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Found 466004 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:472800 (history)  Vaccinated:2012-11-01
Age:43.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-03, Days after onset: 2
Location:South Carolina  Entered:2012-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA709BA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash on both arms.

VAERS ID:472801 (history)  Vaccinated:2012-11-01
Age:37.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2012-11-03, Days after onset: 1
Location:Maryland  Entered:2012-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: 36 weeks pregnant
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Private     Purchased by: Unknown
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Significant pain, swelling, and redness at the injection site. Symptoms of fatigue and body aches. 48 hours after the vaccine was administered, the injection site is still extremely swollen and red.

VAERS ID:472806 (history)  Vaccinated:2012-11-01
Age:28.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-03, Days after onset: 2
Location:Virginia  Entered:2012-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
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
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Abdominal pain upper, Body temperature decreased, Fatigue, Headache, Hyperhidrosis, Nausea, Neck pain, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Tired, achy, headache, neck hurts, nausea, stomach cramps, temp of 95.9, sweating. 1st time receiving flu shot.

VAERS ID:472808 (history)  Vaccinated:2012-11-01
Age:65.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Male  Submitted:2012-11-03, Days after onset: 0
Location:Texas  Entered:2012-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses at time of Vaccination.
Preexisting Conditions: The only known allergy is to the Tetanus vaccine.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA UNAR
Administered by: Other     Purchased by: Other
Symptoms: Chills, Feeling of body temperature change, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Woke up with severe aches and pains all over. He said he was freezing, but he was very hot and feverish. He was shivering. He woke up several times throughout the night with the same symptoms. He felt better during the day, but still had the aches and pains, no more fever.

VAERS ID:473256 (history)  Vaccinated:2012-11-01
Age:65.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-03, Days after onset: 2
Location:New Mexico  Entered:2012-11-03
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
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Private
Symptoms: Rash pruritic, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient states that she got a bump that is warm to touch and very itchy.

VAERS ID:473429 (history)  Vaccinated:2012-11-01
Age:69.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-04, Days after onset: 3
Location:Virginia  Entered:2012-11-04
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0162951UNRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site inflammation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Redness and inflammation at injection site. Pt. fainted approx. 7 hours after receiving vaccine.

VAERS ID:473606 (history)  Vaccinated:2012-11-01
Age:35.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2012-11-04, Days after onset: 2
Location:California  Entered:2012-11-04
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
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Military     Purchased by: Unknown
Symptoms: Injection site cellulitis, Injection site erythema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Cellulitis at injection site, redness, fever.

VAERS ID:473431 (history)  Vaccinated:2012-11-01
Age:4.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:Kentucky  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
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
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B204AA1IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH732AA IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0121321SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.G0091521SCRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site cellulitis, Injection site swelling, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling around injection site. Seen at after hour treatment center and diagnosed with cellulitis. Seen in office 11-5-12, appears to be local reaction to vaccine and is resolved today.

VAERS ID:477319 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-05, Days after onset: 4
Location:Unknown  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA001011
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a patient of unknown age. The patient was vaccinated with expired dose of M-M-R II on 01-NOV-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effects were reported. The outcome of expired vaccine used is unknown. Expired vaccine used is not related to M-M-R II. Additional information has been requested.

VAERS ID:473292 (history)  Vaccinated:2012-11-01
Age:23.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Female  Submitted:2012-11-06, Days after onset: 3
Location:Ohio  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU4335AA IMRA
Administered by: Public     Purchased by: Other
Symptoms: Hypoaesthesia, Nodule
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Enlarged nodule under right armpit, numb feeling, approximately the size of a quarter sized marble.

VAERS ID:473419 (history)  Vaccinated:2012-11-01
Age:42.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 6
Location:Illinois  Entered:2012-11-07
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: None
Diagnostic Lab Data: CT Scan Brain, MRI, 2D Echo, Carotid Doppler, EEG, CXR Many labs taken all normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUH759AA IDLA
Administered by: Private     Purchased by: Private
Symptoms: Aphasia, Chest X-ray normal, Computerised tomogram head, Computerised tomogram normal, Diarrhoea, Echocardiogram normal, Electroencephalogram normal, Fatigue, Feeling abnormal, Headache, Laboratory test normal, Nuclear magnetic resonance imaging normal, Speech disorder, Transient ischaemic attack, Ultrasound Doppler, Ultrasound Doppler normal, Visual impairment
SMQs:, Ischaemic cerebrovascular conditions (narrow), Dementia (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, arterial (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Noninfectious diarrhoea (narrow)
Write-up: 11/1/2012, started with severe diarrhea and headache, on 11/2/2012 had Visual problem for approx 5 minutes felt like my eyes were looking in another direction and everything was real far away, on 11/3/2012 had difficulty speaking for approx 45 minutes, went to ER, was worked up for a stroke, DX: TIAs possible MS. To date my brain is foggy, difficulty speaking on occasion getting words out can''t remember what to say, headaches and very tired.

VAERS ID:473489 (history)  Vaccinated:2012-11-01
Age:65.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 6
Location:New Mexico  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fatigued and dehydrated
Preexisting Conditions: None
Diagnostic Lab Data: No
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4311A0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Amnesia, Chills, Feeling abnormal, Headache, Injection site erythema, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Sore red arm at injection site. 11/02/12 stated having nausea, chills, memory loss, headache and felt miserable.

VAERS ID:476447 (history)  Vaccinated:2012-11-01
Age:56.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-04
Location:Texas  Entered:2012-11-07, Days after submission: 3
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 - observation only
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Injection site erythema, Pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Pt. state soreness, and redness. RPh - observe redness span 3 inches all direction from injection site.

VAERS ID:477641 (history)  Vaccinated:2012-11-01
Age:75.0  Onset:0000-00-00
Gender:Male  Submitted:2012-11-07
Location:Unknown  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes zoster
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002914
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 75 years old male patient. The primary reporter is pharmacist. Pharmacist called to report that an unspecified patient received ZOSTAVAX vaccination at an unspecified healthcare facility by an unspecified healthcare provider on 01-NOV-2012 and developed a round oval rash 3 inches in diameter at the injection site a couple of days later after vaccination. No further information is available. No other co-suspects were reported. No concomitant medications were reported. On an unknown date the patient experienced injection site pruritus. No treatment information was reported. The relatedness for injection site pruritus is unknown for ZOSTAVAX. {Additional information has been requested./Additional information is not expected.}

VAERS ID:473536 (history)  Vaccinated:2012-11-01
Age:4.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2012-11-08, Days after onset: 7
Location:Texas  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: CBC, NASAL SWAB FOR FLU AND SWAB THROAT
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Culture throat positive, Full blood count, Influenza virus test positive, Pain in extremity, Pyrexia, Streptococcus test positive
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: AFTER RECEIVING THE FLU MIST 30 MIN''S LATER COMPLAINED ABOUT STOMACH HURTING. BY THE TIME WE GOT HOME AT 4:00PM THAT DAY HE HAD TEMP. OF 102% AND CONTINUED THROUGH THE NIGHT CALL THE DR. NEXT DAY. THEY DID NOT GET BACK WITH ME. GAVE HIM TYLENOL ALT. WITH ADVIL ALL THAT WEEKEND FEVER 102-103 AND HE WAS COMPLAINING OF ACHES IN LEGS. FEVER CAME DOWN WITH MEDICATION AS SOON AS WORE OFF CAME BACK. TOOK HIM BACK TO DR. MONDAY 11/5/2012 SHE SAID IT WAS ALLERGIES. GAVE HIM MEDS FOR ALLERGY NASONEX AND CLARITIN. TUESDAY NO BETTER SLEEP ALL DAY AND STILL HAS FEVER GOING ON 6 DAY''S. WENT BACK TO DR. WEDNESDAY TESTED POSITIVE FOR FLU AND STREP. TAKING TAMAFLU AND TYLENOL AND ADVIL. SEEMS TO BE DOING BETTER BUT STILL HAS FEVER IF NOT MEDICATED ON TIME BUT NOT AS HIGH. DR. SAID HE WOULD BE BETTER BY THIS MONDAY 11/12/12 AND COULD GO BACK TO SCHOOL. WE ARE SURE HOPING SO.

