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From the 10/8/2021 release of VAERS data:

Found 691,295 cases where Vaccine is 6VAX-F or ADEN or ADEN_4_7 or ANTH or BCG or CEE or CHOL or DF or DPIPV or DPP or DT or DTAP or DTAPH or DTAPHEPBIP or DTAPIPV or DTAPIPVHIB or DTIPV or DTOX or DTP or DTPHEP or DTPHIB or DTPIHI or DTPIPV or DTPPHIB or DTPPVHBHPB or EBZR or FLU(H1N1) or FLU3 or FLU4 or FLUA3 or FLUA4 or FLUC3 or FLUC4 or FLUN(H1N1) or FLUN3 or FLUN4 or FLUR3 or FLUR4 or FLUX or FLUX(H1N1) or H5N1 or HBHEPB or HBPV or HEP or HEPA or HEPAB or HEPATYP or HIBV or HPV2 or HPV4 or HPV9 or HPVX or IPV or JEV or JEV1 or JEVX or LYME or MEA or MEN or MENB or MENHIB or MER or MM or MMR or MMRV or MNC or MNQ or MNQHIB or MU or MUR or OPV or PER or PLAGUE or PNC or PNC10 or PNC13 or PPV or RAB or RUB or RV or RV1 or RV5 or RVX or SMALL or SSEV or TBE or TD or TDAP or TDAPIPV or TTOX or TYP or UNK or VARCEL or VARZOS or YF and Vaccination Date from '1990-01-01' to '2020-11-30'

Table

   
Event OutcomeCountPercent
Death6,2100.9%
Permanent Disability16,2732.35%
Office Visit37,5065.43%
Emergency Room180,71426.14%
Emergency Doctor/Room13,3571.93%
Hospitalized63,7179.22%
Hospitalized, Prolonged2,9380.42%
Recovered323,40646.78%
Birth Defect1010.01%
Life Threatening12,1101.75%
Not Serious220,59031.91%
TOTAL† 876,922† 126.85%
† Because some cases have multiple vaccinations and symptoms, a single case can account for multiple entries in this table. This is the reason why the Total Count is greater than 691295 (the number of cases found), and the Total Percentage is greater than 100.



Case Details

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VAERS ID: 25001 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Wisconsin  
Vaccinated:1990-06-04
Onset:1990-06-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9Q01042 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

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

Write-up: Loud intense cry with screaming for 1 1/2 hrs. Seen next day, child normal.


VAERS ID: 25003 (history)  
Form: Version 1.0  
Age: 0.8  
Sex: Male  
Location: Texas  
Vaccinated:1990-01-29
Onset:1990-02-04
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259962 / 4 - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 241950 / 4 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Delirium, Hypokinesia, Hypotonia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hypotonic, Hyporesponsive episode, Infant died: Reyes text Syndrome. Vaccine given for routine immunizations.


VAERS ID: 25009 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Male  
Location: Florida  
Vaccinated:1990-04-05
Onset:1990-04-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0333P / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Deafness
SMQs:, Hearing impairment (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: recurrent otitis media, measles
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES90030661

Write-up: 15mon. male w/ hx of recurrent ear infections & measles in Feb. 89''. 5Apr89 was given MMR. Within 24 hrs /p vaccine, parents noted hearing deficit, confirmed by physician exam.


VAERS ID: 25019 (history)  
Form: Version 1.0  
Age: 0.8  
Sex: Male  
Location: North Carolina  
Vaccinated:1990-06-08
Onset:1990-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271967 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Received DTP on 8JUN90 & had prolonged fever for a week''s time


VAERS ID: 25020 (history)  
Form: Version 1.0  
Age: 4.0  
Sex: Female  
Location: New York  
Vaccinated:1990-06-14
Onset:1990-06-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Asthma, Face oedema, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Subcut- Epinephrine, Bendryl & Solumedrol IV
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Urticaria, wheezy, & periorbital edema which abated /p administration of subcut. epinephrine, Bendryl IV, Solumendrol IV


VAERS ID: 25021 (history)  
Form: Version 1.0  
Age: 32.0  
Sex: Female  
Location: Florida  
Vaccinated:1990-06-08
Onset:1990-06-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RUB: RUBELLA (MERUVAX II) / MERCK & CO. INC. 2359R / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthralgia, Bradycardia, Chills, Hypotension, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad), Hypokalaemia (broad)

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

Write-up: /p receiving vaccine developed headache, sorejoints, chills, sternal chest pain, low grade fever, low blood pressure & low heart rate, chills again, relief lasted about 2-2.5 hrs. I have not found the low B/P & HR documented.


VAERS ID: 25022 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Maryland  
Vaccinated:1990-04-26
Onset:1990-04-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271911 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Injection site reaction, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: fever 102 F. local adenopathy, screaming episode & local reaction


VAERS ID: 25026 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Washington  
Vaccinated:1990-01-12
Onset:1990-01-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DT: DT ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 229974 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9A11092 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 244970 / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1990-01-14
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: child found dead in bed 14Jan90. Had full check up 12Jan90 with immunizations DPT/HIB/Oral Polio


VAERS ID: 25027 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Female  
Location: New York  
Vaccinated:1990-05-29
Onset:1990-05-31
   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. 1022S / UNK - / SC

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

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

Write-up: fever 102.5 F, rash


VAERS ID: 25033 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Male  
Location: Illinois  
Vaccinated:1990-06-25
Onset:1990-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271912 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: 16May90 Oral polio vaccine Lederle 265-927
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Elevated temp (as high as 104.3), headache, vomiting, irritable 40 hours.


VAERS ID: 25034 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Male  
Location: Wisconsin  
Vaccinated:1990-06-20
Onset:1990-06-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271912 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)

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

Write-up: Prolonged screaming


VAERS ID: 25037 (history)  
Form: Version 1.0  
Age: 31.0  
Sex: Female  
Location: Michigan  
Vaccinated:1990-04-03
Onset:1990-04-04
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (NO BRAND NAME) / MICHIGAN DEPT PUB HLTH 127 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthma, Dyspnoea, Hypersensitivity, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: NOT GIVEN

Write-up: 31yr old women admitted to Hosp with hives and tightness of her chest for the preceding 36 hours, at least. Approximately 36 hrs after vaccination had hives, prutitus, tightness of the chest, dyspnea, urticaria & wheezing.


VAERS ID: 25038 (history)  
Form: Version 1.0  
Age: 0.8  
Sex: Female  
Location: California  
Vaccinated:1990-03-05
Onset:1990-03-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9G01042 / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pyrexia, Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Elevated temp (103), some vomiting, lethargy


VAERS ID: 25039 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Indiana  
Vaccinated:1990-06-14
Onset:1990-06-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11033 / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Hypotonia, Stupor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Prematurity 27w on monitor for Hx apnea/bradycardia
Allergies:
Diagnostic Lab Data: HCT stable; Blood, Urine, CSF Cultures Neg
CDC Split Type:

Write-up: Hypotonia, Hyporesponsive reaction.


VAERS ID: 25040 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Male  
Location: Arkansas  
Vaccinated:1990-06-14
Onset:1990-06-15
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 250978 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Hypotonia, Stupor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

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

Write-up: 15 min period of being limp and unresponsive. No breathing difficulties, no jerking, no fever.


VAERS ID: 25042 (history)  
Form: Version 1.0  
Age: 1.0  
Sex: Male  
Location: Minnesota  
Vaccinated:1990-06-14
Onset:1990-06-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME) / PFIZER/WYETH 4898107 / UNK - / SC
YF: YELLOW FEVER (YF-VAX) / CONNAUGHT LABORATORIES 0B11048 / UNK - / SC

Administered by: Public       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 106F rectally beginning 1 hr after immunizations and lasting <24 hrs. Seen at ER treated w/tylenol & cool baths.


