit;no further details were provided;

VAERS ID:86861 (history)  Vaccinated:1996-05-08
Age:40.7  Onset:1996-05-08, Days after vaccination: 0
Gender:Male  Submitted:1996-05-10, Days after onset: 2
Location:Mississippi  Entered:1996-06-10, 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:
Current Illness: NONE
Preexisting Conditions: h/a caused from car accident yrs ago
Diagnostic Lab Data: NA
CDC Split Type: MS96021
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.VHA465A60IMRA
Administered by: Other     Purchased by: Other
Symptoms: Nausea, Nuchal rigidity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: nausea & stiff neck;nausea only lasted until early AM 9MAY96, neck remained stiff until late PM;today all sx have subsided

VAERS ID:87757 (history)  Vaccinated:1996-05-13
Age:40.0  Onset:1996-05-17, Days after vaccination: 4
Gender:Female  Submitted:1996-05-30, Days after onset: 13
Location:New York  Entered:1996-06-20, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humulin N
Current Illness:
Preexisting Conditions: diabetic, suspected UTI;there have been outbreaks of hepatitis in the patient''s geographic area;
Diagnostic Lab Data:
CDC Split Type: 960069911
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 1IM 
Administered by: Private     Purchased by: Other
Symptoms: Hyperbilirubinaemia
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow)
Write-up: pt recv vax 13MAY96 & 17MAY96 MD was running a UA on pt who had suspected UTI;analysis revealed presence of bilirubin in pt urine;pt is asymptomatic for hepatitis;MD rechecked pt urine twice & it was positive for bilirubin 2nd & 3rd time;

VAERS ID:87430 (history)  Vaccinated:1996-04-03
Age:40.0  Onset:1996-04-16, Days after vaccination: 13
Gender:Male  Submitted:1996-06-16, Days after onset: 61
Location:Wisconsin  Entered:1996-07-01, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1350A0 LA
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Optic neuritis, Visual disturbance
SMQs:, Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad)
Write-up: 2wk post vax pt devel optic neuritis & exacerbation of preexisting MS

VAERS ID:87437 (history)  Vaccinated:1996-05-14
Age:40.7  Onset:1996-05-15, Days after vaccination: 1
Gender:Female  Submitted:1996-06-26, Days after onset: 42
Location:California  Entered:1996-07-01, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1204B2 LA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Myalgia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: body aches, vomiting, h/a, chills started 15MAY96;PE rx meds;

VAERS ID:87486 (history)  Vaccinated:1996-05-13
Age:40.1  Onset:1996-05-25, Days after vaccination: 12
Gender:Female  Submitted:1996-06-27, Days after onset: 33
Location:D.C.  Entered:1996-07-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.1205B SCLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: rash & arthralgias 12 days p/vax-resolved in 2 wk

VAERS ID:88627 (history)  Vaccinated:1996-04-24
Age:40.0  Onset:1996-05-02, Days after vaccination: 8
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:1996-07-18
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: allergy, PCN
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96051973
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 24APR96 & 2MAY96 pt exp nausea, vomiting, diarrhea;

VAERS ID:88665 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:1996-05-01
Gender:Male  Submitted:0000-00-00
Location:Maryland  Entered:1996-07-18
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: No relevant data
CDC Split Type: WAES96052674
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Herpes zoster, Pain
SMQs:
Write-up: 2 children recv vax 3MAY96 & father who claimed never had chicken pox devel shingles on arm;MD dx shingles;

VAERS ID:88679 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:1996-07-18
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: exposure, varicella
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES96060232
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax & failed to devel antibodies;

VAERS ID:89061 (history)  Vaccinated:1995-04-04
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Vermont  Entered:1996-08-02
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: No relevant data;
CDC Split Type: WAES95061191
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1541A   
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax 4APR95 & exp significant pain @ the inj site radiating to axilla;no further details were provided;

VAERS ID:88722 (history)  Vaccinated:1996-06-21
Age:40.6  Onset:1996-06-22, Days after vaccination: 1
Gender:Male  Submitted:1996-07-02, Days after onset: 10
Location:Virginia  Entered:1996-08-06, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: diabetic-diet controlled
Preexisting Conditions: PCN & sulfa
Diagnostic Lab Data:
CDC Split Type: VA96043
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L710954 RA
Administered by: Public     Purchased by: Other
Symptoms: Affect lability, Asthenia, Dyspnoea, Face oedema, Oedema, Paraesthesia, Pharyngitis, Speech disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 21JUN96 & 22JUN96 exp rash;irritation in mouth;23JUN96 12noon exp sore throat & numbness of lips, SOB, swollen tongue;24JUN96 throat more sore felt like flu;25JUN96 speech slurred, tongue & face swollen;c/o feeling mental effect

VAERS ID:88962 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1996-08-08
Location:Kentucky  Entered:1996-08-14, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bone disorder, Chills, Hyperhidrosis, Hypokinesia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: arm hurt, bone started popping, cold sweats, could not raise arm over head, deep aching pain in top of arm;

VAERS ID:89441 (history)  Vaccinated:1995-05-12
Age:40.3  Onset:1995-05-12, Days after vaccination: 0
Gender:Female  Submitted:1996-06-24, Days after onset: 409
Location:Pennsylvania  Entered:1996-08-23, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: CO5944
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4J61014 SCA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypokinesia, Injection site hypersensitivity, Injection site pain, Myasthenic syndrome, Neuropathy, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 10mm local rxn which is painful, red and tender to touch. heavy feeling in entire arm w/ pain on movement & decreased sensation in fingers. c/o decreased sensation rt arm and shoulder pain. pain at inj site.

VAERS ID:89510 (history)  Vaccinated:1995-02-17
Age:40.4  Onset:1995-02-22, Days after vaccination: 5
Gender:Female  Submitted:1996-06-20, Days after onset: 483
Location:New Jersey  Entered:1996-08-23, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO6454
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES4H611560IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 15 x 10 cm area of erythema & warmth over deltoid, lt;onset occurred on the fifth day following inj;

VAERS ID:89340 (history)  Vaccinated:1996-08-03
Age:40.0  Onset:1996-08-05, Days after vaccination: 2
Gender:Female  Submitted:1996-08-07, Days after onset: 2
Location:Colorado  Entered:1996-08-27, Days after submission: 20
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: NKA;had frequent Td inj $g10 yrs ago d/t nature of job;
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER436760 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site inflammation, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax & devel painful induration of 6cm x 5cm @ site;inflammation also of larger area;

VAERS ID:90337 (history)  Vaccinated:1996-07-01
Age:40.0  Onset:1996-07-01, Days after vaccination: 0
Gender:Male  Submitted:1996-08-14, Days after onset: 44
Location:Florida  Entered:1996-09-23, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp soreness to touch to the inj site w/Havrix dose 1
Other Medications: Inderal
Current Illness:
Preexisting Conditions: HTN
Diagnostic Lab Data:
CDC Split Type: 960116991
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 1IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Similar reaction on previous exposure to drug
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax JUL96 & 1-2 days p/vax pt exp soreness to touch @ inj site which resolved w/o tx;

VAERS ID:90434 (history)  Vaccinated:1996-08-01
Age:40.0  Onset:1996-08-01, Days after vaccination: 0
Gender:Female  Submitted:1996-09-27, Days after onset: 57
Location:Vermont  Entered:1996-10-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Pred, Glucotrol, Insulin
Current Illness:
Preexisting Conditions: diabetes
Diagnostic Lab Data: SEP96 platelet count 12 THS/MM#;13SEP96 platelet count 15 THS/MM3;SEP96 Guaiac stool-positive;
CDC Split Type: WAES96091129
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Colitis, Diarrhoea, Gastrointestinal haemorrhage, Petechiae, Purpura, Pyrexia, Thrombocytopenic purpura, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax AUG96 & 2wk p/ vax pt devel low fever, abd discomfort & some loose stools;pt treated for poss diverticulitis for 1wk;6SEP96 pt became more ill w/worsening sx & hosp;devel n/v, petechiae & purpura;dx thrombocytopenia;tx w/med

VAERS ID:90486 (history)  Vaccinated:1996-07-25
Age:40.7  Onset:1996-08-21, Days after vaccination: 27
Gender:Male  Submitted:1996-10-02, Days after onset: 42
Location:Maryland  Entered:1996-10-04, Days after submission: 2
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: wound management
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49681150  
Administered by: Public     Purchased by: Private
Symptoms: Drug ineffective, Face oedema, Hypertonia, Infection, Pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: lockjaw/tetanus;pt recv vax 25JUL96 & 8AUG96 exp lockjaw;tx @ hosp;also exp face swelling;

VAERS ID:90703 (history)  Vaccinated:1996-09-21
Age:40.6  Onset:1996-09-21, Days after vaccination: 0
Gender:Female  Submitted:1996-10-08, Days after onset: 17
Location:California  Entered:1996-10-15, 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: out of lt hand
Preexisting Conditions: NONE
Diagnostic Lab Data: EMG/NCS ordered labs pending;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt saw MD 7OCT96 c/o rt arm pain & paresthesias even since vax 21SEP96;it was done @ another clinic;

VAERS ID:90995 (history)  Vaccinated:1996-05-17
Age:40.0  Onset:1996-07-18, Days after vaccination: 62
Gender:Male  Submitted:0000-00-00
Location:Texas  Entered:1996-10-18
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: allergy, PCN;
Diagnostic Lab Data: 18JUL96 varicella antibody negative
CDC Split Type: WAES96072224
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0388B1SC 
Administered by: Public     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax 15APR96 & 17MAY96 & 18JUL96 pt titer was tested & did not register;it remained negative & pt exp no other adverse events;

VAERS ID:91223 (history)  Vaccinated:1996-10-18
Age:40.1  Onset:1996-10-19, Days after vaccination: 1
Gender:Female  Submitted:1996-10-20, Days after onset: 1
Location:California  Entered:1996-10-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Lupron 23SEP96
Current Illness: NONE
Preexisting Conditions: endometriosis dx 4SEP96;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00676P0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Angioneurotic oedema, Face oedema, Malaise, Oedema peripheral, Pruritus, Rash, Urticaria, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: feeling sl unwell 19OCT AM;1030AM 19OCT noted red itchy, sl edematous area inside both wrists;rash progressed up forearms;lt side upper lip swollen by 330PM;scattered areas of hives started DPH;swollen face & urticaria w/mild angio ed

VAERS ID:91693 (history)  Vaccinated:1996-09-23
Age:40.0  Onset:1996-09-26, Days after vaccination: 3
Gender:Female  Submitted:1996-09-27, Days after onset: 1
Location:Alaska  Entered:1996-10-30, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896275012L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Breast pain, Lymphadenopathy, Pain
SMQs:, Lipodystrophy (broad)
Write-up: pt recv vax & devel lt axillary lymphadenopathy;pt has been exp lt ax pain, which radiates to the lt breast;reporter attributed the pain to the lymphadenopathy;

VAERS ID:92969 (history)  Vaccinated:1995-08-30
Age:40.0  Onset:1995-09-01, Days after vaccination: 2
Gender:Female  Submitted:1995-12-01, Days after onset: 91
Location:California  Entered:1996-10-30, Days after submission: 334
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: no allergy history;no illness @ time of vax;
Diagnostic Lab Data:
CDC Split Type: 950093751
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1267A41IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & exp hives 2 days p/vax;became progressively worse;tx w/oral DPH in ER:pt believes that hives would have subsided if untreated but DPH helped;pt not sure if hives caused by vax, but can not attribute them to any other cau

VAERS ID:93021 (history)  Vaccinated:1995-09-01
Age:40.0  Onset:1995-09-01, Days after vaccination: 0
Gender:Female  Submitted:1995-10-31, Days after onset: 60
Location:Ohio  Entered:1996-10-30, Days after submission: 365
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: 950114261
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: approx 1mo ago (SEP95) pt recv vax & w/in 24 hr devel flu-like sx (achy, fever, nausea);

