VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
51414
38.3 M 01-Jan-1991 Rx@ 05-Apr-1993 MIL- 14-Sep-1999
SERIOUS: Hospitalized(10) Disability
COSTARTS: ARTHRALGIA/ASTHENIA/DYSPNEA/LAB TEST ABNORM/RASH/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
TYP UNCLASSIFIED
MEN UNCLASSIFIED
CHOL UNCLASSIFIED
ANTH UNCLASSIFIED
SYMPTOM TEXT: joint pain, fatigue & rash feet, dyspnea hosp FEB93 to MAR93;
OTHER MEDS: pt also recvd Anthrax vax;
LAB DATA: Febrile agglutins pos; Typhoid 1:320; pos core HBAB; neg antibody HB; neg antigen HB; neg ted; neg
ANA; neg RHF; neg stools ova & culture; neg oth agglut;
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
51415
40.9 F 01-Jan-1991 Rx@ 05-Apr-1993 - 14-Sep-1999
SERIOUS: Hospitalized(14)
COSTARTS: ASTHENIA/DYSPNEA/ESR INC/LAB TEST ABNORM/RASH/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
TYP UNCLASSIFIED
MEN UNCLASSIFIED
CHOL UNCLASSIFIED
ANTH UNCLASSIFIED
SYMPTOM TEXT: rash feet & rt hand dyspnea & fatigue;
OTHER MEDS: Pt recvd Anthrax & immune globulin;
LAB DATA: ANA neg; neg RH, neg stools ova & cult; sed rate 76; pos Typhoid agglutin "H" 1:160, pos
immunoplectrophoresis Poly clonal gamopathy;
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
51416
34.0 M Rx@ 05-Apr-1993 MIL- 16-Feb-1999
SERIOUS: Hospitalized()
COSTARTS: ARTHRALGIA/ASTHENIA/LAB TEST ABNORM/PAIN ABDO/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
TYP UNCLASSIFIED
MEN UNCLASSIFIED
CHOL UNCLASSIFIED
ANTH UNCLASSIFIED
SYMPTOM TEXT: abdo pain, fatigue, joint pain; hosp 18MAR93;
OTHER MEDS: NONE
LAB DATA: pos febrile aggluttines Typhoid H 1:320 dil; pos rest; neg ANA, Neg RHF, neg sed;
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
51431
M 05-Dec-1990 Rx@ 05-Apr-1993 MIL- 16-Feb-1999
COSTARTS: ARTHRALGIA/ASTHENIA/LAB TEST ABNORM/LYMPHADENO/RASH/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
TYP UNCLASSIFIED
MEN UNCLASSIFIED
CHOL UNCLASSIFIED
ANTH UNCLASSIFIED
SYMPTOM TEXT: rash hands, joint pains, fatigue, lymph node swelling;
OTHER MEDS: Anthrax;
LAB DATA: pos cervical & ax lymp adenopathy; pos Bx-nonsnuclear infilt
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
107470
33.6 M 20-Jan-1998 Rx@ 22-Jan-1998 2 17-Feb-1998 TX MIL- 09-Sep-1999
COSTARTS: EDEMA INJECT SITE/HYSN INJECT SITE/MASS INJECT SITE/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV016 1 LA SC
SYMPTOM TEXT: 12cm x 4cm x 4cm red swollen nodule to lt deltoid;no discharge, +redness, +tenderness, negative
streaking;no tx;
OTHER MEDS: NA
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NA
PREX ILLNESS: NA
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
110504
39.0 M 02-Apr-1998 Rx@ 11-Apr-1998 9 12-May-1998 MB MIL- 09-Sep-1999
COSTARTS: HYSN INJECT SITE/PAIN INJECT SITE/POS RECHAL/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 1 SC
SYMPTOM TEXT: severe red, painful arm @ site of inj;
PREVIOUS VAX ILL: pt exp severe red, painful w/anthrax
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: seafood, ASA, INH
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
111835
24.4 M 17-May-1998 Rx@ 18-May-1998 1 16-Jun-1998 OTH- 09-Sep-1999
SERIOUS: Life-threatening Hospitalized(13)
COSTARTS: GAIT ABNORM/GUILLAIN BARRE SYND/HYPOKINESIA/LAB TEST ABNORM/MYASTHENIA/MYOPATHY/NEUROPATHY/REFLEXES
DEC/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 2 A SC
SYMPTOM TEXT: pt recv vax & noted weakness of feet-over next 24hr worsens to include knees & hands;pt adm to hosp
EMG showed conduction abn of legs & hands;dx GBS;pt able to walk small distances & fine motor of hands improving;
OTHER MEDS: NONE (OTC creatinine & protein drinks)
LAB DATA: EMG, x-rays negative, spinal tap negative;
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