VAERS ID: 25043 (history)  
Form: Version 1.0  
Age: 0.1  
Sex: Female  
Location: Wisconsin  
Vaccinated:1990-06-14
Onset:1990-06-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 9B11033 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)

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

Write-up: Unconsolable crying for $g 4 hours immediately following 1st DTP vaccination.


VAERS ID: 25044 (history)  
Form: Version 1.0  
Age: 2.0  
Sex: Male  
Location: California  
Vaccinated:1990-05-24
Onset:1990-05-30
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 12275 / UNK - / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Gait disturbance, Personality disorder, Pyrexia, Somnolence, Speech disorder
SMQs:, Peripheral neuropathy (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), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: Beginning 6 days after immunization had 3 days of fever followed by 3 days of slurred speech, wide-based gait, lethargy, and bizarre behavior, followed in turn by complete resolution.


VAERS ID: 25045 (history)  
Form: Version 1.0  
Age: 0.5  
Sex: Female  
Location: Texas  
Vaccinated:1990-06-18
Onset:1990-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9B11033 / 5 - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Cyanosis, Hypotonia, Muscle twitching, Pallor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 9Apr90 2nd dose DPT limp & blue around mouth, 13Jan90 1st dose lethargic~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 4 hrs /p injection DPT .25 cc child woke up crying, parents noted child pale & blue around mouth, extremities were twitching, in route to MD ofc. childs head went limp.


VAERS ID: 25046 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:1990-06-18
Onset:1990-06-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OF11072 / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: fever $g 102 F, pain & induration of thigh at inject site


VAERS ID: 25047 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Mississippi  
Vaccinated:1990-03-27
Onset:1990-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 04039011A

Write-up: continuous crying since vaccine. Pt seen in ER


VAERS ID: 25048 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Male  
Location: California  
Vaccinated:1990-05-17
Onset:1990-05-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271914 / 3 - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Insomnia, Screaming
SMQs:, Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Tylenol
Current Illness:
Preexisting Conditions: general good health
Allergies:
Diagnostic Lab Data: CBC 10.1, WBC 76.9 other labs illegible to read
CDC Split Type:

Write-up: pt screaming for hours, still crying much 21May90 & 19Jun90. Parents report still not sleeping well at night, pt appears otherwise healthy now


VAERS ID: 25049 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1990-06-12
Onset:1990-06-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES OF11072 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Hypochromic anaemia, Hypotonia, Pallor, Stupor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Labs drawn 12Jun90 WBC - 10,700, HgB - 9.8, Polys - 54, Mono - 5, Lymphs - 41
CDC Split Type:

Write-up: Hypotomic-Hyporesponsive, very pale, about 4 hrs after 1st DTP injection


VAERS ID: 25050 (history)  
Form: Version 1.0  
Age: 3.0  
Sex: Female  
Location: California  
Vaccinated:1990-05-07
Onset:1990-05-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 4 LL / IM

Administered by: Military       Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: fever. inject site reaction


VAERS ID: 25051 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Male  
Location: South Dakota  
Vaccinated:1990-05-04
Onset:1990-05-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11038 / 5 RL / IM

Administered by: Military       Purchased by: Unknown
Symptoms: Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: fever, inject site reaction, swelling in right thigh


VAERS ID: 25059 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-06-15
Onset:1990-06-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 259964 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 259964L / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Screaming
SMQs:, Hostility/aggression (broad)

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

Write-up: screaming for 5-6 hrs /p DTP/OPV


VAERS ID: 25062 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Female  
Location: Colorado  
Vaccinated:1990-06-26
Onset:1990-06-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 9MO1012 / UNK LL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Agitation, Anorexia, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

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

Write-up: 18 mon. female w/ DPT 11:00am in lt thigh. 48 hrs /p T 101-103 w/ irritability refused to bear weight or sit up. Refusing solid food but drinking Pedolyte well. Peak T 103, Excessive sleepiness the past 48 hrs.


VAERS ID: 25063 (history)  
Form: Version 1.0  
Age: 0.4  
Sex: 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 / UNK - / 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
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: ~ ()~~~In patient
Other Medications: acetaminophen
Current Illness:
Preexisting Conditions:
Allergies:
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: 25068 (history)  
Form: Version 1.0  
Age:   
Sex: 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 / 3 - / 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), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? 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
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: 25072 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: 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. - / UNK - / -

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), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? 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
Allergies:
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


VAERS ID: 25077 (history)  
Form: Version 1.0  
Age: 6.0  
Sex: Male  
Location: American Samoa  
Vaccinated:1990-03-08
Onset:1990-03-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Pulmonary oedema
SMQs:, Cardiac failure (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: Wiskott-Aldrich Syndrome~ ()~~~In patient
Other Medications: 8-Mar-90 Dalacin C (Clindamycin) 65 mg p.o.
Current Illness: Sinusitis chron
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: confirmatory findings: x-ray examination thorax ECG
CDC Split Type: 90A130008

Write-up: Lung Oedema


VAERS ID: 25112 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Tennessee  
Vaccinated:1990-01-04
Onset:1990-01-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 241920 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site oedema, Rash, Screaming
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9000067.01

Write-up: Child presented in office same evening following immunization with splotchy erythema on entire leg, swelling 2 cm & irritability; crying episode (2PM to 2AM).. Treates w/Tempra and cold compresses. child had a low grade fever of 99 at imm.


VAERS ID: 25130 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Arizona  
Vaccinated:1990-06-19
Onset:1990-06-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0B11061 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Convulsion, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: CBC/spinal tap - WNL
CDC Split Type:

Write-up: High fever /w convulsion, Dx; Febrile seizure


VAERS ID: 25131 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: Connecticut  
Vaccinated:1990-06-25
Onset:1990-06-28
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 2130R / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 102 F, achy joints, fatigue


VAERS ID: 25132 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: D.C.  
Vaccinated:1990-06-22
Onset:1990-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0F11081 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0609B / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (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: ~ ()~~~In patient
Other Medications: ORAL POLIO VACCINE GIVEN SIMULTANEOUSLY
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: BRIEF GENERALIZED SEIZURE AFTER DTP AND ORAL POLIO VACCINE #1. SPONTANEOUS RECOVERY. PT PRESENTLY WELL.


VAERS ID: 25133 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Female  
Location: Texas  
Vaccinated:1990-03-02
Onset:1990-04-04
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 1648R / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Back pain, Haematuria
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: NO PREVIOUS KIDNEY PROBLEMS
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SEVERE BACK PAIN & SEVERE HEMATURIA RESULTED WITHIN 2 DAYS /P 1ST DOSE OF HBV-VACCINE GIVEN OF 2MAR90. 2ND INJECT GIVEN ON 8MAY90. WITHIN 2 DAYS PT C/O BACK PAIN AND HEMATURIA. PHYSICIAN FELT SYMPTOMS FROM VACCINE.


VAERS ID: 25134 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:1990-04-24
Onset:1990-04-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271912 / UNK - / IM
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER NA / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Screaming
SMQs:, Hostility/aggression (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: SCREAMED 8 DAYS AFTER DPT/OPV GIVEN 4-24-90. NORMAL NOW.


VAERS ID: 25137 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Female  
Location: Virginia  
Vaccinated:1990-05-28
Onset:1990-05-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262913 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 05595/2414R / UNK - / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 277943 / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Bradycardia, Hypotension, Stupor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT HAD INTERMITTENT BRADYCARDIA, LOW BP AND ALTERED CONSCIOUSNESS.