VAERS ID:93087 (history)  Vaccinated:1995-12-21
Age:40.0  Onset:1995-12-21, Days after vaccination: 0
Gender:Female  Submitted:1996-03-11, Days after onset: 81
Location:Indiana  Entered:1996-10-30, Days after submission: 233
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic to muscle relaxants;
Diagnostic Lab Data:
CDC Split Type: 950143421
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1442A60IMA
Administered by: Other     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax & 1hr post vax pt exp swelling in arm (inj site) & radiating pain in arm (inj site);arm doubled in size w/in 2 hr;tx ice, motrin, & DPH;sx resolved p/5 days;

VAERS ID:93105 (history)  Vaccinated:1996-01-14
Age:40.0  Onset:1996-01-14, Days after vaccination: 0
Gender:Female  Submitted:1996-01-18, Days after onset: 4
Location:Texas  Entered:1996-10-30, Days after submission: 286
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: 960005561
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Private     Purchased by: Private
Symptoms: Hypotension, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & exp hypotension & urticaria;ER or MD visit was required;pt sx were treated w/DPH, lasted 2 days & resolved;vaccination series was discontinued;

VAERS ID:93345 (history)  Vaccinated:1996-04-29
Age:40.0  Onset:1996-04-29, Days after vaccination: 0
Gender:Male  Submitted:1996-05-17, Days after onset: 18
Location:Ohio  Entered:1996-10-30, Days after submission: 166
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960066731
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IMA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Headache, Myalgia, Photosensitivity reaction
SMQs:, Rhabdomyolysis/myopathy (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax & w/in several hr post vax pt exp severe h/a, fatigue, sensitivity to light & an achy feeling;pt was seen by MD for h/a & given Ibuprofen;sx lasted approx 36hr & then resolved;

VAERS ID:93347 (history)  Vaccinated:1996-05-01
Age:40.0  Onset:1996-05-01, Days after vaccination: 0
Gender:Female  Submitted:1996-05-30, Days after onset: 29
Location:California  Entered:1996-10-30, Days after submission: 153
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: 960069841
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IMA
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & 24 hr p/vax pt exp fever;48 hr p/vax exp gen body rash;all sx resolved w/in 2 days w/o tx;

VAERS ID:93351 (history)  Vaccinated:1996-04-03
Age:40.0  Onset:1996-04-03, Days after vaccination: 0
Gender:Female  Submitted:1996-05-29, Days after onset: 55
Location:Iowa  Entered:1996-10-30, Days after submission: 154
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: 960069901
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1810A40IMA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 3APR96 & same day pt exp a localized reaction (soreness);

VAERS ID:93384 (history)  Vaccinated:1996-06-28
Age:40.0  Onset:1996-06-28, Days after vaccination: 0
Gender:Female  Submitted:1996-08-28, Days after onset: 61
Location:New York  Entered:1996-10-30, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp localized pain w/Engerix-B dose 1
Other Medications: Loestrin FE
Current Illness:
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type: 960096821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1853A42IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Headache, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 28JUN96 & that evening exp fever, h/a, heavy armpit pain, some rash on chest;pt stated that began to feel better p/1wk;

VAERS ID:93400 (history)  Vaccinated:1996-03-13
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1996-07-25
Location:Missouri  Entered:1996-10-30, Days after submission: 97
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;NKA
Diagnostic Lab Data:
CDC Split Type: 960105871
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1949A20IMRA
Administered by: Public     Purchased by: Other
Symptoms: Alopecia
SMQs:
Write-up: pt recv vax 13FEB96 & right away hair came out in clumps;pt ponytail one-half as big as formerly;

VAERS ID:93500 (history)  Vaccinated:1996-08-21
Age:40.0  Onset:1996-08-23, Days after vaccination: 2
Gender:Male  Submitted:1996-08-30, Days after onset: 7
Location:Alabama  Entered:1996-10-30, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960127921
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2098A60IMA
Administered by: Other     Purchased by: Public
Symptoms: Headache, Influenza, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & 2-7 days post vax pt exp flu-like sx, nausea, h/a & gen malaise;pt was seen by MD;tx unk;

VAERS ID:93501 (history)  Vaccinated:1996-08-22
Age:40.0  Onset:1996-08-24, Days after vaccination: 2
Gender:Female  Submitted:1996-08-30, Days after onset: 6
Location:Alabama  Entered:1996-10-30, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960127931
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2098A60IMA
Administered by: Other     Purchased by: Public
Symptoms: Headache, Influenza, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & 2-7 days post vax & exp flu-like sx, nausea, h/a & gen malaise;seen by MD;tx unk;

VAERS ID:91451 (history)  Vaccinated:1996-10-01
Age:40.6  Onset:1996-10-02, Days after vaccination: 1
Gender:Female  Submitted:1996-10-15, Days after onset: 13
Location:Wisconsin  Entered:1996-11-01, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00376P1 LA
Administered by: Other     Purchased by: Private
Symptoms: Cellulitis, Hypokinesia, Myalgia, Oedema, Pain, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 1OCT96 & by evening 2OCT lt arm (upper) was sore & warm;3OCT whole lt arm painful-couldn''t wear watch;ROM limited;upper arm reddened & edematous;tx meds, dx cellulitis;

VAERS ID:91458 (history)  Vaccinated:1996-10-17
Age:40.9  Onset:1996-10-18, Days after vaccination: 1
Gender:Female  Submitted:1996-10-24, Days after onset: 6
Location:Florida  Entered:1996-11-01, 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: Adalat
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: FL96073
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH6F712770IMLA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Generalised oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 17OCT96 & devel itching & swelling all over body & eyelids the following day;went to MD who prescribed Pred;

VAERS ID:91631 (history)  Vaccinated:1996-10-08
Age:40.3  Onset:1996-10-09, Days after vaccination: 1
Gender:Male  Submitted:1996-10-24, Days after onset: 15
Location:Massachusetts  Entered:1996-11-05, 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: Glucatrol, Cardura, Calan SR
Current Illness:
Preexisting Conditions: DM, HTN, cockroaches, ragweed
Diagnostic Lab Data: Lyme test negative;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E3026GB0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ear pain, Facial palsy, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax 8OCT96 & noted earache, tingling feeling lt side of face;was seen @ hosp probable Bell''s Palsy seen in office 10OCT96 confirmed lt sided Bell''s palsy;initial lyme test in ER was reported as negative;

VAERS ID:91801 (history)  Vaccinated:1996-10-15
Age:40.2  Onset:1996-10-15, Days after vaccination: 0
Gender:Female  Submitted:1996-11-06, Days after onset: 22
Location:Maryland  Entered:1996-11-08, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: MD96048
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E30266B0 LA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: hot flashes;flush face;welt devel around sit of inj;also reddened area 4" diameter;itchy & warm to touch 1hr past inj;pt took med;

VAERS ID:92055 (history)  Vaccinated:1996-11-07
Age:40.0  Onset:1996-11-07, Days after vaccination: 0
Gender:Female  Submitted:1996-11-11, Days after onset: 4
Location:Virginia  Entered:1996-11-18, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS00376P IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Dyspnoea, Hyperhidrosis, Hypertension, Paraesthesia, Tachycardia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: 8 of 25 employees recv vax & 1 of which was severe;pt had immed systemic rxn (tachycardia-pulse reg, cold sweats, inc BP to 138/100, SOB, extremity tingling;911 was called & pt taken to ER-tx & released;

VAERS ID:92123 (history)  Vaccinated:1996-10-25
Age:40.0  Onset:1996-10-25, Days after vaccination: 0
Gender:Female  Submitted:1996-11-15, Days after onset: 21
Location:California  Entered:1996-11-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Duril
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 RA
Administered by: Other     Purchased by: Private
Symptoms: Oedema, Pain, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: w/in 3hr of vax red, inflamed rt arm, from elbow to shoulder;edema 4+ lasted 4 days, pruritis, pain;tx w/ice, DPH;

VAERS ID:92173 (history)  Vaccinated:1996-10-30
Age:40.3  Onset:1996-10-31, Days after vaccination: 1
Gender:Female  Submitted:1996-11-09, Days after onset: 9
Location:Ohio  Entered:1996-11-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: mold allergies active
Preexisting Conditions: mold allergies
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Influenza, Injection site hypersensitivity, Injection site oedema, Injection site pain, Myalgia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: redness & swelling @ site;site was warm & sore;limb was sore to elbow & into shoulder for about 3 days;had very mild flu sx for 1 day;site still shows redness;

VAERS ID:92221 (history)  Vaccinated:1996-10-10
Age:40.1  Onset:1996-10-10, Days after vaccination: 0
Gender:Female  Submitted:1996-11-01, Days after onset: 22
Location:Oregon  Entered:1996-11-20, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Amitryptyline for h/a
Current Illness: NONE
Preexisting Conditions: NONE x/migraine h/a
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712374IMLA
Administered by: Other     Purchased by: Private
Symptoms: Paraesthesia, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: approx 1hr p/vax pt became very flushed from face to mid chest;cheeks were the most affected & also had small hives;no itching, some facial tingling;nurse had left when sx began;

VAERS ID:92317 (history)  Vaccinated:1996-10-25
Age:40.1  Onset:1996-10-25, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Massachusetts  Entered:1996-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp similar rxn w/1st dose of Hep B;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: MA9631
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0310D1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Hypokinesia, Influenza, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: flu-like sx;h/a;st: body aches;arm pain;fever 101.2, couldn''t even stand up;seen @ clinic blood work drawn there;similar rxn to first;

VAERS ID:92394 (history)  Vaccinated:1996-10-23
Age:40.8  Onset:1996-10-23, Days after vaccination: 0
Gender:Female  Submitted:1996-10-24, Days after onset: 1
Location:Michigan  Entered:1996-11-25, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies any prev illness;
Preexisting Conditions: bilat mastectomy 6yr ago;auto immune disease p/leaking of post op silicone implants
Diagnostic Lab Data:
CDC Split Type: MI96166
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49682040IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Back pain, Dyspnoea, Ear pain, Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: 1/2hr p/vax pt exp nausea couple of hr later exp SOB, gen aching & h/a;awoke @ 4AM 24OCT w/severe back pain & ha/;didn''t take temp but feels has low grade temp & ears hurt;

VAERS ID:92454 (history)  Vaccinated:1996-11-20
Age:40.8  Onset:1996-11-21, Days after vaccination: 1
Gender:Female  Submitted:1996-11-22, Days after onset: 1
Location:D.C.  Entered:1996-11-27, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: PPD by MSD lot# 100646P given 20NOV96;
Current Illness: NONE
Preexisting Conditions: allergy to dust, cotton seed;
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0890D0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypokinesia, Myalgia, Oedema, Pain, Pyrexia, Rash, Skin disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: t99.6 po;pt states arthralgia started lt knee & 4th finger lt hand approx 12hr p/vax;p/additional 12hr c/o pain lt knee on ambulation, aching in lt 4th finger inc & appearance of erythematous, swollen, painful area;skin appears as ora

VAERS ID:92479 (history)  Vaccinated:1996-11-08
Age:40.4  Onset:1996-11-08, Days after vaccination: 0
Gender:Male  Submitted:1996-11-12, Days after onset: 4
Location:Massachusetts  Entered:1996-11-29, Days after submission: 17
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: MA9623
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F712261 RA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Injection site pain, Lymphadenopathy, Oedema peripheral, Pain, Pyrexia, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 8NOV96 devel fever (did not take temp), felt woozy arm pain @ site of inj;all resolved in 2 days;also devel bilat rash in armpits, rt armpit also swollen & red, lt rash only;lateral pain in armpits R$gL;