VAERS ID:473667 (history)  Vaccinated:2012-11-01
Age:46.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Female  Submitted:2012-11-08, Days after onset: 5
Location:Nevada  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Admitted on 10/9/12 with DKA and acute renal failure secondary to new onset type 1 DM. Had mild fevers up to 100.9 on the days leading up to the vaccination but was not being treated for an infection.
Preexisting Conditions: Allergies: hives with amphotericin PMH: hypothyroidism
Diagnostic Lab Data: 11/3/12 blood culture x 1 set: no growth; 11/3/12 WBC 9.4
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AB0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0142830IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Blood culture negative, Oedema peripheral, Pyrexia, White blood cell count normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever of 102.1 F with left and right upper extremity swelling.

VAERS ID:473668 (history)  Vaccinated:2012-11-01
Age:64.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Female  Submitted:2012-11-08, Days after onset: 5
Location:Virginia  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Denies
Preexisting Conditions: Penicillin, Codeine, Sulfonamides
Diagnostic Lab Data: Mone, started on by mouth Prednisone
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH729AB IMLA
Administered by: Public     Purchased by: Private
Symptoms: Rash generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Woke up with hive looking rash on trunk, neck, inner arms and down inside of legs.

VAERS ID:473672 (history)  Vaccinated:2012-11-01
Age:55.0  Onset:2012-11-06, Days after vaccination: 5
Gender:Male  Submitted:2012-11-08, Days after onset: 2
Location:Michigan  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Chills, Fatigue, Pyrexia, Rash erythematous, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Slight fever feel, then chills. Tired. Main effect was pimple like rash that appeared on forearms and elbow area, fingers. Then spread to neck and ears, some at other parts of body distributed randomly. Raised red bumps 3mm diameter, itchy and will pop if squeezed releasing small amount of clear fluid.

VAERS ID:476357 (history)  Vaccinated:2012-11-01
Age:79.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2012-11-07, Days after onset: 5
Location:Florida  Entered:2012-11-08, 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: Not known
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H013014 SCUN
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Pain
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Localized pain and redness that started as a dime and grew to a half dollar per px. Ice helped pain. As of 11/5/12 reaction subsided.

VAERS ID:477890 (history)  Vaccinated:2012-11-01
Age:2.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-08
Location:Unknown  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002118
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0011AE SCUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report was received from a registered nurse concerning to a female patient of unknown age. The nurse stated that the patient on 01-NOV-2012, was vaccinated subcutaneously with a dose of 0.5 ml MMR II (lot # 672573/0011AE; exp. date: 16-DEC-2013) which was later determined to have a temperature excursion that was not supported; MMR II reached 56 degrees F for 16 hours. No adverse effect were reported. No other co-suspects were reported. No concomitant medications were reported. Additional information has been requested.

VAERS ID:477892 (history)  Vaccinated:2012-11-01
Age:37.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 7
Location:Unknown  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA000959
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0334AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Laceration, Medication error
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)
Write-up: This spontaneous report as received from a Licensed practical nurse refers to a 37 years old female (staff member) who on 01-NOV-2012 cut her finger on a piece with a prefilled syringe of VAQTA that broke during the administration of the vaccine. During a product quality complaint follow up call, the nurse confirmed that the prefilled syringe was RECOMBIVAX HB (lot # reported as H00849, exp date: 28-FEB-2015) pediatric formulation rather than VAQTA. The nurse stated that she misspoke during the initial report. The finger administer was cleaned and bandaged. No lab diagnostic test was performed. At the time of the report, the patient was recovering. This is one of the several reports of the same source. Additional information has been requested.

VAERS ID:474022 (history)  Vaccinated:2012-11-01
Age:9.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Male  Submitted:2012-11-02, Days after onset: 0
Location:California  Entered:2012-11-09, 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: Laryngitis
Preexisting Conditions: Allergic Rhinitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH733AD6IMUN
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, warmth & swelling 8 1/2 cm x 5 1/2 cm at injection site.

VAERS ID:473888 (history)  Vaccinated:2012-11-01
Age:1.6  Onset:2012-11-04, Days after vaccination: 3
Gender:Female  Submitted:2012-11-12, Days after onset: 8
Location:Washington  Entered:2012-11-13, 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: No, she was in absolutely perfect health
Preexisting Conditions: Absolutely none; she was a perfectly healthy child at the time of vaccination
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
Administered by: Unknown     Purchased by: Other
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever of 101 degrees Fahrenheit, lasted about 36 hours. One week later a rash appeared on trunk and spread to back of neck and behind the ears.

VAERS ID:476745 (history)  Vaccinated:2012-11-01
Age:78.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Female  Submitted:2012-11-06, Days after onset: 3
Location:Rhode Island  Entered:2012-11-13, Days after submission: 7
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
TDAP: TDAP (ADACEL)SANOFI PASTEURU4384AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Area (R) upper arm - red, painful, edematous since 11/3/12 - Rx''ed with cool compresses, watch for signs of infection.

VAERS ID:474149 (history)  Vaccinated:2012-11-01
Age:37.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2012-11-14, Days after onset: 12
Location:Virginia  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to bees
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEUR 1IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD 1PO 
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH350AA1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Oedema peripheral, Pain in extremity, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pain, numbness, severe swelling, rash on most of arm. Rash, swelling, pain has lasted 2 weeks (though shrinking, has not yet subsided completely on 12/14).

VAERS ID:474164 (history)  Vaccinated:2012-11-01
Age:26.0  Onset:2012-11-04, Days after vaccination: 3
Gender:Female  Submitted:2012-11-14, Days after onset: 10
Location:South Dakota  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Pain in extremity
SMQs:, Arthritis (broad)
Write-up: SORENESS IN UPPER ARM, PAIN IN ELBOW AND WRIST JOINTS.

VAERS ID:474585 (history)  Vaccinated:2012-11-01
Age:71.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Female  Submitted:2012-11-07, Days after onset: 4
Location:Alaska  Entered:2012-11-16, Days after submission: 9
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: Methylparaben; Thimerosal
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA736AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1417AA IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B081AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Flu and PNEUMOVAX given on 11/1/12 in (L) deltoid. Pt has history of (L) partial mastectomy and sentinel lymph node biopsy. A few days later her upper (L) arm became hot, red and tender. Still red on 11/6/12 but improving.

VAERS ID:474767 (history)  Vaccinated:2012-11-01
Age:65.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Male  Submitted:2012-11-16, Days after onset: 14
Location:Florida  Entered:2012-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA006030
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Nausea, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: This spontaneous report as received from a physician refers to a 65 years old male patient. The patient was vaccinated subcutaneously with a dose of ZOSTAVAX (lot # and dose not reported) on 01-NOV-2012. Other suspect therapies included Influenza a dose of Virus Vaccine (manufacturer unknown) (lot #, dose and route not reported) on 01-NOV-2012. No concomitant medications were reported. The physician reported that the patient had a fever, tremors, shakes, nausea, vomiting after getting the shots. He was seen in the emergency room two days after the getting the shots (on 03-NOV-2012). No treatment was given for the events. The outcome of tremors, shakes, vomiting, had a fever and nausea was unknown. The relatedness for the reported events was not provided for ZOSTAVAX and Influenza Virus Vaccine (manufacturer unknown). Additional information has been requested.

