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VAERS ID: 25063 (history)  
Age: 0.4  
Gender: Female  
Location: Illinois  
Vaccinated:1990-06-27
Onset:1990-06-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 65929 / - - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Pyrexia, Rash, Screaming
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: acetaminophen
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fever 105-105.4 for about 16 hrs crying uncontrollably, started about 2 hrs /p receiving DTP. Pt examined 29-jun-90 has rash that looks like enterovirus. Her fever has resolved & she is clinically fine.


VAERS ID: 25064 (history)  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RUB: RUBELLA (MERUVAX II) / MERCK & CO. INC. - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Congenital anomaly
SMQs:, Congenital, familial and genetic disorders (narrow)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Platlets - 117,000, Lumbar puncture - normal except for protein concentration 1.46g/dl, Intrauterine infection dx, Rubella virus was cultured from throat of baby 6Jan88.
CDC Split Type: WAES90060087

Write-up: mother vaccinated w/ Rubella 1979. Pregancey uneventful, delivered 1st child girl 10-nov-87 baby wt 2340 gm & 11 days postmature. Baby severe petechial rash covering face, body & limbs, liver enlarged. Postnatal problems included seizures


VAERS ID: 25065 (history)  
Age: 20.0  
Gender: Female  
Location: New Jersey  
Vaccinated:1989-10-24
Onset:1989-11-03
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site reaction, Tenosynovitis
SMQs:, Tendinopathies and ligament disorders (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Diabetic & Cystic fibrosis
Diagnostic Lab Data:
CDC Split Type: B073089143

Write-up: Pt experienced tendinitis of the biceps brachii of her arm 10 days /p receiving influenza virus vaccine.


VAERS ID: 25066 (history)  
Age: 1.0  
Gender: Female  
Location: Foreign  
Vaccinated:0000-00-00
Onset:1988-07-13
Submitted: 1988-10-26
   Days after onset:105
Entered: 1990-07-09
   Days after submission:621
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MM: MEASLES + MUMPS (MM-VAX) / MERCK & CO. INC. - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Apnoea, Bradycardia, Pyrexia, Tachycardia, Vomiting, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant history
Diagnostic Lab Data: CSF 973 mg/dl comment protein
CDC Split Type: ARR47.344

Write-up: Pt vaccinated w/ MMVAX, developed fever, weight loss, vomiting, apena, tachycardia, bradycardia & subsequently died.


VAERS ID: 25067 (history)  
Age:   
Gender: Unknown  
Location: Wisconsin  
Vaccinated:1989-11-15
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4898038 / - - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Cellulitis, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: CLL (sic)
Diagnostic Lab Data: none
CDC Split Type: B034189159

Write-up: Pt experienced extreme edema & was hospitalized following adm. of Td vaccine. Condition was described as cellulitis of the lt arm. the pt fully recovered /p treatment /w antibiotics.


VAERS ID: 25068 (history)  
Age:   
Gender: Male  
Location: Oregon  
Vaccinated:1990-01-25
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / 2 - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Drug ineffective, Encephalitis
SMQs:, Lack of efficacy/effect (narrow), Noninfectious encephalitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no hx of allergies
Diagnostic Lab Data: 10Jan90 titier test - nonresponder, Herpes varicella was recovered from the brain
CDC Split Type: EBU900170

Write-up: nonresponder to a previous 3 dose series with MSD vaccine, encephalitis, Herpes varicella recovered from the brain


VAERS ID: 25069 (history)  
Age: 34.0  
Gender: Male  
Location: Michigan  
Vaccinated:1989-11-09
Onset:1989-11-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: allery to penicillins & shell-fish
Diagnostic Lab Data:
CDC Split Type: B073089154

Write-up: Pt developed hives 6 days /p receiving Influenza Virus vaccine. As of January 22, 1990, it was reported that he had recovered


VAERS ID: 25070 (history)  
Age:   
Gender: Male  
Location: Wisconsin  
Vaccinated:1989-11-21
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH - / - - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: B073090001

Write-up: Pt developed weakness in his arms and legs, DX as Guillain-Barre Syndrome /p receiving Influenza Virus Vaccine


VAERS ID: 25071 (history)  
Age:   
Gender: Female  
Location: Minnesota  
Vaccinated:1989-10-27
Onset:1989-10-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4898137 / - - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Dizziness, Headache, Influenza, Injection site oedema, Injection site pain, Injection site reaction, Nausea
SMQs:, Acute pancreatitis (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), Vestibular disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: B073089142

Write-up: pt developed erythema, edema, warmth, itching, stinging & pain in approx. 4" X 6" area at site of injection /p receiving vaccine. Experienced flu-like symptoms. That include haedache, light-headedness, dizziness, nausea within 3 hrs /p vacc


VAERS ID: 25072 (history)  
Age: 16.0  
Gender: Male  
Location: New York  
Vaccinated:1990-06-03
Onset:1990-06-05
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Abdominal pain, Blood amylase increased, Enzyme abnormality, Pancreatitis
SMQs:, Acute pancreatitis (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no relevant hx
Diagnostic Lab Data: Lab test serum amylase 6Jun90 - 2000
CDC Split Type: WAES90060353

Write-up: Pt developed abdominal pain & 6Jun90 admitted to hosp. DX pancreatisis & required surgery


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