VAERS ID:92527 (history)  Vaccinated:1996-10-24
Age:40.2  Onset:1996-10-24, Days after vaccination: 0
Gender:Female  Submitted:1996-11-12, Days after onset: 19
Location:Colorado  Entered:1996-12-02, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: CO96053
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49681641IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt reported pain in lt shoulder, aching & dec movement on 8NOV96;stated the inj was given into the joint;advised to see PMD;13NOV6 950AM pt reports aching in arm immed p/vax;seen by MD for pain limited movement of lt arm;

VAERS ID:92572 (history)  Vaccinated:1996-10-29
Age:40.0  Onset:1996-10-30, Days after vaccination: 1
Gender:Female  Submitted:1996-10-31, Days after onset: 1
Location:California  Entered:1996-12-03, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: allegra;Nazocort
Current Illness: NONE
Preexisting Conditions: hayfever, food allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71227 SCA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Eye disorder, Headache, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: h/a, droopy rt eye lid, body aches, nausea, chills;expect sx resolution over next 24 hr;

VAERS ID:93820 (history)  Vaccinated:1996-07-13
Age:40.9  Onset:1996-07-13, Days after vaccination: 0
Gender:Female  Submitted:1996-07-17, Days after onset: 4
Location:Wisconsin  Entered:1996-12-13, Days after submission: 149
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Percocet, Dicloxacillin, Advil
Current Illness: open dislocation of finger on rt hand
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896208021L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)PFIZER/WYETH   RA
Administered by: Private     Purchased by: Other
Symptoms: Affect lability, Injection site mass, Injection site oedema, Injection site pain, Malaise, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad)
Write-up: pt recv vax & inj site became hard & tender w/swelling spreading down to the fingers;also exp fever, malaise & moodiness;

VAERS ID:94307 (history)  Vaccinated:1996-03-01
Age:40.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Wisconsin  Entered:1997-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: ELISA negative;FAMA negative;
CDC Split Type: WAES96111778
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax MAR96 & ELISA testing revealed a lack of seroconversion;

VAERS ID:94319 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1997-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: varicella antibody 1:4 positive ACIF;varicella antibody negative VZV screen;
CDC Split Type: WAES96112163
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax & 1mo p/vax pt tested negative on a VZV screen, but tested positive w/the ACIF test w/a result of 1:4;

VAERS ID:94330 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1997-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Varicella antibody negative VZV screen; varicella antibody negative ACIF test;
CDC Split Type: WAES96120009
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax & 4months p/vax lab eval by VZV screen & ACIF test revealed a lack of seroconversion;

VAERS ID:94583 (history)  Vaccinated:1996-10-10
Age:40.2  Onset:1996-10-11, Days after vaccination: 1
Gender:Female  Submitted:1996-10-14, Days after onset: 3
Location:Texas  Entered:1997-01-30, Days after submission: 108
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Calan SR
Current Illness: NONE
Preexisting Conditions: NONE-BP
Diagnostic Lab Data:
CDC Split Type: TX96158
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F711943 LA
Administered by: Other     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 10OCT96 & 14OCT96 rxn reported;11OCT96 pt devel hives-no diff breathing etc;to MD on 12OCT96 for hives given Medrol & DPH-resolved;

VAERS ID:94742 (history)  Vaccinated:1997-01-07
Age:40.1  Onset:1997-01-07, Days after vaccination: 0
Gender:Female  Submitted:1997-01-14, Days after onset: 7
Location:Florida  Entered:1997-02-03, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Erythromycin
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2009A41IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Headache, Injection site pain, Malaise, Myalgia, Pain, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: w/in 2hr p/vax pt began to feel warm & lightheaded;pt stated didn''t feel good;afeb;pt stated arm was excruciatingly painful to move from collar bone to fingertips;pt felt warm;pallor;heavy feeling in arm;not self;soreness in arm;

VAERS ID:94813 (history)  Vaccinated:1996-10-30
Age:40.2  Onset:1996-10-30, Days after vaccination: 0
Gender:Female  Submitted:1997-01-14, Days after onset: 76
Location:Michigan  Entered:1997-02-05, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49681680IMA
Administered by: Public     Purchased by: Unknown
Symptoms: Dyspnoea, Paraesthesia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad)
Write-up: pt woke up 11PM & had a hard time breathing;felt tingling in spine;weird, scary sensation;uncontrollable shaking;lasted for about 1/2hr;pt husband took pt to ER;

VAERS ID:94664 (history)  Vaccinated:1996-11-18
Age:40.8  Onset:1996-11-20, Days after vaccination: 2
Gender:Unknown  Submitted:0000-00-00
Location:New Jersey  Entered:1997-02-06
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC, SMAC, LFT''s all nl;
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: Hypersensitivity, Lymphangitis, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 18NOV96 & 20NOV pt devel ipsilateral lymphangitis lasting 2 days;this was followed by an allergic rash which has been steroid resistant;

VAERS ID:95050 (history)  Vaccinated:1997-01-15
Age:40.9  Onset:1997-01-18, Days after vaccination: 3
Gender:Female  Submitted:1997-01-22, Days after onset: 4
Location:Pennsylvania  Entered:1997-02-14, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NA
CDC Split Type: PA9705
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6D81109  RA
Administered by: Public     Purchased by: Unknown
Symptoms: Cellulitis, Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: cellulitis-local rxn;

VAERS ID:95673 (history)  Vaccinated:1996-10-11
Age:40.0  Onset:1996-10-11, Days after vaccination: 0
Gender:Female  Submitted:1996-10-25, Days after onset: 14
Location:Oklahoma  Entered:1997-03-06, Days after submission: 132
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unspecified ulcer medication
Current Illness: unk
Preexisting Conditions: ulcer
Diagnostic Lab Data:
CDC Split Type: 896311014L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: w/in 2 hr of vax pt devel redness & swelling @ the inj site & swelling of the lt hand;redness & swelling @ the inj site have resolved but the hand remained swollen @ the date of this report;

VAERS ID:95704 (history)  Vaccinated:1996-10-29
Age:40.9  Onset:1996-10-29, Days after vaccination: 0
Gender:Female  Submitted:1996-11-05, Days after onset: 7
Location:Massachusetts  Entered:1997-03-06, Days after submission: 121
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896318012L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: pt devel a dull, constant h/a w/in 24hr of vax;h/a is unrelieved by Advil;

VAERS ID:95736 (history)  Vaccinated:1996-10-24
Age:40.2  Onset:1996-10-31, Days after vaccination: 7
Gender:Female  Submitted:1996-11-13, Days after onset: 13
Location:Indiana  Entered:1997-03-06, Days after submission: 113
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid;Prozac, oral contraceptive, vitamins
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 896337020L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968189 IM 
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 2 days p/vax pt devel an itchy, papular rash on the scalp;the rash spread to shoulders, back, chest, & arms;tx w/medrol dosepak;when the medrol was discontinued, the rash returned;

VAERS ID:95781 (history)  Vaccinated:1996-11-10
Age:40.7  Onset:1996-11-10, Days after vaccination: 0
Gender:Female  Submitted:1996-12-17, Days after onset: 37
Location:California  Entered:1997-03-06, 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: NONE
CDC Split Type: 896355014L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968162 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: w/in 4hr p/vax pt devel an inj site rxn characterized by an area of erythema & induration measuring 50mm in diameter;pt had recovered @ the date of this report;this is 1 of 4 pt from this site to devel an inj site rxn p/flu vax;

VAERS ID:95789 (history)  Vaccinated:1996-10-01
Age:40.0  Onset:1996-10-02, Days after vaccination: 1
Gender:Female  Submitted:1996-10-02, Days after onset: 0
Location:North Carolina  Entered:1997-03-06, Days after submission: 155
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:
Diagnostic Lab Data:
CDC Split Type: 896277006L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968140 IMA
Administered by: Other     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 1 day p/vax pt devel an inj site rxn characterized by redness, warmth, & swelling;this is one of three employees from this site to devel an inj site rxn p/flu vax;

VAERS ID:95872 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Tennessee  Entered:1997-03-11
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: No relevant data;
CDC Split Type: WAES96111408
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis, Infection
SMQs:, Hepatitis, non-infectious (narrow)
Write-up: pt recv vax in 1980 & in 1996 pt tested positive for hepatitis C while volunteering to donate blood;

VAERS ID:95896 (history)  Vaccinated:1994-06-23
Age:40.7  Onset:1994-08-01, Days after vaccination: 39
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:1997-03-11
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: No relevant data;
CDC Split Type: WAES96011517
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1465W2  
Administered by: Other     Purchased by: Other
Symptoms: Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 23JUN94 & on 1AUG95 pt broke out in bumps & hives;pt reported that many people @ work place devel hives when all vaccinated (WAES96011518);

VAERS ID:95998 (history)  Vaccinated:1996-02-01
Age:40.0  Onset:1996-02-01, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:California  Entered:1997-03-11
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: allergy, sulfa; allergy, PCN
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96050032
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: pt recv vax FEB96 & approx MAR96 pt devel 500 lesions, noted to be petechiae, on trunk & extremities & none on face or feet;

VAERS ID:96017 (history)  Vaccinated:1996-05-22
Age:40.0  Onset:1996-05-24, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Indiana  Entered:1997-03-11
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: No relevant data;
CDC Split Type: WAES96052397
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 3  
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 22MAY96 & 24MAY96 pt devel an itchy rash @ the inj site described as indurated 3 circular, red & warm @ the inj site;

VAERS ID:96042 (history)  Vaccinated:1996-06-18
Age:40.0  Onset:1996-06-19, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Alabama  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness:
Preexisting Conditions: diabetes
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96062320
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site haemorrhage, Injection site mass, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pt recv vax 18JUN96 & 19JUN96 pt devel hematoma @ the inj site & swelling & hardness @ the inj site;it was noted that the pt had no adverse events following the prev two doses of vax;

VAERS ID:96084 (history)  Vaccinated:1996-07-31
Age:40.1  Onset:1996-07-31, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: NONE
Preexisting Conditions: neurological disorder
Diagnostic Lab Data: 31JUL96 BP 140/88;
CDC Split Type: WAES96080478
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1196B0IM 
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Hyperhidrosis, Hypertension, Hypertonia, Hyperventilation, Paraesthesia, Personality disorder
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hostility/aggression (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: pt recv vax 31JUL96 & p/vax pt exp tightness/distress in chest, temporary numbness & tingling in legs, a funny feeling all over, feeling of tightness, & devel diaphoresis & an in resp rate to 28;BP also inc to 140/88;adm to ER & treated;

VAERS ID:96143 (history)  Vaccinated:1991-03-22
Age:40.5  Onset:1991-04-19, Days after vaccination: 28
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:1997-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gentamycin;antihistamines;
Current Illness: infection, eye
Preexisting Conditions:
Diagnostic Lab Data: 1991 Anti-HBS positive;HBSAG positive;Anti-HCV positive;liver enzymes nl;SEP90 HBSAG negative;
CDC Split Type: WAES96100042
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0658S2  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Hepatitis, Infection, Influenza, Laboratory test abnormal, Neuropathy, Pneumonia, Sinusitis
SMQs:, Hepatitis, non-infectious (narrow), Lack of efficacy/effect (narrow), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: 19APR91 pt felt had flu;pt devel neuropathy, pneumonia, sinusitis, hepatitis A, B & C;lab eval revealed anti-HBs positive;anti-HBc positive;HBsAg positive (prev neg SEP90);anti-HBsA positive;anti-HVC positive & liver enzymes abn;

VAERS ID:96183 (history)  Vaccinated:1996-09-30
Age:40.0  Onset:1996-09-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Maine  Entered:1997-03-11
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: No relevant data;
CDC Split Type: WAES96110169
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Oedema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: pt recv vax 30SEP96 & pt exp swelling in breast area & the entire arm where pt recv vax;

VAERS ID:96274 (history)  Vaccinated:1996-11-17
Age:40.0  Onset:1996-11-23, Days after vaccination: 6
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lorazepan;Benztrapinc;Halopendail;ferrous gluconate;
Current Illness:
Preexisting Conditions: allergic-PCN, fish;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4968182 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oedema peripheral, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: swelling/itching, & redness of arms/legs;