VAERS ID: 25163 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: Illinois  
Vaccinated:1990-01-03
Onset:1990-01-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 262912 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 256923(0598E) / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Somnolence, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9000092.01

Write-up: PT APPEARED LETHARGIC APPROX. 8 HRS AFTER DTP/OPV IMMUN, CHILD HAD SEVERE LETHARGY AND GAGGING EPISODES AND WAS HOSP. FOR OBSERVATION


VAERS ID: 25164 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-01-04
Onset:1990-01-10
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Muscle twitching, Pyrexia, Screaming
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 9000099.01

Write-up: PT IMMUNIZED 1-4-90.1-10-90 PT EXPERIENCED JERKING MOVEMENTS INTERMITTENTLY FOR 18 HRS.HIGH PITCHED CRY FOR 24 HRS.TYLENOL GIVEN FOR LOW GRADE FEVER.OFFICE VISIT 1-10AND1-15;INFANT RECOVERED


VAERS ID: 25166 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Female  
Location: California  
Vaccinated:1990-03-23
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 - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Injection site abscess, Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: B034190051

Write-up: PT DEVELOPED A 1 CM AREA OF ERYTHEMA AND EDEMA,(POSS STERILE ABSCESS) WHICH PERSISTED 4 WEEKS FOLLOWING INJECT. OF TETANUS AND DIPHTHERIA TOXOIDS ADS.LESION WILL BE DRAINED BY FLANAGAN TO DETERMINE IF STERILE ABSCESS.


VAERS ID: 25167 (history)  
Form: Version 1.0  
Age: 66.0  
Sex: Female  
Location: New York  
Vaccinated:1990-01-01
Onset:1990-04-01
   Days after vaccination:90
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME) / PFIZER/WYETH NA / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Dyspnoea, Face oedema, Injection site hypersensitivity, Injection site oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ace INHIBITOR UNSPECIFIED; NSAID - UNSPECIFIED
Current Illness:
Preexisting Conditions: HX OF HYPERTENSION
Allergies:
Diagnostic Lab Data:
CDC Split Type: B033990050

Write-up: PT EXPERIENCED ITCHING AND EDEMA AT INJECTION SITE OF TETANUS TOXOID ADSORBED.4 MO LATER, PT DEVEL SWELLING AROUND EYES AND UPPER RESP. DIFFICULTIES ASSO. WITH FOOD. PT REPORTEDLY RECEIVED TETANUS INJECT ONLY 3 YEARS EARLIER.PT HOSPITALIZED


VAERS ID: 25168 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-01-20
Onset:1990-01-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER 4898208 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Myalgia, Pain, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NARDIL FOR SEVERAL YEARS
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: B034190048

Write-up: SORENESS IN RIGHT ARM AFTER INJECTION FOR ONE DAY. ON 1-21-90 THE SITE BECAME SWOLLEN AND SORE. 1-24-90 DEVELOPMENT OF ACHING IN BOTH LEGS. 1-26-90 HIVE LIKE LUMPS IN BOTH LEGS.PT HAD ER TREATMENT OF 1-29-90 AND FROM DRS BERGOYNE AND BENNER


VAERS ID: 25169 (history)  
Form: Version 1.0  
Age: 43.0  
Sex: Female  
Location: South Carolina  
Vaccinated:1990-04-06
Onset:1990-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / UNKNOWN MANUFACTURER 4898184 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Cellulitis, Injection site mass, Injection site oedema, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: B034190047

Write-up: PT PRESENTED IN ER WITH SEVERE PAIN,REDNESS,SWELLING OF UPPER LEFT ARM(INDURATION OF 11CM BY 9.5 CM, ONE DAY AFTER VACCIN. REACTION DESCRIBED AS CELLULITIS.


VAERS ID: 25172 (history)  
Form: Version 1.0  
Age: 10.0  
Sex: Male  
Location: New York  
Vaccinated:1990-04-10
Onset:1990-04-13
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / PFIZER/WYETH 4898121 / UNK - / SC

Administered by: Private       Purchased by: Private
Symptoms: Injection site hypersensitivity
SMQs:, Hypersensitivity (narrow)

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: B033990049

Write-up: PT DEVELOPED 3 x 4 CM SWELLING DESCRIBED AS A WHEAL AT SOI 3 DAYS AFTER ADMIN OF TETANUS AND DIPHTHERIA TOXOIDS ADS, ADULT.


VAERS ID: 25431 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Illinois  
Vaccinated:1990-06-05
Onset:1990-06-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1388R / UNK - / SC

Administered by: Private       Purchased by: Private
Symptoms: Convulsion, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LUMBAR PUNCTURE NEGATIVE ,CTSCAN HEAD- NEGATIVE, UBC 4,300
CDC Split Type:

Write-up: 6 HRS AFTER VACCINE, FEVER AND SEIZURE(LEFT FOCAL SEIZURE)


VAERS ID: 25233 (history)  
Form: Version 1.0  
Age: 36.0  
Sex: Female  
Location: Oregon  
Vaccinated:1990-02-05
Onset:1990-02-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Chills, Headache, Lymphadenopathy, Nausea, Pharyngitis, Pyrexia
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

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: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900144

Write-up: FOUR HRS AFTER FIRST DOSE OF HEP B VAX, PT EXP FEVER, CHILLS, NAUSEA. EXP HEADACHE ONE DAY AFTER ADMIN OF VAX. FOR THE FOLLOWING 2 WEEKS SHE DEVELPD SEVERE UPPER RESP INFECTION /W/ SEVERE SWOLLEN GLANDS. NO TREATMENT GIVEN. SYMPTOMS ABATED.


VAERS ID: 25234 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-04-26
Onset:1990-04-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Paraesthesia, Vasodilatation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900155

Write-up: PT APPEARED FLUSHED AND SAID ARM TINGLED IMMEDIATELY AFTER INJECTION. PT NOT EXAMINED BY PHYSICIAN.


VAERS ID: 25235 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Female  
Location: Florida  
Vaccinated:1990-04-10
Onset:1990-04-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Dermatitis bullous, Mucous membrane disorder, Somnolence
SMQs:, Severe cutaneous adverse reactions (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900161

Write-up: DAY OF VAX., PT BECAME LETHARGIC, DEVELOPED BLISTERS AND REDNESS(INFLAMMATION) OF MUCOUS MEMBRANE OF MOUTH. TREATED WITH BENADRYL. OUTCOME: NO INJURY.


VAERS ID: 25283 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:1990-06-12
Onset:1990-06-15
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271964 / UNK - / IM
HIBV: HIB (PROHIBIT) / CONNAUGHT LABORATORIES 9L01043 / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Cyanosis, Hypotonia, Screaming
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)

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

Write-up: high pitched cry, Hypotonia < 10 seconds /w bluish lips


VAERS ID: 25284 (history)  
Form: Version 1.0  
Age: 5.0  
Sex: Female  
Location: Texas  
Vaccinated:1990-06-27
Onset:1990-06-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 265938 / UNK - / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0610F / UNK - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: Fever of 103 F


VAERS ID: 25285 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Male  
Location: Florida  
Vaccinated:1990-06-12
Onset:1990-06-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271967 / UNK LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 271967 / UNK LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Convulsion, 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Fever starting several hrs /p DTP, had a seizure approx. 12 midnight lasted < 5 minutues.


VAERS ID: 25287 (history)  
Form: Version 1.0  
Age: 1.3  
Sex: Female  
Location: Ohio  
Vaccinated:1990-06-20
Onset:1990-06-28
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 279946 / UNK - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1227S / UNK - / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Past history of seizure /w fever
Allergies:
Diagnostic Lab Data: Normal electrolytes, CBC serum glucose & calcium
CDC Split Type:

Write-up: Tonic seizure activity involving the rt leg & arm. Head & eyes drawn to rt


VAERS ID: 25288 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Male  
Location: Maine  
Vaccinated:1990-06-25
Onset:1990-06-25
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / SCLAVO 128A7 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Headache, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: Pt has hx of seizures X 2 yrs but not on meds, asthma also
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Td booster on 6Jun90 & reported on 27Jun90 had a headache since vacc. Temp of 99.6 F, examed bu MD for possible rxn. 2" swelling at inject. site.