VAERS ID:478229 (history)  Vaccinated:2012-11-01
Age:  Onset:0000-00-00
Gender:Female  Submitted:2012-11-16
Location:Florida  Entered:2012-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA001222
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0669AE IMUN
Administered by: Other     Purchased by: Other
Symptoms: Accidental exposure, No adverse event, Syringe issue
SMQs:
Write-up: This spontaneous report ass received from a physician as well as the patient of unknown age. The physician was vaccinated with VAQTA (dose and route not reported) (lot number reported as 0669AE expired date 07-DEC-2014) on 01-NOV-2012. No other co-suspects were reported. No concomitant medications were reported. On 01-NOV-2012 while aspirating a prefilled syringe of VAQTA the plunger came out and some of the dose of the VAQTA got on the physician. No adverse event reported. The outcome was unknown at the time of report. Additional information is not expected.

VAERS ID:474749 (history)  Vaccinated:2012-11-01
Age:58.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-18, Days after onset: 17
Location:Unknown  Entered:2012-11-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No. At 6 PM I started to feel congestion in chest. At 9PM I felt like I had flu symptoms. At 3 AM got up, felt nauseated and fainted, which resulted in a broken ankle.
Preexisting Conditions: NONE Vaccine name: AFLURIA Lot: 58907 Manuf. CSL Biotherapies Expires 06/30/13
Diagnostic Lab Data: x-ray showed broken fibula which resulted in surgery with plate and 6 screws. Also observed for head injury. Nausea stopped at 10 AM next day.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED58907 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Ankle fracture, Fibula fracture, Flushing, Influenza like illness, Nausea, Surgery, Syncope, Upper respiratory tract congestion, X-ray limb abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: No sickness prior. At 6 PM chest congestion. At 9 PM felt like I had the flu. Got up at 3 AM to get med to help, felt very nauseated and flushed. I fainted resulting in a broken ankle needing surgery with plate and 6 screws.

VAERS ID:478364 (history)  Vaccinated:2012-11-01
Age:68.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-19, Days after onset: 18
Location:Massachusetts  Entered:2012-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity; Malignant melanoma; Rheumatoid arthritis; Hypothyroidism; Hypercholesterolaemia; Hypertension; Osteopenia; Asthma; Prophylaxis
Preexisting Conditions: Liver function test abnormal; Carotid artery stenosis; Thyroid function test abnormal; Tachycardia; SULFA, Drug hypersensitivity; NORVASC, Drug hypersensitivity; nystatin, Drug hypersensitivity; LIPITOR, Drug hypersensitivity; Lisinopril, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA004160
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12069010UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138470UNUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0130171SCUN
Administered by: Other     Purchased by: Other
Symptoms: Chills, Diarrhoea, Fatigue, Headache, Pain
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: This spontaneous report was received from a medical assistant regarding a 68 years old female patient with asthma, osteopenia, hypertension, hypercholesterolemia, hypothyroidism, rheumatoid arthritis, melanoma, allergy to sulfa drugs, allergy to NORVASC, allergy to nystatin, allergy to LIPITOR and allergy to lisinopril. The patient''s medical history included tachycardia, abnormal thyroid tests, carotid artery stenosis and abnormal liver function tests. On 24-JUL-2009, the patient was vaccinated subcutaneously with dose 1, 0.65 milliliter (ml) ZOSTAVAX. On 01-NOV-2012, the patient was vaccinated subcutaneously with dose 2, 0.65 ml ZOSTAVAX (lot# reported as 013017, expiry 09-OCT-2013). Concomitant medications included SYNTHROID, nitroglycerin (manufacturer unknown), PLAQUENIL, fluticasone propionate, ADVAIR DISKUS, CRESTOR, PROAIR HFA, omeprazole (manufacturer unknown), felodipine (manufacturer unknown) and atenolol (manufacturer unknown). On 01-NOV-2012, after administration of second dose the patient experienced body aches, chills, diarrhea, fatigue and headache. The patient sought medical attention (called Healthcare professional (HCP)). No treatment was given for the events. On 05-NOV-2012, the patient called her physician and reported that the adverse reactions had abated. The relatedness for body aches, chills, diarrhea, fatigue and headache was unknown for ZOSTAVAX. Additional information has been requested.

VAERS ID:475001 (history)  Vaccinated:2012-11-01
Age:34.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-20, Days after onset: 19
Location:Unknown  Entered:2012-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rubber sensitivity; Drug hypersensitivity; Diabetes mellitus
Preexisting Conditions: VYTORIN hypersensitivity; LIPITOR hypersensitivity; Simvastatin hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA007488
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H012650 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Thrombophlebitis superficial
SMQs:, Embolic and thrombotic events, venous (narrow), Thrombophlebitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This initial information was received from a nurse concerning an approximately 34 years old female patient with diabetes, simvastatin (manufacturer unknown) allergy (CASE #1211USA007941), LIPITOR allergy, VYTORIN allergy (Case#1211USA008157) and latex allergy who on 01-NOV-2012, the patient was vaccinated intramuscularly in the right arm with a dose of 0.5 ml PNEUMOVAX23 lot # (H012650), exp date 27-FEB-2014. No other co-suspects were reported. No concomitant medications were reported. It was reported that on 01-NOV-2012 the patient developed redness and swelling at the injection site of the right arm 5 hours after administration of PNEUMOVAX23. The patient was evaluated at the emergency room on the same date and was treated with vancomycin IV and LOVENOX injection. On 02-NOV-2012, the patient was evaluated in the emergency room again and was diagnosed with a superficial thrombosis of the right cephalic vein. On the same date, the patient was admitted to the hospital and on 04-NOV-2012, the patient was discharged from the hospital. Details of hospitalization were not known at the time of report. The nurse stated that the thrombosis was attributed to a reaction to the IV administration of vancomycin. On an unspecified date, the patient recovered from the events. It was reported that the patient sought medical attention by going to hospital. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:475060 (history)  Vaccinated:2012-11-01
Age:58.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-10, Days after onset: 9
Location:Louisiana  Entered:2012-11-20, Days after submission: 10
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR  IDAR
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site mass, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Itching within 5 min. Redness, swelling, lump - hard within 20 min. Site reaction only. No treatment.

VAERS ID:475070 (history)  Vaccinated:2012-11-01
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-20
Location:Arizona  Entered:2012-11-20
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:
Diagnostic Lab Data: Patient was given a Tdap on 11-01-12 but had one back in 2006 from Hospital
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA698AA1IMUN
TDAP: TDAP (ADACEL)SANOFI PASTEURU4383AA IMUN
Administered by: Public     Purchased by: Public
Symptoms: Incorrect dose administered
SMQs:
Write-up: None stated.

VAERS ID:475165 (history)  Vaccinated:2012-11-01
Age:68.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:2012-11-20
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: Allergy: Dust mites; No birth defects; Diverticulitis; GERD; Hiatal hernia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AC IMLA
Administered by: Other     Purchased by: Public
Symptoms: Chills, Cough, Headache, Malaise, Nausea, Oropharyngeal pain, Pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Nausea, vomiting x 2, fever, chills, sore throat, body aches, "terrific" headache x 2 days. No congestion, slight cough, no diarrhea, malaise for 1 week.