VAERS ID:96401 (history)  Vaccinated:1997-03-08
Age:40.5  Onset:0000-00-00
Gender:Female  Submitted:1997-03-17
Location:Kentucky  Entered:1997-03-19, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Malaise
SMQs:
Write-up: pt exp sickness Sunday, Monday, & Tuesday;

VAERS ID:96407 (history)  Vaccinated:1997-03-14
Age:40.7  Onset:1997-03-14, Days after vaccination: 0
Gender:Female  Submitted:1997-03-17, Days after onset: 3
Location:Maryland  Entered:1997-03-21, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp sore arm @ 28 w/Td;
Other Medications: Ritalin, Prozac
Current Illness: NONE
Preexisting Conditions: asthma, ADHA, lactose intolerance
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6J81325 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Back pain, Eye pain, Headache, Injection site pain, Nausea, Neck pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Arthritis (broad)
Write-up: 14MAR97 w/in 20min of vax pt states felt feverish, nauseated & eyes hurt, h/a, neckache, backache that evening;joints hurt, arm hurt @ inj site;temp 98 or 99 per pt lat arm was weak & throbbing;

VAERS ID:96726 (history)  Vaccinated:1997-03-14
Age:40.9  Onset:1997-03-15, Days after vaccination: 1
Gender:Female  Submitted:1997-03-22, Days after onset: 7
Location:Washington  Entered:1997-04-04, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash @ 40yr old w/Hep A vax dose 1;
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMVHA503A60IM 
Administered by: Private     Purchased by: Private
Symptoms: Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt states 24hr p/vax devel fine red rash that got hive-like later DPH given as needed & sx subsided p/48-72hr later;

VAERS ID:96799 (history)  Vaccinated:1997-01-14
Age:40.9  Onset:1997-01-20, Days after vaccination: 6
Gender:Female  Submitted:1997-01-21, Days after onset: 1
Location:Maryland  Entered:1997-04-09, Days after submission: 77
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: NKDA
Diagnostic Lab Data:
CDC Split Type: MD97001
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F812041IMRA
Administered by: Public     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: pt c/o swelling, erythema & itching since evening of 20JAN97 in rt deltoid area;area is approx 95mm x 70mm;afeb;encouraged warm compresses;denies pain or soreness;referred to FMP;MD prescribed DPH;pt seen by dentist on 20JAN97 given lidocai

VAERS ID:97057 (history)  Vaccinated:1996-12-27
Age:40.7  Onset:1997-01-01, Days after vaccination: 5
Gender:Female  Submitted:1997-01-06, Days after onset: 5
Location:Louisiana  Entered:1997-04-18, Days after submission: 101
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: EEG pending;MRI-Brain scan nl;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1469B0SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6A810172IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Convulsion, Injection site reaction, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad)
Write-up: pt exp felt hot but temp not measured;local rxn;adenopathy: local inj site area;pain in joints;convuls;

VAERS ID:98755 (history)  Vaccinated:1995-10-25
Age:40.0  Onset:1995-10-26, Days after vaccination: 1
Gender:Female  Submitted:1997-02-06, Days after onset: 469
Location:Maine  Entered:1997-04-18, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6302
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61143 IMA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Skin nodule
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: sore arm w/hard, indurated area;

VAERS ID:98794 (history)  Vaccinated:1995-10-20
Age:40.9  Onset:1995-10-20, Days after vaccination: 0
Gender:Female  Submitted:1997-02-05, Days after onset: 474
Location:Ohio  Entered:1997-04-18, Days after submission: 71
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: environmental allergies, PCN
Diagnostic Lab Data:
CDC Split Type: CO6229
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F61167  A
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: itchy @ site w/in 5min of inj;then 4x4 area of redness no systemic rxn;

VAERS ID:98806 (history)  Vaccinated:1995-10-23
Age:40.3  Onset:1995-10-23, Days after vaccination: 0
Gender:Female  Submitted:1997-02-05, Days after onset: 471
Location:Maryland  Entered:1997-04-18, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness: cold for several weeks
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO6246
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5J61007   
Administered by: Other     Purchased by: Other
Symptoms: Cough, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: fever 103 8hr post inj;fever cont as of 27OCT95, 100.4;generalized body aches, productive cough (yellow mucous) & nausea;will be seen by MD today 28OCT95;

VAERS ID:98889 (history)  Vaccinated:1995-10-06
Age:40.9  Onset:1995-10-08, Days after vaccination: 2
Gender:Female  Submitted:1997-02-05, Days after onset: 486
Location:New Jersey  Entered:1997-04-18, Days after submission: 71
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: frequent bronchitis, allergic rhinitis
Diagnostic Lab Data:
CDC Split Type: CO6181
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES5F611330IMRA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site reaction, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: localized rxn w/fever, muscle aches & pains;

VAERS ID:97449 (history)  Vaccinated:1997-04-30
Age:40.4  Onset:1997-04-30, Days after vaccination: 0
Gender:Female  Submitted:1997-05-01, Days after onset: 1
Location:Wisconsin  Entered:1997-05-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications:
Current Illness: pricked finger
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH49681102IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Myalgia, Oedema peripheral, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: sore, red & swollen lt deltoid 8cm x 7cm;

VAERS ID:98047 (history)  Vaccinated:1997-03-20
Age:40.2  Onset:1997-03-20, Days after vaccination: 0
Gender:Female  Submitted:1997-04-30, Days after onset: 40
Location:South Carolina  Entered:1997-05-16, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations: pt exp temp, n/v, diarrhea w/flu vax ;
Other Medications: PPD by Connaught given 20MAR97 lot# 244611;
Current Illness: pt denied any
Preexisting Conditions: dx 3mo ago w/hypothyroidism & now is on Synthroid;hysterectomy, back surgery x 2 for herniated disc;allergic to Demerol, Codeine, etc., has a lactose intolerance & says is allergic to turnip greens, broccoli & yeast;cannot take ASA & NSAIDS
Diagnostic Lab Data: EENT ears neg;NECK supple. Thyroid gland not palpable;LUNGS clear to auscultation;HEART nl sinus rhyth,no murmur;abd soft, nontender;liver & spleen not palpable;prelvic/rectal not done;extremities no edema, no varicosities;neuro no localiz
CDC Split Type: SC97020
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2133A40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Hypersensitivity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax & 2 hr later devel a high fever to 104, n/v & diarrhea;came to ER on that noc of admission;was given some IV DPH, IV Phenergan but cont to have vomiting & was adm to hosp for observation;allerg rxn;

VAERS ID:98084 (history)  Vaccinated:1997-04-25
Age:40.0  Onset:1997-04-26, Days after vaccination: 1
Gender:Female  Submitted:1997-05-19, Days after onset: 23
Location:Unknown  Entered:1997-05-19
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
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Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Headache, Injection site hypersensitivity, Injection site oedema, Injection site pain, Nausea, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 24hr post vax pt devel local swelling redness, itching & pain @ inj site-eventually involving arm from upper arm @ inj site to the elbow;joint pain in fingers & knees-mild h/a, nausea x 3-4 days;subsided w/o sequellae;no temp recorded;

VAERS ID:99063 (history)  Vaccinated:1996-03-28
Age:40.4  Onset:1996-03-30, Days after vaccination: 2
Gender:Female  Submitted:1996-12-05, Days after onset: 250
Location:Minnesota  Entered:1997-05-27, Days after submission: 172
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp redness of about 1/2" around inj site of 1st dose in series;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6545
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN109D1 A
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, 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: large local rxn extending from elbow to shoulder, swelling & redness;started 24hr p/2nd dose & lasted 3 days;

VAERS ID:99468 (history)  Vaccinated:1996-11-13
Age:40.8  Onset:1996-11-14, Days after vaccination: 1
Gender:Female  Submitted:1996-11-21, Days after onset: 7
Location:Georgia  Entered:1997-05-29, Days after submission: 188
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lo/ovral, Centriu, Advil
Current Illness: UNK
Preexisting Conditions: allergies to PCN, Declomycin, Tetanus toxin, insect stings, tetanus anitoxin;no hx of rxn p/prev flu vax;
Diagnostic Lab Data: UNK
CDC Split Type: 010150960130000
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS6F713060IMA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Malaise, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 13NOV96 & 14NOV96 pt devel an inj site rxn 3inches in diameter w/redness, induration & erythema;pt seen in MD ofc 15NOV96;pt exp aches, malaise & nausea;

VAERS ID:99983 (history)  Vaccinated:1996-08-28
Age:40.0  Onset:1996-08-30, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Maryland  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES96090474
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 28AUG96 & 30AUG96 pt exp cellulitis which consisted of redness, swelling & tenderness around the inj site;tx w/ATB;

VAERS ID:100093 (history)  Vaccinated:1997-01-30
Age:40.0  Onset:1997-02-26, Days after vaccination: 27
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1997-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Erythromycin
Current Illness: NONE
Preexisting Conditions: rash;hayfever;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97030278
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0989D1IM 
Administered by: Other     Purchased by: Private
Symptoms: Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 30JAN97 & 26FEB97 pt devel a rash that spread over body for 16hr that was described as diffuse & erythematous, w/pinpoint papules on arms, trunk & scalp;presented to MD;tx DPH;devel lesions that became worse devel hives;

VAERS ID:98634 (history)  Vaccinated:1997-05-14
Age:40.2  Onset:1997-05-16, Days after vaccination: 2
Gender:Male  Submitted:1997-05-29, Days after onset: 13
Location:Indiana  Entered:1997-06-03, 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:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6J81325 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Hyperhidrosis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: n/v, diarrhea, sweats, APAP, fluids, rest;

VAERS ID:98700 (history)  Vaccinated:1997-02-25
Age:40.8  Onset:1997-03-01, Days after vaccination: 4
Gender:Female  Submitted:1997-03-06, Days after onset: 5
Location:Maryland  Entered:1997-06-06, Days after submission: 91
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: NONE
Diagnostic Lab Data: CXR;EKG
CDC Split Type: MD97005
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES5L71095 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Dyspnoea, Myalgia, Neck pain, Pharyngitis, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax & lt arm became sore;devel fever p/this 101;spoke w/MD 6MAR97 in morning;states lt arm is sore & moving pain up to neck w/problems breathing;to ER;hosp r/o pneumonia;c/o sore throat;pt mad @ PMD secretary;

VAERS ID:99155 (history)  Vaccinated:1997-04-16
Age:40.5  Onset:1997-04-16, Days after vaccination: 0
Gender:Female  Submitted:1997-04-21, Days after onset: 5
Location:Florida  Entered:1997-06-18, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: FL97003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2186A42IMLA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6F81204 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: pt states rt arm became numb about 2hr p/vax could not use hadn that day;lt arm hurts in deltoid area;can not lift arm upwards toward shoulder;pt states has applied heating pad x''s several days;

VAERS ID:99837 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:1996-04-13
Gender:Male  Submitted:1997-07-03, Days after onset: 446
Location:Ohio  Entered:1997-07-08, Days after submission: 5
Life Threatening? Yes
Died? Yes
   Date died: 1996-04-14
   Days after onset: 1
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97062171
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Infection
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv vax 1986 & 13APR96 pt was hosp w/probable pneumococcal infect;On 14APR96 pt died;COD was pneumococcal sepsis;

VAERS ID:99916 (history)  Vaccinated:1997-06-16
Age:40.9  Onset:1997-06-19, Days after vaccination: 3
Gender:Female  Submitted:1997-06-23, Days after onset: 4
Location:Mississippi  Entered:1997-07-08, 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: Modrate;HCTZ
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER439176 IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pain, swelling, redness, itching, indurated @ site of inj;Motrin & ice to site;

