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This is VAERS ID 151821

Case Details

VAERS ID: 151821 (history)  
Form: Version 1.0  
Age: 52.0  
Sex: Male  
Location: Unknown  
Vaccinated:1999-12-21
Onset:1999-12-21
   Days after vaccination:0
Submitted: 2000-04-21
   Days after onset:121
Entered: 2000-05-10
   Days after submission:19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
LYME: LYME (LYMERIX) / SMITHKLINE BEECHAM - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Arthralgia, Chills
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dilantin, Lipitor, Lopressor, Acetylsalicylic acid
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 20000005691

Write-up: 75 minutes post vax on 12/21/99, the pt/surgeon was in the middle of an operation when he suddenly experienced diffuse arthralgias throughout his body. Three minutes later, he experienced rigors. The adverse reaction was severe enough that the surgeon had to step away from the operation that he was performing. The rigors spontaneously resolved after a duration of two minutes, and the pt could then continue the operation. The arthralgias resolved after approximately one hour. The most recent information received on 1/5/00 reports the condition of the pt is resolved.


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