VAERS ID:475178 (history)  Vaccinated:2012-11-01
Age:33.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Female  Submitted:2012-11-12, Days after onset: 9
Location:Minnesota  Entered:2012-11-20, 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: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: Reported only
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH21932IN 
Administered by: Other     Purchased by: Private
Symptoms: Nasal discomfort, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Complained of nasal and throat irritation.

VAERS ID:475963 (history)  Vaccinated:2012-11-01
Age:58.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2012-11-26, Days after onset: 24
Location:Utah  Entered:2012-11-29, Days after submission: 3
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: Oxycodone, Meperidine = rash/hives
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4463BA0IDLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 11/2/12 Patient reported itching at injection site and a swollen red area 2.5 in x 3.5 in surrounding injection site, 24 hours after vaccine administration she used cetirizine 10mg and Diphenhydramine for 3-4 days. All itching and swelling resolved by day 5.

VAERS ID:478730 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 28
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011269
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 01-NOV-2012 at 12:30, the patient was vaccinated with RECOMVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478731 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 28
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011265
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 01-NOV-2012 06:55, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478744 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 28
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011267
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 01-NOV-2012 at 10:19, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478747 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-29, Days after onset: 28
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011266
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn female patient of unknown age. On 01-NOV-2012 08:19, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478762 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-29, Days after onset: 28
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011268
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn female patient of unknown age. On 01-NOV-2012 at 10:28, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hours time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479139 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 29
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011073
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn female patient of unknown age. On 01-NOV-2012 11:16, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294E, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479157 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 29
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011075
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 01-NOV-2012 14:06, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:476407 (history)  Vaccinated:2012-11-01
Age:4.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Male  Submitted:2012-11-07, Days after onset: 5
Location:California  Entered:2012-12-04, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B178DA0IMLA
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH21096IN 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0233AE2SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0076991SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm red & swollen, per mother pt was scratching the area.

VAERS ID:476659 (history)  Vaccinated:2012-11-01
Age:36.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2012-12-05, Days after onset: 33
Location:Iowa  Entered:2012-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted (possible migraine)
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH721AC10IMRA
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Muscular weakness, Stress, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: On 11/7/12 reported to this RN that had onset of periodic tremors and weakness in right arm within 1-2 days of injection. Evening of 11/7 had additional tremors of face. Advised physician care. Continues to experience some symptoms though to lesser degree as of 12/5. Worsen with fatigue/stress. Neurology refer made by primary care physician; appt pending this month. No clear association ID''d by primary physician.

VAERS ID:476954 (history)  Vaccinated:2012-11-01
Age:12.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-12-06, Days after onset: 35
Location:Washington  Entered:2012-12-06
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: Wilson''s Disease; Migraines; Concussion
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ21592IN 
Administered by: Private     Purchased by: Unknown
Symptoms: Migraine
SMQs:
Write-up: Migraine after FLUMIST.

VAERS ID:480554 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-12-01, Days after vaccination: 30
Gender:Unknown  Submitted:0000-00-00
Location:Unknown  Entered:2012-12-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1212USA009450
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Alopecia
SMQs:
Write-up: This spontaneous report as received from a consumer mother refers to a 15 year old female patient with no pertinent history or drug reactions/allergies who about a month and a half ago (approximately in November 2012) was vaccinated with GARDASIL (product circular: 9883616). No other co-suspects were reported. No concomitant medications were reported. Within the month (approximately in December 2012), the patient started drastically losing her hair. The patient''s mother consulted the physician and subsequently scheduled appointments with a specialist (unspecified) to determine a diagnosis. At the time of reporting, the patient''s condition has not improved. The relatedness for the event was unknown for GARDASIL. Additional information has been requested

VAERS ID:480618 (history)  Vaccinated:2012-11-01
Age:53.0  Onset:2013-01-01, Days after vaccination: 61
Gender:Male  Submitted:2013-01-08, Days after onset: 7
Location:Georga  Entered:2013-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: DMII, COPD, HTN
Diagnostic Lab Data: Rapid Flu Ag/EIA test
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Influenza A virus test positive
SMQs:
Write-up: Positive test for influenza A.

VAERS ID:480713 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2013-01-08, Days after onset: 68
Location:Unknown  Entered:2013-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1301USA002559
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a pharmacist concerning her Husband, who In "November or December 2012" had received ZOSTAVAX 0.65 ml subcutaneously. He developed a red raised area at the injection site that lasted about 5-7 days and resolved in "November or December of 2012". It was unspecified if patient received treatment. The patient did not sought medical attention. The pharmacist had also received ZOSTAVAX at the same time and experienced a similar AE (captured in Case # 1301USA002198). Additional information is not expected.

VAERS ID:480753 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2013-01-09, Days after onset: 69
Location:Unknown  Entered:2013-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1301USA002198
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report was received from a female pharmacist of unknown age reporting on herself. The pharmacist was vaccinated with, 0.65 ml ZOSTAVAX, SC in November or December 2012 (lot # and site of administration not reported). No other co-suspects were reported. No concomitant medications were reported. Subsequently, in November or December 2012, the pharmacist experienced red raised area at the injection site that lasted about a week. No treatment was given. The pharmacist did not seek medical attention. It was also reported that the therapy was not reintroduced. The outcome of red raised area at the injection site was reported as recovered/resolved. The relatedness for red raised area at the injection site was not reported for ZOSTAVAX. This is one of several reports from the same source. Additional information is not expected.

VAERS ID:480771 (history)  Vaccinated:2012-11-01
Age:62.0  Onset:2012-11-02, Days after vaccination: 1
Gender:Female  Submitted:2013-01-09, Days after onset: 68
Location:Washington  Entered:2013-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Fatigue, Malaise, Mobility decreased, Musculoskeletal pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad)
Write-up: 5 days of extreme malaise/fatigue. 2+ months of severe deltoid and shoulder pain with significantly limited mobility; primary mobility restrictions were with external rotation; felt similar to a rotator cuff tear. Currently, pain is abating and mobility improving.

VAERS ID:483056 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2013-01-30, Days after onset: 90
Location:Unknown  Entered:2013-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1301USA011645
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0138311UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a nurse refers to a male patient of unknown age. The nurse reported that the patient received his second dose of GARDASIL about 13 months after his first dose. First dose of GARDASIL (lot # reported as 1261AA, exp unspecified) was administered on 04-OCT-2011 and the second dose (lot # H013831, exp unspecified) was administered on 01-NOV-2012. No adverse effects reported. The outcome was unknown at the time of report. Additional information has been requested.

VAERS ID:483129 (history)  Vaccinated:2012-11-01
Age:65.0  Onset:2012-11-05, Days after vaccination: 4
Gender:Male  Submitted:2013-01-24, Days after onset: 80
Location:Oregon  Entered:2013-01-31, 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
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1234051UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709AE1UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA1UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Pyrexia, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Right arm over bicep and deltoid area and anterior chest with reddened sunburn appearing rash. Fever 102.