VAERS ID:100226 (history)  Vaccinated:1994-01-01
Age:40.9  Onset:1995-08-01, Days after vaccination: 577
Gender:Male  Submitted:1997-07-11, Days after onset: 710
Location:Unknown  Entered:1997-07-15, Days after submission: 4
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 49 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: pt recv RECOMBIVAX JUN97;
Current Illness:
Preexisting Conditions: sugery, stomach;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97062322
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Other     Purchased by: Other
Symptoms: Hepatocellular damage, Pharyngitis, Rhinitis
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: pt recv vax 1JAN94 & JUN97 respectively;1AUG95 pt devel a cold which lasted for 6mo & lost one thrid of liver function;pt was hosp NOV95 & spent 7 wk there;pt MD said the cold was r/t vax;pt has been back in the hosp 3 or 4X since then;

VAERS ID:101393 (history)  Vaccinated:1996-03-27
Age:40.0  Onset:1996-03-29, Days after vaccination: 2
Gender:Female  Submitted:1997-04-11, Days after onset: 377
Location:D.C.  Entered:1997-07-22, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6535
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES    
Administered by: Public     Purchased by: Public
Symptoms: Hypertonia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: severe cramps in both legs & feet;unable to drive car;As of 1APR96 only has soreness in one calf muscle in leg;did not seek med attention;

VAERS ID:101460 (history)  Vaccinated:1996-03-18
Age:40.7  Onset:1996-03-18, Days after vaccination: 0
Gender:Female  Submitted:1997-03-31, Days after onset: 378
Location:Arkansas  Entered:1997-07-22, Days after submission: 112
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: CO6528
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST.K11722  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypertonia, Oedema peripheral, Tongue disorder, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: tongue thickness, arm redness & swelling;tightness sounds in neck, no fever p/3rd dose;bitten by a cat;

VAERS ID:101469 (history)  Vaccinated:1996-05-02
Age:40.1  Onset:1996-05-08, Days after vaccination: 6
Gender:Male  Submitted:1997-03-31, Days after onset: 327
Location:Connecticut  Entered:1997-07-22, Days after submission: 112
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: very mild flu-like sx p/a post exposure series in 1989;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO6611
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)PASTEUR MERIEUX INST. 6IMA
Administered by: Other     Purchased by: Other
Symptoms: Angioneurotic oedema, Arthralgia, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: urticaria over a 48hr period encompassing 70% of body;also had fever arthralgias of neck & feet;12MAy96 devel angioedema of lips;tx w/oral pred & as of 15MAy96 sx resolved;

VAERS ID:100683 (history)  Vaccinated:1997-02-01
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97041362
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)
Write-up: pt recv vax FEB97 & devel a rash consisting of approx 5-6 lesions around the inj site;

VAERS ID:100695 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:1997-01-24
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Serevent;Vanceril;Claritin;Zephrex;Rhinocort;
Current Illness:
Preexisting Conditions: allergy erythromycin;allergy ASA;allergy, sulfa;asthma;exposure varicella;
Diagnostic Lab Data: No relevant data
CDC Split Type: WAES97041572
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis bullous
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & had outbreak of varicella-like rash on 24JAN97 p/exposure to vaccinated child;2nd outbreak of varicella-like rash occurred 1FEB97 p/exposure to vaccinated child;both outbreaks were resolved w/Zovirax;

VAERS ID:101126 (history)  Vaccinated:1997-06-13
Age:40.0  Onset:1997-06-13, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Iowa  Entered:1997-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97061357
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1479D1  
Administered by: Private     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: pt recv vax 13JUN97 & pt began nursing;

VAERS ID:101284 (history)  Vaccinated:1997-07-10
Age:40.2  Onset:1997-07-11, Days after vaccination: 1
Gender:Female  Submitted:1997-07-16, Days after onset: 5
Location:Louisiana  Entered:1997-08-05, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: patch prozac;
Current Illness: NONE
Preexisting Conditions: codeine, ASA, breast implants
Diagnostic Lab Data: blood count, CT scan;
CDC Split Type: LA970702
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1006D0SCRA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES7B915180IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Injection site oedema, Lymphadenopathy, Myalgia, Neck pain, Neuropathy, Pyrexia, Skin nodule
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt states started w/sx the morning p/vax c/o edema @ site, under lt arm & a nodule @ the base of neck;c/o h/a, fatigue, fever 99.5;c/o soreness from mid lt arm up to neck;saw PMD & was referred to MD;MD felt is was a brachial plexus rxn;

VAERS ID:102505 (history)  Vaccinated:1997-08-14
Age:40.2  Onset:1997-08-15, Days after vaccination: 1
Gender:Female  Submitted:1997-08-26, Days after onset: 11
Location:Illinois  Entered:1997-09-15, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)PFIZER/WYETH498061   
Administered by: Private     Purchased by: Private
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: swelling, erythema, pain @ inj site;DPH, cold packs;

VAERS ID:102518 (history)  Vaccinated:1997-05-05
Age:40.0  Onset:1997-08-29, Days after vaccination: 116
Gender:Male  Submitted:1997-09-11, Days after onset: 13
Location:South Dakota  Entered:1997-09-16, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: APAP
Current Illness:
Preexisting Conditions: NKA; no relevant medical history;
Diagnostic Lab Data: 29AUG97 SGPT 141;SGOT 77;LDH 727;GGTP 362;Cholesterol 287;Triglycerides 197;
CDC Split Type: 970212351
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1819A11  
Administered by: Public     Purchased by: Public
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood lactate dehydrogenase increased, Chest pain, Gamma-glutamyltransferase increased, Hepatic function abnormal, Hypercholesterolaemia, Hyperlipidaemia
SMQs:, Liver related investigations, signs and symptoms (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (broad)
Write-up: pt recv vax 5MAY97 & 29AUG97 pt exp mid-upper chest discomfort & followed up w/MD;subsequent ultrasound of liver & gallbladder & stress test were all nl;liver function test were elevated;no tx was given & condition of pt unk;

VAERS ID:102539 (history)  Vaccinated:1997-08-28
Age:40.9  Onset:1997-08-30, Days after vaccination: 2
Gender:Female  Submitted:1997-09-05, Days after onset: 6
Location:California  Entered:1997-09-16, 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: Elacon
Current Illness: NONE
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIES6H812690IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: mild swelling/warmth/redness & tenderness over site of immun lt deltoid 1wk later;tx local heat, pain reliever;

VAERS ID:102642 (history)  Vaccinated:1997-09-08
Age:40.0  Onset:1997-09-12, Days after vaccination: 4
Gender:Female  Submitted:1997-09-15, Days after onset: 3
Location:Minnesota  Entered:1997-09-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
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 LABORATORIES7C915834IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 12SEP97 redness started & tender on 14SEP was put on DPH & Cephalexin @ hosp ER;

VAERS ID:102708 (history)  Vaccinated:1996-10-01
Age:40.5  Onset:1996-11-02, Days after vaccination: 32
Gender:Female  Submitted:1997-09-24, Days after onset: 325
Location:Colorado  Entered:1997-09-26, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: LP, MRI, Biopsy
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 9 A
Administered by: Private     Purchased by: Private
Symptoms: Arthritis, Neuropathy
SMQs:, Peripheral neuropathy (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Arthritis (narrow)
Write-up: demyelinating peripheral neuropathy-both hands, both feet-misdiagnosed prev as arthritis;

VAERS ID:102790 (history)  Vaccinated:1997-08-25
Age:40.0  Onset:1997-08-28, Days after vaccination: 3
Gender:Male  Submitted:1997-09-22, Days after onset: 25
Location:North Carolina  Entered:1997-09-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)CONNAUGHT LABORATORIES7FA16791  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dry eye, Ear disorder, Facial palsy, Headache, Neck pain
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Arthritis (broad)
Write-up: pt recv vax 25AUG97 & 28AUG pt exp h/a, severe rt sided neck pain, & extreme dryness of eye, causing immed disposal of contact lens;29AUG PM taken to ER w/rt sided facial paralysis to r/o stroke;rt ear extremely sensitive to sound. It was reported that the patient recovered from this experience without any sequalae

VAERS ID:103004 (history)  Vaccinated:1997-09-11
Age:40.3  Onset:1997-09-16, Days after vaccination: 5
Gender:Female  Submitted:1997-10-01, Days after onset: 15
Location:California  Entered:1997-10-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Ecchymosis, Injection site hypersensitivity, Injection site mass, Injection site oedema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 4 days p/vax localized swelling, lumpiness & irritation;p/2 days turned into bruising around the area;no tx only ice used;

VAERS ID:103176 (history)  Vaccinated:1997-10-10
Age:40.7  Onset:1997-10-10, Days after vaccination: 0
Gender:Female  Submitted:1997-10-10, Days after onset: 0
Location:New Jersey  Entered:1997-10-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: shellfish
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F818830IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Hypoxia, Nausea, Paraesthesia, Tachycardia
SMQs:, Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Respiratory failure (broad)
Write-up: pt c/o tingling in bilat hands, dizziness & c/o nausea;pt laid safely on floor & states wants to lay down in case faints;pt given epi immed;pt pulse down from 130bpm p/5min to 90 bpm;pt given 02p;

VAERS ID:103184 (history)  Vaccinated:1997-10-09
Age:40.0  Onset:1997-10-09, Days after vaccination: 0
Gender:Female  Submitted:1997-10-09, Days after onset: 0
Location:Texas  Entered:1997-10-15, 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: Ortho-Novum
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781600IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: vaccine site rt deltoid redness w/inc itching-area about size of half dollar-ice applied;

VAERS ID:103167 (history)  Vaccinated:1997-10-06
Age:40.3  Onset:1997-10-07, Days after vaccination: 1
Gender:Male  Submitted:1997-10-13, Days after onset: 6
Location:Minnesota  Entered:1997-10-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: EPS, EKG, Holter Monitor, CXR, Lab draws x 4-enzymes, ETC;
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781681IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cardiac arrest, Syncope, Vasodilatation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad)
Write-up: 6OCT vax given 1400;7OCT hot flushes started 630PM blacked out 9PM w/subsequent black outs;seen by MD;has 8 sec periods where heart stopped;adm to CCU w/6-7times, 8sec heart stopped;pacemaker considered-last episode 8OCT 130PM;

VAERS ID:103759 (history)  Vaccinated:1997-08-22
Age:40.9  Onset:1997-08-22, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1997-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Buspar
Current Illness:
Preexisting Conditions: allergy, antihistamine;
Diagnostic Lab Data: No relevant data;
CDC Split Type: WAES97081720
Vaccination
Manufacturer
Lot
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Anorexia, Cough, Headache, Insomnia, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax 22AUG97 & pt exp nausea, h/a, coughing & incredible sleep disturbance which persisted since the first evening was vaccinated;pt had no fever or lesions;

VAERS ID:103329 (history)  Vaccinated:1997-10-14
Age:40.7  Onset:1997-10-14, Days after vaccination: 0
Gender:Male  Submitted:1997-10-16, Days after onset: 2
Location:Ohio  Entered:1997-10-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: hx of compazene & sulfa rxn;
Diagnostic Lab Data: throat cult
CDC Split Type:
Vaccination
Manufacturer
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Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F81759   
Administered by: Other     Purchased by: Other
Symptoms: Ear pain, Headache, Infection, Nuchal rigidity, Pharyngitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: severe h/a, stiff neck, beet red throat, ear pain, poss strep;

VAERS ID:103992 (history)  Vaccinated:1997-10-02
Age:40.8  Onset:1997-10-20, Days after vaccination: 18
Gender:Female  Submitted:1997-10-22, Days after onset: 2
Location:South Carolina  Entered:1997-10-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER4978182  RA
Administered by: Unknown     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/in 20min area was 6cm w/itching & some swelling;

VAERS ID:103909 (history)  Vaccinated:1997-10-17
Age:40.0  Onset:1997-10-17, Days after vaccination: 0
Gender:Female  Submitted:1997-10-20, Days after onset: 3
Location:Texas  Entered:1997-10-29, Days after submission: 9
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergic Betadine, Formaldehyde
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F817525IMRA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: itching @ site then gen itching & SOB-Zyrtec, maxaire, epi, pred for 5 days;

