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VAERS: Montana 1Jan98-30Nov99 [sample]
Introduction, Summary, Individual reports.A sample of VAERS reports for the State of Montana for the period January 1, 1998 through November 30, 1999. Unfortunately, often the date of Vaccination is missing. Also frequently missing are the lot numbers for the Vaccines. VAERS ID numbers with a * are records duplicated under different vaccines. Number of records indicated by the search program for some vaccines: HEPB HepB&HIB MMR live OPV IPV DTAP HEPA Tdadult Varivax USA 5486 384 3891 2238 1649 4023 682 2149 4483 Idaho 49 0 39 19 12 26 15 14 8 Montana 18 3 18 12 5 12 3 Montana cont': DTP 7, 1 DTPH, 10 PPV, 3 RV, 1 R, 7 TD, VARCEL 34. See the VAERS glossary for commonly used abbreviations. The Adverse Vaccine Researchable Database may be found at:http://fedbuzz.com/vaccine/vac.html SUMMARY FOR MONTANA, VAERS PARTIAL LISTING FOR 1/1/1998-11/30/1999 The number of cases (98) for the time period may be incomplete; also the vaccine list may be incomplete. VAERS ID AGE SEX VACCINATION SYMPTOMS 107133 1 M DTP fever, seizure, rash, ER/hosp. 110937 0 F DTP cried 5 hours, fever 110938 0 M DTP fever, cried cont for 3 hours 118033 1 F DTP fever & seizure 123188 1 F DTP fever, trbl breathing, hosp. 123199 1 F DTP hives, fever 123389 4 M DTP chpox type 400-500 blister-like lesions 116694 55 F DTPH red swollen area, trbl breathing. 107799 0 M HEPB fever 4 days. 110937* 0 F HEPB cried for 5 hrs, fever. 110938* 0 M HEPB fever, cried cont for 3 hours 112029 33 M HEPB constant headache 8 days 112172 39 F HEPB severe arthralgia & paresthesia 113968 35 F HEPB rash & puffiness/warmth. 114238 49 F HEPB rash, itchy and painful. 114286 50 F HEPB rash, itchy and painful. 116023 M HEPB unable see out of rt eye,dizzy,nausea 117849 11 M HEPB hives, seen in ER 118617 43 F HEPB general body aches & swollen glands 119915 M HEPB rash 120008 45 F HEPB flu like, fatigue, headache 122041 0 M HEPB fever, hospital, labored breathing 125009 42 F HEPB arthralgias, fatigue, Hep C 128235 47 F HEPB p/vax pt exp severe migraine; 5 days 128436 19 M HEPB(A?) swelling in lympth nodes, fatigue 130310 33 F HEPB hives, itching 118518 0 F HBHEPB apnea, hosp, neutropenia 119251 0 M HBHEPB irritable, vever, bulging fontanelle. 123191 0 F HBHEPB 8hr crying, fever, poss grand mal sz. 106168 19 F MMR ? pregnant following vax. 109730 25 F MMR dizzy, burning @ temple, numbness 111355 21 M MMR Hosp, GBS demyelinating polyneuropathy 111689 5 M MMR,DTAP vax arm red,hot,painful for 2wk. 111877 5 F MMR large bruise below inj site 114457 1 M MMR varicella like rash,fussy, sleep disp. 116646 1 F MMR fever,rash,150 lesions,varicella 118033 1 F MMR fevers, complex febrile seizure 119788 5 M MMR erythema,pallor,warm,pruritic site 122062 5 F MMR, DTAP red area 1.5 inches 122569 11 F MMR h/ache,stomach ache, pain, cramps,dizzy 123188* 1 F MMR fever, trbl breathing, hosp. 123199 1 F MMR hives & fever. 123389* 4 M MMR chpox type 400-500 blister-like lesions 126815 1 M MMR blister bumps, fever, irritable 127697 5 M MMR expired vax given. 128411 1 F MMR cant sleep,fever,fussy,screaming,stiff 128552 11 F MMR fatigue, fever, sore th., measles rash 107798 0 M OPV Temp, ER, seizure, hosp, r/o meningitis 107799* 0 M OPV fever 4 days. 111689* 5 M OPV vax arm red,hot,painful for 2wk. 111877* 5 F OPV large bruise below inj site 114457* 1 M OPV varicella like rash, fussy, poor sleep 116646* 1 F OPV fever,rash,150 lesions,varicella 119788* 2 M OPV erythema,pallor,warm,pruritic site 122062* 5 F OPV, DTAP red area 1.5 inches 123199* 1 F OPV hives & fever. 123389* 4 M OPV chpox type 400-500 blister-like lesions 128411* 1 F OPV cant sleep,fever,fussy,screaming,stiff 129304 1 F OPV redness & swelling 2 inch x 1.5 inch. 107798* 0 M DTAP Temp, ER, seizure, hosp, r/o meningitis 107799* 0 M DTAP fever 4 days. 111689* 5 M DTAP vax arm red,hot,painful for 2wk. 111877* 5 F DTAP large bruise below inj site 116646* 1 F DTAP fever,rash,150 lesions,varicella 118518* 0 F DTAP apnea, hosp, neutropenia 119251* 0 M DTAP irritable, vever, bulging fontanelle. 119788* 2 M DTAP erythema,pallor,warm,pruritic site 122062* 5 F DTAP red area 1.5 inches 122395 1 M DTAP ER/resp failure, DIED (pneumonia) 123191* 0 F DTAP 8hr crying, fever, poss grand mal sz. 126815* 1 M DTAP blister bumps, fever, irritable 127697 5 M DT expired vax given. 117989 18 M HEPA chills, vision loss, body hurt, seizure 127911 18 F HEPA 1hr incapacitating h/a, red rash 128436* 19 M HEPA lymph nodes sore ribs sore, lethargy 110937* 0 F IPV cried 5 hours, fever 110938* 0 M IPV fever, cried cont for 3 hours 118518* 0 F IPV apnea, hosp, neutropenia 119251* 0 M IPV irritable, fever, bulging fontanelle. 123191* 0 F IPV 8hr crying, fever, poss grand mal sz. 107476 79 M PPV red rash & burning sensation. 110561 72 F PPV erythema, edema, rxn to vax 113105 61 F PPV arm swell to twice nl size 113313 52 F PPV pain, deltoid tendonitis 114581 PPV devel deep pain @ inj site, infect 115906 89 F PPV severe swelling, yellow arm, pneumonia 116796 38 F PPV redness & swelling 117325 24 F PPV bells type palsy on side of face 117326 73 M PPV eye watering, partial paralysis face 129482 75 M PPV arm aching & swelling, warm 118518* 0 F RV apnea, hosp, neutropenia 119251* 0 M RV irritable, fever, bulging fontanelle. 126842 0 M RV intussusception, surgery & appendectomy 115527 21 F R recv vax/pregnant, termination of preg. 110565 51 F TD sweaty, hears flutters, seizure 113528 62 M TD fever, soreness/swelling 113901 51 F TD erythema, discomfort 114694 24 F TD swelling, erythema 114738 56 TD swelling, red streaking inc elbow,.. 120704 17 M TD pain, edema, nausea 123724 38 TD erythema, induration lt shoulder 106453 1 F TTOX devel chickenpox 113966 65 F TTOX fingers tingled, hurt, swollen 106453* 1 F Varcel devel chickenpox 106494 1 M Varcel Rash, eczema like or hard chickenpox 106570 59 M Varcel pain in shoulder at inj site 106795 8 M Varcel exp full blown chickenpox, fever,.. 106813 1 M Varcel devel chickenpox 106814 4 M Varcel devel chickenpox 106851 Varcel devel chickenpox 106887 F Varcel devel chickenpox 106888 M Varcel devel chickenpox 106890 6 M Varcel devel chickenpox 106905 11 M Varcel devel chickenpox approx 60 lesions.. 110029 16 F Varcel exposed, plus vax = devel chickenpox 110032 14 M Varcel exposed, plus vax = devel chickenpox 110044 2 F Varcel exposed, plus vax = devel chickenpox 110139 3 M Varcel varicella, 18 itchy lesions 110168 32 F Varcel 1 wk pregnant at time of vax 111670 2 F Varcel diarrhea, vomiting, hosp 1 wk for sz 114457* 1 M Varcel varicella like rash,fussy, sleep disp. 114471 33 F Varcel Chronic pain, neuralgia 116646* 1 F Varcel rash, over 150 lesions, severe pruritus 117162 13 F Varcel pimple like rash in mouth, itching,h/a 118440 33 F Varcel cont nausea, neuralgia 122777 1 F Varcel lesions from head to toe, fever 122943 3 M Varcel mild rash, < 30 bumps, itchy 2 days 122947 2 F Varcel devel 20-25 bumps 122959 1 F Varcel devel rash on bottom & fever 122961 3 M Varcel chickenpox rash back & throughout body 123031 7 F Varcel devel red bump dime size at inj site 123140 1 M Varcel acute varicella, "moderate" 123389* 4 M Varcel chpox type 400-500 blister-like lesions 123639 1 M Varcel full blown chickenpox with 85 lesions 124087 6 M Varcel broke out w/full-blown chickenpox 126815* 1 M Varcel blister bumps, fever, irritable 128552* 11 F Varcel fatigue, fever, sore th., measles rash Your query returned 7 records. ------------------------------------------------------------------------ VAERS ID 107133 State MT Vaccine Type DTP Vaccination Name DTP Manufacturer CONNAUGHT LABS Age in Years 1 Adverse Event Onset Date 8/29/96 Sex M Lab Data test for menigitis negative w/in 30hr p/vax devel fever above 104 & sz;taken to ER given ice bath, adm over night to hosp;tested for Reported Text meningitis-negative;high fever lasted 4 days, then a few days later broke out in rash;since then had sx w/high fever assoc w/ear infect Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 