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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
------------------------------------------------------------------------
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