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Case Details (Sorted by Age)

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VAERS ID:182444 (history)  Vaccinated:2002-02-22
Age:11.0  Onset:2002-02-23, Days after vaccination: 1
Gender:Male  Submitted:2002-03-08, Days after onset: 13
Location:New Jersey  Entered:2002-03-14, Days after submission: 6
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
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5156A20IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt''s father called and said child had Hep-B shot on 2/22/02 and on 2/23/02, he had a red rash all over his body. It was raised and red with white centers and itchy. It''s the first time this has happened. Father denies any previous allergic reactions. MD was notified and states this could be an allergic rash to IZ. States should not get. Father called family doctor and he ordered Benadryl.

VAERS ID:182468 (history)  Vaccinated:2001-09-15
Age:11.0  Onset:2001-09-15, Days after vaccination: 0
Gender:Female  Submitted:2002-03-07, Days after onset: 173
Location:New Jersey  Entered:2002-03-14, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES01092006
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site inflammation, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a registered nurse concerning a 11 year old female who on 09/15/2001 was vaccinated with a third dose of hep b vaccine recombinant IM in the arm. On 09/15/2001, the pt experienced a localized reaction which involved a large area of the injection site and below which was quiet inflammed. The pt was treated with hiphendydramino hydrochloride and warm compresses. Additional info has been received from a registered nurse. The nurse reported that the pt had a large induration around, above and below the injection site. No further info is expected.

VAERS ID:182496 (history)  Vaccinated:2001-11-28
Age:11.0  Onset:2001-12-01, Days after vaccination: 3
Gender:Male  Submitted:2002-03-07, Days after onset: 96
Location:Unknown  Entered:2002-03-14, 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: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0112USA0147B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Cardiac disorder, Crying, Lethargy, Listless
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a pharmacist concerning an 11 year old male family member who on 28-2001 was vaccinated with Hepatitis B vaccine recombinant (yeast). On approximately 01-DEC-2001, the patient became tired and listless, he had a loss of appetite, he became depressed, he cried a lot, was afraid to go to school and mentioned that his heart felt funny. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:182633 (history)  Vaccinated:2002-03-07
Age:11.0  Onset:2002-03-07, Days after vaccination: 0
Gender:Female  Submitted:2002-03-07, Days after onset: 0
Location:Colorado  Entered:2002-03-19, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: CO02003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5230A20IMRA
Administered by: Public     Purchased by: Public
Symptoms: Blood pressure increased, Dysphagia, Dyspnoea, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: After the hep b vaccination, the pt complained of trouble breathing, throat swelling with trouble swallowing. The pt was given Benadryl. Her blood pressure was 110/60. She was transported to the hospital and released home.

VAERS ID:182796 (history)  Vaccinated:2002-03-14
Age:11.0  Onset:2002-03-18, Days after vaccination: 4
Gender:Male  Submitted:2002-03-21, Days after onset: 3
Location:New Jersey  Entered:2002-03-25, 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: NONE
Current Illness: NONE
Preexisting Conditions: strep infection
Diagnostic Lab Data: ultrasound left testicle
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1515K1 LA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pain, Swelling
SMQs:, 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: Four days after receiving MMR vaccine, the pt developed pain, swelling, redness at left testicle. Mother gave Tylenol with some relief from pain, but it became worse on 03/19/2002. Seen by family physician, referred to ER on 03/20/2002 and was seen by urologist; taking doxycycline 100 mg at this time.

VAERS ID:182831 (history)  Vaccinated:2002-02-21
Age:11.0  Onset:2002-02-21, Days after vaccination: 0
Gender:Female  Submitted:2002-03-15, Days after onset: 22
Location:Illinois  Entered:2002-03-26, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER5156A20 LA
Administered by: Public     Purchased by: Public
Symptoms: Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mother states her face swelled up and she developed hives within less than 24 hrs. Denies any respiratory, airway involvement. Treated with Dimetapp and resolved in 48 hrs.