VAERS ID:484489 (history)  Vaccinated:2012-11-01
Age:53.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2013-02-14, Days after onset: 105
Location:Unknown  Entered:2013-02-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions: Herpes zoster 12 years ago
Diagnostic Lab Data:
CDC 'Split Type': WAES1302USA003824
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Blister, Injection site erythema, Injection site pain, Injection site pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: This spontaneous report was received from a health professional via company representative refers to a 53 year old female patient. The patients medical history included an episode of shingles about twelve years ago. On an unknown date in NOV-2012, the patient was vaccinated with a dose of ZOSTAVAX (lot number, expiry date and route was not reported). No concomitant medications reported. ON an unknown date in NOV-2012, the patient stated that one day after receiving ZOSTAVAX, the patient developed soreness and redness around the injection site. The next day the redness around the injection site spread to about 4 inches in diameter. Additionally the patient developed three blisters that did not open. On the fourth day, the patient experienced severe burning and itching around the injection site that extended down to the elbow. By the fifth day after receiving ZOSTAVAX, the adverse symptoms disappeared. There was no lab diagnostics performed. There was no treatment rendered for the events. The outcome of the reported events were recovered at the time of this report. The patient did not seek medical attention. Additional information is not expected.

VAERS ID:484684 (history)  Vaccinated:2012-11-01
Age:63.0  Onset:2012-11-03, Days after vaccination: 2
Gender:Male  Submitted:2013-02-15, Days after onset: 104
Location:California  Entered:2013-02-15
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: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSUH730AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Injection site swelling, Joint stiffness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: SWOLLEN INJECTION SITE, WITH NUMBNESS TO THE LEFT ARM AND LEFT SIDE OF BODY. SX RESOLVED EXCEPT FOR RESIDUAL SENSATION OF TIGHTNESS TO HIS LEFT HAND.

VAERS ID:486156 (history)  Vaccinated:2012-11-01
Age:80.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Male  Submitted:2013-01-25, Days after onset: 85
Location:Nevada  Entered:2013-03-04, Days after submission: 38
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: Allergies; Naphazoline; Ferrous sulfate; Codeine; Chlorpheniramine; Diagnoses: Screening for skin conditions; Chronic lymphoid leukemia without mention of remission; Loss of weight; Myelodysplastic Syndrome, unspecified; Lymphoma; Other malaise and fatigue; Hepatitis B; Hypertension; Hyperlipidemia; Environmental allergies; Olecranon bursitis; Psoriasis; Anemia, Macrocytic; Thrombocytosis; COPD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1230031UNLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Fatigue, Feeling hot, Irritability
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Vestibular disorders (broad)
Write-up: Weakness, weight loss, fatigue, feeling faint, feeling irritable, sensation of warmth.

VAERS ID:487778 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Unknown  Submitted:2013-03-26, Days after onset: 145
Location:Unknown  Entered:2013-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303USA012282
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from an immunization official (also reported as health care worker) refers 6 patients (demographics unspecified). Between 01-NOV-2012 to 15-NOV-2012, the patients received MMR II (lot number, expiry date, dose, route, site unspecified) that were exposed to unknown temperatures. The MMR II were exposed to unknown temperatures from 01-NOV-2012 to 15-NOV-2012. Immunization official reported that the practice had no vaccine temperature storage records for the time period in question; it could not be determined if a vaccine temperature storage excursion actually occurred. No adverse effect reported. The outcome was unknown. It was unspecified if the patients had sought medical attention. All telephone attempts to obtain follow-up information have been unsuccessful. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:487785 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Unknown  Submitted:2013-03-26, Days after onset: 145
Location:Unknown  Entered:2013-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1303USA012281
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from an immunization official (also reported as health care worker) refers 7 patients (demographics unspecified). Between 01-NOV-2012 to 15-NOV-2012, the patients might have received VARIVAX (Merck) (lot number, expiry date, dose, route, site unspecified) that were exposed to unknown temperatures. The VARIVAX (Merck) were exposed to unknown temperatures from 01-NOV-2012 to 15-NOV-2012. Immunization official reported that the practice had no vaccine temperature storage records for the time period in question; it could not be determined if a vaccine temperature storage excursion actually occurred. No adverse effect reported. The outcome was unknown. It was unspecified if the patients had sought medical attention. All telephone attempts to obtain follow-up information has been unsuccessful. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:491617 (history)  Vaccinated:2012-11-01
Age:81.0  Onset:2013-04-26, Days after vaccination: 176
Gender:Male  Submitted:2013-05-15, Days after onset: 19
Location:Ohio  Entered:2013-05-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1305USA008075
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Post herpetic neuralgia
SMQs:
Write-up: This spontaneous report as received from a physician refers to an 81 year old male patient. Within in the last six months, approximately in November 2012 the patient was vaccinated with ZOSTAVAX (lot number not provided). Within two weeks, approximately on 26-APR-2013 the patient experienced shingles. The patient also developed and was still experienced post herpetic neuralgia(PHN). The outcome of adverse events was reported as not recovered. The patient had sought medical attention via office visit. Additional information is not expected.

VAERS ID:496554 (history)  Vaccinated:2012-11-01
Age:64.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-13
Location:North Carolina  Entered:2013-07-12, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: There were no other vaccinations administered on the same date. The subject reported no relevant medical history prior to vaccination with FLUARIX. It was unknown if the subject had previously received any flu shots.
Diagnostic Lab Data: UNK
CDC 'Split Type': A1008231A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Private     Purchased by: Other
Symptoms: Food allergy
SMQs:
Write-up: This case was reported by a consumer (subject) and described the occurrence of peanut allergy in a 64-year-old male subject who was vaccinated with FLUARIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. On 1 November 2012 the subject received a dose of FLUARIX (unknown details). In November 2012, less than one month after vaccination with FLUARIX, the subject experienced peanut allergy. The subject stated he "received the flu vaccine and developed a peanut allergy." The subject stated that the immunization series was not discontinued. At the time of reporting the event was unresolved.

VAERS ID:496571 (history)  Vaccinated:2012-11-01
Age:  Onset:2013-02-01, Days after vaccination: 92
Gender:Male  Submitted:2013-05-13, Days after onset: 100
Location:Unknown  Entered:2013-07-12, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': A1014087A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a consumer and described the occurrence of influenza in an adult male subject who was vaccinated wtih influenza vaccine (manufacturer unspecified). A physician or other health care professional has not verified this report. In November 2012 the subject received unspecified dose of influenza vaccine (unknown). In February 2013, approximately three months after vaccination with influenza vaccine, the subject experienced influenza and vaccination failure. The subject''s spouse reported "my husband (the subject) and I both got the flu shot in November and I got the pneumonia shot three years ago. Well, I went into the hospital two weeks ago with pneumonia for eight days and came home and was home for three days and he came down with the flu. He is not allowed around me at all. If I get the flu I am going to get it ten times worse so, we are really trying to avoid it as much as possible this year has been really bad because of this crazy weather pattern." This case was assessed as medically serious by GSK. At the time of reporting the outcome of the influenza was unspecified. For case regarding the spouse please see case A0981843A.

VAERS ID:496598 (history)  Vaccinated:2012-11-01
Age:  Onset:0000-00-00
Gender:Female  Submitted:2013-05-13
Location:Unknown  Entered:2013-07-12, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': A1005277A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Gait disturbance, Hypoaesthesia, Poor peripheral circulation
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: This case was reported by a healthcare professional, via another manufacturer, and described the occurrence of leg numbness in a female subject of unspecified age who was vaccinated with influenza vaccine (GlaxoSmithKline). In November 2012 the subject received a dose of influenza vaccine (unknown details). In 2012, less than one week after vaccination with influenza vaccine ("about one week afterwards"), the subject experienced leg numbness and lack of blood circulation in both legs. The lack of blood circulation in both legs was described as "a sensation similar to when your circulation has been cut off from sitting on your legs too long." The healthcare professional also reported that "this numbness has made walking more difficult." At the time of reporting the outcome of the events were unspecified.