VAERS ID: 25289 (history)  
Form: Version 1.0  
Age: 15.0  
Sex: Female  
Location: New York  
Vaccinated:1990-06-22
Onset:1990-06-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 2566933 / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Bradycardia, Dizziness, Hypotension, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Dehydration (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Amoxicillin 250 mg tid X 10 day (initated 12Jun90)
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 5-10 min /p injection, pt felt faint & nearly passed out. Pt looked pale, totally gray & BP before inject 100/60 dropped 80/50. Pulse 40-50, pt responsive through episode. Systoms resolved within 5-10 /p inject.


VAERS ID: 25290 (history)  
Form: Version 1.0  
Age: 1.5  
Sex: Female  
Location: Texas  
Vaccinated:1990-06-27
Onset:1990-06-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 271912 / 4 - / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Hypotonia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no rxn to previous DTP X3
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Limp attack /p DTP. RX: Benadryl for rxn, Rec. (sic) no more pertussis.


VAERS ID: 25291 (history)  
Form: Version 1.0  
Age: 25.0  
Sex: Female  
Location: Indiana  
Vaccinated:1990-01-15
Onset:1990-01-19
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: FIRST VAX~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900088

Write-up: PT BROKE OUT WITH HIVES 4 DAYS AFTER RECVD FIRST ENGERIX B INOCULATION. HIVES HAVE CONTINUED FOUR WEEKS. ANTIHISTAMINE THERAPY.


VAERS ID: 25292 (history)  
Form: Version 1.0  
Age: 41.0  
Sex: Female  
Location: North Carolina  
Vaccinated:1990-02-09
Onset:1990-02-09
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Hypertonia, Injection site hypersensitivity, Myalgia, Neuritis, Pain, Paraesthesia, Paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness:
Preexisting Conditions: INDERAL, AND RECOMBIVAX-HB ADMINISTERED 1988.
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900091

Write-up: Pt exp discomfort, warmth, edema around inject site; treated with Tylenol and ice; saw ER; devlpd muscle and joint aches; neurologist 22FEB90 diagnosed flu;


VAERS ID: 25293 (history)  
Form: Version 1.0  
Age: 31.0  
Sex: Female  
Location: North Carolina  
Vaccinated:1990-02-28
Onset:1990-02-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: N/A
Current Illness:
Preexisting Conditions: ALLERG TO PENICILLIN AND CODEINE. 2-9-90 UNDERWENT BILATERAL TUBAL LIGATION.
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900092

Write-up: PT ONSET OF EVENTS SAME DAY SHE RECVD ENGERIX-B:REDNESS, WARMTH AT SOI, WITH VERY SLIGHT SWELLING. TREATMENT OF ICE-PACK AND 2 TABLETS OF ADVIL.


VAERS ID: 25294 (history)  
Form: Version 1.0  
Age: 35.0  
Sex: Female  
Location: Washington  
Vaccinated:1990-01-30
Onset:1990-01-30
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Coordination abnormal, Face oedema, Headache, Influenza, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (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: ~ ()~~~In patient
Other Medications: ASPIRIN
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900093

Write-up: 11 TO 12 HRS AFTER INJECTION, PT EXP NAUSEA, EQUILIBRIUM DISTURBANCES, HEADACHE ON LEFT SIDE OF HEAD, SOME SWELLING ON LEFT SIDE OF FACE. NO TREATMENT. SIX HRS LATER, NO SYMPTOMS.


VAERS ID: 25295 (history)  
Form: Version 1.0  
Age: 22.0  
Sex: Female  
Location: Ohio  
Vaccinated:1990-03-05
Onset:1990-03-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Rash, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: VIAL DESCRIPTION: SINGLE DOSE, CLEAR; SLIGHTLY CLOUDY WHITE
CDC Split Type: EBU900094

Write-up: ONE HR POST-INJECTION, PT EXP RASH ALL OVER BODY; HIVES ON BACK, BUTTOCKS AND AXILLAE; EARS WERE HOT. NO SHORTNESS OF BREATH. BENADRYL GIVEN ORALLY. NO ADDITIONAL DOSES WILL BE GIVEN.


VAERS ID: 25296 (history)  
Form: Version 1.0  
Age: 23.0  
Sex: Male  
Location: Texas  
Vaccinated:1990-02-28
Onset:1990-03-01
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Ear disorder, Ear pain, Injection site reaction, Insomnia, Lymphadenopathy, Nuchal rigidity, Pharyngitis, Pyrexia, Red blood cell sedimentation rate increased, Vomiting
SMQs:, Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: SEDIMENTATION RATE = ELEVATED, THROAT CULTURE = NORMAL, BODY TEMP = 103.6 DEGREES F (ALL ON 01-MAR-90)
CDC Split Type: EBU900095

Write-up: SINCE 3-2-90 PT EXP STIFF NECK, FEVER, VOMITING, SORE THROAT, SWOLLEN GLANDS, PAIN IN EARS WHICH ARE FULL OF FLUID. TREATED /W/ AMOXIL,TYLENOL 3,TYNATAN.SORE THROAT GONE. SOME SYMPTOMS PERSIST.


VAERS ID: 25297 (history)  
Form: Version 1.0  
Age:   
Sex: Male  
Location: New York  
Vaccinated:1990-01-18
Onset:1990-01-20
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Face oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Lack of efficacy/effect (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: IMMUNE COMPLEXES, COMPLEMENT ACTIVATION = NORMAL. SEDIMENTATION RATE = 1.
CDC Split Type: EBU900097

Write-up: PT EXP HIVES 3 DAYS AFTER RECEIVING HIS SECOND INJECT OF ENGERIX B ON 1-18-90. EVALUATED (2-12-90) BY IMMUNOLOGIST BECAUSE OF RECURRING EPISODES OF PERIORBITAL EDEMA. NO HEPATITIS B SURFACE ANTIBODY WAS NOTED.


VAERS ID: 25298 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Female  
Location: Kentucky  
Vaccinated:1990-02-22
Onset:1990-02-22
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Anorexia, Arthralgia, Chills, Headache, Malaise, Myalgia, Nausea, Pyrexia, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: MOTRIN, MULTIVITAMINS, PREMARIN
Current Illness:
Preexisting Conditions: ALLERGIC TO PENICILLIN.
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900098

Write-up: PT RECVD 1 INJECT OF ENGERIX-B AND EXPERIENCED ACHING ALL OVER, GENERAL MALAISE, NAUSEA, LOW GRADE TEMP AND HEADACHE ON 2-22-90. EVENTS CLEARED ON 2-24-90. SYMPTOMS STOPPED ON OWN.


VAERS ID: 25299 (history)  
Form: Version 1.0  
Age: 38.0  
Sex: Female  
Location: Washington  
Vaccinated:1990-01-19
Onset:1990-02-01
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Candidiasis, Herpes zoster, Hypersensitivity, Infection, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: DYAZIDE,HYDROCORTISONE,.05%DIPROLENE,KEFLEX 500mg,ALPHA KERI OIL, ERYTHROMYCIN ETHYLSUCCINATE, ZOVIRAX, MONISTAT VAGINAL SUPPOSITORIES, DYAZIDE 50mg FOR EDEMA
Current Illness:
Preexisting Conditions: COMMUNICABLE DISEASE HISTORY INCLUDE CHILDHOOD CHICKEN POX, MUMPS AND AS A YOUNG ADULT, SHINGLES.
Allergies:
Diagnostic Lab Data: SYMPTOMS CONT.:MD''S OPINION HERPES ZOSTER. 3-6 LARGE AMT DRAINAGE;CLUSTER AREAS COVERED BODY(SCALP TO TOES).3-16 NOT IMPROVING. 3-27 ERUPTIONS HEALING. 4-2-90 DIAGNOSED MONILIA. LAB DATA:NO PATHOGENS NOTED IN ERUPTIONS.
CDC Split Type: EBU900099

Write-up: 1 OR 2 RED RAISED ERUPTIONS(.5 TO 1 cm) ON UPER LF ARM WITH IRRITATION AND ITCHING. TREATED /W/ DIPROLENE.2-19-90 2ND DOSE OF ENGERIX B ERUPTIONS LARGER NOW CRUSTY.2-22 TREATED /W/ KEFLEX FOR IMPETIGO.2-26 DIAG POSS ALLERG REACT TO HEP B.


