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Case Details

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VAERS ID:359283 (history)  Vaccinated:2009-09-23
Age:74.0  Onset:2009-09-24, Days after vaccination: 1
Gender:Male  Submitted:2009-10-02, Days after onset: 8
Location:Michigan  Entered:2009-10-02
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR43199AA1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0625Y1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Inflammation, Local reaction
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Office visit 9/25/09 - localized, inflammatory 10 x 20 cm area of redness.

VAERS ID:359284 (history)  Vaccinated:2009-09-26
Age:55.0  Onset:2009-09-26, Days after vaccination: 0
Gender:Female  Submitted:2009-10-04, Days after onset: 8
Location:Ohio  Entered:2009-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Seasonal Allergies
Preexisting Conditions: Seasonal (erythromycin sulfa)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960323P1IMRA
Administered by: Other     Purchased by: Private
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Vaccine given 9/26/09. Patient complained of Diarrhea on 9/26/09. Started on 10/2/09. Patient seen in ER. On 10/4/09. Patient said Doctor gave steroids dose pack, said Doctor told her possible allergy to component in shot. Doctor also questioned. Patient about possible chicken pox. Patient going to see family MD. 10/05/09.

VAERS ID:359285 (history)  Vaccinated:2009-10-02
Age:27.0  Onset:2009-10-02, Days after vaccination: 0
Gender:Female  Submitted:2009-10-03, Days after onset: 1
Location:Kansas  Entered:2009-10-05, Days after submission: 2
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97841P1 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Contusion, Dizziness, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient bruised instantly when given shot she also felt dizziness after careful uncertainly she felt fine except her arm was sore.

VAERS ID:359286 (history)  Vaccinated:2009-09-30
Age:83.0  Onset:2009-09-30, Days after vaccination: 0
Gender:Female  Submitted:2009-10-04, Days after onset: 4
Location:Indiana  Entered:2009-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: None~ ()~~0.00~Patient
Other Medications: LASIX; SULAR; Synthroid; LIPITOR; SPIRIVA; AVALIDE; AMARYL; Metoprolol; Metformin
Current Illness: None
Preexisting Conditions: Diabetes; Hypertension; Hyperlipidemia; COPD; CHF
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960321P IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dehydration, Hypotension, Malaise, Urinary tract infection
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad)
Write-up: Patient stayed at pharmacy for 20 min and felt fine. Later that night she told her daughter she wasn''t feeling well. She talked with her doctor that morning. Doctor didn''t think it was from vaccine. Daughter took her to ER that day. Pt was slightly dehydrated w/UTI, BP was low ER doctor told her to never get flu shot again.

VAERS ID:359287 (history)  Vaccinated:2009-10-04
Age:57.0  Onset:2009-10-04, Days after vaccination: 0
Gender:Male  Submitted:2009-10-04, Days after onset: 0
Location:New Jersey  Entered:2009-10-04
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
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT8172AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient experienced joint pains and slight fever.

VAERS ID:359288 (history)  Vaccinated:2009-09-28
Age:69.0  Onset:2009-09-29, Days after vaccination: 1
Gender:Male  Submitted:2009-10-02, Days after onset: 3
Location:California  Entered:2009-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Hypertension
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97843P21IMUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0632Y1IMUN
Administered by: Other     Purchased by: Public
Symptoms: Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swelling, rash about 5" below injection site.

VAERS ID:359289 (history)  Vaccinated:2009-09-22
Age:18.0  Onset:2009-09-22, Days after vaccination: 0
Gender:Male  Submitted:2009-09-22, Days after onset: 0
Location:New Jersey  Entered:2009-10-04, Days after submission: 12
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3178BA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Patient experienced arm pain about 15 minutes post vaccination and nausea 30 minutes post vaccination.