VAERS ID:498955 (history)  Vaccinated:2012-11-01
Age:0.5  Onset:2013-07-05, Days after vaccination: 246
Gender:Female  Submitted:2013-08-08, Days after onset: 34
Location:Wisconsin  Entered:2013-08-09, 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:
Current Illness:
Preexisting Conditions: The subject''s medical history was not reported. The subject''s vaccination history included 2 doses of PENTACEL: lot number C4231AA received on 27 June 2012 and lot number C4269AA received on 05 September 2012.
Diagnostic Lab Data:
CDC 'Split Type': 201308204
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4186AA0UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest X-ray normal, Cough, Laboratory test abnormal, Nasopharyngitis, Pertussis, Polymerase chain reaction, Post-tussive vomiting, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Initial report received on 30 July 2013 from the Investigator participating in a post-marketing study under the reference number M5A16. A case of pertussis disease in a 14-month-old female subject (initials not collected) was identified by the investigator based on review of data from the Electronic Disease Surveillance (EDSS) electronic database. The subject had received the following vaccinations: PENTACEL (dose 1) lot number C4231AA received on 27 June 2012, PENTACEL (dose 2) lot number C4269AA received on 05 September 2012, and DAPTACEL (dose 3) lot number C4186AA on 01 November 2012. The subject developed a cough on 05 July 2013, approximately 246 days after the last dose, and a paroxysmal cough without a whoop on 12 July 2013. The subject also developed cold like symptoms on 05 July 2013, and posttussive vomiting and sleep disturbance (start dates not reported). Laboratory testing included positive PCR on 17 July 2013. Chest x-ray findings were negative. Corrective treatments consisted of azithromycin starting on 18 July 2013 for 5 days. The subject was not hospitalized. At the time of final contact on 23 July 2013, the subject''s cough was still persisting. The duration of the cough was reported at that time as 18 days. Investigator causality assessment is not required as per protocol. This is one case out of a cumulative total of 204 cases solicited from the EDSS database during the surveillance period from 01 January 2010 to 30 July 2013. These 204 cases represent children who received 3 or more doses of sanofi pasteur vaccine; cases of pertussis disease in children who received DTaP combination vaccines from other manufacturers are not reported as per study protocol. Documents held by sender: None.

VAERS ID:498969 (history)  Vaccinated:2012-11-01
Age:  Onset:0000-00-00
Gender:Female  Submitted:2013-08-09
Location:Unknown  Entered:2013-08-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA003523
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a health care worker refers to a female patient of unknown age. In September 2012 the patient received her first dose of GARDASIL (lot # not reported) (strength and total daily dose not reported). In November 2012 the patient received the second dose of the vaccine (lot # not reported) (strength and total daily dose not reported). This patient had yet to receive the third dose of the vaccine and at the time of report it was way past the timing of the dosing schedule in the prescribing information. No side effects were reported. It was unspecified whether the patient sought for medical attention. The outcome was unknown. Additional information is not expected.

VAERS ID:504691 (history)  Vaccinated:2012-11-01
Age:60.0  Onset:0000-00-00
Gender:Female  Submitted:2013-09-30
Location:Unknown  Entered:2013-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1309USA005079
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: This spontaneous report as received from a physician via a company representative refers to a female patient who is between 60 and 69 year old. About one year ago (approximately November 2012) the patient was vaccinated with ZOSTAVAX. Dose and route were not reported. On an unknown date, after being vaccinated with ZOSTAVAX, the patient developed a bad case of shingles on the thoracic region of the body. The patient sought medical attention by an office visit on an unspecified date. The outcome of developed a bad case of shingles on the thoracic region of the body is unknown. Additional information has been requested.

VAERS ID:520370 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Unknown  Submitted:2014-01-23, Days after onset: 448
Location:Unknown  Entered:2014-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA008617
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012576 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: Information has been received from a registered nurse regarding a patient of an unknown age and gender. On 12-OCT-2012 at 18:00, ZOSTAVAX lot # H012576 was exposed to -8 for an estimated total time out of range of 10 hours 20 min. On 01-NOV-2012, the patient was vaccinated with an out of temperature range dose of ZOSTAVAX (dose and route administration were not provided) (lot # H012576, exp date 28-SEP-2013) (dose number was not provided). No adverse experience had been reported. This is one of 182 reports from the same source. Additional information has been requested.

VAERS ID:520954 (history)  Vaccinated:2012-11-01
Age:  Onset:2012-11-01, Days after vaccination: 0
Gender:Unknown  Submitted:2014-01-28, Days after onset: 453
Location:Unknown  Entered:2014-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA009236
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0435AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: Information has been received from a registered nurse regarding a patient of unknown age and gender. On 01-NOV-2012, the patient was administered with a dose VARIVAX (Lot # 0435AE, expiry 28-FEB-2014) (Route, dosing regimen and frequency unknown) which was exposed to a temperature excursion of up to -3 degrees Centigrade. No adverse events were reported. No product quality issue was reported. This is one of the many reports received from the same source. Additional information has been requested.

VAERS ID:526109 (history)  Vaccinated:2012-11-01
Age:  Onset:2014-03-13, Days after vaccination: 497
Gender:Female  Submitted:2014-03-18, Days after onset: 5
Location:Unknown  Entered:2014-03-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1403USA007086
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: Information has been received from a medical assistant concerning a female patient (age not reported) who in November (reported as "Noember") 2013 was vaccinated with dose one of GARDASIL (route and site not reported) for disease prevention. On 13-MAR-2014 the patient received the second dose of GARDASIL. No adverse effects noted to patient. The patient did not seek for medical attention. Additional information has been requested.

VAERS ID:476835 (history)  Vaccinated:2012-11-02
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-30
Location:Unknown  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA013678
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012523 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a pharmacist refers to an unspecified number of patients who have developed redness at the injection site after receiving ZOSTAVAX (Lot #, dose/frequency, route and duration were unspecified) on an unknown date in 2011, "in the past year", but the area affected was "very small". No treatment information was reported. The outcome was unknown. Additional information has been requested.

VAERS ID:472775 (history)  Vaccinated:2012-11-02
Age:3.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-02, Days after onset: 0
Location:Michigan  Entered:2012-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 4 cm Blotchy, erythema @ thigh within 10 mins after MMR
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB677BA1IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0601AA1SCLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site reaction, Rash macular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 4 cm blotchy, erythema on thigh within 10 mins after MMR.

VAERS ID:473188 (history)  Vaccinated:2012-11-02
Age:18.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-02, Days after onset: 0
Location:New York  Entered:2012-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type': NYC1200017
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0097460IMLA
Administered by: Private     Purchased by: Public
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Immediately after administration of GARDASIL, pt had a syncope episode which lasted about 60 sec. Pt was examined by a physician. Pt pulse was 44, BP: 122/65. Pt laid down for 15 mins and was given juice. Vital signs were: BP: 114/70 O2: 100, Pulse: 60. Pt remained seated for an additional 15 mins. Vital signs were 126/77, O2: 99% and Pulse: 65. Pt was clear to go home by PA.

VAERS ID:472805 (history)  Vaccinated:2012-11-02
Age:60.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-03, Days after onset: 1
Location:California  Entered:2012-11-03
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) (FLUZONE INTRADERMAL)SANOFI PASTEUR 1IDRA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: Felt very dizzy; the room was spinning when I lied down to go to sleep. Upon awakening at 6 AM, I still felt dizzy and slightly nauseated. Symptoms have subsided (it''s 12:45 PM) but I still feel waves of dizziness if I lie down or move my head too suddenly.