VAERS ID:104046 (history)  Vaccinated:1997-07-28
Age:40.5  Onset:1997-07-31, Days after vaccination: 3
Gender:Female  Submitted:1997-10-21, Days after onset: 82
Location:Maine  Entered:1997-10-29, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: unk
Other Medications: NONE
Current Illness: erythema nodosum;ulcerated lesions;
Preexisting Conditions: NKA, unk
Diagnostic Lab Data: c-reactive protein, electrophoresis pattern
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0565E2IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chest pain, Condition aggravated, Pain, Vaginal infection
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: erythema nodosum, pain legs, chest, vaginal lesions;low grade fever 31JUL97-2SEP97;tx rest, lidocaine topical APAP #3, percoat, vitrex, pred;

VAERS ID:104142 (history)  Vaccinated:1996-02-02
Age:40.0  Onset:1996-02-02, Days after vaccination: 0
Gender:Female  Submitted:1996-10-23, Days after onset: 263
Location:Unknown  Entered:1997-10-30, Days after submission: 372
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: atopic dermatitis;
Diagnostic Lab Data:
CDC Split Type: 960155711A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 2FEB96 & same day post vax pt exp a rash on shoulder which resolved spontaneously & urinary tract irritation;

VAERS ID:104143 (history)  Vaccinated:1996-03-02
Age:40.0  Onset:1996-03-05, Days after vaccination: 3
Gender:Female  Submitted:1996-10-23, Days after onset: 231
Location:Unknown  Entered:1997-10-30, Days after submission: 372
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp rash w/Engerix-B dose 1;
Other Medications:
Current Illness:
Preexisting Conditions: Atopic dermatitis
Diagnostic Lab Data:
CDC Split Type: 960155711B
Vaccination
Manufacturer
Lot
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 1IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysuria, Rash, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 2MAR96 & 5MAR96 pt exp a rash all over body (even scalp);pt recv DPH;rash resolved;

VAERS ID:104182 (history)  Vaccinated:1993-09-11
Age:40.0  Onset:1996-09-17, Days after vaccination: 1102
Gender:Female  Submitted:1996-09-23, Days after onset: 6
Location:Unknown  Entered:1997-10-30, Days after submission: 402
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: 960139811
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & approx 1 wk post vax pt exp itching, redness & rash on neck, chest, & back;

VAERS ID:104229 (history)  Vaccinated:1996-10-18
Age:40.0  Onset:1996-10-18, Days after vaccination: 0
Gender:Female  Submitted:1997-10-21, Days after onset: 368
Location:Illinois  Entered:1997-10-30, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 960165371
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2117A21IMA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: pt recv vax & the evening p/vax 18OCT96 pt exp chills, nausea, fever & malaise;sx resolved w/o treatment;

VAERS ID:105999 (history)  Vaccinated:1997-01-06
Age:40.0  Onset:1997-01-30, Days after vaccination: 24
Gender:Male  Submitted:1997-05-23, Days after onset: 112
Location:Georgia  Entered:1997-10-30, Days after submission: 160
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: diabetic myotrophy
Diagnostic Lab Data:
CDC Split Type: 970032341
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2125A40IMA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Insomnia, Myasthenic syndrome
SMQs:, Malignancy related conditions (narrow), Arthritis (broad)
Write-up: pt recv vax 6JAN97 & exp bilat shoulder, arm, & hand & joint pains, weakness in hands, & insomnia;tx w/advil;events persisting;internist/infect disease specialist indicated pt sx are not r/t vax but to diabetic myopathy;

VAERS ID:106022 (history)  Vaccinated:1997-01-01
Age:40.0  Onset:1997-01-01, Days after vaccination: 0
Gender:Male  Submitted:1997-03-19, Days after onset: 77
Location:Ohio  Entered:1997-10-30, Days after submission: 225
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: 970060951
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: pt recv vax & end of JAN97 & a couple of days later devel arthralgia;pt also devel a low grade fever;sx lasted a couple of wk & resolved w/no treatment;

VAERS ID:106035 (history)  Vaccinated:1997-02-20
Age:40.0  Onset:0000-00-00
Gender:Male  Submitted:1997-03-31
Location:Florida  Entered:1997-10-30, Days after submission: 213
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 970075011
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Visual disturbance
SMQs:, Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: pt recv vax FEB97 & devel visual disturbance;20MAR97 pt was given dose 2 of vax;sx cont;

VAERS ID:106039 (history)  Vaccinated:1997-03-04
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1997-04-11
Location:Massachusetts  Entered:1997-10-30, Days after submission: 202
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergic to ASA
Diagnostic Lab Data:
CDC Split Type: 970083351
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2009A40IM 
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: pt recv vax 4MAR97 & devel arthralgia in the first 3 wk of March;event spontaneously resolved;

VAERS ID:106074 (history)  Vaccinated:1997-05-22
Age:40.0  Onset:1997-05-26, Days after vaccination: 4
Gender:Female  Submitted:1997-06-16, Days after onset: 21
Location:Minnesota  Entered:1997-10-30, Days after submission: 136
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 970144511
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2116C60IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Oedema peripheral, Osteoarthritis
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: pt recv vax 22MAY97 & 4 days later devel bilat joint pain & swelling of the hands & wrists;tx w/OTC anti-inflammatories;pt is still exp sx;

VAERS ID:106108 (history)  Vaccinated:1997-06-10
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:1997-07-15
Location:Florida  Entered:1997-10-30, Days after submission: 107
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: pt had blood transfusions in NOV95 or NOV96 (unk if done in US because pt reportedly did a lot of traveling;
Diagnostic Lab Data: HEP A negative; HEP C neg; Hep B surface AG positive;Hepatitis b IGM core AB neg;
CDC Split Type: 970168641
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2133A40IMLA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Depression, Headache, Migraine, Myalgia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 10JUN97 & c/o chronic migraine h/a;pt reportedly never had them before;also had c/o tiredness, lethargy, muscle soreness & feeling down in the dumps;muscle soreness resolved but still is exp h/a, tiredness & lethargy;

VAERS ID:104100 (history)  Vaccinated:1997-10-09
Age:40.0  Onset:1997-10-09, Days after vaccination: 0
Gender:Female  Submitted:1997-10-16, Days after onset: 7
Location:Pennsylvania  Entered:1997-11-03, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Estrace
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: electrocardiogram negative;blood tests negative;CT scan negative;
CDC Split Type: 897295014L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES49781933IMA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Facial palsy, Gait disturbance, Infection, Myasthenic syndrome, Myelitis, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: 5 hr p/vax pt exp chills, t99;that afternoon pt exp numbness of fingers rt hand;numbness to elbow;the next day exp numbness of rt knee & hips;2 days post vax pt exp numbness & tingling in jaw;muscle weakness;CVA;dx GBS;drag leg when walk

VAERS ID:104302 (history)  Vaccinated:1997-10-20
Age:40.7  Onset:1997-10-20, Days after vaccination: 0
Gender:Female  Submitted:1997-10-24, Days after onset: 4
Location:Vermont  Entered:1997-11-03, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH 0SCRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: rt upper arm, deltoid area became hot to touch w/tenderness, along w/a hard raised rash of 3" inches in circumference around the inj site;reporter states flu vax provided by Wyeth tubex prepared w/ 5/8" for Im shot;

VAERS ID:104429 (history)  Vaccinated:1997-10-27
Age:40.1  Onset:1997-10-28, Days after vaccination: 1
Gender:Female  Submitted:1997-10-29, Days after onset: 1
Location:North Dakota  Entered:1997-11-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt devel hot & tender x24hr w/flu vax;
Other Medications: Vancenase;Proventil inhaler;
Current Illness: nONE
Preexisting Conditions: environmental allergies-cats-dogs-molds/asthma;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0846D0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Chills, Hypertension, Hypothermia, Oedema peripheral, Pain, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: pt stated the noc p/vax c/o pain lungs, chills, arm painful red & swollen;28OCT97 pt came to clinic area of redness &s welling measure 5x5 T98.5 o, Bp 128/70;

VAERS ID:104519 (history)  Vaccinated:1997-10-20
Age:40.2  Onset:1997-10-20, Days after vaccination: 0
Gender:Female  Submitted:1997-10-22, Days after onset: 2
Location:Michigan  Entered:1997-11-07, Days after submission: 16
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: allergies: PCN, sulfa, Eythromycin & other mycin-drugs
Diagnostic Lab Data:
CDC Split Type: MI97127
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1819A10IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Eye disorder, Headache, Nausea, Pyrexia, Skin discolouration, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: w/in a few hr p/vax pt began to feel fatigued & devel dark colored circle under eyes w/small hives (about 6);devel a h/a;grade fever (99-100) & joint pains;23OCT97 fatigued w/hives;eyes feeling hot;

VAERS ID:105014 (history)  Vaccinated:1997-08-27
Age:40.8  Onset:0000-00-00
Gender:Male  Submitted:1997-08-28
Location:Pennsylvania  Entered:1997-11-07, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness: bee sting
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897241012L
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (TRI-IMMUNOL)LEDERLE LABORATORIES443263 IMA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: pt recv vax & 1 day post vax no adverse event had occurred @ that time;16SEP97 pt exp tenderness @ the inj site;pt recovered;

VAERS ID:104583 (history)  Vaccinated:1997-10-14
Age:40.4  Onset:1997-10-17, Days after vaccination: 3
Gender:Female  Submitted:1997-10-22, Days after onset: 5
Location:South Carolina  Entered:1997-11-10, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: s
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: SC97055
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)MEDEVA PHARMA, LTD.E32872GA0 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 14OCT97 pt recv vax;17OCT97 unable to move, very painful, sl fever used heating pad, APAP 22OCT97 unable to reach out still applying heat some fever found by RN;told to use cool compress APAP;

VAERS ID:104678 (history)  Vaccinated:1997-10-30
Age:40.2  Onset:1997-10-30, Days after vaccination: 0
Gender:Female  Submitted:1997-10-31, Days after onset: 1
Location:Colorado  Entered:1997-11-12, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: codeine
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781650 LA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Pain, Rash, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: dizziness, nausea, vomiting, extremity sore arm, spots on eyelids;

VAERS ID:104809 (history)  Vaccinated:1997-10-29
Age:40.9  Onset:1997-10-30, Days after vaccination: 1
Gender:Female  Submitted:1997-11-03, Days after onset: 4
Location:Ohio  Entered:1997-11-17, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Estrogen
Current Illness: NONE
Preexisting Conditions: asthma
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F819171IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hyperaesthesia, Infection, Myalgia, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt recv vax 615AM 29OCT97 @ work site;10PM noticed soreness in arm when rolled over;next AM had area size of silver dollar that was red warm & hurt to touch;saw 3rd shift Rn & went to work;930PM 30OCT97 was called to med;had infect;

VAERS ID:104813 (history)  Vaccinated:1997-10-30
Age:40.3  Onset:1997-10-30, Days after vaccination: 0
Gender:Female  Submitted:1997-10-30, Days after onset: 0
Location:Illinois  Entered:1997-11-17, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Aldactone
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: IL97100
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES7F817550IMRA
Administered by: Private     Purchased by: Other
Symptoms: Anxiety, Dizziness, Ear disorder, Vasodilatation
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: dizzy-hot-sinking feeling plugged ears-red skin;