VAERS ID:359290 (history)  Vaccinated:2009-09-30
Age:54.0  Onset:2009-09-30, Days after vaccination: 0
Gender:Female  Submitted:2009-10-02, Days after onset: 2
Location:California  Entered:2009-10-02
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
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA468AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, 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: Noticed slight pain, redness + swelling that same evening Dx cellulitis Rx for KEFLEX.

VAERS ID:359291 (history)  Vaccinated:2009-10-01
Age:68.0  Onset:2009-10-03, Days after vaccination: 2
Gender:Female  Submitted:2009-10-03, Days after onset: 0
Location:Illinois  Entered:2009-10-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nitrofurantoin 100mg
Current Illness: None
Preexisting Conditions: Sulfa; Penicillin
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED6349111A0UNLA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Injection site haematoma, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Bruising at site of injection 1 inch in diameter left arm red itching right ear, right, left forearms, scalp, waist, abdomen, upper thigh right, left.

VAERS ID:359292 (history)  Vaccinated:2009-10-03
Age:35.0  Onset:2009-10-03, Days after vaccination: 0
Gender:Male  Submitted:2009-10-03, Days after onset: 0
Location:Arizona  Entered:2009-10-03
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
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.5006850IN 
Administered by: Military     Purchased by: Military
Symptoms: Confusional state, Flushing, Hyperhidrosis, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Pt flush c/o nausea, confusion, diaphoresis and sick. BP 130/80 P74- pt on co + next to RN for observation and cont. monitoring. Denies SOB/tighness in chest.

VAERS ID:359293 (history)  Vaccinated:2009-09-19
Age:55.0  Onset:2009-09-19, Days after vaccination: 0
Gender:Male  Submitted:2009-10-03, Days after onset: 14
Location:Delaware  Entered:2009-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3204AA0IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Chills, Conjunctival hyperaemia, Eye swelling, Hyperhidrosis, Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Conjunctival disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Swelling of lips and eyes. Within 2 hrs Conjanitiva red. Chills followed by sweats. 4-5 hrs. after vaccine fine the next day.

VAERS ID:359294 (history)  Vaccinated:2009-10-03
Age:44.0  Onset:2009-10-03, Days after vaccination: 0
Gender:Female  Submitted:2009-10-03, Days after onset: 0
Location:Florida  Entered:2009-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ATENOLOL 50mg
Current Illness: None
Preexisting Conditions: Mitral valve prolapse; Palpitations
Diagnostic Lab Data: BP- 120/80 Glucose- 84
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97843P2 UNLA
Administered by: Other     Purchased by: Private
Symptoms: Blood glucose normal, Dizziness, Hyperhidrosis, Injection site swelling, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient had arm swelling @ injection site, lightheaded, fainting sweating- Patient given 1 dose of EPIPEN.

VAERS ID:359295 (history)  Vaccinated:2009-10-01
Age:12.0  Onset:2009-10-01, Days after vaccination: 0
Gender:Female  Submitted:2009-10-03, Days after onset: 2
Location:Maine  Entered:2009-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: Type II ahyperlipidemia
Diagnostic Lab Data: None known
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500709P0IN 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0847Y1SCUN
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Fatigue, Nausea, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Administered FLUMIST, VARIVAX #2. Patient vomited, hives, tired, dizzy. Administered Xyzal to patient. Hives disappeared and felt better. Nausea stopped. Observed patient then went home.

VAERS ID:359296 (history)  Vaccinated:2009-10-02
Age:57.0  Onset:2009-10-02, Days after vaccination: 0
Gender:Female  Submitted:2009-10-02, Days after onset: 0
Location:Ohio  Entered:2009-10-03, Days after submission: 1
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
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97848PIC0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus, Rash, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On hour after receiving the vaccination, pt complained of itching arms, "hot facial cheeks", and slight rash on chest. Pt took 50 mg Diphenhydramine. Refused further medical treatment. Within 15 minutes, symptoms had abated. Paint on arms from remodeling could have played a role.

