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Case Details

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VAERS ID:359383 (history)  Vaccinated:2009-09-18
Age:16.0  Onset:2009-09-18, Days after vaccination: 0
Gender:Male  Submitted:2009-09-25, Days after onset: 7
Location:New York  Entered:2009-10-05, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FOCALIN; CLONIDINE; RISPERIDAL; PROZAC
Current Illness: None ADHD/Depression
Preexisting Conditions: As in #18 (ADHD/depression) PMH: ADHD, Depresson Allergies: NKDA
Diagnostic Lab Data: Lyme titer 0.33 Lab: CBC, CMP WNL except for borderline low creatinine at 0.69, Cholesterol, UA, ESR WNL. Lyme titer 0.33 (negative). B Microtic and A phagocytophilum AB tests negative.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB715AA1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2907BA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B029AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blood cholesterol normal, Blood creatinine decreased, Borrelia burgdorferi serology, Borrelia burgdorferi serology negative, Facial palsy, Full blood count normal, Red blood cell sedimentation rate normal, Urine analysis normal
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: On 9/18/09, patient came in for well visit (annual P.E.) and received MENACTRA, BOOSTRIX, and Hep B vaccines. Later that evening, he started to experience left facial palsy. Seen in office on 9/21/09 L facial palsy still present. Concern of Lyme, DOXYCYCLINE prescribed for 1 month. Blood work obtained. As of 9/24/09, mother reports by phone that facial palsy still present, but better. 10/15/2009 received records from PCP for visit date 9/21/2009. Patient presents with sx of left facial palsy 3 days post vaccination. PE notes lt facial assymetry, unable to close lt eye fully, + eye tearing. Tx: Doxcycline, eye patch at night and Artificial tears.

VAERS ID:359384 (history)  Vaccinated:2009-09-13
Age:0.2  Onset:2009-09-16, Days after vaccination: 3
Gender:Male  Submitted:2009-09-21, Days after onset: 5
Location:California  Entered:2009-10-05, Days after submission: 14
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 PASTEURU319YAA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURN2919AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC532B0Y7DA4IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red area of induration; warm- left deltoid

VAERS ID:359385 (history)  Vaccinated:2009-09-10
Age:81.0  Onset:2009-09-20, Days after vaccination: 10
Gender:Female  Submitted:2009-09-21, Days after onset: 1
Location:New York  Entered:2009-10-05, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADVAIR; ACTOS; EVISTA.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS07839Y2 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: B low grade fever & diarrhea.

VAERS ID:359386 (history)  Vaccinated:2009-08-03
Age:25.0  Onset:2009-08-16, Days after vaccination: 13
Gender:Female  Submitted:2009-09-24, Days after onset: 39
Location:California  Entered:2009-10-05, Days after submission: 11
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 10/13/09 Medical records received for date 9/24/09 PMH: abdominal pain
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0294Y3IMLA
Administered by: Public     Purchased by: Private
Symptoms: Abdominal distension, Abdominal pain, Constipation, Flatulence, Headache, Somnolence, Weight increased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Abdominal bloating, gassiness, discomfort for several weeks, beginning one week after each dose of GARDASIL & progressively worse. 10/13/09 Medical records received for date 9/24/09. DX: Abdominal pain, gassiness after gardasil vaccine, no clear relationship. Presenting symptoms: pt c/o three weeks of abdominal bloating, pain, pressure beginning 1 week after getting gardasil vaccine dose 1 and 2. On dose 3 same symptoms plus weight gain, 2 to 3 weeks bad HA, constipation but daily BM, feeling groggy. Had similar abdominal pain 3yrs prior in which diet changes and exercised helped. Assessment: PE WNL except LLQ diffusely tender.

VAERS ID:359387 (history)  Vaccinated:2009-09-28
Age:16.0  Onset:2009-09-28, Days after vaccination: 0
Gender:Female  Submitted:2009-09-28, Days after onset: 0
Location:Texas  Entered:2009-10-05, 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: None
Current Illness: c/o of minor sore throat
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97840P10IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Dyskinesia, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Patient received FLUVIRIN, then approximately, one minute later complained of lightheadedness, she sat down then lost consciousness for approximately 15 seconds, then had seizure like movement, for approximately 5 seconds. She then slowly woke up. Paramedics arrived and her vitals were normal.