110937 State MT Vaccine Type DTP Vaccination Name DTP Manufacturer CONNAUGHT LABS Age in Years 0 Adverse Event Onset Date 4/23/98 Sex F Reported Text mom reported day p/vax pt cried for 5hr p/vax;pt was afeb APAP was given q 4 hr; Recovered Y ------------------------------------------------------------------------ VAERS ID 110938 State MT Vaccine Type DTP Vaccination Name DTP Manufacturer CONNAUGHT LABS Age in Years 0 Adverse Event Onset Date 4/20/98 Sex M Reported Text pt recv vax &had fever of 103 & cried cont for 3hr p/vax;APAP given; Recovered Y ------------------------------------------------------------------------ VAERS ID 118033 State MT Vaccine Type DTP Vaccination Name DTP Manufacturer CONNAUGHT LABS Age in Years 1 Adverse Event Onset Date 12/30/97 Sex F Lab Data EEG normal;Cerebrospinal fluid normal, wbc 18,000 Reported Text fevers w/complex febrile sz; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 123188 State MT Vaccine Type DTP Vaccination Name UNK. DTP Manufacturer UNCLASSIFIED Age in Years 1 Adverse Event Onset Date 5/11/99 Sex F Lab Data CXR, blood tests; p/vax pt was running temp (sometimes very hot, sometimes not-did not take temp @ home);pt was having trouble Reported Text breathing;had to be propped up w/pillow to breathe or be held by mom all noc;child had inc trouble breathing;father took to hosp Pre-exisiting conditions ear infect 4/8/99 Other Medications vitamin drops;4/8/99 Amoxicilin for ear infect Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 123199 State MT Vaccine Type DTP Vaccination Name DTP Manufacturer CONNAUGHT LABS Age in Years 1 Adverse Event Onset Date 5/27/99 Sex F pt recv vax 5/26/99 & 5/27/99 mom & child presented Reported Text w/apparent hives on both thighs & buttocks;mom reported child felt sl feverish last noc & gave APAP;prescribed DPH; ------------------------------------------------------------------------ VAERS ID 123389 State MT Vaccine Type DTP Vaccination Name DTP Manufacturer CONNAUGHT LABS Age in Years 4 Adverse Event Onset Date 5/20/98 Sex M Lab Data dx lab te:6/5/98, polymerase chain react, inadequate scab specimen, 6/22 scab specimen positive p/ pt recv vax approx 7 days later pt devel sx of varicella. 2 days later devel 400-500 chickenpox type, Reported Text blister-like lesions essentially everywhere. 2nd tests revealed wild type varicella zoster virus. 1st test inadequate. Recovered Y -------------------------------------------------------------------------- Your query returned 1 records. ------------------------------------------------------------------------ VAERS ID 116694 State MT Vaccine Type DTPH Vaccination Name TETRAMUNE Manufacturer LEDERLE Age in Years 55 Adverse Event Onset Date 11/6/98 Sex F pt recv vax 6NOV98 & 8hr p/vax rt deltoid red/swollen Reported Text area 13mm x 13mm measures 33cm lt deltoid 31cm;also onset of swelling of nasal mucosa/tightness w/breathing onset 24hr p/vax; Pre-exisiting conditions PCN, sulfa & e-mycins Other Medications Progesterone;PPD by parke david lot# 4525G013 Recovered Y ------------------------------------------------------------------------ Your query returned 18 records. ------------------------------------------------------------------------ VAERS ID 107799 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 0 Adverse Event Onset Date 2/11/98 Sex M pt recv vax 11FEB98 930AM on 11FEB98 by 430PM had fever of 103;fever peaked Friday evening @ 104.5;mom medicated Reported Text w/alternating doses of infant APAP;fever did not drop below 100;mom gave tepid bath;fever from 100-104 until Sunday Recovered Y ------------------------------------------------------------------------ VAERS ID 110937 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 0 Adverse Event Onset Date 4/23/98 Sex F Reported Text mom reported day p/vax pt cried for 5hr p/vax;pt was afeb APAP was given q 4 hr; Recovered Y ------------------------------------------------------------------------ VAERS ID 110938 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 0 Adverse Event Onset Date 4/20/98 Sex M Reported Text pt recv vax &had fever of 103 & cried cont for 3hr p/vax;APAP given; Recovered Y ------------------------------------------------------------------------ VAERS ID 112029 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 33 Adverse Event Onset Date 5/19/98 Sex M 27MAY98 pt visited clinic & reported constant h/a in the Reported Text back of head since the evening of 19MAY98;approx 24hr p/vax;also working noc & had been doing a lot of mopping floors;h/a would diminish but remained used advil; Recovered U ------------------------------------------------------------------------ VAERS ID 112172 State MT Vaccine Type HEPB Vaccination Name UNK. HEPATITIS B Manufacturer UNCLASSIFIED Age in Years 39 Sex F Lab Data all lab test nl; Reported Text pt recv vax APR98 & exp severe arthralgia & paresthesia since; ------------------------------------------------------------------------ VAERS ID 113968 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 35 Adverse Event Onset Date 8/31/98 Sex F by 12hr p/vax pt had erythema on neck, face, scalp exp puffiness @ rash site, pruritis, warmth to touch;denies Reported Text rash on other body surfaces, denies resp distress;unaware of contact w/new cosmetics soaps, lotions, shampoos, etc; Pre-exisiting conditions macrodantin, weed killers, pesticides, soaps, barley dust Other Medications allegra Recovered N ------------------------------------------------------------------------ VAERS ID 114238 State MT Vaccine Type HEPB Vaccination Name RECOMBIVAX HB Manufacturer MSD Age in Years 49 Adverse Event Onset Date 7/1/98 Sex F Lab Data Skin biopsy-no significant findings Pt recv vax on 6/10/98; in mid-July before 2nd dose vax pt exp macular,papular rash under her breasts covering Reported Text stomach & on anterior thighs. Rash sometimes itchy & painful. Pt tx=Hydrocortisone & Zyrtec. Pt gradual improving Pre-exisiting conditions Allergic to Compazine & Neosporin Recovered Y ------------------------------------------------------------------------ VAERS ID 114286 State MT Vaccine Type HEPB Vaccination Name RECOMBIVAX HB Manufacturer MSD Age in Years 50 Sex F Lab Data skin biopsy done-no significant findings; pt exp macular papular rash under breasts, covering Reported Text stomach & on anterior thighs;rash sometimes itchy & sometimes painful;tx w/hydrocortisone & Zyrtec; Pre-exisiting conditions allergic to compazine;neosporin Recovered Y ------------------------------------------------------------------------ VAERS ID 116023 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Adverse Event Onset Date 8/5/98 Sex M Reported Text pt recv vax 3AUG98 & pt was unable to see out of rt eye, exp dizziness & nausea; Pre-exisiting conditions ulcer Recovered Y ------------------------------------------------------------------------ VAERS ID 117849 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 11 Adverse Event Onset Date 11/2/98 Sex M Reported Text pt recv vax & c/o hives on rt arm & lt leg;referred secretary to call parents;rash;seen in ER; Recovered U ------------------------------------------------------------------------ VAERS ID 118617 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 43 Adverse Event Onset Date 1/28/99 Sex F Reported Text Pt recv vax on 1/28/99; 3 hr post vax pt exp general body aches & swollen glands in neck Pre-exisiting conditions Asthma, Hypothyroidism, Hypoglycemia; Allergic to Morphine & Demerol Other Medications Inhaler, Premarin, Progesterin, Synthroid Recovered Y ------------------------------------------------------------------------ VAERS ID 119915 State MT Vaccine Type HEPB Vaccination Name RECOMBIVAX HB Manufacturer MSD Sex M Reported Text Pt recv vax on unspecified day; post vax pt exp rash Recovered Y ------------------------------------------------------------------------ VAERS ID 120008 State MT Vaccine Type HEPB Vaccination Name RECOMBIVAX HB Manufacturer MSD Age in Years 45 Sex F Reported Text Pt recv vax on 