VAERS ID: 25301 (history)  
Form: Version 1.0  
Age: 39.0  
Sex: Female  
Location: North Carolina  
Vaccinated:1990-03-08
Onset:1990-03-09
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Cough, Dyspnoea, Influenza, Pharyngitis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NO KNOWN ALLERGIES FOR 1ST AND 2ND DOSES OF RECOMBIVAX GIVEN INTRAMUSCULARLY ON 06-AUG-89 AND 07-SEP-89
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900101

Write-up: RECVD SECOND VAX ON 3/8/90. YHE NEXT DAY ONSET OF SYPTOMS:TEMP 99.8,SORE THROAT,SWELLING IN THROAT,FLY SYMPTOMS,BREATHING DIFFS,COUGH. NO TREATMENT PRESCRIBED.SYMPTOMS REMAINED 13-MAR-90.


VAERS ID: 25302 (history)  
Form: Version 1.0  
Age: 39.0  
Sex: Female  
Location: Virginia  
Vaccinated:1990-03-02
Onset:1990-03-07
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Hepatitis
SMQs:, Hepatitis, non-infectious (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: ~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: BLACK VACCINEE IS DIALYSIS PATIENT WHO WORKS WITH OTHER DIAL. PTS."ANTI-HIV"POSITIVE. IN 1988 RECEIVED SERIES OF 3 HEPTAVAX SHOTS.AND 2/6/90 HEPTAVAX BOOSTER. ALL PREV TESTS FOR HBSAG AND HBCAG NEG.PT IS ON ROUTINE MEDS OF DIAL. PTS.
Allergies:
Diagnostic Lab Data: 2/90 TESTED NEGATIVE FOR HBSAG AND HBCAG. 3/7/90 TESTED POS FOR HBSAG.
CDC Split Type: EBU900102

Write-up: HBSAG:POSITIVE 5 DAYS POST IMMUNIZATION.5 DAYS AFTER PT RECEIVED FIRST DOSE(2 x 1ml VIALS=40 MCG)OF ENGERIX-B PT PRESENTED WITH HBSAG POS.NO TREATMENT GIVEN. TO DATE "NO CHANGE IN PTS CLINICAL COND. FOLLOW UP1:RETEST FOUND PT NEG FOR HBSAG


VAERS ID: 25303 (history)  
Form: Version 1.0  
Age: 32.0  
Sex: Female  
Location: Minnesota  
Vaccinated:1990-02-12
Onset:1990-02-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain, Chills, Headache, Influenza, Injection site reaction, Lymphadenopathy, Myalgia, Nuchal rigidity, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NO HIST OF ALLERGY
Allergies:
Diagnostic Lab Data: MOBILE RT ANT CERVICAL NODE IS PRESENT OTHERWISE NO ADENOPATHY. NO SKIN RASH,URTICARIA,ANGIOEDEMA APPARENT. SOI SHOWS 1cm ECCHYMOSIS BUT NO OTHER PROBLEMS.ASSESMENT:REACT TO HEP VAX. 3-13-90:HGB 15.7,WBC UP TO 17,800 /W/ NORMAL DIFFERENTIAL
CDC Split Type: EBU900103

Write-up: ABDOMINAL PAIN,SOI LF DEL 1 cm ECCHYMOSIS,FEVER,HEADACHES,MESENTERIC ADENITIS,MYALGIAS,NECK STIFF,EPIGASTRIC PAIN,SHAKING,CHILLS,POSSIBLE FLU,POSS REACTION TO HEP VAX. ENGERIX-B GIVEN ON 12-FEB-90 AND 12-MAR-90. FURTHER DETAILS ON WORM.


VAERS ID: 25304 (history)  
Form: Version 1.0  
Age: 48.0  
Sex: Female  
Location: Illinois  
Vaccinated:1990-03-05
Onset:1990-03-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Ecchymosis, Injection site mass, Injection site pain, Injection site reaction
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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: ~ ()~~~In patient
Other Medications: PREMARIN, SYNTHROID 0.1
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900104

Write-up: AT SOI: INDURATION,PAIN,ECCHYMOSIS,REDNESS,PRURITUS.RECVD 1ST DOSE 3-5-90.NIGHT OF 3-6-90 SYMPTOMS ST OUTER ASPECT OF REDDENED AREA.GIVEN CHLOR-TRIMETON 4 MG.IMPROVED 5 HRS LATER(LESS RED AND ITCHY). ITCHING LASTED 3 DAYS.SYMPTS GONE 1 WEEK


VAERS ID: 25306 (history)  
Form: Version 1.0  
Age: 40.0  
Sex: Female  
Location: Alabama  
Vaccinated:1990-03-13
Onset:1990-03-13
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Diarrhoea, Malaise, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: H-BIG ?? ADMIN DATE-13-MAR-90
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900106

Write-up: RECVD ENGERIX-B INJECT ALONG WITH HBIG ON 3-13-90 FOR NEEDLE STICK INJURY. ONE DAY LATER PT HAD ONSET OF NAUSEA, VOMITING, DIARRHEA. NO TREATMENT GIVEN. AS OF 3-19-90,PT DID NOT FEEL WELL


VAERS ID: 25307 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:1990-02-26
Onset:1990-02-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Diarrhoea, Malaise, Nausea, Pyrexia
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900107

Write-up: 2ND DOSE OF ENGERIX-B GIVEN ON 2/23/90. 3-4 DAYS LATER VACCINEE HAD ONSET OF MALAISE,FATIGUE. ON 2/28/90 SHE DEVLPD NAUSEA,TEMP INCREASE,DIARRHEA. SINCE, SHE HAS BEEN EXPERIENCED FATIGUE,MILD NAUSEA. NO TREATMENT GIVEN.


VAERS ID: 25308 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-02-28
Onset:1990-02-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Hangover, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NO UNDERLYING ILLNESSES
Allergies:
Diagnostic Lab Data: BODY TEMP: 2-28-90 99.5 DEGREES F TO 100.5 DEGREES F.
CDC Split Type: EBU900108

Write-up: VACCINEE RECVD FIRST DOSE OF ENGERIX-B ON 2-20-90. ON 2-28-90 PT HAD ONSET OF FEVER AND NAUSEA. TOOK ASPIRIN FOR FEVER. RESOLVED 24 HRS;NAUSEA PERSISTED 5 DAYS.3-3-90 FELT HUNGOVER. WEAK FEELING SEV DAYS.3-10-90 FELT FINE.PT WON''T GET 2ND V


VAERS ID: 25309 (history)  
Form: Version 1.0  
Age: 24.0  
Sex: Male  
Location: Texas  
Vaccinated:1990-03-05
Onset:1990-03-06
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Chills, Diarrhoea, Nausea, Pyrexia, Rhinitis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: TYLENOL 3/6/90, TAKES INDERAL DAILY
Current Illness:
Preexisting Conditions: NONE SIGNIFICANT; NO KNOWN DISEASE OR ALLERGIES PT IS IN A HIGH RISK AREA ( EMERGENCY ROOM ).
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900109

Write-up: RECVD 1ST VAX ON 3-8-90. ONSET BEGAN IN AM OF 3-9-90: DIARRHEA,NAUSEA,VOMITING,TEMP OF 102 F,SNEEZING,RUNNY NOSE AND CHILLS. NOT SEEN BY PHYS AND NO TREATMENT GIVEN.RECOVERED 3-10-90. FOLLOW UPRECVD ENGERIX-B 1cc ON 3-5-90 EVENTS START ON 6