VAERS ID:359388 (history)  Vaccinated:2009-09-22
Age:6.0  Onset:2009-09-23, Days after vaccination: 1
Gender:Female  Submitted:2009-09-25, Days after onset: 2
Location:New Jersey  Entered:2009-10-05, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same as above~DTaP (no brand name)~4~1.60~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3176DA0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: About 16 hrs after admin of FLUZONE''0910, (L) tight became very large, swollen, erythema, tender, hot - $g10 cm induration.

VAERS ID:359389 (history)  Vaccinated:2009-09-16
Age:44.0  Onset:2009-09-18, Days after vaccination: 2
Gender:Female  Submitted:2009-10-05, Days after onset: 17
Location:Michigan  Entered:2009-10-05
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: Penicillin allergy.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS9783PP1 IMRA
Administered by: Public     Purchased by: Private
Symptoms: Incorrect dose administered, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient received 1 ml IM dose of FLUVIRIN. Instead of recommended dose of .5 ml. Patient reports onset of rash on 9/18/09 that has not resolved with topical OTC creams. Provided referral to clinic for f/u.

VAERS ID:359390 (history)  Vaccinated:2009-10-02
Age:32.0  Onset:2009-10-02, Days after vaccination: 0
Gender:Male  Submitted:2009-10-05, Days after onset: 3
Location:Oregon  Entered:2009-10-05
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3177AA3IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Feeling cold, Hypoaesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: During night after vaccination pt was chilled, couldn''t catch breath, arms went numb. Didn''t take temp. Didn''t wake wife. Felt better next morning. Completely ok after that day.

VAERS ID:359391 (history)  Vaccinated:2009-09-29
Age:72.0  Onset:2009-10-03, Days after vaccination: 4
Gender:Female  Submitted:2009-10-04, Days after onset: 1
Location:California  Entered:2009-10-05, 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: PREDNISONE.
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97846P2A UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Patient reported rash around injection site on upper arm. I instructed her to take BENADRYL every 6 hours and to call her doctor if worsens or not clears completely.

VAERS ID:359392 (history)  Vaccinated:2009-09-11
Age:14.0  Onset:2009-09-12, Days after vaccination: 1
Gender:Male  Submitted:2009-09-15, Days after onset: 3
Location:Louisiana  Entered:2009-10-05, Days after submission: 20
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: Cerebral Palsy.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3011AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURUF486AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0857Y1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Herpes zoster, Rash vesicular
SMQs:, Retroperitoneal fibrosis (broad), Hypersensitivity (narrow)
Write-up: Pt presented with c/o right sided back pain & vesicular rash to right buttock & right leg. Referred to FNP. Dx: Herpes ZOSTER. Rx: VALTREX 500 mg TID X 7 days. ZOVIRAX cream to affected area QID X 5 days TYLENOL #3 PRN - pain.

VAERS ID:359393 (history)  Vaccinated:2009-10-01
Age:42.0  Onset:2009-10-02, Days after vaccination: 1
Gender:Female  Submitted:2009-10-05, Days after onset: 3
Location:Florida  Entered:2009-10-05
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: Varicose veins
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA460AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC303AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen - red - hot- @ site, 5x5 mm hardness. Rx - BACTRIM.

VAERS ID:359394 (history)  Vaccinated:2009-09-29
Age:12.0  Onset:2009-09-29, Days after vaccination: 0
Gender:Female  Submitted:2009-10-05, Days after onset: 6
Location:Massachusetts  Entered:2009-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flintstone MV; Fluvoxamine, 25 g; ABILIFY 7.50 mg.
Current Illness: F/U (B)OM
Preexisting Conditions: Allergy to sulfa; PCN;OCD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3013AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B030AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: See attached email from mother.