9/18/98; post vax pt exp flu-like syndrome of nausea, fatigue, weak, headache Recovered U ------------------------------------------------------------------------ VAERS ID 122041 State MT Vaccine Type HEPB Vaccination Name UNK. HEPATITIS B Manufacturer UNCLASSIFIED Age in Years 0 Adverse Event Onset Date 3/17/99 Sex M Lab Data ultrasound kidneys, urine cult, blood tests-- no pertinent findings; Reported Text p/vax 2-3 days pt devel fever 101.7;had to be readmitted to hosp, labored breathing- 7 day course of Gentamycin; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 125009 State MT Vaccine Type HEPB Vaccination Name RECOMBIVAX HB Manufacturer MSD Age in Years 42 Adverse Event Onset Date 3/12/96 Sex F Lab Data chem panel w/inc SGOT, inc SGPT, CMV, EBV, hep screen w/in 48hr p/vax pt devel severe knee arthralgias, severe Reported Text & persistent fatigue & w/in wk lichen planus shortly p/that tested positive for hep C; Other Medications pt recv hep b vax by MSD lot# 1196B given 1/30/99 Recovered N ------------------------------------------------------------------------ VAERS ID State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 47 Adverse Event Onset Date 7/9/99 Sex F Reported Text p/vax pt exp severe migraine;lasted 5 days; Pre-exisiting conditions has had migraines for years; never lasted 5 days Other Medications rx for migraines, imatrex Recovered Y ------------------------------------------------------------------------ VAERS ID 128436 State MT Vaccine Type HEPB Vaccination Name RECOMBIVAX HB Manufacturer MSD Age in Years 19 Adverse Event Onset Date 7/29/99 Sex M Lab Data mono & strep tests done few days a/vaccine administered were negative; pt recv hep A 6/16/99 pt accidentally given hep A #2 7/28/99;had been to MD few days a/7/28 because Reported Text fatigue;mono & strep negative;7/29/99 devel swelling in lymph nodes on rt side of neck, rt side ribs sore, lethargy, sleeping 4hr during day ------------------------------------------------------------------------ VAERS ID 130310 State MT Vaccine Type HEPB Vaccination Name ENGERIX-B Manufacturer SMITHKLINE Age in Years 33 Adverse Event Onset Date 10/29/99 Sex F Reported Text p/vax devel hives on arms, abd & some on lt upper arm;denied resp diff but was uncomfortable d/t itching; Other Medications Dynabac completed for bronchitis ------------------------------------------------------------------------ Your query returned 3 records. ------------------------------------------------------------------------ VAERS ID 118518 State MT Vaccine Type HBHEPB Vaccination Name COMVAX Manufacturer MSD Age in Years 0 Adverse Event Onset Date 12/5/98 Sex F Lab Data CBC- neutropenia Reported Text pt recv vax 2DEC98 & devel apnea & was hosp;CBC w/differential revealed neutropenia;pt recovered Life Threating Illness Y Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 119251 State MT Vaccine Type HBHEPB Vaccination Name COMVAX Manufacturer MSD Age in Years 0 Sex M Lab Data nl CAT scan, normal LP, electrolytes showed HCO3 low @ 13 metabolic studies pending; Reported Text irritable & fever 9hr p/vax bulging fontanelle noted 16hr p/vax; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 123191 State MT Vaccine Type HBHEPB Vaccination Name COMVAX Manufacturer MSD Age in Years 0 Adverse Event Onset Date 3/11/99 Sex F Reported Text possible grand mal sz p/fussiness & crying for 8hr;fever up to 102;child well @ time of vax; Recovered Y ------------------------------------------------------------------------ Your query returned 18 records. ------------------------------------------------------------------------ VAERS ID 106168 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 19 Adverse Event Onset Date 12/1/97 Sex F pt recv vax 10OCT97 & pregnancy test was done prior to inj w/negative results;pt was educated to avoid Reported Text pregnancy for 3mo;pt returned to clinic on 1DEC97 requesting pregnancy test, which was positive;pt states thinks got pregnant 31OCT97; Pre-exisiting conditions asthma Other Medications accolate, proventil, beclovent, intal Recovered U ------------------------------------------------------------------------ VAERS ID 109730 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 25 Adverse Event Onset Date 3/11/98 Sex F pt remained in clinic x 10-15min w/no rxn;pt called from Reported Text home about 1hr later complained dizziness & burning @ temple;pt told to take advil;2hr later pt c/o lt arm & lt side of face w/numbness & tongue feeling swollen; Pre-exisiting conditions sensitivity to neosporin & Bactrim Other Medications Cephalexin Recovered Y ------------------------------------------------------------------------ VAERS ID 111355 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 21 Adverse Event Onset Date 2/25/97 Sex M Lab Data 2/27/97-nerve conduction test-predominantly demyelinating polyneuropathy Reported Text pt recv second dose of hep B vax; devel GBS; seen in ER and was hosp for 14 days; Recovered Y Disability Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 111689 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 5 Adverse Event Onset Date 4/24/98 Sex M w/in 24hr of vax arm became red, hot & painful & hurt Reported Text for 2 wk;seen 8 days later still red in the area between DTAP site & MMR site; Pre-exisiting conditions hayfer Other Medications NKA Recovered Y ------------------------------------------------------------------------ VAERS ID 111877 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 5 Sex F Lab Data CBC, PT, PTT bleeding time all nl; Reported Text large bruise on lt arm below inj site;bruising extended across joint into forearm; Recovered Y ------------------------------------------------------------------------ VAERS ID 114457 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 1 Adverse Event Onset Date 8/31/98 Sex M Lab Data CBC, chem 7, blood cult, ESR rash on trunk, face, legs to clinic 31AUG98;gen varicella like rash secondary to varicella vax;pt fussy, Reported Text not sleeping well 2SEP98;dx viral synd probably secondary to post vax; inc fussiness, dec appetite, acting more ill;T102; Pre-exisiting conditions NKA Recovered Y ------------------------------------------------------------------------ VAERS ID 116646 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 1 Adverse Event Onset Date 10/26/98 Sex F devel fever 102.9, rhinitis 10 days p/vax;devel papular rash the next day that started on trunk, spread to Reported Text extremities;over 150 lesions w/severe pruritus;clinically c/w varicella but no vesicles only papules; Pre-exisiting conditions reactive airway disease Recovered Y ------------------------------------------------------------------------ VAERS ID 118033 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 1 Adverse Event Onset Date 12/30/97 Sex F Lab Data EEG normal;Cerebrospinal fluid normal, wbc 18,000 Reported Text fevers w/complex febrile sz; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 119788 State MT Vaccine Type MMR Vaccination Name MMR DISCONTINUED JUNE 1981 Manufacturer MSD Age in Years 5 Adverse Event Onset Date 2/22/99 Sex M Pt recv vax on 2/17/99; on 2/22/99 pt exp erythema/ Reported Text pallor/ warm/ pruritic/ raised on vax site-LA; tx=Elocon cream ------------------------------------------------------------------------ VAERS ID 122062 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 5 Adverse Event Onset Date 5/9/99 Sex F mom stated noticed localized red area on lt leg @ DTAP Reported Text inj site approx 4x4cm marked area w/Sharpe marker, parent instructed to return to clinic if size of red area inc;no temp or other complaints; Recovered U ------------------------------------------------------------------------ VAERS ID 122569 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 11 Adverse Event Onset Date 9/23/98 Sex F 9/16/98 pt recv 1st dose of vax & 9/23/98 pt exp headache, stomach ache, stomach ache described ``spasms Reported Text of pain that come in waves'' also exp aches & cramps in legs, aches in neck, cramping in