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Case Details (Sorted by Age)

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VAERS ID:388064 (history)  Vaccinated:2009-04-16
Age:9.0  Onset:2009-04-16, Days after vaccination: 0
Gender:Male  Submitted:2010-05-14, Days after onset: 393
Location:Maryland  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0905USA02148
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0221Y UNUN
Administered by: Other     Purchased by: Public
Symptoms: Injection site reaction
SMQs:
Write-up: Information has been received from a Registered Nurse (R.N.)concerning an unspecified number of patients who on an unspecified date were vaccinated with a dose of VARIVAX (Merck). It was reported that the patients had an injection site reactions occurring from VARIVAX (Merck). Medical attention was sought via an office visit. In follow up the nurse reported that a 9 year old male patient received from the Vaccines for Children program a dose of VARIVAX (Merck) (lot # 663823/0221Y) on 16-APR-2009. He recovered. This is one of several reports from the same source. No further information is available.

VAERS ID:388230 (history)  Vaccinated:2009-08-03
Age:9.0  Onset:2009-09-04, Days after vaccination: 32
Gender:Male  Submitted:2010-05-14, Days after onset: 252
Location:New Jersey  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0908USA00700
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0799Y1SCUN
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a Nurse Practitioner (N.P) concerning a 3 or 4 patients who on an unspecified date were vaccinated with a dose of VARIVAX (Merck). It was reported that the patients complained about redness around the injection site. It was reported that this was something that had not happened in the past. Follow up information has been received from the nurse practitioner concerning a 9 year old male student with seasonal allergies who on 03-AUG-2009, at 2:15 P.M., was vaccinated subcutaneously with the second dose of VARIVAX (Merck) (lot # 664712/0799Y) into the left arm. There was no illness at time of vaccination. On 04-SEP-2009, at 4:55 P.M., the patient developed injection site red, hot and swollen. No medical attention was sought. On an unspecified date, the patient recovered. This is one of several reports received from the same source. Additional information is not expected.

VAERS ID:388302 (history)  Vaccinated:2009-03-24
Age:9.0  Onset:2009-03-25, Days after vaccination: 1
Gender:Male  Submitted:2010-05-14, Days after onset: 415
Location:Maryland  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0903USA05486
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1784X SCRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered nurse concerning a 9 year old male who on 24-MAR-2009 was vaccinated SC with VARIVAX (Merck) (lot # 662459/1784X) into the right arm. On 25-MAR-2009 the patient developed large red, swollen area at injection site and tenderness in right axilla. The patient was examined on 27-MAR-2009 but symptoms were resolving without treatment. It was unspecified if the patient sought medical attention. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:388323 (history)  Vaccinated:2009-04-01
Age:9.0  Onset:2009-04-04, Days after vaccination: 3
Gender:Female  Submitted:2010-05-14, Days after onset: 405
Location:Florida  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0904USA00890
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1544X1SCUN
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a licensed practical nurse concerning a 9 year old female with no medical history or drug allergies who was vaccinated with the first and the second (lot # 662201/1544X) dose of VARIVAX (Merck), SQ, 0.5ml on 24-JAN-2001 and 01-APR-2009 respectively. There was no concomitant medications. On 04-APR-2009 the patient experienced red thigh, swollen thigh that looked like cellulitis. The patient had no lab diagnostics studies performed. The physician saw the patient. At the time of the report the patient was recovering. A lot check has been initiated. Follow up information has been received from a licensed practical nurse concerning a patient with no illness at time of vaccination who was vaccinated with the second dose of VARIVAX (Merck) on 01-APR-2009 at 3:30 PM. She developed cellulitis left thigh. The patient was prescribed KEFLEX and warm compress. The event required emergency room/doctor visit. At the time of the report the patient was recovered. A standard lot check investigation was performed. All in-process quality checks for the lot number in question were satisfactory. The lot met the requirements of the Center for Biologics Evaluation and Research and was released. No further information is available.

VAERS ID:388412 (history)  Vaccinated:0000-00-00
Age:9.0  Onset:0000-00-00
Gender:Male  Submitted:2010-05-14
Location:New York  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0905USA01434
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inflammation, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a physician concerning a 9 year old male who was vaccinated with a second dose of VARIAX (Merck). There was no concomitant medication. On unknown date the patient''s arm got swollen and inflamed all the way down to his elbow. On an unspecified date, the patient recovered. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:388532 (history)  Vaccinated:2009-04-21
Age:9.0  Onset:2009-04-21, Days after vaccination: 0
Gender:Female  Submitted:2010-05-14, Days after onset: 388
Location:Ohio  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Strabismus
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0905USA00925
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Urticaria, Vaccine positive rechallenge, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 9 year old female with strabismus who on 21-APR-2009 was vaccinated with the third dose of VARIVAX (Merck) (lot# not reported) IM into the right arm. On 21-APR-2009 the patient developed chest pain, vomiting followed by urticarial rash around face and neck and rare on trunk. The symptoms relieved with MAALOX and BENADRYL. The patient had similar reactions at the age of 7 and a half years after the second dose of VARIVAX (Merck) (lot# not reported), but her parents didn''t remember until after the patient was given the third dose mistakenly. Subsequently, on 21-APR-2009, the patient recovered from chest pain, vomiting and urticarial rash around face. The patient sought medical attention by visiting the doctor. Additional information is not expected.