VAERS ID: 25310 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Wyoming  
Vaccinated:1990-03-20
Onset:1990-03-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NO ACTIVE INFECTIONS, NO KNOWN YEAST SENSITIVITY, NO KNOWN ALLERGIES TO MEDICATIONS, NO UNDERLYING ILLNESSES
Allergies:
Diagnostic Lab Data: IN ER: NO SHORTNESS OF BREATH, THROAT SWELLING OR RESPIRATORY DIESTRESS
CDC Split Type: EBU900110

Write-up: PT EXPCD URTICARIA ON ARMS 3:10 PM, APPROX 6 HRS AFTER 1ST INJECT OF ENGERIX-B. 9:20 PM IN ER FOR TREATMENT OF RASH. GIVEN BENADRYL(IM) AND DISCHARGED ON ATARAX. 3-22-90 PERSISTANT ITCHING AND RASH VISIBLE ON ARMS.3-27-90 ARMS CLEAR NOSYMPS


VAERS ID: 25311 (history)  
Form: Version 1.0  
Age: 31.0  
Sex: Female  
Location: Maryland  
Vaccinated:1990-03-02
Onset:1990-03-08
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Headache, Lymphadenopathy, Myalgia, Pyrexia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)

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: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NO CONCOMITANT ILLNESSES
Allergies:
Diagnostic Lab Data: SYPMTOMS CONT.: 3-21-90 SYMPTOMS RESOLVING; "FELT FINE" BY 3-22-90. PHYS AND NURSE "FEEL THE ILLNESS IS UNRELATED TO VAX."
CDC Split Type: EBU900111

Write-up: 3-2-90 RECVD VAX. 3-8-90 HEADACHE,BODY ACHE,LYMPH NODES SWOLLEN,FEVER 101.4 F DROPPED A DAY LATER.3-17-90 PT EXP RASH WHICH PERSISTED 2.5 DAYS.PHYS MISTAKED GERMAN MEASLES BUT IMMUNE TO.FURTHER DIAG WAS VIRAL ILLNES.3-19-90 JOINTS ACHED


VAERS ID: 25313 (history)  
Form: Version 1.0  
Age: 25.0  
Sex: Female  
Location: Kentucky  
Vaccinated:1990-02-28
Onset:1990-02-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Injection site pain, Injection site reaction, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: ALLERGIC TO PENCILLIN AND ERYTHROMYCIN.
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900113

Write-up: INJECT ON 2-28-90. ONSET OF BURNING SENSATION ON 3-2-90. RASH AROUND SOI ONSET 3-5-90 WHICH CLEARED BY 3-8-90.


VAERS ID: 25314 (history)  
Form: Version 1.0  
Age: 38.0  
Sex: Male  
Location: Illinois  
Vaccinated:1990-03-19
Onset:1990-03-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Back pain, Hypertonia, Muscle spasms
SMQs:, Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypokalaemia (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: ~ ()~~~In patient
Other Medications: INH ADMINISTERED 10-01-89 TAKES INH
Current Illness:
Preexisting Conditions: POSITIVE TB TEST 8-29-89
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900117

Write-up: FOUR HRS AFTER VAX (IM RT DELTOID EXP MUSCLE SPASMS IN LOWER BACK,BOTH ARMS BOTH LEGS RESULTING IN CHARLEY HORSES IN LOW BACK. UNCOMFORTABLE FOR 2 DAYS. NO TREATMENT GIVEN.BACK DISCOMFORT CONT UNTIL 4-9-90. PT REFUSED TO CONT VACCINATIONS


VAERS ID: 25315 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Female  
Location: Ohio  
Vaccinated:1990-03-14
Onset:1990-03-14
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Headache, 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), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: ALLERGIC TO DUST, NONE OTHER
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900118

Write-up: ONE WEEK AFTER 1ST VAX (IM,DELT)SHE DEVELPD HIGH FEVER,ACHINESS,HEADACHES. PHYSYCIAN TREATMENT UNSPECIFIC. OUTCOME:UNKNOWN. PHYSICIAN DECIDED PT WILL NOT RECEIVE FURTHER DOSES OF ENGERIX-B. EVENTS CLEARED ON 3-17-90.


VAERS ID: 25316 (history)  
Form: Version 1.0  
Age: 50.0  
Sex: Female  
Location: Florida  
Vaccinated:1990-02-23
Onset:1990-02-23
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective, Influenza, Malaise, Pyrexia
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NEEDLE STICK 8-24-89 , GIVEN RECOMBIVAX-HB APPROX 8-30-89, AND ON 9-26-89,~ ()~~~In patient
Other Medications: CARDIZEM, MAVACOR, HYDROCHLOROTHIAZIDE, ELAVIL
Current Illness:
Preexisting Conditions: EXTREMELY OVERWEIGHT, LUPUS, HIGH BLOOD PRESSURE, STOMACH STAPLED
Allergies:
Diagnostic Lab Data: TITERS FOR HBSAB AFTER NEEDLE STICK 8-24-89 AND BEFORE STARTING SERIES OF HEP-B VAX, RECOMB (ABOUT 8-30-89)=NEGATIVE.3-1-90 TITERS FOR HBSAB(AFTER SERIES OF 3 HEPATITIS B VAXS) = NEGATIVE
CDC Split Type: EBU900119

Write-up: ONSET OF SICKNESS IMMED.FOLLOWING INJECTION (IM,DELT) HAD FEVER AND FLU-LIKE SYMPTOMS .TESTS FOUND PT WAS NON-RESPONDER.RHEUMATOLOGIST FELT NON-RESPONSE WAS RESULT OF LUPUS.RECVD ADDITIONAL DOSE OF ENGERIX-B ON 3-23-90 RETEST TITER.SIMSYMPS


VAERS ID: 25317 (history)  
Form: Version 1.0  
Age: 43.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-03-28
Onset:1990-03-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 585A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Influenza, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (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: ON MED (UNSPECIFIED)FOR MITRAL VALVE PROLAPSE
Current Illness: POST-NASAL DRIP,SORE THROAT,COUGH,99 F
Preexisting Conditions: MITRAL VALVE PROLAPSE
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900120

Write-up: EXPER. FLU-LIKE SYMPTOMS, FEVER 1.5 HRS AFTER VAX(IM,DELT) NO RASH. NO MED GIVEN TO TREAT SYMPTOMS. RECOVERY 30-MAR-90. PHYS FEELS IT WAS FLU. SUBSEQUENT VAX IS PLANNED.


VAERS ID: 25318 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Colorado  
Vaccinated:1990-03-15
Onset:1990-03-15
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Nuchal rigidity
SMQs:, Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900121

Write-up: PT HAD SHOULDER PAIN AND NECK PAIN AFTER VAX (IM,DELT) ON 3-15-90. TREATMENT: NSAID (OTC). OUTCOME: TO DATE, SYMTOMS CONTINUE WITH "LITTLE ABAITMENT".


VAERS ID: 25319 (history)  
Form: Version 1.0  
Age: 28.0  
Sex: Female  
Location: Kentucky  
Vaccinated:1990-03-29
Onset:1990-03-29
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Influenza, Injection site reaction, Malaise, Myalgia, Nausea, Pruritus, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900122

Write-up: PT RECVD 1ST ENGERIX-B DOSE (DELT) 3-29-90 AM. SAME DAY EXPER RED AREA AT SOI, NAUSEA. FOLLOWING DAY ACHES SUBSIDING 4-1-90;NAUSEA CONTINUED.3-31-90 FLU-LIKE SYMPTOMS. 4-4-90 RASH AT LF AXILLARY AREA NOT AT SOI.TREATMENT TYLENOL BENADRYL.