back/swollen gums, dizzy 9/25; mild rash Pre-exisiting conditions unknown Other Medications unknown Recovered U ------------------------------------------------------------------------ VAERS ID 123188 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 1 Adverse Event Onset Date 5/11/99 Sex F Lab Data CXR, blood tests; p/vax pt was running temp (sometimes very hot, sometimes not-did not take temp @ home);pt was having trouble Reported Text breathing;had to be propped up w/pillow to breathe or be held by mom all noc;child had inc trouble breathing;father took to hosp Pre-exisiting conditions ear infect 4/8/99 Other Medications vitamin drops;4/8/99 Amoxicilin for ear infect Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 123199 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 1 Adverse Event Onset Date 5/27/99 Sex F pt recv vax 5/26/99 & 5/27/99 mom & child presented Reported Text w/apparent hives on both thighs & buttocks;mom reported child felt sl feverish last noc & gave APAP;prescribed DPH; ------------------------------------------------------------------------ VAERS ID 123389 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 4 Adverse Event Onset Date 5/20/98 Sex M Lab Data dx lab te:6/5/98, polymerase chain react, inadequate scab specimen, 6/22 scab specimen positive p/ pt recv vax approx 7 days later pt devel sx of varicella. 2 days later devel 400-500 chickenpox type, Reported Text blister-like lesions essentially everywhere. 2nd tests revealed wild type varicella zoster virus. 1st test inadequate. Recovered Y ------------------------------------------------------------------------ VAERS ID 126815 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 1 Adverse Event Onset Date 7/26/99 Sex M Reported Text mom rpt she noticed 2 blister bumps on pt on evening of vax; 8 more cam on 7/29, fever 101, was irritable; Pre-exisiting conditions none infant born at 36 weeks gestation & in nicu for 2weeks Recovered U ------------------------------------------------------------------------ VAERS ID 127697 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 5 Adverse Event Onset Date 8/20/99 Sex M Reported Text post vax given-noticed it was expired; Pre-exisiting conditions pertussis rxn; Recovered Y ------------------------------------------------------------------------ VAERS ID 128411 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 1 Adverse Event Onset Date 7/30/99 Sex F p/vax pt awoke & could not sleep;devel fever 100.6 to 102.0;pt not eating but is drinking okay;pt crabby & Reported Text fussy;sl erythema;dec mobility;mild pharyngitis secondary to fever & vax;pt screaming, stiff, T104;snoring;can't swallow;sz; Pre-exisiting conditions NKA, no birth defects Recovered Y ------------------------------------------------------------------------ VAERS ID 128552 State MT Vaccine Type MMR Vaccination Name MMR II Manufacturer MSD Age in Years 11 Adverse Event Onset Date 9/3/99 Sex F Lab Data CXR negative Reported Text fatigue, high fever, sore throat, rash consistent w/measles, Koplik's spots; Pre-exisiting conditions allergy induced asthma ------------------------------------------------------------------------ Your query returned 12 records. ------------------------------------------------------------------------ VAERS ID 107798 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 0 Adverse Event Onset Date 2/4/98 Sex M seen @ clinic w/temp 103.3 ax;tx w/Rocephin;seen by MD & Reported Text ped consult;seen @ clinic 9AM 5FEB98;temp 101.5 ax rocephin given; seen in ER 5FEB98 714PM temp 98R sz;sent to hosp for sepsis r/o meningitis; ------------------------------------------------------------------------ VAERS ID 107799 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 0 Adverse Event Onset Date 2/11/98 Sex M pt recv vax 11FEB98 930AM on 11FEB98 by 430PM had fever of 103;fever peaked Friday evening @ 104.5;mom medicated Reported Text w/alternating doses of infant APAP;fever did not drop below 100;mom gave tepid bath;fever from 100-104 until Sunday Recovered Y ------------------------------------------------------------------------ VAERS ID 111689 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 5 Adverse Event Onset Date 4/24/98 Sex M w/in 24hr of vax arm became red, hot & painful & hurt Reported Text for 2 wk;seen 8 days later still red in the area between DTAP site & MMR site; Pre-exisiting conditions hayfer Other Medications NKA Recovered Y ------------------------------------------------------------------------ VAERS ID 111877 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 5 Sex F Lab Data CBC, PT, PTT bleeding time all nl; Reported Text large bruise on lt arm below inj site;bruising extended across joint into forearm; Recovered Y ------------------------------------------------------------------------ VAERS ID 114457 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 1 Adverse Event Onset Date 8/31/98 Sex M Lab Data CBC, chem 7, blood cult, ESR rash on trunk, face, legs to clinic 31AUG98;gen varicella like rash secondary to varicella vax;pt fussy, Reported Text not sleeping well 2SEP98;dx viral synd probably secondary to post vax; inc fussiness, dec appetite, acting more ill;T102; Pre-exisiting conditions NKA Recovered Y ------------------------------------------------------------------------ VAERS ID 116646 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 1 Adverse Event Onset Date 10/26/98 Sex F devel fever 102.9, rhinitis 10 days p/vax;devel papular rash the next day that started on trunk, spread to Reported Text extremities;over 150 lesions w/severe pruritus;clinically c/w varicella but no vesicles only papules; Pre-exisiting conditions reactive airway disease Recovered Y ------------------------------------------------------------------------ VAERS ID 119788 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 5 Adverse Event Onset Date 2/22/99 Sex M Pt recv vax on 2/17/99; on 2/22/99 pt exp erythema/ Reported Text pallor/ warm/ pruritic/ raised on vax site-LA; tx=Elocon cream ------------------------------------------------------------------------ VAERS ID 122062 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 5 Adverse Event Onset Date 5/9/99 Sex F mom stated noticed localized red area on lt leg @ DTAP Reported Text inj site approx 4x4cm marked area w/Sharpe marker, parent instructed to return to clinic if size of red area inc;no temp or other complaints; Recovered U ------------------------------------------------------------------------ VAERS ID 123199 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 1 Adverse Event Onset Date 5/27/99 Sex F pt recv vax 5/26/99 & 5/27/99 mom & child presented Reported Text w/apparent hives on both thighs & buttocks;mom reported child felt sl feverish last noc & gave APAP;prescribed DPH; ------------------------------------------------------------------------ VAERS ID 123389 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 4 Adverse Event Onset Date 5/20/98 Sex M Lab Data dx lab te:6/5/98, polymerase chain react, inadequate scab specimen, 6/22 scab specimen positive p/ pt recv vax approx 7 days later pt devel sx of varicella. 2 days later devel 400-500 chickenpox type, Reported Text blister-like lesions essentially everywhere. 2nd tests revealed wild type varicella zoster virus. 