VAERS ID:104869 (history)  Vaccinated:1990-09-28
Age:40.0  Onset:1991-03-03, Days after vaccination: 156
Gender:Female  Submitted:1997-10-29, Days after onset: 2432
Location:Texas  Entered:1997-11-19, Days after submission: 21
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp optical neuritis w/HBV dose 1;
Other Medications: PPD given 3OCT90 exp ecchymosis;Gentamicin sulf solution;
Current Illness: staphylococcal infect;
Preexisting Conditions: myositis 17JUL89;
Diagnostic Lab Data: 19APR91 CBC w/diff;Elisa 24APR91;CBC w/diff 2MAY91;3JUN91 microb;
CDC Split Type: TX97151
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
HEP: HEP B (FOREIGN)MERCK & CO. INC.1595R1 LA
Administered by: Public     Purchased by: Public
Symptoms: Agitation, Anaphylactoid reaction, Asthma, Dyspepsia, Insomnia, Lymphadenopathy, Pharyngitis, Rhinitis
SMQs:, Anaphylactic reaction (narrow), Agranulocytosis (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Oropharyngeal infections (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 3MAR91 dyspepsia p/2nd dose HBV;11MAR91 upper resp;22MAR91 anaphylaxis rash, bronchospasm, irritability, insomnia;24APR91 lymphadenopathy;3JUN91 rhinos;

VAERS ID:104897 (history)  Vaccinated:1997-10-31
Age:40.2  Onset:1997-10-31, Days after vaccination: 0
Gender:Female  Submitted:1997-11-05, Days after onset: 5
Location:Utah  Entered:1997-11-19, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: UT970635
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781465 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0906E0 RA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Eructation, Hypokinesia, Injection site oedema, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (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), Hypotonic-hyporesponsive episode (broad)
Write-up: pt states felt fine a/vax;later chills, fever, swelling of lt deltoid, couldn''t move arm;feeling of being unwell-burped up egg taste;reported sx to hlth dept 5NOV97;states knows this was a rxn to flu shot;

VAERS ID:104960 (history)  Vaccinated:1997-11-12
Age:40.6  Onset:1997-11-12, Days after vaccination: 0
Gender:Female  Submitted:1997-11-12, Days after onset: 0
Location:California  Entered:1997-11-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: sulfa drugs
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978189 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Dysgeusia, Dyspepsia, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: pounding h/a, unsettled stomach (butterfly''s), tired, body aches (no soreness @ inj site), & medicine taste in mouth;took 3 regular strength APAP;

VAERS ID:105325 (history)  Vaccinated:1997-10-20
Age:40.8  Onset:1997-10-20, Days after vaccination: 0
Gender:Female  Submitted:1997-11-18, Days after onset: 29
Location:South Carolina  Entered:1997-12-02, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH49781820IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: local rxn of 6cm x 6cm redder area w/swelling occurred 20min p/vax & vax was given by employer as a yearly thing;

VAERS ID:107265 (history)  Vaccinated:1997-01-09
Age:40.0  Onset:1997-01-23, Days after vaccination: 14
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1997-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97030607
Vaccination
Manufacturer
Lot
Dose
Route
Site
RUB: RUBELLA (MERUVAX II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 9JAN97 & 23JAN97 pt devel hives;pt was seen @ local hlth clinic were was treated w/med;

VAERS ID:105958 (history)  Vaccinated:1997-09-18
Age:40.9  Onset:1997-10-02, Days after vaccination: 14
Gender:Male  Submitted:1997-10-22, Days after onset: 20
Location:Ohio  Entered:1998-01-05, Days after submission: 75
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: pt recv flu vax by Connaught lot# 7F81754 on 8OCT97
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: OH97096
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1196B0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Alopecia
SMQs:
Write-up: pt exp hair loss p/vax;

VAERS ID:107536 (history)  Vaccinated:1996-10-16
Age:40.0  Onset:1996-10-17, Days after vaccination: 1
Gender:Female  Submitted:1997-11-29, Days after onset: 408
Location:South Carolina  Entered:1998-01-15, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6943
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71289   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Hypotension, Malaise, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & devel allergic rxn w/localized itching & a hot spot the size of a saucer, became hypotensive 110/70 according to pt a hypertensive on med;the following morning pt devel malaise & felt poorly;

VAERS ID:107593 (history)  Vaccinated:1996-10-04
Age:40.2  Onset:1996-10-04, Days after vaccination: 0
Gender:Female  Submitted:1997-11-28, Days after onset: 420
Location:Florida  Entered:1998-01-15, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: Ortho tricylien
Current Illness: poss mild URI starting
Preexisting Conditions: bronchiectasis
Diagnostic Lab Data:
CDC Split Type: CO6838
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F71247  LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Influenza, Injection site hypersensitivity, Injection site oedema, Pruritus, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax & exp local rxn, flu like sx;immed area of redness, itching then inc redness & swelling of upper lt arm in red (illegible), lasted 3-4 days;

VAERS ID:107614 (history)  Vaccinated:1996-10-08
Age:40.7  Onset:1996-10-08, Days after vaccination: 0
Gender:Female  Submitted:1997-11-28, Days after onset: 416
Location:Georgia  Entered:1998-01-15, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6887
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)CONNAUGHT LABORATORIES6F7129325IMLA
Administered by: Private     Purchased by: Private
Symptoms: Insomnia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: w/in 4hr post vax pt exp shock waves every 5 minutes;now they occur every 5-10sec;pt hasn''t slept for days;if there is no stimulation then pt is fine;can''t even watch a TV now;described as adrenaline like kick, like when frightened but not

VAERS ID:107093 (history)  Vaccinated:1997-11-13
Age:40.7  Onset:1997-11-16, Days after vaccination: 3
Gender:Female  Submitted:1997-11-21, Days after onset: 5
Location:Georgia  Entered:1998-01-21, Days after submission: 61
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TD
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897339010L
Vaccination
Manufacturer
Lot
Dose
Route
Site
OPV: POLIO VIRUS, ORAL (ORIMUNE)LEDERLE LABORATORIES4485044PO 
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Hypokinesia, Myasthenic syndrome, Neck pain, Nuchal rigidity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: pt recv vax & 3 days post vax pt devel a h/a;4 days devel a low grade fever, neck pain & stiffness w/limitation of movement, & rt arm weakness;tx w/APAP w/o relief;

VAERS ID:106731 (history)  Vaccinated:1997-09-10
Age:40.7  Onset:1997-10-01, Days after vaccination: 21
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:1998-01-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD 9/10/97
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Ferritin elevated
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0552E1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alopecia
SMQs:
Write-up: pt recv vax 10SEP97 & noted 50% hair loss p/dose 2 of vax;October throughout December 1997 pt had been to attending physician;they could not discover a reason for the 50% hair loss;

VAERS ID:106743 (history)  Vaccinated:1997-12-31
Age:40.2  Onset:1998-01-12, Days after vaccination: 12
Gender:Female  Submitted:1998-01-14, Days after onset: 2
Location:Florida  Entered:1998-01-23, 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: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES98020640
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0739E0 LA
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 31DEC97 & 12JAN98 pt devel a rash on back, breast, & buttocks;

VAERS ID:107185 (history)  Vaccinated:1997-12-08
Age:40.3  Onset:1997-12-13, Days after vaccination: 5
Gender:Female  Submitted:1998-01-22, Days after onset: 40
Location:Georgia  Entered:1998-02-02, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft;Clarin
Current Illness: NONE
Preexisting Conditions: gastric ulcer 1986;bronchitis JUN97;ruptured c6-5 & C6 disc
Diagnostic Lab Data:
CDC Split Type: 897314054L
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUSHIELD)PFIZER/WYETH4978188  LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0328E0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Cough, Dizziness, Malaise, Myalgia, Pharyngitis, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 13DEC97 rash to chest & back;16DEC97 malaise, aching all over, sore throat, cough, dizziness-lasted 2 wk;low grade fever;27JAN98 mild rash still present;

VAERS ID:109376 (history)  Vaccinated:1997-07-25
Age:40.0  Onset:1997-07-30, Days after vaccination: 5
Gender:Female  Submitted:1998-01-29, Days after onset: 183
Location:Unknown  Entered:1998-02-02, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97091278
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.1586D1SC 
Administered by: Public     Purchased by: Other
Symptoms: Dermatitis bullous, Pruritus, Skin disorder
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 25JUL97 & 30JUL97 pt exp pruritic lumps on legs & one on face described as a blister w/a red base;

VAERS ID:107361 (history)  Vaccinated:1996-10-31
Age:40.2  Onset:1996-11-05, Days after vaccination: 5
Gender:Male  Submitted:1998-01-26, Days after onset: 447
Location:Louisiana  Entered:1998-02-10, Days after submission: 15
Life Threatening? No
Died? Yes
   Date died: 1996-11-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unk
Current Illness:
Preexisting Conditions: no hx of diabetes
Diagnostic Lab Data: unk
CDC Split Type: 0010150980002
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUOGEN)PARKE-DAVIS    
Administered by: Other     Purchased by: Other
Symptoms: Coma, Diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: pt recv vax 31OCT96 & exp diabetic coma on 5NOV96 & died that day;pt had no hx of diabetes;

VAERS ID:107796 (history)  Vaccinated:1998-02-17
Age:40.1  Onset:1998-02-18, Days after vaccination: 1
Gender:Female  Submitted:1998-02-19, Days after onset: 1
Location:New Mexico  Entered:1998-02-23, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications: pt recv hep B vax lot# 2356A2
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: NM98005
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0748E1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Face oedema, Oedema, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 17FEB98 w/o difficulty;w/in 24hr redness & swelling of face & anterior neck assoc w/local pruritus & thickening;self rx w/DPH;

VAERS ID:107876 (history)  Vaccinated:1998-02-17
Age:40.7  Onset:1998-02-18, Days after vaccination: 1
Gender:Female  Submitted:1998-02-19, Days after onset: 1
Location:Wisconsin  Entered:1998-02-27, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM2492A21IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Back pain, Eye pain, Face oedema, Neck pain
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: pt c/o neck discomfort (rt sided);tiredness, eye pressure & both eyes were swollen (eyelids puffy);back hurting;19FEB97 still has some neck discomfort;

VAERS ID:107922 (history)  Vaccinated:1998-01-15
Age:40.2  Onset:1998-01-17, Days after vaccination: 2
Gender:Female  Submitted:1998-02-05, Days after onset: 19
Location:Michigan  Entered:1998-03-02, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: pt devel soreness p/any type vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: sulfa-states had hives in past p/sulfa drug taken;states not physician dx;bees, hornets, ants;
Diagnostic Lab Data:
CDC Split Type: MI98012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1819A12IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hyperaesthesia, Hypokinesia, Myalgia, Oedema peripheral, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: pt states felt gen soreness in upper lt arm area p/vax;states 17JAN98 pain extended into thumb & pointer finger of lt hand;numbing, cramping feeling started;diff grasp objects;fingers & lt hand swelled; 1/4" bruise inj site;

VAERS ID:108045 (history)  Vaccinated:1997-08-21
Age:40.8  Onset:1997-09-01, Days after vaccination: 11
Gender:Female  Submitted:1998-02-27, Days after onset: 179
Location:Colorado  Entered:1998-03-06, 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: THyroid
Current Illness: no illness
Preexisting Conditions: asthma
Diagnostic Lab Data: elbow x-ray done 27JAN98-shows no degenerative processes
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0469E0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dyspepsia, Hypokinesia, Osteoarthritis, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: rt elbow pain x 1wk p/vax;26NOV to family MD p/sx worsened got med;sx subsided for about 2-3wk;16JAN98 lt thumb & elbow started swelling w/pain & heat;27JAN went to see orthopedic MD:on inflammatory;upset stomach;diff carrying things;

VAERS ID:108276 (history)  Vaccinated:1995-06-29
Age:40.4  Onset:1995-06-29, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp SOB & tonge felt sl enlarged w/dose 1 hep b vax;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97020543A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1523W0  
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 29JUN95 & w/in 1hr of vax pt devel a sl SOB & tongue felt sl enlarged as if burned from hot food;it was reported that these sensation started diminishing approx 3hr later;