VAERS ID: 25320 (history)  
Form: Version 1.0  
Age: 35.0  
Sex: Female  
Location: California  
Vaccinated:1990-04-02
Onset:1990-04-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Headache, Hyperaesthesia, Hypoaesthesia, Myalgia, Nausea, Pain, Paraesthesia, Tooth disorder, Visual field defect
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TREATED /W/ IBUPROFEN(600 mg QID 4-3-90 - ?),MEDROL DOSEPAK WITH FELDENE (4-7-90 - ?) NO OTHER MEDS EXCEPT ACTIFED PRN
Current Illness:
Preexisting Conditions: ALLERGIC TO IODINE (SHORTNESS OF BREATH); HAD ANAPHYLAXIS ;HIST OF HAY FEVER X 1 WEEK IN SPRING
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900123

Write-up: PT RECVD 1ST INJECT(LF,DELT) 4-2-90 ONSET OF LF NECK, SHOULDER AND LF JAW PAIN; EXP TINGLING IN LF HAND AND FINGERS AND RT SIDED HEADACHE WITH NAUSEA,SCOMATA.INTERMITTENT HYPERESTHESIA/HYPOESTHESIA OF THE LEFT CHEEK WHICH PERSISTS.


VAERS ID: 25321 (history)  
Form: Version 1.0  
Age: 28.0  
Sex: Female  
Location: Arizona  
Vaccinated:1990-04-05
Onset:1990-04-05
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 586A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Asthenia, Chills, Neuropathy, Oedema, Pain, Paraesthesia, Paralysis, Tremor
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NOT PREVIOUSLY VACCINATED AGAINST HEP-B AND RECEIVED NO HBIG FOR THE NEEDLE~ ()~~~In patient
Other Medications:
Current Illness: NEEDLE STICK INJURY
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900125

Write-up: PR RECVD 1ST INJECT(IM,DELT) 4-5-90 THAT NIGHT HAD ONSET OF PARESIS. LOSS OF MUSCULAR STRENGTH IN BOTH UPPER EXTREMITIES PROGRESSED,RESEMBLING RADICULOPATHY PATTERN. NO TREATMENT GIVEN. TO DATE NEUROPATHY IS PROGRESSING


VAERS ID: 25322 (history)  
Form: Version 1.0  
Age: 35.0  
Sex: Female  
Location: Kentucky  
Vaccinated:1990-02-28
Onset:1990-03-02
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Headache, Influenza, Malaise, Nausea, Somnolence
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (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: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: ALLERGIC TO CODEINE, MORPHINE, PERCODAN.
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900126

Write-up: HEADACHE,LETHARHY,MALAISE,NAUSEA,AND FLU-LIKE SYMPTOMS LASTED FOR 16 HRS AFTER 1ST DOSE OF ENGERIX-B. TREATED /W/ OTC MED TYLENOL ES,MOTRIN,REST.RECOVERD SAME DAY.


VAERS ID: 25323 (history)  
Form: Version 1.0  
Age: 44.0  
Sex: Male  
Location: New York  
Vaccinated:1990-03-07
Onset:1990-03-07
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hepatitis
SMQs:, Hepatitis, non-infectious (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALUMINUM HYDROXIDE, CALCIUM CARBONATE, EPOGEN, FERROUS SULFATE, FOLIC ACID, HEPARIN, PROCARDIA, TENORMIN, VITAMIN B&C COMPLEX
Current Illness:
Preexisting Conditions: END-STAGE RENAL FAILURE.
Allergies:
Diagnostic Lab Data: HBSAG TEST RESULTS:("CUT-OFF POSITIVE HBSAG IS .054") RESULTS:(1/90) .005=NEG;(2/90) .006=NEG; (3/7/90 POST 1ST VAX) .061=WEAKLY POS; (3/7/90) .065=WEAKLY POS; (4/2/90 POST 2ND VAX) .087=POS
CDC Split Type: EBU900129

Write-up: HEMODIALYSIS PT TESTED NEG FOR HBSAG PRIOR TO 1ST DOSE OF ENGERIX-B GIVEN ON 2/28/90.RESULTS FOR HBSAG ON 3/7/90 "WEAKLY POS" PT RECEIVED 2ND DOSE ENGERIX-B ON 3/31/90 AND TESTED POS FOR HBSAG.SUBSEQUENT TESTS ON 4/4,9 AND 10/90 ALL NEG.


VAERS ID: 25324 (history)  
Form: Version 1.0  
Age: 65.0  
Sex: Female  
Location: New York  
Vaccinated:1990-03-28
Onset:1990-04-03
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ERYTHROPOIETIN,FERROUS SULFATE,FOLIC ACID,GLUCOTROL,HEPARIN,HYDRALAZINE,ISOSORBIDE(40),LANOXIN,VERAPAMIL 80 mg,TYLENOL(PRN),NITROGLYCERIIN(PRN)
Current Illness: DIABETES,HEMODIALYSIS
Preexisting Conditions: END-STAGE RENAL DISEASE, DIABETES, ON MAINTENANCE HEMODIALYSIS
Allergies:
Diagnostic Lab Data: POST FIRST VAX: 4-3-90 .065=WEAKLY POS.;4-3-90 .072 WEAKLY POSITIVE; 4-10-90 .015=NEGATIVE; 4-10-90 .017=NEGATIVE
CDC Split Type: EBU900130

Write-up: HEMODIELYSIS PT RECVD 1ST DOSE OF ENGERIX-B(IM) ON 03-APR-90. HBSAG ON 4-3-90 WERE WEAKLY POS. ON 4-10-90 HBSAG WAS NEGATIVE. NO TREATMENT REQUIRED.


VAERS ID: 25325 (history)  
Form: Version 1.0  
Age: 26.0  
Sex: Female  
Location: Mississippi  
Vaccinated:1990-03-26
Onset:1990-03-26
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / -

Administered by: Private       Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: TESTS FOR HEP-B ANTIBODIES (3-26-90) NEGATIVE. 4/30/90, AFTER ENGERIX-B BOOSTER DOSE, TEST FOR HEP-B ANTIBODIES = POSITIVE
CDC Split Type: EBU900131

Write-up: SERIES OF VAXS GIVEN: DOSE#1 12-19-89, DOSE #2 1-22-90, AND DOSE #3 2-24-90.ONE MO AFTER #3 RESULTS NEG.4TH BOOSTER OF ENGERIX-B GIVEN 3-30-90 ACHIEVED PROTECTION AGAINST HEP-B


VAERS ID: 25326 (history)  
Form: Version 1.0  
Age: 28.0  
Sex: Male  
Location: Alabama  
Vaccinated:1990-03-27
Onset:1990-03-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / SC

Administered by: Private       Purchased by: Private
Symptoms: Hypersensitivity, Rhinitis
SMQs:, Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900132

Write-up: RECVD 2ND DOSE OF ENGERIX-B 3-27-90 DEVELPD NASAL ALLERGY 3-39-90. RUNNY NOSE CONGESTION LASTING 4 WEEKS. TO TREATMENT. RECOVERED


VAERS ID: 25327 (history)  
Form: Version 1.0  
Age: 40.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:1990-03-15
Onset:1990-03-29
   Days after vaccination:14
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Cerebrovascular disorder, Drug ineffective, Eye disorder, Paraesthesia
SMQs:, Lack of efficacy/effect (narrow), Peripheral neuropathy (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Corneal disorders (broad), Retinal disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: ASPIRIN
Current Illness:
Preexisting Conditions: HISTORY OF HEADACHE. ALLERGIES: PCN, SULFA & 0BARB
Allergies:
Diagnostic Lab Data: CAT SCAN: LESION IN L CEREBRAL HEMISPHERE. 5/90 TEST FOR HBSAG=NEG, FOR HB CORE ANTIGEN=NEG.
CDC Split Type: EBU900133

Write-up: 1ST DOSE ENGERIX-B 3-15-90, ONSET OF UNILAT NUMBNESS & TINGLING(RT HAND & FOOT) ON 3-29-90. AS OF 4-12-90 COND. PERSISTS. F/U 11FEB91: MD FELT THERE WAS A POSSIBILITY OF A PRIMARY NEURO PROBLEM AND THAT IT''S ?ABLE IF SXS D/T VAC.


