On 6/8/99, the pt received her first dose of Lymerix.  Almost immediately post - vax, she experienced "achy" muscle pain in both thighs. Arthalgia, can't stand for very long, pain. Can't walk for very long, pain. Fatigue, hair loss, headaches, joint stiffness, joint swelling, muscle pain, pain in feet, pain in hands and pain in lower back.  In November, 1999, the pt had surgery for twisted fallopian tube (left ovary). This event was not related to Lymerix per consumer. She was negative for endometriosis.  Now she is having pain in hands, lower back and feet. In addition to headaches and fatigue. She cannot stand or walk for very long. She was treated with anti-inflammatory medication, which did not help. A neurologist was consulted. A recent Lyme test was neg.   The most recent information received on 3/10/00 reports the condition of the pt is ongoing. The following info was obtained from medical records. From 5/18/00 to at least 3/21/02, the subject was under the care of an "emerging disease specialist." The subject reported that she experienced, beginning in June 1999, "from waist down musle and joint pain particularly upper legs and pelvic area. Feet, hands, shoulders, arms, lower back-aches, spasms, pain. Fatigue and feeling drained." On a questionnaire, the vaccinee indicated that she experienced the following additional symptoms beginning in June 1999: irregular heartbeat; joint pain involving the wrist, hips, knees, ankles and elbows; swelling of the ankle joints; back pain "below the waist"; sciatica; "radiating nerve root pain" of the shoulder; unexplained weight gain; increased Lyme symptoms during menstrual periods; headache; "weakness/paralysis legs severe"; "tingling, numbness hands feet"; and "depression/behavioral change." She indicated that all of these symptoms were on-going. She also indicated that she experienced incrreased menstrual bleeding from July 1999 until November 1999. While under the care of this specialist, the vaccinee also reported irritability, short-term memory loss, sharp pain in the elbows and toes, inability to close the right hand, feeeling of being off balance, headache accompanied by nausea, visual shadows, hair loss, a rahs on the spot of hair loss, "trauma to immune system," waking up in the middle of the night, and bizarre dreams. During this time period, the physician noted that the vaccinee appeared to be in pain, and had "abnormal" fingers. The finger abnormality was not specified. Lyme Western blots was positive three times, on 5/24/00, 4/5/01 and 9/26/01. The physician's initial diagnosis was "History of Lyme-vaccine." On 12/13/00, the specialist made a diagnosis of Lyme disease. The physician prescribed Biaxin, Ceftin, Suprax, Zithromax, Motrin, and Bicillin L-A. As of 3/21/02, the vaccinee felt "washed out" whenever she would "do a lot." She was receiving therapy iwth clarithromycin at that time. Following the reported onset of Lyme disease, the vaccinee experienced hypertriglyceridemia, hypercholesterolemia, mitral valve prolapse, possible shingles, and torsion of the left tubo-ovarian complex. She underwent uterine hysteroscopy; dilatation and curettage; operative laparoscopy; lysis of multiple bowel, omental, and left tube and ovary adhesions; cautery of endometriosis lesions; and left partial salpingectomy. These events were not reported as adverse events due to vaccine administration but were found during the course of review of the vaccinee's medical records. Therefore, they are not listed as adverse events. The most recent info was received on 5/6/02. As of 3/21/02, the vaccinee reported that if she were to "do a lot" she would become "washed out." She was receiving therapy with clarithromycin at that time. Case 2000020536-1 has been identified as a duplicate record of this case. All info in case 2000020536-1 has been incorporated in this case A0322625A (formerly, 200007075-1) will stand as the case of record for this vaccinee.