VAERS ID:183240 (history)  Vaccinated:2001-08-06
Age:11.0  Onset:2001-08-06, Days after vaccination: 0
Gender:Female  Submitted:2002-03-27, Days after onset: 233
Location:Texas  Entered:2002-04-08, Days after submission: 11
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: TX02044
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.6325L0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Loss of consciousness, Nausea, Pallor, Rash
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Mom states the patient became very pale, dizzy and passed out in car on the way home. Once in house, became nauseated, pale, ongoing. Doctor notified 2 days later. Patient developed red rash on arms/stomach. Doctor notified. Mother called and reported to us on this day.

VAERS ID:183564 (history)  Vaccinated:2002-03-27
Age:11.0  Onset:2002-03-28, Days after vaccination: 1
Gender:Male  Submitted:2002-04-11, Days after onset: 13
Location:Pennsylvania  Entered:2002-04-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1067L1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Headache, Nausea, Pain, Pyrexia, Somnolence
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Hep-B booster received at 19:30. At 01:00, child awoke yelling "everything hurts" and fever of 102.5F. Fever continued at 101F for 3 days with nausea. Fever came back over 2 weeks. Also had headache and weakness for 3 weeks and sleepiness.

VAERS ID:183647 (history)  Vaccinated:2002-03-01
Age:11.0  Onset:2002-03-02, Days after vaccination: 1
Gender:Male  Submitted:2002-04-11, Days after onset: 39
Location:New Jersey  Entered:2002-04-17, Days after submission: 6
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt received the Hep-B vaccine and had moderate to severe swelling and tenderness at the injection site on 3/2/02. By 3/4/02, the swelling and pain decreased and the pt made a good recovery.

VAERS ID:183807 (history)  Vaccinated:2002-04-12
Age:11.0  Onset:2002-04-12, Days after vaccination: 0
Gender:Female  Submitted:2002-04-15, Days after onset: 3
Location:Virginia  Entered:2002-04-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Clarifin
Current Illness: NONE
Preexisting Conditions: Environmental alleriges, seizure disorder
Diagnostic Lab Data: NONE
CDC Split Type: VA02012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5225A92IMLA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Psychomotor hyperactivity, Rash erythematous, Rash pruritic
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Akathisia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Late 04/12/2002 or early 04/13/2002 pt complained of itchy rash, about 20 mosquito bite like raised, red, some with blisters. Size about 1/4" or less. Location trunk and extremities. Mother of pt denies of any fever and fatigue. Pt was somewhat "hyper" Friday evening. Pt continues to have this rash today. May go to pmd''s if no improvements.

VAERS ID:183818 (history)  Vaccinated:2002-03-27
Age:11.0  Onset:2002-03-27, Days after vaccination: 0
Gender:Male  Submitted:2002-03-28, Days after onset: 1
Location:Tennessee  Entered:2002-04-23, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TN02010
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5272A20IMLA
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: HBV given at 10am at school. Pt arrived home at 4:30pm complained of back itching. Mom took pt to MD. Pt had urticaria on trunk and extremities. Gave IM steroid and PO Bendaryl. Pt sent home. Mom states itching resumed today at school. Resolved with bendaryl. Arrived home with face flushed this pm and possible high temp. To flu with MD.

VAERS ID:183862 (history)  Vaccinated:2002-04-09
Age:11.0  Onset:2002-04-09, Days after vaccination: 0
Gender:Male  Submitted:2002-04-16, Days after onset: 7
Location:Virginia  Entered:2002-04-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Isoniezid, PPD
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.085362 LA
IPV: POLIO VIRUS, INACT. (POLIOVAX)CONNAUGHT LTD.T13912 LA
TD: TD ADSORBED (NO BRAND NAME)CONNAUGHT LABORATORIESV0519AA2 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed swelling, erythema and itch on the left upper arm the day of hep b and IPV vaccines. The swelling gradually progressed until pt was examined on 04/12/2002 (4" x 5 1/2"). There was no sign of infection. Immediate response followed Epinephria and benadryl.