VAERS ID:388625 (history)  Vaccinated:1997-02-27
Age:9.0  Onset:2009-11-24, Days after vaccination: 4653
Gender:Male  Submitted:2010-05-14, Days after onset: 170
Location:Unknown  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1001USA02042
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Mumps, Parotitis
SMQs:, Oropharyngeal infections (narrow)
Write-up: Information has been received from a physician concerning a 11 year old male who on 11-MAY-1989 was vaccinated with a first dose of MMR II. On 27-FEB-1997, the patient was vaccinated with a second dose of MMR II (routes, sites, and lots number were not reported). On 25-NOV-2009 the patient experienced right parotitis. The right side of the patient''s neck was swollen. The patient was afebrile. On 29-NOV-2009, the patient was diagnosed with mumps. The outcome for mumps was not reported. Follow up information has been received indicating that the 21 year old male patient (also reported as 19 years old) on 24-NOV-2009 experienced mumps (previously reported as 25-NOV-2009). The patient was diagnosed on 27-NOV-2009, the patient was afebrile. This is one of several reports from the same source. No further information is available.

VAERS ID:388674 (history)  Vaccinated:2001-02-21
Age:9.0  Onset:2010-01-09, Days after vaccination: 3244
Gender:Male  Submitted:2010-05-14, Days after onset: 124
Location:New York  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: diagnostic laboratory, 83, Parotitis count; body temp, 102.8 degre
CDC Split Type: WAES1001USA02025
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Laboratory test, Mumps, Parotitis
SMQs:, Neuroleptic malignant syndrome (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning an 18 year old male who on 14-OCT-1994 and 21-FEB-2001 was vaccinated with the first and the second doses of MMR II respectively. On 09-NOV-2009 the patient experienced mumps. On 26-NOV-2009, the patient was diagnosed and the patient was afebrile. The patient had left parotitis. The parotitis count was 83. At the time of the report, the outcome of the patient was unknown. Follow up information has been received from a physician reported that on 09-JAN-2010 (also reported as 09-NOV-2009) the 18 year old (also reported as 12 year old) patient experienced mumps. On 10-JAN-2010 (also reported as 26-NOV-2009) the patient was diagnosed and the patient''s body temperature was 102.8 degree Fahrenheit (also reported as afebrile). It was reported that the patient was exposed to others with mumps 2 weeks ago. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:388881 (history)  Vaccinated:2008-08-13
Age:9.0  Onset:2010-01-23, Days after vaccination: 528
Gender:Male  Submitted:2010-05-14, Days after onset: 110
Location:New York  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: serum immunoglobulin G, 01/25/10, 9.62; serum immunoglobulin M, 01/25/10, <1:10; serum amylase test, 01/25/10, 516
CDC Split Type: WAES1002USA01325
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blood amylase increased, Blood immunoglobulin G, Blood immunoglobulin G decreased, Blood immunoglobulin M, Blood immunoglobulin M decreased, Ear pain, Mumps, Parotitis, Vaccine breakthrough infection
SMQs:, Acute pancreatitis (broad), Oropharyngeal infections (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 8 year old male who on 02-NOV-2000 was vaccinated with a first dose of MMR II. On 13-AUG-2007 the patient was vaccinated with a second dose of MMR II. It was reported that the patient did not receive the third dose of MMR II. It was reported that the patient was not vaccinated with a third dose. On 23-JAN-2010 the patient experienced mumps. The patient was diagnosed with mumps on 25-JAN-2010. Other symptoms presented by the patient included right parotitis and pain the right ear. First blood work test performed on 25-JAN-2010 included IgM (<1:10), IgG (9.62) and amylase (516). Second blood work was not performed. The final outcome for mumps was not reported. This is one of several reports from the same source. No further information is available.

VAERS ID:389029 (history)  Vaccinated:2008-11-12
Age:9.0  Onset:2009-05-04, Days after vaccination: 173
Gender:Female  Submitted:2010-05-14, Days after onset: 375
Location:Texas  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0905USA00578
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1190X1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a physician concerning a 10 year old female who on 11-APR-2008 was vaccinated with a 0.5 mL first dose of VARIVAX (Merck). On the same date the patient received a dose of MMR II (MSD). Concomitant therapy included influenza virus vaccine (manufacturer unspecified) on 12-NOV-2008. On the same date the patient received a second dose of VARIVAX (Merck) (lot # 661988/1190X). On 04-MAY-2009 the patient was broke out with 8 or 9 lesions and diagnosed with breakthrough chicken pox. No laboratories studies performed. The patient sought unspecified medical attention. At the time of this report the patient had not recovered. The patient was lost to follow up. No further information is available.