1st test inadequate. Recovered Y ------------------------------------------------------------------------ VAERS ID 128411 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 1 Adverse Event Onset Date 7/30/99 Sex F p/vax pt awoke & could not sleep;devel fever 100.6 to 102.0;pt not eating but is drinking okay;pt crabby & Reported Text fussy;sl erythema;dec mobility;mild pharyngitis secondary to fever & vax;pt screaming, stiff, T104;snoring;can't swallow;sz; Pre-exisiting conditions NKA, no birth defects Recovered Y ------------------------------------------------------------------------ VAERS ID 129304 State MT Vaccine Type OPV Vaccination Name ORIMUNE Manufacturer LEDERLE Age in Years 1 Adverse Event Onset Date 9/29/99 Sex F p/vax notice redness & swelling 9/29/99 told to mark area & go to ER if worsens;area of redness increased Reported Text w/bullous lesion over central area/redness 5x4cm that easily blanches/put on Keflex, Zyrtec then atarax for age & weight; Pre-exisiting conditions eczema Recovered Y ------------------------------------------------------------------------ [Image] Your query returned 12 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 107798 State MT Vaccine Type DTAP Vaccination Name INFANRIX Manufacturer SMITHKLINE Age in Years 0 Adverse Event Onset Date 2/4/98 Sex M seen @ clinic w/temp 103.3 ax;tx w/Rocephin;seen by MD & Reported Text ped consult;seen @ clinic 9AM 5FEB98;temp 101.5 ax rocephin given; seen in ER 5FEB98 714PM temp 98R sz;sent to hosp for sepsis r/o meningitis; ------------------------------------------------------------------------ VAERS ID 107799 State MT Vaccine Type DTAP Vaccination Name TRIPEDIA Manufacturer CONNAUGHT LABS Age in Years 0 Adverse Event Onset Date 2/11/98 Sex M pt recv vax 11FEB98 930AM on 11FEB98 by 430PM had fever of 103;fever peaked Friday evening @ 104.5;mom medicated Reported Text w/alternating doses of infant APAP;fever did not drop below 100;mom gave tepid bath;fever from 100-104 until Sunday Recovered Y ------------------------------------------------------------------------ VAERS ID 111689 State MT Vaccine Type DTAP Vaccination Name TRIPEDIA Manufacturer CONNAUGHT LABS Age in Years 5 Adverse Event Onset Date 4/24/98 Sex M w/in 24hr of vax arm became red, hot & painful & hurt Reported Text for 2 wk;seen 8 days later still red in the area between DTAP site & MMR site; Pre-exisiting conditions hayfer Other Medications NKA Recovered Y ------------------------------------------------------------------------ VAERS ID 111877 State MT Vaccine Type DTAP Vaccination Name TRIPEDIA Manufacturer CONNAUGHT LABS Age in Years 5 Sex F Lab Data CBC, PT, PTT bleeding time all nl; Reported Text large bruise on lt arm below inj site;bruising extended across joint into forearm; Recovered Y ------------------------------------------------------------------------ VAERS ID 116646 State MT Vaccine Type DTAP Vaccination Name INFANRIX Manufacturer SMITHKLINE Age in Years 1 Adverse Event Onset Date 10/26/98 Sex F devel fever 102.9, rhinitis 10 days p/vax;devel papular rash the next day that started on trunk, spread to Reported Text extremities;over 150 lesions w/severe pruritus;clinically c/w varicella but no vesicles only papules; Pre-exisiting conditions reactive airway disease Recovered Y ------------------------------------------------------------------------ VAERS ID 118518 State MT Vaccine Type DTAP Vaccination Name ACEL-IMUNE Manufacturer LEDERLE Age in Years 0 Adverse Event Onset Date 12/5/98 Sex F Lab Data CBC- neutropenia Reported Text pt recv vax 2DEC98 & devel apnea & was hosp;CBC w/differential revealed neutropenia;pt recovered Life Threating Illness Y Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 119251 State MT Vaccine Type DTAP Vaccination Name INFANRIX Manufacturer SMITHKLINE Age in Years 0 Sex M Lab Data nl CAT scan, normal LP, electrolytes showed HCO3 low @ 13 metabolic studies pending; Reported Text irritable & fever 9hr p/vax bulging fontanelle noted 16hr p/vax; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 119788 State MT Vaccine Type DTAP Vaccination Name ACEL-IMUNE Manufacturer LEDERLE Age in Years 5 Adverse Event Onset Date 2/22/99 Sex M Pt recv vax on 2/17/99; on 2/22/99 pt exp erythema/ Reported Text pallor/ warm/ pruritic/ raised on vax site-LA; tx=Elocon cream ------------------------------------------------------------------------ VAERS ID 122062 State MT Vaccine Type DTAP Vaccination Name INFANRIX Manufacturer SMITHKLINE Age in Years 5 Adverse Event Onset Date 5/9/99 Sex F mom stated noticed localized red area on lt leg @ DTAP Reported Text inj site approx 4x4cm marked area w/Sharpe marker, parent instructed to return to clinic if size of red area inc;no temp or other complaints; Recovered U ------------------------------------------------------------------------ VAERS ID 122395 State MT Vaccine Type DTAP Vaccination Name ACEL-IMUNE Manufacturer LEDERLE Age in Years 1 Adverse Event Onset Date 2/4/99 Sex M sputum cult strep pneumoniae;CXR atelectasis lt lower Lab Data lung & rt mid lung; WBC-22.3,RBC-4.50, hgb-11.4, HCT-35.1, 02 sat 79-84%;heart rate 160-180;ABG: pO2-126, pCO2-64 child adm to ER 4FEB99 less than 30 days p/vax;pt Reported Text presented to ER in resp distress, T101, retractions;intubated;had bradycardia then loss of pulse, expired 1105pm 4Feb99, cause of death: pneumonia Pre-exisiting conditions allergy to amoxicillin Other Medications Pediazole;Dimetapp; Motrin Died Y Recovered N ------------------------------------------------------------------------ VAERS ID 123191 State MT Vaccine Type DTAP Vaccination Name TRIPEDIA Manufacturer CONNAUGHT LABS Age in Years 0 Adverse Event Onset Date 3/11/99 Sex F Reported Text possible grand mal sz p/fussiness & crying for 8hr;fever up to 102;child well @ time of vax; Recovered Y ------------------------------------------------------------------------ VAERS ID 126815 State MT Vaccine Type DTAP Vaccination Name INFANRIX Manufacturer SMITHKLINE Age in Years 1 Adverse Event Onset Date 7/26/99 Sex M Reported Text mom rpt she noticed 2 blister bumps on pt on evening of vax; 8 more cam on 7/29, fever 101, was irritable; Pre-exisiting conditions none infant born at 36 weeks gestation & in nicu for 2weeks Recovered U ------------------------------------------------------------------------ Your query returned 1 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 127697 State MT Vaccine Type DT Vaccination Name DT ADSORBED, PEDIATRIC Manufacturer CONNAUGHT LABS Age in Years 5 Adverse Event Onset Date 8/20/99 Sex M Reported Text post vax given-noticed it was expired; Pre-exisiting conditions pertussis rxn; Recovered Y ------------------------------------------------------------------------ Your query returned 3 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 117989 State MT Vaccine Type HEPA Vaccination Name HAVRIX Manufacturer SMITHKLINE Age in Years 18 Adverse Event Onset Date 10/19/98 Sex M Pt recv vax on 10/19/98; on same day pt exp fever Reported Text &chills, vision loss, body hurt, seizure, unable to walk or sit up Pre-exisiting conditions Allergic to Penicillin, Codeine, Demerol, Cafergot, eye drops, Pertussis, bees Recovered Y ------------------------------------------------------------------------ VAERS ID 127911 State MT Vaccine Type HEPA Vaccination Name HAVRIX Manufacturer SMITHKLINE Age in Years 25 Adverse Event Onset Date 8/27/99 Sex F 1hr p/vax pt devel an incapacitating h/a;h/a worse lying down;could feel a throbbing in head that matched hear Reported Text beat;h/a lasted 1hr;fever (did not take temp) devel 6hr p/vax gone by next day;red rash area @ yellow fever site; Pre-exisiting conditions irritable bowel synd;psoriasis;migraines; Recovered Y ------------------------------------------------------------------------ VAERS ID 128436 State MT Vaccine Type HEPA Vaccination Name HAVRIX Manufacturer SMITHKLINE Age in Years 19 Adverse Event Onset Date 7/29/99 Sex M Lab Data mono & strep tests done few days a/vaccine administered were negative; pt recv hep A 6/16/99 pt accidentally given hep A #2 7/28/99;had been to MD few days a/7/28 because Reported Text fatigue;mono & strep negative;7/29/99 devel swelling in lymph nodes on rt side of neck, rt side ribs sore, lethargy, sleeping 4hr during day ------------------------------------------------------------------------ Your query returned 5 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 110937 State MT Vaccine Type IPV Vaccination Name POLIOVAX Manufacturer CONNAUGHT LTD Age in Years 0 Adverse Event Onset Date 4/23/98 Sex F Reported Text mom reported day p/vax pt cried for 5hr p/vax;pt was afeb APAP was given q 4 hr; Recovered Y ------------------------------------------------------------------------ VAERS ID 110938 State MT Vaccine Type IPV Vaccination Name POLIOVAX Manufacturer CONNAUGHT LTD Age in Years 0 Adverse Event Onset Date 4/20/98 Sex M Reported Text pt recv vax &had fever of 103 & cried cont for 3hr p/vax;APAP given; Recovered Y ------------------------------------------------------------------------ VAERS ID 118518 State MT Vaccine Type IPV Vaccination Name POLIOVAX Manufacturer CONNAUGHT LTD Age in Years 0 Adverse Event Onset Date 12/5/98 Sex F Lab Data CBC- neutropenia Reported Text pt recv vax 2DEC98 & devel apnea & was hosp;CBC w/differential revealed neutropenia;pt recovered Life Threating Illness Y Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 119251 State MT Vaccine Type IPV Vaccination Name POLIOVAX Manufacturer CONNAUGHT LTD Age in Years 0 Sex M Lab Data nl CAT scan, normal LP, electrolytes showed HCO3 low @ 13 metabolic studies pending; Reported Text irritable & fever 9hr p/vax bulging fontanelle noted 16hr p/vax; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 123191 State MT Vaccine Type IPV Vaccination Name POLIOVAX Manufacturer CONNAUGHT LTD Age in Years 0 Adverse Event Onset Date 3/11/99 Sex F Reported Text possible grand mal sz p/fussiness & crying for 8hr;fever up to 102;child well @ time of vax; Recovered Y ------------------------------------------------------------------------ Your query returned 10 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 107476 State MT Vaccine Type PPV Vaccination Name PNU-IMUNE(R)23 Manufacturer LEDERLE Age in Years 79 Adverse Event Onset Date 1/27/98 Sex M Reported Text red rash left upper arm-burning sensation in the rash; Pre-exisiting conditions sulfa, cipro Recovered N ------------------------------------------------------------------------ VAERS ID 110561 State MT Vaccine Type PPV Vaccination Name PNU-IMUNE(R)23 Manufacturer LEDERLE Age in Years 72 Adverse Event Onset Date 4/15/98 Sex F pt recv vax & does have erythema @ the site today of approx 11cm x 11cm;this is very minimal edema but there Reported Text is a mild amount of erythema;impression: local site rxn to pneumococcal vax;pt to recv DPH;arm felt swollen 15APR98 evening; Pre-exisiting conditions allergies: APAP w/codeine, catchamal blockers Other Medications Vasotec, Norvasc, HCTZ, Premarin, ASA, allopurinol, Vitamin Recovered Y ------------------------------------------------------------------------ VAERS ID 113105 State MT Vaccine Type PPV Vaccination Name PNEUMOVAX 23 Manufacturer MSD Age in Years 61 Adverse Event Onset Date 11/12/97 Sex F pt recv vax 12NOV97 & a little later arm slowly started to Reported Text swell & upper arm remained twice it nl size for several days; Pre-exisiting conditions seasonal allergy Other Medications Amitriptyline;Zyretec;Premarin;flexeril;Flonase;Flovent; Recovered Y ------------------------------------------------------------------------ VAERS ID 113313 State MT Vaccine Type PPV Vaccination Name UNK. PNEUMOCOCCAL POLYVALENT Manufacturer UNCLASSIFIED Age in Years 52 Adverse Event Onset Date 12/1/97 Sex F Lab Data 14JUN98 x-ray WNL pt recv vax 3NOV97 & 1DEC97 pt c/ lt upper arm pain;stated it had come on p/vax & had worsened since Reported Text that time;@ that time pt felt to have a deltoid tendonitis;pt put on med;pt still having deltoid tendonitis & pain under acromion; Other Medications recv allergy shots every two weeks ------------------------------------------------------------------------ VAERS ID 114581 State MT Vaccine Type PPV Vaccination Name PNU-IMUNE(R)23 Manufacturer LEDERLE pt recv vax & devel deep pain @ the inj site;pt also Reported Text devel striations of infect radiating from he inj site to the neck & elbow; Recovered U ------------------------------------------------------------------------ VAERS ID 115906 State MT Vaccine Type PPV Vaccination Name PNU-IMUNE(R)23 Manufacturer LEDERLE Age in Years 89 Adverse Event Onset Date 10/5/98 Sex F pt recv vax 5OCT98 & that evening pt devel n/v & syncope;also devel severe swelling @ site of vax Reported Text progressed into cellulitis;pt lt arm turned yellow from elbow to wrist;pt hosp;while in hosp vomited, aspirated the vomitus & devel pneumonia Pre-exisiting conditions HTN, asthma, thyroid problems, prev dose of pnu imune 23 administered in 1992; Other Medications Zestoretic, thyroid supplement Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 116796 State MT Vaccine Type PPV Vaccination Name PNEUMOVAX 23 Manufacturer MSD Age in Years 38 Adverse Event Onset Date 11/3/98 Sex F Reported Text Pt recv vax on 11/3/98; on same day pt exp redness & swelling Pre-exisiting conditions Hx of Hodgkins disease-stage 2A, Hypothyroidism due to radiation, splenectomy Other Medications Synthroid, Vancenase Recovered Y ------------------------------------------------------------------------ VAERS ID 117325 State MT Vaccine Type PPV Vaccination Name PNEUMOVAX 23 Manufacturer MSD Age in Years 24 Adverse Event Onset Date 10/31/98 Sex F bells type palsy noted on lt side of face;devel w/in Reported Text 12-18hr p/vax;DPH given w/no effect;MD currently tx w/pred; Recovered N ------------------------------------------------------------------------ VAERS ID 117326 State MT Vaccine Type PPV Vaccination Name PNEUMOVAX 23 Manufacturer MSD Age in Years 73 Adverse Event Onset Date 11/3/98 Sex M rt eye watering, partial paralysis of face nerve rt side Reported Text w/ptosis;rt corner of mouth not totally paralyzed;pred given; Other Medications Lanoxin;Verapamil;ASA; Recovered N ------------------------------------------------------------------------ VAERS ID 129482 State MT Vaccine Type PPV Vaccination Name PNU-IMUNE(R)23 Manufacturer LEDERLE Age in Years 75 Adverse Event Onset Date 10/1/99 Sex M p/vax pt upper arm started aching & swelling which then Reported Text proceeded down the arm into the hand;the arm was warm to touch;it stayed swollen all day; Other Medications Coumadin;Paxil;Zestoretic Recovered Y ------------------------------------------------------------------------ Your query returned 3 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 118518 State MT Vaccine Type RV Vaccination Name ROTASHIELD Manufacturer WYETH Age in Years 0 Adverse Event Onset Date 12/5/98 Sex F Lab Data CBC- neutropenia Reported Text pt recv vax 2DEC98 & devel apnea & was hosp;CBC w/differential revealed neutropenia;pt recovered Life Threating Illness Y Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 119251 State MT Vaccine Type RV Vaccination Name ROTASHIELD Manufacturer WYETH Age in Years 0 Sex M Lab Data nl CAT scan, normal LP, electrolytes showed HCO3 low @ 13 metabolic studies pending; Reported Text irritable & fever 9hr p/vax bulging fontanelle noted 16hr p/vax; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 126842 State MT Vaccine Type RV Vaccination Name ROTASHIELD Manufacturer WYETH Age in Years 0 Adverse Event Onset Date 6/25/99 Sex M Lab Data 6/27, blood & urine cultures, neg; 6/28/99, barium enema, intussusception 2days p/vax pt fussy & vomit; 6/28 pt lethargic & began Reported Text passing currant-jelly stools; hosp; dx=intussusception; not reduced by barium enema; surgery-ileocolic intussusception reduced & appendectomy Recovered Y Hospitalized Y ------------------------------------------------------------------------ [Image] Your query returned 1 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 115527 State MT Vaccine Type R Vaccination Name MERUVAX II Manufacturer MSD Age in Years 21 Adverse Event Onset Date 9/13/98 Sex F pt recv vax & was pregnant (LMP 26JUL98);MD reported Reported Text that pt had elective termination of 7wk from LMP;it was uncertain if the fetus had any complications or congenital anomalies; Recovered N ------------------------------------------------------------------------ Your query returned 7 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 110565 State MT Vaccine Type TD Vaccination Name TD ADSORBED, ADULTS Manufacturer CONNAUGHT LABS Age in Years 51 Adverse Event Onset Date 4/14/98 Sex F awoke feeling sweaty became very