VAERS ID:359395 (history)  Vaccinated:2009-09-18
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2009-09-18
Location:Texas  Entered:2009-10-05, Days after submission: 17
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) (FLUZONE)SANOFI PASTEURU3214AA1UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:359396 (history)  Vaccinated:2009-10-01
Age:54.0  Onset:2009-10-01, Days after vaccination: 0
Gender:Female  Submitted:2009-10-05, Days after onset: 4
Location:Ohio  Entered:2009-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FOLIC ACID-Rheumatoid arthritis 1ml - daily; METHOTREXATE - slow Arthritis 2.5 mg tablets 3Xtimes; DICLOFENAC - 50ml inflammatory medicine; TYLENOL 650mp Pain- nonprescription
Current Illness: No
Preexisting Conditions: Rheumatoid Arthritis
Diagnostic Lab Data: No
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IJLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Diarrhoea, Erythema, Headache, Hyperhidrosis, Hypoaesthesia facial, Oedema peripheral, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: - Got chills- body felt drain, swollen in left arm - Redness under arm, headaches, sweating - TYLENOL, diarrhea, vomiting, numbness in face.

VAERS ID:359397 (history)  Vaccinated:2009-09-16
Age:62.0  Onset:2009-09-17, Days after vaccination: 1
Gender:Female  Submitted:2009-09-28, Days after onset: 11
Location:California  Entered:2009-10-05, 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: Pt taking PREMARIN
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97839P20IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0632Y0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Chills, Cold sweat, Loss of consciousness, Nausea, Pain in extremity, Pharyngeal oedema
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Swollen throat, passed out, no fever, nausea cold sweat chills sore area x 3 days.

VAERS ID:359398 (history)  Vaccinated:2009-08-18
Age:14.0  Onset:2009-08-20, Days after vaccination: 2
Gender:Female  Submitted:2009-09-08, Days after onset: 19
Location:New Jersey  Entered:2009-10-05, Days after submission: 27
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.0087Y0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Received GARDASIL shot on 8/18/09. Developed hives on 08/20/09 w/c lasted 2 days and an ED visit on 8/21/09.

VAERS ID:359399 (history)  Vaccinated:2009-08-27
Age:45.0  Onset:2009-08-29, Days after vaccination: 2
Gender:Male  Submitted:0000-00-00
Location:Arizona  Entered:2009-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rx renewal
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURUF551BA0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Local reaction, Muscle spasms, Torticollis
SMQs:, Dystonia (narrow), Ocular motility disorders (broad)
Write-up: Had localized reaction, then with 2 days neck spasms. Has to manually turn his head so it is midline. Dx: torticollis.

VAERS ID:359400 (history)  Vaccinated:2009-09-23
Age:54.0  Onset:2009-09-23, Days after vaccination: 0
Gender:Male  Submitted:2009-09-23, Days after onset: 0
Location:Ohio  Entered:2009-10-05, 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: Unknown
Current Illness: Unknown/claimed none
Preexisting Conditions: Patient stated none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97846P1 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Immediately after vaccination, a soft + bump (approximately 1 inch in diameter) appeared at the site of vaccination. An ice pack was applied for about 5 minutes and when removed, the bump was barely noticeable. Patient said he felt fine and his arm didn''t hurt.

VAERS ID:359401 (history)  Vaccinated:2009-09-11
Age:54.0  Onset:2009-09-11, Days after vaccination: 0
Gender:Female  Submitted:2009-09-11, Days after onset: 0
Location:Illinois  Entered:2009-10-05, Days after submission: 24
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97839P2 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient became light headed/ dizzy and requested ambulance. EMT came and took her to ER. Did not receive any (EPI PEN) medication etc at pharmacy where she received vaccine as she just seemed dizzy.

VAERS ID:359402 (history)  Vaccinated:2009-09-22
Age:39.0  Onset:2009-09-25, Days after vaccination: 3
Gender:Female  Submitted:2009-09-29, Days after onset: 4
Location:Texas  Entered:2009-10-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rhinitis without Fever
Preexisting Conditions: DM, cirrhosis of liver
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3177CA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Complained of pain 9-25-09 but no redness, firmness of area, or swelling; no warmth noted at site, no other symptoms noted or reported on 9-29-09 redness of area approximately 3 inches in diameter - firm to touch and warm with slight swelling physician ordered Rocephin 500 mg IM, Kenalog 40mg IM and Bactrim OS BID x 7.

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