VAERS ID:359297 (history)  Vaccinated:2009-09-25
Age:80.0  Onset:2009-10-01, Days after vaccination: 6
Gender:Male  Submitted:2009-10-03, Days after onset: 2
Location:Texas  Entered:2009-10-03
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: MD ordered
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS9784911IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site swelling, Joint swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Swelling at shoulder joint - MD states- possible injection into/swelling of bursa (became Acute care).

VAERS ID:359298 (history)  Vaccinated:2009-09-03
Age:80.0  Onset:2009-09-04, Days after vaccination: 1
Gender:Male  Submitted:2009-10-03, Days after onset: 29
Location:Virginia  Entered:2009-10-02, 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: Type II Diabetes; CHD; BPH; GERD and hypertension
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960305P IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site haemorrhage, Injection site pain, Musculoskeletal pain, Musculoskeletal stiffness, Skin discolouration
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patients letter states: day after injection given, injection site very sore. 4 days after injection, shoulder and upper arm became painful and stiff. 6 days later there was discoloration of area around left elbow including lower and upper forearm. Went to Dr. on Sept. 16 and believes the injection caused a hemorrhage that still pains him as of Sept. 24.

VAERS ID:359299 (history)  Vaccinated:2009-09-30
Age:10.0  Onset:2009-09-30, Days after vaccination: 0
Gender:Male  Submitted:2009-10-01, Days after onset: 1
Location:Arizona  Entered:2009-10-02, Days after submission: 1
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:
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Manufacturer
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B046BA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site cellulitis
SMQs:
Write-up: His L shoulder area @ the site of TDAP injection 2-5 cm x 5 cm round Cellulitis IM ROCEPHIN 10mg and PO AUGMENTIN 500 PO BID x 4 warm compress to area

VAERS ID:359301 (history)  Vaccinated:2009-09-25
Age:51.0  Onset:2009-10-02, Days after vaccination: 7
Gender:Female  Submitted:2009-10-02, Days after onset: 0
Location:California  Entered:2009-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~1~0.00~Patient
Other Medications:
Current Illness: L eye hemorrhage, R/L deltoid pain
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED01649211A0UNLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenopia, Eye haemorrhage, Eye pruritus, Glaucoma, Immunisation reaction, Injection site pain, Ocular hyperaemia, Pain in extremity, Scleral discolouration
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Glaucoma (narrow), Corneal disorders (broad), Retinal disorders (broad), Scleral disorders (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 9/25/09 16:35 within 30 minutes left outer eye felt heavy and was itching. Spoke to person who stated this was one of the reactions to AFLURIA vaccine. I spoke to Dr. who stated, no concern. Color will go from red-$gblue-$gred last 3 weeks. It is a glaucoma hemorrhage. One hour later started with right and left deltoid pain 0-10 "5 lasted 2 days." PCM Dr. have not seen provider or received treatment for symptoms only verbal advice. "No longer have R/L deltoid pain but concerned about L red eye. Spot under iris in white area (sclera). Patient notified to follow up with provider for care. Patient agreed and understood.

VAERS ID:359302 (history)  Vaccinated:2009-09-24
Age:41.0  Onset:2009-09-24, Days after vaccination: 0
Gender:Female  Submitted:2009-09-25, Days after onset: 1
Location:California  Entered:2009-10-02, Days after submission: 7
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
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED0724911A0UNLA
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Musculoskeletal pain, Ocular hyperaemia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt c/o R lower back pain radiating on R buttock 10 min after pt received the pt received the influenza vaccine. Pt also c/o both eyes red when she got home. No pain, no itching.

VAERS ID:359303 (history)  Vaccinated:2009-09-24
Age:20.0  Onset:2009-09-25, Days after vaccination: 1
Gender:Female  Submitted:2009-09-25, Days after onset: 0
Location:California  Entered:2009-10-02, Days after submission: 7
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED01649211A0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Burning sensation, Erythema, Musculoskeletal stiffness, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt c/o swollen both hands and feet when she woke up this morning. Burning sensation, fingers stiff with pain, redness noted.

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