112155
24.0 M 29-Apr-1998 Rx@ 29-Apr-1998 1 25-Jun-1998 ID MIL-ID98022 09-Sep-1999
COSTARTS: ASTHENIA/DIARRHEA/DIPLOPIA/DIZZINESS/NAUSEA/POS RECHAL/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 1 SC
SYMPTOM TEXT: double vision;dizziness;nausea;fatigue;diarrhea;tx w/rest/phenergan/antivert;
PREVIOUS VAX ILL: pt exp psddrf ouy, vertigo, dizziness w/dose 1 anthrax vax;
OTHER MEDS: NONE
LAB DATA: ABG-nl to r/ anxiety;LFT & serum lytes nl;hyperventilation
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
112156
24.0 M 15-Apr-1998 Rx@ 15-Apr-1998 0 25-Jun-1998 ID MIL-ID98022 09-Sep-1999
COSTARTS: DIZZINESS/SYNCOPE/VERTIGO/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 0 SC
SYMPTOM TEXT: pt recv vax & passed out, exp vertigo & dizziness;
OTHER MEDS: NONE
LAB DATA: ABG nl to r/o anxiety;LFT & serum lytes nl;hyperventilation
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113338
22.0 M 31-Mar-1998 Rx@ 01-Apr-1998 1 11-Aug-1998 MIL- 09-Sep-1999
COSTARTS: HEADACHE/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 0
SYMPTOM TEXT: h/a for approx 2wk p/vax;started one day p/vax given;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NA
PREX ILLNESS: NA
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113339
22.1 M 28-Apr-1998 Rx@ 29-Apr-1998 1 11-Aug-1998 MIL- 09-Sep-1999
COSTARTS: HEADACHE/POS RECHAL/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 1
SYMPTOM TEXT: h/a for approx 2wk p/vax;started 1 day p/vax;
PREVIOUS VAX ILL: pt exp h/a w/dose 1 anthrax;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NA
PREX ILLNESS: NA
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113340
22.1 M 14-May-1998 Rx@ 14-May-1998 0 11-Aug-1998 MIL- 09-Sep-1999
COSTARTS: HEADACHE/POS RECHAL/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 2
SYMPTOM TEXT: h/a for approx 2wk p/vax;started one day p/vax given;
PREVIOUS VAX ILL: pt exp h/a w/dose 1&2 anthrax vax;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NA
PREX ILLNESS: NA
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113367
21.1 M 31-Mar-1998 Rx@ 18-Aug-1998 PA - 09-Sep-1999
COSTARTS: EDEMA INJECT SITE/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 0
SYMPTOM TEXT: pt exp swelling in rt arm where the shot was given;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113368
21.2 M 17-Apr-1998 Rx@ 18-Aug-1998 PA - 09-Sep-1999
COSTARTS: EDEMA INJECT SITE/POS RECHAL/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 1
SYMPTOM TEXT: pt exp swelling in arm where shot was given;
PREVIOUS VAX ILL: pt exp swelling in rt arm w/dose 1 anthrax;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113369
21.2 28-Apr-1998 Rx@ 29-Apr-1998 1 18-Aug-1998 PA - 09-Sep-1999
COSTARTS: CHILLS/FLU SYND/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 2
SYMPTOM TEXT: pt recv vax & devel severe cold, felt like the flu (4 days);
PREVIOUS VAX ILL: pt exp swelling in arm of vax w/dose 1& 2 anthrax;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113512
25-Mar-1998 Rx@ 26-Mar-1998 1 20-Aug-1998 MIL- 26-Apr-1999
COSTARTS: FEVER/MALAISE/MYALGIA/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 1 A SC
SYMPTOM TEXT: pt recv vax & 4hr later exp malaise, myalgias & T102.2 w/o any preceding;viral-like sx & no
localizing source of infect;
OTHER MEDS: Flexeril
LAB DATA: UA negative;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113513
04-May-1998 Rx@ 04-May-1998 0 20-Aug-1998 MIL- 26-Apr-1999
COSTARTS: EDEMA INJECT SITE/HYSN INJECT SITE/PAIN INJECT SITE/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 2 A SC
SYMPTOM TEXT: pt had redness, swelling & pain from inj site (upper tricep) to lower forearm;this occurred w/in 2