diaphoretic, hears flutters, collapsed, ? faint or sz-became Reported Text incontinent;30sec duration pt feels probably loss of consciousness; & not sz;5-10min felt nl;lightheaded-cold sx; Pre-exisiting conditions underactive thryorid Other Medications Synthroid Recovered Y ------------------------------------------------------------------------ VAERS ID 113528 State MT Vaccine Type TD Vaccination Name TD ADSORBED, ADULTS Manufacturer CONNAUGHT LABS Age in Years 62 Adverse Event Onset Date 8/13/98 Sex M Lab Data NONE-pt did not feel well enough to come in for exam; Reported Text fever of 102 ax;myalgias;malaise;soreness @ inj site w/o swelling;resolved by 15AUG98; Pre-exisiting conditions tobacco addiction, depression, arthritis, dyslipedenia,prostate ca, pernicious anemia; Other Medications Empirin #3;Amitriptyline, B12, Paxil, Restoril Recovered Y ------------------------------------------------------------------------ VAERS ID 113901 State MT Vaccine Type TD Vaccination Name TD ADSORBED, ADULTS Manufacturer CONNAUGHT LABS Age in Years 51 Adverse Event Onset Date 8/20/98 Sex F Reported Text erythema, induration, discomfort @ inj site over area approx 8cm x 4cm; Pre-exisiting conditions chloranphenicol Other Medications Lotensin;Amitirpixillie;Premarin Recovered Y ------------------------------------------------------------------------ VAERS ID 114694 State MT Vaccine Type TD Vaccination Name TD ADSORBED, ADULTS Manufacturer CONNAUGHT LABS Age in Years 24 Adverse Event Onset Date 9/18/98 Sex F Reported Text local swelling, erythema & induration of about 10cm; Recovered Y ------------------------------------------------------------------------ VAERS ID 114738 State MT Vaccine Type TD Vaccination Name TD ADSORBED, ADULTS Manufacturer CONNAUGHT LABS Age in Years 56 Reported Text lt arm swelling, red streaking inc elbow, shoulder & joint pain; Other Medications Premarin;Vitamins; Recovered Y ------------------------------------------------------------------------ VAERS ID 120704 State MT Vaccine Type TD Vaccination Name TD ADSORBED, ADULTS Manufacturer CONNAUGHT LABS Age in Years 17 Adverse Event Onset Date 8/6/98 Sex M Reported Text Pt recv vax on 8/5/98; on 8/6/98 pt exp pain, edema, nausea Recovered Y ------------------------------------------------------------------------ VAERS ID 123724 State MT Vaccine Type TD Vaccination Name TD ADSORBED, ADULTS Manufacturer CONNAUGHT LABS Age in Years 38 Adverse Event Onset Date 5/18/99 Reported Text large area of erythema, induration lt shoulder started 5/18/99;seen in office 5/21/99;sx resolving slowly Recovered Y ------------------------------------------------------------------------ Your query returned 2 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 106453 State MT Vaccine Type TTOX Vaccination Name TETANUS TOX Manufacturer CONNAUGHT LABS Age in Years 1 Adverse Event Onset Date 9/19/97 Sex F Reported Text pt recv vax 31MAY96 & pt devel chickenpox that consisted of approx 6 lesions; Pre-exisiting conditions Unknown Recovered Y ------------------------------------------------------------------------ VAERS ID 113966 State MT Vaccine Type TTOX Vaccination Name TETANUS TOX ADSORBED Manufacturer WYETH Age in Years 65 Adverse Event Onset Date 7/10/98 Sex F Lab Data measured arm: picture taken of lt arm; fingers tingled;couple of hr later the whole arm hurt, next day swollen;pt recv tetanus as cleaning up flash Reported Text flood damage from 4JUL98;PE showed 12cm x 17cm edematous & erythematous area lt deltoid;tender rt cervical (under ear lobe) enlarg Recovered U ------------------------------------------------------------------------ Your query returned 34 records. Viewing page 1 of 1 ------------------------------------------------------------------------ View the VAERS glossary here to see commonly used abbreviations. VAERS ID 106453 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 9/19/97 Sex F Reported Text pt recv vax 31MAY96 & pt devel chickenpox that consisted of approx 6 lesions; Pre-exisiting conditions Unknown Recovered Y ------------------------------------------------------------------------ VAERS ID 106494 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 9/3/97 Sex M pt recv vax 20AUG97 & 3SEP97 pt exp a rash over stomach, legs & trunk, which later resolved;p/initial rash Reported Text resolved pt exp an eczema-type rash on lt thigh;10SEP97 pt was examined @ a MD office for URI;rash looked like a hard chickenpox; Recovered Y ------------------------------------------------------------------------ VAERS ID 106570 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 59 Adverse Event Onset Date 1/7/97 Sex M pt recv vax 7JAN97 & ever since vax pt exp pain in lt Reported Text shoulder right where inj went in;pt also reports it hurts mostly @ noc when pt has been inactive; Pre-exisiting conditions dust allergy;insect allergy;pollen allergy Other Medications Duratuss; Recovered U ------------------------------------------------------------------------ VAERS ID 106795 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 8 Adverse Event Onset Date 11/3/97 Sex M pt recv vax 1JUN95 & 1NOV97 pt exp full blown chickenpox Reported Text (covered from head to toe), fever, h/a, chills, sore throat & dysphagia; Pre-exisiting conditions PCN allergy Recovered Y ------------------------------------------------------------------------ VAERS ID 106813 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 11/21/97 Sex M Reported Text pt recv vax 27AUG97 & 21NOV97 pt devel chickenpox ( 5 lesions); Recovered Y ------------------------------------------------------------------------ VAERS ID 106814 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 4 Adverse Event Onset Date 11/25/97 Sex M Reported Text pt recv vax 6MAY97 & 25NOV97 pt devel chickenpox (15 lesions); Recovered Y ------------------------------------------------------------------------ VAERS ID 106851 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Sex M Reported Text pt recv vax 7JUL95 & subsequently devel chickenpox; Recovered U ------------------------------------------------------------------------ VAERS ID 106887 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Sex F Reported Text pt recv vax 19JUL97 & pt devel chickenpox that were described as unusual grouped type; Recovered U ------------------------------------------------------------------------ VAERS ID 106888 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Adverse Event Onset Date 11/1/97 Sex M Reported Text pt recv vax JUN95 & approx 27NOV97 pt devel chickenpox; Recovered U ------------------------------------------------------------------------ VAERS ID 106890 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 6 Adverse Event Onset Date 12/1/97 Sex M Reported Text pt recv vax 27MAR97 & pt devel chickenpox; Recovered Y ------------------------------------------------------------------------ VAERS ID 106905 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 11 Adverse Event Onset Date 11/18/97 Sex M pt recv vax 1JUN95 & 18NOV97 pt devel chickenpox, approx Reported Text 60 lesions w/itching, h/a, slit fever;pt lethargic & vomited twice; Recovered U ------------------------------------------------------------------------ VAERS ID 110029 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 16 Adverse Event Onset Date 12/27/97 Sex F Pt exposed to varicella 13Dec97. Pt recv vax 17Dec97 1st Reported Text dose varicella vax. 27Dec97 Pt devel chickenpox. Less than 50 lesions from chest up & fever. Lesions lasted 7-10 days. Pre-exisiting conditions Varicella exposure Other Medications Unknown Recovered Y ------------------------------------------------------------------------ VAERS ID 110032 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 14 Adverse Event Onset Date 12/27/97 Sex M Pt hx of exposure to chickenpox through siblings 14Dec97. 