VAERS ID:388121 (history)  Vaccinated:2010-05-13
Age:9.0  Onset:2010-05-15, Days after vaccination: 2
Gender:Male  Submitted:2010-05-18, Days after onset: 3
Location:Maryland  Entered:2010-05-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1707Y1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 6-7 cm red, itchy area at site of injection site approx. 2 cm of induration.

VAERS ID:388799 (history)  Vaccinated:2010-05-14
Age:9.0  Onset:2010-05-14, Days after vaccination: 0
Gender:Male  Submitted:2010-05-15, Days after onset: 1
Location:Virginia  Entered:2010-05-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.036221IMLA
Administered by: Private     Purchased by: Private
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting - began several hours after vaccine given.

VAERS ID:388862 (history)  Vaccinated:2010-05-17
Age:9.0  Onset:2010-05-18, Days after vaccination: 1
Gender:Male  Submitted:2010-05-20, Days after onset: 2
Location:Alabama  Entered:2010-05-21, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Obesity; Asthma
Diagnostic Lab Data: Bacterial culture of vaccinated arm: Neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0048Y1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Bacterial test negative, Erythema, Oedema, Rash vesicular
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 9 yo male with 15cm of erythema and edema and 3cm vesicular reaction after varicella vaccine administered 5-18-10.

VAERS ID:389127 (history)  Vaccinated:2010-05-14
Age:9.0  Onset:2010-05-16, Days after vaccination: 2
Gender:Female  Submitted:2010-05-17, Days after onset: 1
Location:Mississippi  Entered:2010-05-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1606Y1UNRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vesicular rash on trunk in 2 days. Erythema around injection site (about 6 cm diam).

VAERS ID:389202 (history)  Vaccinated:2010-05-12
Age:9.0  Onset:2010-05-14, Days after vaccination: 2
Gender:Female  Submitted:2010-05-14, Days after onset: 0
Location:Washington  Entered:2010-05-24, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1670Y1IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1414Y1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased, Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 4 in diam redness and swelling and 99.5 temp.

VAERS ID:389204 (history)  Vaccinated:2008-05-13
Age:9.0  Onset:0000-00-00
Gender:Male  Submitted:2010-05-24
Location:Massachusetts  Entered:2010-05-25, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1977L1UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Body temperature increased, Rash, Rash erythematous, Rash papular, Skin lesion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient developed rash/seen in office/not itchy his T about 101 degrees. Rash c/w varicella (Fluid-filled small papular lesions with erythematous base), confirmed with my partner also.

VAERS ID:389328 (history)  Vaccinated:2010-05-24
Age:9.0  Onset:2010-05-24, Days after vaccination: 0
Gender:Female  Submitted:2010-05-25, Days after onset: 1
Location:Pennsylvania  Entered:2010-05-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: seasonal allergies currently on INH for latent TB
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1024Y1IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0095Z0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1223Y1SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1130Y1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Child c/o pain and itching to site. Site where varicella and MMR given swollen and rashed approximately 12 cm. Child then c/o nausea and dizziness.

VAERS ID:389352 (history)  Vaccinated:2010-05-13
Age:9.0  Onset:2010-05-13, Days after vaccination: 0
Gender:Female  Submitted:2010-05-20, Days after onset: 7
Location:Arkansas  Entered:2010-05-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Macrocephaly; Developmental delay
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1428Y1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Mom stated child had a seizure and was going to the ER.

VAERS ID:389592 (history)  Vaccinated:2010-05-27
Age:9.0  Onset:2010-05-27, Days after vaccination: 0
Gender:Female  Submitted:2010-05-28, Days after onset: 1
Location:North Carolina  Entered:2010-05-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS 0IJLA
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1IJRA
Administered by: Unknown     Purchased by: Other
Symptoms: Catatonia, Cyanosis, Hypotension, Pallor, Pruritus, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Paying co-pay at window, patient became extremely pale, blue lips, catatonic, said, "throat hurts". Nurse took her back to treatment room where she was laid down, knees elevated, bp checked (extremely low). Sat up, given Gatorade. Checked bp x2, color returned to face and lips. Left building. Fifteen minutes later returned patient to facility with large, raised, itchy welts/hives extending out from the injection site. Patient was administered Benadryl and monitored for approximately 45 minutes. One day after event patient continue to complaining of itching but with reduced hives.

VAERS ID:389600 (history)  Vaccinated:2010-05-11
Age:9.0  Onset:2010-05-11, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2010-05-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma; Allergic rhinitis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB384AA0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0075Y0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3088AA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Blood glucose normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: 5 to 10 minutes after receiving 3 injections pt became faint. Glucose level 80. Administered 4 oz fruit juice. VS WNL. Patient fully recovered 10 -15 minutes post administration.

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