VAERS ID:108277 (history)  Vaccinated:1995-08-01
Age:40.5  Onset:1995-08-02, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:California  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97020543B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1523W1  
Administered by: Other     Purchased by: Other
Symptoms: Asthma, Dyspnoea, Similar reaction on previous exposure to drug, Tongue oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax & w/in 24hr pt devel tongue swelling, SOB & bronchospasm;

VAERS ID:108309 (history)  Vaccinated:1997-03-10
Age:40.0  Onset:1997-03-11, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt had no drug effect p/3 doses hep b vax;
Other Medications:
Current Illness: hepatitis b exposure
Preexisting Conditions: hepatitis b exposure;
Diagnostic Lab Data: 1997 serum hepatitis b surface negative
CDC Split Type: WAES97031338
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Drug ineffective, Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Lack of efficacy/effect (narrow), Oropharyngeal infections (narrow), Arthritis (broad)
Write-up: pt recv vax & pt was exposed to hep b;following exposure, titers were taken & noted to be negative;therefore;pt exp joint pain 11MAR97;pt devel cold which was snot felt to be r/t vax;

VAERS ID:108320 (history)  Vaccinated:1997-04-01
Age:40.4  Onset:1997-04-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: neck pain;resp infect
Diagnostic Lab Data:
CDC Split Type: WAES97040393
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1374D0IM 
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Headache, Insomnia, Neck pain, Pain, Paraesthesia, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: pt recv vax 1APR97 & & 1/2hr p/vax pt exp paresthesia in lt shoulder which radiated to hand;exp numbness & tingling;h/a in middle of noc that woke pt up;SOB, warm flushing feeling;5APR97 exp burning sensation on feet;felt hot;neck pain

VAERS ID:108332 (history)  Vaccinated:1996-09-10
Age:40.0  Onset:1996-09-14, Days after vaccination: 4
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97040824
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Pharyngitis, Rhinitis
SMQs:, Agranulocytosis (broad), Oropharyngeal infections (narrow)
Write-up: pt recv vax 10SEP96 & 14SEP96 pt devel a terrible cold;

VAERS ID:108387 (history)  Vaccinated:1997-03-14
Age:40.6  Onset:1997-05-02, Days after vaccination: 49
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data: CBC WNL;Liver function tests WNL;Lyme titer negative;erythrocyte sedimentation 42;serum ANA positive;serum rheumatoid factor positive;UA negative;
CDC Split Type: WAES97052625
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Antinuclear antibody, Arthralgia, Osteoarthritis, Pyrexia, Rash, Red blood cell sedimentation rate increased, Serum sickness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: pt recv vax 14MAR97 & 2MAY97 pt exp a flat erythematous leg rash which travelled & a serum sickness like rxn consisting of fever, joint swelling & arthralgia;a visit to MD was required;ANA positive;ESR 42;

VAERS ID:108515 (history)  Vaccinated:1992-12-13
Age:40.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Alaska  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp redness around inj site & itching w/dose 1 hep b vax;
Other Medications: NONE
Current Illness:
Preexisting Conditions: PCN allergy
Diagnostic Lab Data: NONE
CDC Split Type: WAES97081645B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site mass, Pruritus, Similar reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 13DEC92 & devel severe pruritus & a 10cm. area of erythema & induration @ the inj site which persisted 1wk post vax;pt recovered;

VAERS ID:108566 (history)  Vaccinated:1997-04-01
Age:40.0  Onset:1997-06-01, Days after vaccination: 61
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: WAES97100871
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Alopecia
SMQs:
Write-up: pt recv vax MAR97 & JUN97 pt exp diffuse hair loss in clumps;

VAERS ID:108571 (history)  Vaccinated:0000-00-00
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: pneumnectomy
Diagnostic Lab Data: diagnostic lab test negative varicella antibody levels;
CDC Split Type: WAES97101261
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective, Malaise
SMQs:, Lack of efficacy/effect (narrow)
Write-up: pt recv 2 doses of vax & became violently ill & lab values indicated a lack of seroconversion;

VAERS ID:108607 (history)  Vaccinated:1997-11-19
Age:40.0  Onset:1997-11-21, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: unk
Diagnostic Lab Data:
CDC Split Type: WAES97111780
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Other     Purchased by: Other
Symptoms: Cough, Laryngospasm
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Hypersensitivity (narrow)
Write-up: pt recv vax 19NOV97 & 21NOV97 pt exp dry cough & tightening of throat;

VAERS ID:108615 (history)  Vaccinated:1997-11-05
Age:40.3  Onset:1997-11-12, Days after vaccination: 7
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: unk
Current Illness:
Preexisting Conditions: hayfever
Diagnostic Lab Data:
CDC Split Type: WAES97120647
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Infection
SMQs:
Write-up: pt recv vax 5NOV97 & 12NOV97 pt exp a vaginal yeast infect;pt had never had a vaginal yeast infect before;

VAERS ID:108632 (history)  Vaccinated:1997-09-10
Age:40.7  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:1998-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No relevant data;
Other Medications: NONE
Current Illness:
Preexisting Conditions: obesity
Diagnostic Lab Data:
CDC Split Type: WAES97121442
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0552E1IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alopecia
SMQs:
Write-up: pt recv vax 10SEP97 & p/vax pt exp alopecia on head which has gradually worsened;

VAERS ID:109428 (history)  Vaccinated:1996-05-08
Age:40.0  Onset:1996-05-09, Days after vaccination: 1
Gender:Unknown  Submitted:1997-03-05, Days after onset: 300
Location:Arkansas  Entered:1998-03-10, Days after submission: 370
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Nail injury
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897125027L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)PFIZER/WYETH  IM 
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Hypertonia, Paraesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt recv vax 08May96. Within 24-48 hr, pt exp numbness of face & hands lasting several days. Also exp muscle spasms, shortness of breath, "black outs & minor strokes".

VAERS ID:109485 (history)  Vaccinated:1997-02-19
Age:40.5  Onset:1997-02-24, Days after vaccination: 5
Gender:Female  Submitted:1997-03-11, Days after onset: 15
Location:South Carolina  Entered:1998-03-10, Days after submission: 364
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: needlestick
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897079009L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4968252 IM 
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt recv vax & devel inj site rxn w/1.2-cm area of redness,induration & tenderness. This is 1 of 2 pt from this site to exp adverse rxn p/vax

VAERS ID:109488 (history)  Vaccinated:1996-05-09
Age:40.8  Onset:1996-05-10, Days after vaccination: 1
Gender:Female  Submitted:1997-04-04, Days after onset: 329
Location:Unknown  Entered:1998-03-10, Days after submission: 340
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 897118017L
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)PFIZER/WYETH4958062   
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Malaise, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt recv vax & next day devel fatigue,body aches & malaise lasting as of the date of report. Since vax pt dx w/fibromyalgia. Responded well to prednisone "burst" tx.

VAERS ID:108211 (history)  Vaccinated:1998-02-10
Age:40.0  Onset:1998-02-11, Days after vaccination: 1
Gender:Female  Submitted:1998-03-09, Days after onset: 26
Location:New York  Entered:1998-03-13, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Appendectomy; cervical spine injury; endometriosis; falling
Diagnostic Lab Data: biopsy, Sjogren''s syndrome ruled out; computed axil, neck and head WNL; diagnostic laboratory, 10/??/98, blood work, within normal limits; diagnostic laboratory, 03/10/99, Mono; echocardiography, 03/05/99, results unknown; chest x-ray, normal
CDC Split Type: WAES99020792
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0100E SCLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthenia, Biopsy, Chest X-ray normal, Dizziness, Dry mouth, Echocardiogram, Fatigue, Laboratory test, Lymphadenopathy, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: 10 days p/vax pt exp fever 103, glands in neck very swollen, dizziness, myalgia & joint pain x 3 days;ongoing dizziness, fatigue;extreme dry mouth until present time. Information has been received from a consumer, a 41-year-old Caucasian female with a history of a fall in 1995 which resulted in "some" cervical damage, endometriosis, and an appendectomy who on 10-FEB-1998 was vaccinated SC with PROQUAD. Concomitant therapy included propoxyphene (+) acetaminophen. On 11-FEB-1998 the patient experienced a left dilated pupil. On 20-FEB-1998 the patient experienced a fever 104-105 degrees F x 2.5 days. At this time, the patient experienced severe shortness of breath, which lasted until April 1998. Additionally, the patient noted "right side of face and neck blew up." The swelling lasted for five days. The patient noted that the inside of her mouth peeled and that she had "no saliva." The patient noted that "the no saliva continues at this time." The patient sought unspecified medical treatment. A physician labeled the eye problem "Adie''s Pupil" and said that it was related to a virus. In March 1998 the patient "was given steroids and had mononucleosis." In April 1998 "vision returned to the left eye." The patient further noted "right eye is now beginning to cause problems and will dilate and stay that way for about a day and then return to normal."The patient also has lost 40 pounds. Follow-up information from a physician indicated that the patient received PROQUAD in February, 1998. "After this, the patient developed facial edema and actually developed mumps and mononucleosis. Since that time the patient has had become more severely constiped and has lost 25 pounds, not purposely, although with the decreased salivation she is probably eating less. The patient does have odynophagia with the feeling and sensation of some discomfort of food going down her esphagus. The patient had one episode of vomiting, no nausea. She sometimes goes a week without having a bowel movement which is definitely a change for her. The patient has also seen some bright red blood in her stool which is also new. When her initial symptoms started in February, she had some shortness of breath as well. The patient had dyspnea on exertion and an echocardiogram and chest x-ray were done which were all normal. Additionally, it was noted that the patient''s husband works with many pesticides and other chemicals and she does clean his clothes and is exposed to some of these chemicals. A physicain noted, "This is a somewhat interesting story which suggests some type of anticholinergic phenomenon, particularly given the constipation and dry mouth. Temporarily it seems to be related to the MMR shot, although I would have expected this to ohave resolved by now. GI wise, the weight loss is a problem, as is the new constipation and difficulty swallowing, again which may all be related to an anticholinergic effect, decreased salivation, etc. I am wondering about exposure to chemicals, particularly pesticides which may have some of her proble." Additional follow-up indicated that the patient is now on therapy with PROPULAID and is "not as constipated." Additional information has been requested.

VAERS ID:108704 (history)  Vaccinated:1996-09-26
Age:40.0  Onset:1996-09-26, Days after vaccination: 0
Gender:Male  Submitted:1998-03-17, Days after onset: 537
Location:New York  Entered:1998-03-19, Days after submission: 2
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: blood factor V deficienty, prosthetic aortic heart valve
Diagnostic Lab Data:
CDC Split Type: 19980039171A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM 0  
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Eye disorder, Muscle twitching
SMQs:, Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: pt recv vax 26SEP96 & immed p/vax devel eye quivering & also became dizzy;other people recv vax @ the same time as pt & did not exp these sx;

VAERS ID:108766 (history)  Vaccinated:1997-12-18
Age:40.3  Onset:1997-12-18, Days after vaccination: 0
Gender:Female  Submitted:1997-12-20, Days after onset: 2
Location:Arkansas  Entered:1998-03-19, Days after submission: 89
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE
Other Medications:
Current Illness: NONE
Preexisting Conditions: takes imitran inj
Diagnostic Lab Data:
CDC Split Type: AR986
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1168E2 RA
Administered by: Other     Purchased by: Public
Symptoms: Paraesthesia, Rash maculo-papular, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax 18DEC97 10AM & began to have a rash (red, raised, tiny) w/ c/o tingling & numbness rt hand;referred to MD;later in evening began nausea w/emesis;f/u 720AM 19DEC reveals pt is well & @ work;

VAERS ID:108791 (history)  Vaccinated:1994-03-15
Age:40.6  Onset:1994-03-15, Days after vaccination: 0
Gender:Female  Submitted:1997-09-20, Days after onset: 1284
Location:Washington  Entered:1998-03-23, Days after submission: 184
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp redness & swelling @ inj site & fatigue w/dose 1 hep b vax;
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: elevated sed rate;
CDC Split Type: WA981429B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Asthma, Diarrhoea,