17Dec97 pt recv vax 1st dose of varicella virus Reported Text vax live SC. 27Dec97 pt exp break out of chickenpox. More than 50 lesions.mostly waist up. Slight fever 2 days. Pre-exisiting conditions Varicella exposure Other Medications Unknown Recovered Y ------------------------------------------------------------------------ VAERS ID 110044 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 2 Adverse Event Onset Date 1/15/98 Sex F Pt exposed to varicella 31Dec97. 07Jan98 Pt recv 1 dose Reported Text vax SC. No concomitant med. 15Jan98 Pt exp fever 101. 16Jan98 Pt exp papulovesicular rash, erythematous & pruritic w/greater 50 lesions. Pre-exisiting conditions Varicella exposure Recovered U ------------------------------------------------------------------------ VAERS ID 110139 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 3 Adverse Event Onset Date 12/1/97 Sex M 28Jun95 pt recv 1dose vax. 01Dec97 Pt exp varicella Reported Text w/"18 itchy lesions on his back & trunk lasting 6 days. No fever. Pre-exisiting conditions Unknown Other Medications Unknown Recovered U ------------------------------------------------------------------------ VAERS ID 110168 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 32 Sex F Reported Text 17Oct97 pt recv vax. Pt was 1 wk pregnant at the time of vax (LMP 17Sept97) Pre-exisiting conditions antibiotic allergy Other Medications Unknown Recovered U ------------------------------------------------------------------------ VAERS ID 111670 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 2 Adverse Event Onset Date 5/4/98 Sex F pt recv vax 1MAY98 & 4MAY98 began exp diarrhea et. Reported Text vomiting but was afeb;8MAY98 pt taken to clinic w/sz, released to home when exp yet another sx 9MAY98 returned to clinic was hosp x 1wk for sz; Recovered Y Hospitalized Y ------------------------------------------------------------------------ VAERS ID 114457 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 8/31/98 Sex M Lab Data CBC, chem 7, blood cult, ESR rash on trunk, face, legs to clinic 31AUG98;gen varicella like rash secondary to varicella vax;pt fussy, Reported Text not sleeping well 2SEP98;dx viral synd probably secondary to post vax; inc fussiness, dec appetite, acting more ill;T102; Pre-exisiting conditions NKA Recovered Y ------------------------------------------------------------------------ VAERS ID 114471 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 33 Adverse Event Onset Date 9/1/98 Sex F chronic pain w/cont n/thoracic neuralgia;no lesions Reported Text noted;neurologist can find no other explanation or reason Pre-exisiting conditions allergy to sulfa;Gentamycin;Amoxicillin; Recovered Y ------------------------------------------------------------------------ VAERS ID 116646 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 10/26/98 Sex F devel fever 102.9, rhinitis 10 days p/vax;devel papular rash the next day that started on trunk, spread to Reported Text extremities;over 150 lesions w/severe pruritus;clinically c/w varicella but no vesicles only papules; Pre-exisiting conditions reactive airway disease Recovered Y ------------------------------------------------------------------------ VAERS ID 117162 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 13 Adverse Event Onset Date 11/27/98 Sex F Pt recv vax on 11/12/98; on 11/27/98 pt exp pimple like Reported Text rash in mouth, itching, headache, stomach ache; tx=Benadryl, soda baths ------------------------------------------------------------------------ VAERS ID 118440 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 33 Adverse Event Onset Date 9/1/97 Sex F Lab Data CT repeat 2JUL SEP97 onset of cont nausea & thoracic neuralgia-no Reported Text lesions noted;neurologist can find no other explanation or reason; Pre-exisiting conditions allergy to sulfa & gentamycin & amoxicillin; ------------------------------------------------------------------------ VAERS ID 122777 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 3/20/98 Sex F pt recv vax & devel approx 5 lesions on stomach;3/23/98 Reported Text pt devel lesions from head to toe;pt also exp a low grade temp for approx 24hr; Recovered Y ------------------------------------------------------------------------ VAERS ID 122943 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 3 Adverse Event Onset Date 3/30/98 Sex M pt recv 1st dose varivax in 6/95 & in 3/98 pt devel mild Reported Text rash on his back, less than 30 bumps, area was itchy for 2 days Other Medications unknown Recovered Y ------------------------------------------------------------------------ VAERS ID 122947 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 2 Adverse Event Onset Date 4/16/98 Sex F pt recv 1 dose of varivax in 6/95 & in 4/98 pt devel Reported Text ``20-25 bumps along the front hairline, torso & back of knee''. Pre-exisiting conditions unknown Other Medications unknown Recovered U ------------------------------------------------------------------------ VAERS ID 122959 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 4/20/98 Sex F Reported Text pt recv 1 dose varivax 4/13/98 & 4/20 pt devel rash on bottom & fever. Recovered U ------------------------------------------------------------------------ VAERS ID 122961 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 3 Adverse Event Onset Date 4/8/98 Sex M pt recv 1 dose of varivax in 5/95 & in 4/98 pt devel a Reported Text chickenpox rash w/vesicles on back & scattered throughout body. Recovered Y ------------------------------------------------------------------------ VAERS ID 123031 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 7 Adverse Event Onset Date 4/28/98 Sex F Reported Text pt recv vax & devel one red bump about the size of a dime at the inj site; Pre-exisiting conditions asthma;hip disorder Other Medications Azmacort Recovered Y ------------------------------------------------------------------------ VAERS ID 123140 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 6/1/98 Sex M Reported Text it was rpt by RN pt recv 1st dose varivax 2/9/96 & in 6/98 pt devel acute varicella described as ``moderate'' Recovered Y ------------------------------------------------------------------------ VAERS ID 123389 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 4 Adverse Event Onset Date 5/20/98 Sex M Lab Data dx lab te:6/5/98, polymerase chain react, inadequate scab specimen, 6/22 scab specimen positive p/ pt recv vax approx 7 days later pt devel sx of varicella. 2 days later devel 400-500 chickenpox type, Reported Text blister-like lesions essentially everywhere. 2nd tests revealed wild type varicella zoster virus. 1st test inadequate. Recovered Y ------------------------------------------------------------------------ VAERS ID 123639 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 7/6/98 Sex M p/vax pt exp a full blown case of chickenpox;devel addtl Reported Text vesicles;devel approx 85 lesions on the secondary day;medical attention was sought;viral cult performed; Pre-exisiting conditions septra allergy Recovered Y ------------------------------------------------------------------------ VAERS ID 124087 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 6 Adverse Event Onset Date 10/1/98 Sex M Reported Text it was rpt p/ pt recv vax pt broke out w/full-blown chickenpox Recovered U ------------------------------------------------------------------------ VAERS ID 126815 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 1 Adverse Event Onset Date 7/26/99 Sex M Reported Text mom rpt she noticed 2 blister bumps on pt on evening of vax; 8 more cam on 7/29, fever 101, was irritable; Pre-exisiting conditions none infant born at 36 weeks gestation & in nicu for 2weeks Recovered U ------------------------------------------------------------------------ VAERS ID 128552 State MT Vaccine Type VARCEL Vaccination Name VARIVAX Manufacturer MSD Age in Years 11 Adverse Event Onset Date 9/3/99 Sex F Lab Data CXR negative Reported Text fatigue, high fever, sore throat, rash consistent w/measles, Koplik's spots; Pre-exisiting conditions allergy induced asthma ------------------------------------------------------------------------ |