days p/vax;pt adm for 24hr of ATB & arm elevation w/good results;pt switched 6 day course to ATB;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113514
17-Mar-1998 Rx@ 17-Mar-1998 0 20-Aug-1998 PUB- 26-Apr-1999
COSTARTS: ALLERG REACT/PRURITUS/RASH/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 0 A SC
SYMPTOM TEXT: systemic potentially allerg rxn to last vax;pt had rash & itchy trunk & face 17MAR98;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113595
24.2 M 16-Jul-1998 Rx@ 23-Jul-1998 7 25-Aug-1998 AZ MIL- 09-Sep-1999
COSTARTS: DIZZINESS/VOMIT/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV017 0 LA
SYMPTOM TEXT: pt recv vax 16JUL98 AM & seen @ clinic 23JUL98 645PM for c/o dizziness & vomiting x3 episodes;exam by
MD concluded nl results;no tx given;
PREVIOUS VAX ILL: NONE
OTHER MEDS: NONE
LAB DATA: NONE
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113740
29.4 F 25-Aug-1998 Rx@ 25-Aug-1998 0 02-Sep-1998 NM MIL- 03-Nov-1999
COSTARTS: PARESTHESIA/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV030 1 RA SC
SYMPTOM TEXT: approx 35min p/vax pt c/o numbness & tingling to rt side of face, back, shoulder, & arm;
OTHER MEDS: NA
FUP 60 COMMENTS: Pt has recv subsequent vax w/o rx
HISTORY: NA
PREX ILLNESS: NA
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113742
27.5 M 14-Aug-1998 Rx@ 15-Aug-1998 1 02-Sep-1998 NM MIL- 09-Sep-1999
COSTARTS: MYALGIA/NODULE SKIN/PAIN/RASH/VASODILAT/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV030 1 LA SC
SYMPTOM TEXT: tender, red lump w/soreness in muscle;inc in redness, soreness;erythema >= 5cm w/redness;
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113745
23.6 M 29-Jun-1998 Rx@ 03-Aug-1998 35 02-Sep-1998 NM MIL- 09-Sep-1999
COSTARTS: AMBLYOPIA/DIZZINESS/HEADACHE/HYSN INJECT SITE/VISUAL FIELD DEFECT/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV030 1
HEP MSD 0112H 1
SYMPTOM TEXT: 5 days p/vax #3 pt c/o blurred vision, tunnel vision, lightheadedness, h/a (pinpointed in back of
head);local rxn inj site erythema 1-5cm (diameter);
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
113746
23.0 M 04-Aug-1998 Rx@ 04-Aug-1998 0 02-Sep-1998 NM MIL- 09-Sep-1999
COSTARTS: PAIN CHEST/SYNCOPE/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
TYP SWISS SERUM 14892B 1
ANTH MICHIGAN DPH FAV030 1
SYMPTOM TEXT: approx 5min p/vax pt sat down in waiting area & passed out;when pt came to a few seconds later, c/o
tightness in chest;pt was seen by MD & released;
OTHER MEDS: NONE
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
114290
27.7 M 04-Aug-1998 Rx@ 04-Aug-1998 1 24-Sep-1998 MB MIL- 08-Sep-1999
COSTARTS: ASTHENIA/EDEMA INJECT SITE/EDEMA PERIPH/HYSN INJECT SITE/NAUSEA VOMIT/VASODILAT/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 1 RA IM
SYMPTOM TEXT: Pt recv vax on 8/4/98; on same day pt exp redness &swelling of arm. Pt seen by M.D.; tx=Motrin.
Within 12 hrs pt exp swelling &redness of arm distal to injection site to the wrist, fatigue, nausea &vomitting.
PREVIOUS VAX ILL: UNK
OTHER MEDS: Pt given 1st doese Anthrax vax on 6/24/98
LAB DATA: NONE
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID
--- --- --------- ---------- ------ ----------- ---------- ----- -------------
114292
27.7 F 10-Mar-1998 Rx@ 10-Mar-1998 0 24-Sep-1998 MB MIL- 08-Sep-1999
COSTARTS: EDEMA INJECT SITE/FEVER/MYALGIA/
VAX DETAIL: Type Manufacturer Lot Doses Site Route
ANTH MICHIGAN DPH FAV020 0 RA
SYMPTOM TEXT: Pt recv vax 3/10/98; 1 hr later pt exp swelling of R upper A for 7 dys, fever for 1 dy, soreness for
4 dys.
OTHER MEDS: Birth control pill (Orthonovum 777)
LAB DATA: NONE
FUP COMMENTS: NOT_REQ
FUP 60 COMMENTS: NOT_REQ
HISTORY: NONE
PREX ILLNESS: NONE
VAERSID
-------
Age Sex Vacc Date Onset Date (days) Status Date Birth Date State MFR Report ID