VAERS ID:183900 (history)  Vaccinated:2002-04-09
Age:11.0  Onset:2002-04-09, Days after vaccination: 0
Gender:Female  Submitted:2002-04-12, Days after onset: 3
Location:Kentucky  Entered:2002-04-25, Days after submission: 13
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: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5156A21IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.078860SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Child had initial local response of redness and white "wheel", no systemic reaction and cool compress applied. Redness resolved that night and returned next afternoon with warmth and edness on arm. Remained red and warm on 04/11/2002 am and referred to MD for treatment and evaluation of right arm.

VAERS ID:183929 (history)  Vaccinated:2002-04-18
Age:11.0  Onset:2002-04-18, Days after vaccination: 0
Gender:Female  Submitted:2002-04-22, Days after onset: 4
Location:Texas  Entered:2002-04-26, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5213A22IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received vaccine approx. 4:30pm and by 7pm the pt developed fever of 103 deg. F. which elevated to 104 deg. F over that evening. Tylenol/Motrin given. Ran low-grade fever 100-101 for two days after.

VAERS ID:183934 (history)  Vaccinated:2002-03-20
Age:11.0  Onset:2002-03-22, Days after vaccination: 2
Gender:Female  Submitted:2002-04-24, Days after onset: 32
Location:California  Entered:2002-04-26, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNknown
Diagnostic Lab Data: Not Known
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1067L0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Diarrhoea, Eye oedema, Eye pain, Headache, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mother reported to school nurse. school nurse reported to VNA: Nausea, diarrhea, headache, bulging eyes, pain across eyes. current pain in joints. Treated by acupuncturist

VAERS ID:183971 (history)  Vaccinated:2002-04-17
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2002-04-23
Location:Nebraska  Entered:2002-04-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5230A21IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dyskinesia, Eye movement disorder, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: The pt apparently fainted, fell to floor and had strong jerking movements of arms and legs, mouth pulled up on left side, eyes rolled back for approximately 30 sec. post vaccination. Also hit back of head on uncarpeted floow when he fainted. States he felt "fine" when he regained consciousness. Upon follow-up the pt had no problems following the episode.

VAERS ID:183977 (history)  Vaccinated:2002-04-11
Age:11.0  Onset:2002-04-12, Days after vaccination: 1
Gender:Female  Submitted:2002-04-23, Days after onset: 11
Location:Pennsylvania  Entered:2002-04-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1183J2IMRA
Administered by: Private     Purchased by: Public
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: Left bell''s palsy one day after vaccination.

VAERS ID:184009 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2002-04-22
Location:Wisconsin  Entered:2002-04-30, Days after submission: 8
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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM6523CA22IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Anxiety, Crying
SMQs:, Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: Highly anxious approximately. 4 hrs post injection Uncontrollable crying and anxiety

VAERS ID:184019 (history)  Vaccinated:2002-04-01
Age:11.0  Onset:2002-04-01, Days after vaccination: 0
Gender:Female  Submitted:2002-04-24, Days after onset: 22
Location:Arkansas  Entered:2002-04-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: fever;Hep B (Engerix-B);0;0;In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type: AR0221
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5252A21IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site oedema, Injection site reaction, Pyrexia, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Within 2 to 3 hrs after vaccination, the pt started running a fever, swelling at site and rash that went all over body with some itching. Tried Benadryl and Calomin lotion with no relief-presented to MD on 04/04/2002. Reaction to vaccine. Treated pt with medrol dose pack, adarax.

VAERS ID:184086 (history)  Vaccinated:2002-04-23
Age:11.0  Onset:2002-04-23, Days after vaccination: 0
Gender:Female  Submitted:2002-04-23, Days after onset: 0
Location:California  Entered:2002-05-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM5295A20IMRA
Administered by: Private     Purchased by: Private
Symptoms: Fall, Hyperhidrosis, Syncope, Visual disturbance
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Syncopal episode about 10 mins after receiving vaccine. She suddenly got sweaty and vision blacked out, then fell backwards to the floor hitting her head on the wall.

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