VAERS ID: 25328 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Arizona  
Vaccinated:1990-03-08
Onset:1990-03-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Asthenia, Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: EBU900134

Write-up: ONE WEEK FOLLOWING 1ST INJECTION, PT DEVELPD SEVERE JOINT DISCOMFORT. HAD TROUBLE MAIPULATING HER HANDS AND GETTING OUT OF BED. HAD VOMITING AND DIARRHEA. 4-13-90 SYMPTOMS BEGAN DECREASING AND SHE IS IMPROVING.WILL NOT RECV MORE DOSES.


VAERS ID: 25329 (history)  
Form: Version 1.0  
Age: 35.0  
Sex: Female  
Location: Arizona  
Vaccinated:1990-03-30
Onset:1990-04-12
   Days after vaccination:13
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 597A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Alanine aminotransferase increased, Blood lactate dehydrogenase increased, Diarrhoea, Hepatic function abnormal, Vomiting, White blood cell disorder
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: 4-12-90 LIVER PROFILE GPT = 256, LDH = 490, GOT = 291, GGT = 409
CDC Split Type: EBU900135

Write-up: 2ND DOSE RECVD ON 3-30-90. 4-12-90 EXPERCD VOMITING AND DIARRHEA. LIVER PROFILED AND SHOWED ELEVATED LIVER FUNCTION STUDIES. WBC SLIGHTLY ELEVATED. IN ER AND TREATED CONSERVATIVELY. NOW AWAITING HEP. SCREEN.


VAERS ID: 25330 (history)  
Form: Version 1.0  
Age: 21.0  
Sex: Female  
Location: Virginia  
Vaccinated:1990-04-12
Onset:1990-04-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 597A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Dry mouth, Injection site reaction, Laryngospasm, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (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: BIRTH CONTROL (ORTHUM NOVUM 1/35)
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: REMAINING TWO VIALS (LOT # ENG 597A4, EXP. 3/22/91) DINGY, CLEAR, WHITE, WITH CAPS STILL ON.
CDC Split Type: EBU900136

Write-up: 1ST VAX GIVEN ON 4-12-90. WITHIN HOURS DEVELOPED HIVES ON BOTH SHOULDERS AND THE TOP 1/4 OF BACK. AROUND 7PM HIVES TURNED RED. THROAT FELT DRY AND CLOSING. 4-13-90 PT WAS FINE


VAERS ID: 25333 (history)  
Form: Version 1.0  
Age: 31.0  
Sex: Female  
Location: Colorado  
Vaccinated:1990-04-11
Onset:1990-04-13
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NO PRIOR VAX~ ()~~~In patient
Other Medications: NONE
Current Illness: UNKNOWN
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900139

Write-up: 2 DAYS AFTER VAX, PT EXPER URTICARIA. TREATMENT OF BENADRYL, SELDANE.


VAERS ID: 25334 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Vermont  
Vaccinated:1990-04-09
Onset:1990-04-16
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: MULTIVITAMINS AND CALCIUM
Current Illness:
Preexisting Conditions: N/A
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900140

Write-up: ONE WEEK FOLLOWING 1ST INJECT, PT DEVELPD ABDOMINAL PAIN/CRAMPS, DIARRHEA. A STOOL CULTURE WAS ORDERED. AS OF 4-19-90 NO TREATMENT GIVEN AND ALL SYMPTOMS PERSIST.


VAERS ID: 25335 (history)  
Form: Version 1.0  
Age: 41.0  
Sex: Female  
Location: Vermont  
Vaccinated:1990-04-17
Onset:1990-04-18
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 591A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Dizziness, Dyspepsia, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: RECOMBIVAX INOCS UNEVENTFUL~ ()~~~In patient
Other Medications: N/A
Current Illness:
Preexisting Conditions: ALLERGIC TO MOLDS, ZINC, FLEXERIL. INITIAL RECOMBIVAX INOCULATIONS UNEVENTFUL, BUT NEVER PRODUCED ANTIBODIES
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900141

Write-up: PT A NON-RESPONDER TO RECOMBIVAX AND RECVD 1ST ADDITIONAL DOSE OF ENGERIX B ON 4-17-90. NEXT DAY PT WAS DIZZY, DEVELPD JOINT PAIN, MUSCLE ACHES, UPSET STOMACH. CURRENTLY IMPROVING. NO SUBSEQUENT INJECTS PLANNED


VAERS ID: 25336 (history)  
Form: Version 1.0  
Age: 32.0  
Sex: Female  
Location: Missouri  
Vaccinated:1990-03-01
Onset:1990-04-17
   Days after vaccination:47
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Blood urea increased
SMQs:, Acute renal failure (broad), Retroperitoneal fibrosis (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: CAPOZIDE FOR HIGH BLOOD PRESSURE
Current Illness:
Preexisting Conditions: 2-90 DIAGNOSED HIGH BLOOD PRESSURE. PT POSS RECVD HEPTAVAX OR RECOMBIVAX-HB IN 9-89 & 10-89.
Allergies:
Diagnostic Lab Data: BUN: 1-23-90 = 11; 4-17-90 = 41 (ALL OTHER LEVELS ON SMA6 WERE NORMAL.)
CDC Split Type: EBU900142

Write-up: ELEVATED BUN NOTICED 4/90. REPORTER AND PT FEEL EVENT MAY BE RELATED TO CAPOZIDE.


VAERS ID: 25337 (history)  
Form: Version 1.0  
Age: 33.0  
Sex: Male  
Location: Oregon  
Vaccinated:1990-04-06
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM - / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Headache, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness:
Preexisting Conditions: NOVE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: EBU900145

Write-up: HEADACHE, GENERAL ACHINESS, ARM SORE: REPORTER INDICATED "WILL CONTINUE HEP-B SERIES...DO NOT CONSIDER REACTION VERY SIGNIFICANT...FEEL BENEFITS OUT WEIGH THE RISK."


VAERS ID: 25338 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Oregon  
Vaccinated:1990-04-06
Onset:1990-04-07
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 587A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Nausea, Palpitations, Tachycardia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Dehydration (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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 4-7-90 PM: HEART RATE LOW 90''S TO LOW 100''S.
CDC Split Type: EBU900146

Write-up: NEXT MORNING AFTER VAX,NAUSEA. 4-7-90 EVENING EXPER HEART POUNDING WITH HEART RATE IN LOW 90''S TO LOW 100''S; FELT BETTER MORNING OF 4-8-90. PT WILL CONT. VACCINATIONS.


VAERS ID: 25339 (history)  
Form: Version 1.0  
Age: 41.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1990-04-06
Onset:1990-04-10
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 1990-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 597A4 / UNK - / IM

Administered by: Private       Purchased by: Private
Symptoms: Dysphagia, Hypersensitivity, Oedema, Pharyngitis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~ ()~~~In patient
Other Medications: TYLENOL, AMOXICILLIN 250 mg/q 8 HRS AND HISMANAL 10 mg/DAY
Current Illness:
Preexisting Conditions: NO REMARKABLE HISTORY. NO ALLERGY
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: EBU900147

Write-up: 4 DAYS AFTER INJECT OF ENGERIX-B, PT EXP SWOLLEN PHARYNX LEFT SIDE, TROUBLE SWALLOWING, SORE THROAT AND AN ALLERGIC REACTION. TREATED AMOXICILLIN AND HISMANAL. 2 DAYS AFTER TREATMENT, SYMPTOMS RESOLVED.


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