VAERS ID:472809 (history)  Vaccinated:2012-11-02
Age:38.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-03, Days after onset: 0
Location:Maryland  Entered:2012-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergic to Penicillin
Diagnostic Lab Data: No
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 5UNLA
Administered by: Public     Purchased by: Private
Symptoms: Lethargy, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting, fever, ache, lethargic.

VAERS ID:473229 (history)  Vaccinated:2012-11-02
Age:24.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-03, Days after onset: 1
Location:Washington  Entered:2012-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None listed on consent form
Preexisting Conditions: Latex allergy only as reported on consent form
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12042010IMAR
Administered by: Other     Purchased by: Private
Symptoms: Chest pain, Feeling hot, Nausea, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Ten minutes following her first flu shot, patient returned complaining of pain in her chest and feeling hot and nauseous. We called 911 while observing her and questioning about medical history, etc. Paramedics arrived in 15 minutes and confirmed hives on her spine and administered diphenhydramine and took her for observation.

VAERS ID:472816 (history)  Vaccinated:2012-11-02
Age:50.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-04, Days after onset: 1
Location:Michigan  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: I was hospitalized for flu/pneumonia from Thursday, October 25, 2012 through Sunday, October 28, 2012. I was fever free on Monday, October 29, 2012. My temperature was not taken at the doctor''s office on Friday, November 2, 2012, so I don''t know if I had a fever the day I received my flu AND pneumonia vaccines or not. I was feeling under the weather, but credited that to the residual effects of the pneumonia.
Preexisting Conditions: Only allergies are penicillin (not confirmed suspected childhood reaction) and Demerol (had seizures upon injection in 1994).
Diagnostic Lab Data: Too early to tell -- hesitant to return to the doctor because I doubt there is anything they can do for me.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Body temperature fluctuation, Hyperaesthesia, Influenza like illness, Injection site pain, Injection site reaction, Injection site warmth, Pain
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: On Saturday, November 3rd my temperature fluctuated between 100.7 and 102.2 degrees. I was extremely sore at the injection site, achy, flu-ish and extremely weak. As of today, Sunday, November 4th, my temperature is below 100 degrees, but I still feel very, very weak and I have a 4-6" diameter spot that looks like a sunburn at the site of the injection. It is very hot and sensitive to the touch. I have been on 500 mg of Azithromycin and 750 mg Levofloxacin since Friday, October 26th, 2012 so I don''t think it is an infection.

VAERS ID:472818 (history)  Vaccinated:2012-11-02
Age:54.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-04, Days after onset: 2
Location:Ohio  Entered:2012-11-04
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Known
Preexisting Conditions: None Known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA737AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Pruritus, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Developed rash on arms and itching, progressed to shortness of breath and to feeling of throat closing. EMS called.

VAERS ID:472822 (history)  Vaccinated:2012-11-02
Age:2.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-04, Days after onset: 1
Location:North Carolina  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO illnesses
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)SMITHKLINE BEECHAMAC14B157CA1SYRRL
Administered by: Unknown     Purchased by: Other
Symptoms: Decreased appetite, Injection site erythema, Injection site induration, Injection site mass, Injection site swelling, Injection site warmth, Irritability, Pain in extremity, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Morning after vaccine red area around injection site approximately 3 inches in diameter, swollen, hot, hard mass. Fever, sleepiness, irritability, loss of appetite, pain in leg. Saw Dr at pediatric urgent care Sunday 11/4/2012 received antibiotics for possible infection. Unable to say for sure if it is an infection or vaccine reaction. Told to follow up with Dr this wed 11/7/2012.

VAERS ID:472825 (history)  Vaccinated:2012-11-02
Age:55.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-04, Days after onset: 1
Location:South Dakota  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Known
Preexisting Conditions: None Known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012518 SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection sight reaction, area as large as "baseball" red with edema.

VAERS ID:472829 (history)  Vaccinated:2012-11-02
Age:69.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-04, Days after onset: 2
Location:California  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No, but maybe a bit of sinusitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Lethargy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Fever, light headedness, diarrhea, lethargy, slightly impaired cognitions.

VAERS ID:472902 (history)  Vaccinated:2012-11-02
Age:6.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-05, Days after onset: 3
Location:Puerto Rico  Entered:2012-11-05
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: AUTISTIC
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4127AA IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB549CA IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH1330 IMRA
Administered by: Military     Purchased by: Military
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: RED RASH ON RIGHT ARM.

VAERS ID:472977 (history)  Vaccinated:2012-11-02
Age:10.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:Iowa  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Child was reported to having swelling around injection site approx 3 inches round with swelling and tenderness
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA690AA3IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Child had approx 3 inch circle of redness and swelling around the injection site with tenderness, Ice applied to area and given 25mg po of Benadryl.

VAERS ID:472998 (history)  Vaccinated:2012-11-02
Age:60.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:Colorado  Entered:2012-11-05
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: Anaphylaxis with Penicillin, Asthma, Hayfever, Rheumatoid Arthritis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Feeling cold, Injection site haematoma, Injection site reaction, Musculoskeletal pain, Pain in extremity, Pyrexia, Urine odour abnormal, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Started with a sore arm and very sore shoulder blade on the side of the shot. In the evening I had a fever: wore two bathrobes and two pairs of socks and still couldn''t get warm in bed: took Benadryl early morning to get some sleep. Upon waking, my urine was very strong and I was slightly dizzy. I started feeling better about 12:30 on Saturday. I only drank water on Friday and more lemon water on Saturday to help flush my system. Friday evening I was getting a bruise where the shot was given and got some welts around my arm from the place of the shot. My arm was and is still very sore to touch. The bruise is getting bigger today, Monday, but the welts are getting less; and the arm is still sore.

VAERS ID:473015 (history)  Vaccinated:2012-11-02
Age:4.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:Pennsylvania  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH721AD IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: High fever.

VAERS ID:473048 (history)  Vaccinated:2012-11-02
Age:41.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:Oregon  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergies to penicillin, erythromycin, NSAIDs, sulfas, fiorinal/fioricet; migraine history; low back pain with radiculopathy of rt leg and foot.
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS665210115020IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dry throat, Headache, Oropharyngeal pain, Pain, Pharyngeal disorder, Sensation of heaviness, Vomiting
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Sore throat with raised bright yellow patches scattered on back of throat. This lasted until 11/03/2012 6:00 PM; 11/04/2012 body aches all day then at 3:27 AM of 11/05/2012 one of the worst headaches commenced. Vomited multiple times. Took an Imitrex 100 mg with a Zofran 4 mg to rule out migraine. 11/05/2012 by 9:30 AM left arm (shot arm) is very "heavy" and hurts to move fingers.

VAERS ID:473049 (history)  Vaccinated:2012-11-02
Age:0.3  Onset:2012-11-05, Days after vaccination: 3
Gender:Female  Submitted:2012-11-05, Days after onset: 0
Location:Alaska  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ''Cold''
Preexisting Conditions: None
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B323AA1IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1189AA1IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF629231IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0542AA1PO 
Administered by: Unknown     Purchased by: Public
Symptoms: Eczema, Injection site erythema, Irritability
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: Mother called to report 2 small areas of redness at injection site on right thigh. Raised, looks like ''eczema'' rash. Not fluid filled. Baby was ''fussy'' over the weekend but mother did not report any fevers. No other rashes or signs of reaction other than on right thigh. No treatment taken other than watchful waiting.

VAERS ID:473052 (history)  Vaccinated:2012-11-02
Age:66.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 2
Location:Missouri  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0139400SCLA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site vesicles, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Fever and chills during the night on 11/03/2012 and blisters at the site of injection with redness on 11/5/2012. Physician prescribed Valtrex 1gram 3 times daily for 7 days beginning in the afternoon on 11/5/2012.

VAERS ID:473053 (history)  Vaccinated:2012-11-02
Age:81.0  Onset:2012-11-04, Days after vaccination: 2
Gender:Male  Submitted:2012-11-05, Days after onset: 1
Location:California  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not sure
Preexisting Conditions: None listed at pharmacy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4492BA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Vomiting and Diarrhea.

VAERS ID:473068 (history)  Vaccinated:2012-11-02
Age:1.4  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-05, Days after onset: 3
Location:California  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Yes otitis media
Preexisting Conditions: None
Diagnostic Lab Data: Prednisone and Bendaryl given.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4050AA3IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Rash followed by swelling of the face and welt like rash all ovewr face, body and trunk.

VAERS ID:473438 (history)  Vaccinated:2012-11-02
Age:61.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:Idaho  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diarrhea; Hematomas
Preexisting Conditions: Allergy - Oxycodone, PERCOCET, ATIVAN, RESPIRADOL, codeine; Hypoglycemia; Bipolar
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0125190SCRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pain, Pruritus, Rash erythematous, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Red, painful & itchy bumps with white heads - on rt. side buttock (underneath) - very painful. I can''t take pain meds. I hallucinate.

VAERS ID:473586 (history)  Vaccinated:2012-11-02
Age:69.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-04, Days after onset: 2
Location:California  Entered:2012-11-05, 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:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4524AA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Gout, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: He experienced swelling on right foot (toes & arch) a few hours after flu shot & didn''t know if it was related. It felt like gout & was painful. He took some VICODIN & CELEBREX. Pain & swelling resolved next day.

VAERS ID:473587 (history)  Vaccinated:2012-11-02
Age:1.4  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:Minnesota  Entered:2012-11-05
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: Egg; Dairy; Soy
Diagnostic Lab Data: Past history of egg allergy
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0649AA0SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0155570SCRL
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 4 hours after vaccines got hives.

VAERS ID:473603 (history)  Vaccinated:2012-11-02
Age:4.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 2
Location:California  Entered:2012-11-05
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
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B155BA4IMLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AD3IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH13403IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0287AE1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0110721SCRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling and tenderness (L) arm after vaccination.

VAERS ID:473608 (history)  Vaccinated:2012-11-02
Age:65.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 2
Location:Oregon  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pt was healthy (no obvious signs of sickness)
Preexisting Conditions:
Diagnostic Lab Data: Pt never had problem with flu vaccine before
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206301 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Private
Symptoms: Blister, Injection site erythema, Injection site rash, Injection site swelling
SMQs:, Severe cutaneous adverse reactions (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt called in on 11/3 to report her adverse rxn to the influenza vaccine given on 11/2. Pt reported rash, redness, and swelling around the injection site. The area affected was ~8 in by 3 in. Small blisters/bubbles in the skin formed. Pt came into the pharmacy on 11/5, and the skin problems were improved. Skin was still slightly red, especially area around smallpox scar.

VAERS ID:473609 (history)  Vaccinated:2012-11-02
Age:58.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 2
Location:Louisiana  Entered:2012-11-05
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: Hypertension; Allergies; Osteopenia; Asthma
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4472AA IDRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site vesicles
SMQs:
Write-up: Injection site broke out in blisters the next day - blisters resolving.

VAERS ID:473144 (history)  Vaccinated:2012-11-02
Age:47.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-06, Days after onset: 3
Location:Illinois  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (CERTIVA)BAXTER HEALTHCARE CORP.    
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Unknown     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: High fever that reached 103 for 2 days.

VAERS ID:473191 (history)  Vaccinated:2012-11-02
Age:69.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-06, Days after onset: 3
Location:Washington  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Latex, penicillin, vrs pain killers, grasses
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS    
Administered by: Public     Purchased by: Private
Symptoms: Chills, 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: Chills, diarrhea, low fever.

VAERS ID:473293 (history)  Vaccinated:2012-11-02
Age:46.0  Onset:2012-11-04, Days after vaccination: 2
Gender:Female  Submitted:2012-11-06, Days after onset: 2
Location:Nevada  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient with a history of neurocardiogenic syncope and pacemaker placement admitted on 11/2/12 for recurrent syncopal episodes.
Preexisting Conditions: Allergies: Anaphylaxis to liquid wheat and MSG PMH: syncope, concussion in March 2012, hypothyroidism, tonsillectomy, permanent pacemaker
Diagnostic Lab Data: 11/2/12 WBC 8.3, Neuts 71.7; 11/5/12 WBC 12.6, Neuts 84.7
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR102712AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0142830IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site cellulitis, Injection site erythema, Injection site pain, Neutrophil percentage increased, Oedema peripheral, Pyrexia, White blood cell count increased
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient developed a fever of 101.6 F with erythema and pain at the injection site. On 11/5/12 there is documentation that the "RUE extremity appears to hve grown larger in size, noted redness, pain and heat". The patient is being treated as if she has a cellulis around the injection site.

VAERS ID:473308 (history)  Vaccinated:2012-11-02
Age:24.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-06, Days after onset: 4
Location:Idaho  Entered:2012-11-06
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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMRA
Administered by: Private     Purchased by: Other
Symptoms: Musculoskeletal pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Injection site high on shoulder, shooting pain down arm and to neck. Now experiencing intense shoulder pain.

VAERS ID:474010 (history)  Vaccinated:2012-11-02
Age:4.0  Onset:2012-11-05, Days after vaccination: 3
Gender:Male  Submitted:2012-11-06, Days after onset: 1
Location:Massachusetts  Entered:2012-11-06
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: U/A, urine cx, CBC, Chem 7, urine creatinine/calcium ratio, ASO, C3, scheduled ultrasound
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4214BA3UNLA
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ21403IN 
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH13403UNRA
Administered by: Private     Purchased by: Public
Symptoms: Complement factor C3, Complement factor normal, Culture urine negative, Full blood count normal, Haematuria, Laboratory test normal, Streptococcus test negative, Urine analysis normal, Urine calcium/creatinine ratio
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Pt came for yearly checkup 11/2/12. On 11/5/12 pt examined for hematuria. U/A, urine cx, CBC, Chem 7, urine creat/cal. ratio obtained. All labs WNL so far.

VAERS ID:474126 (history)  Vaccinated:2012-11-02
Age:53.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-03, Days after onset: 0
Location:Montana  Entered:2012-11-06, Days after submission: 3
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
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Dose
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0139380IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness, induration at inj. shot. Cellulitis.

VAERS ID:474660 (history)  Vaccinated:2012-11-02
Age:1.3  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 3
Location:South Carolina  Entered:2012-11-06, 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: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.H0107263UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF709963UNRL
Administered by: Private     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Mom states she was here 11-2-12 for well visit. Received HIB and PREVNAR. Noted a rash behind ears and face itchy, when pt. got home Tuesday.

VAERS ID:473417 (history)  Vaccinated:2012-11-02
Age:0.6  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-07, Days after onset: 5
Location:Michigan  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Ecchymosis
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B330BA2IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH733AC0IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF724952IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0210AE2PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ecchymosis, Injection site discolouration, Injection site induration, Injection site mass
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Mom brought her son in for an office visit concerned about lump under the skin of his left upper lateral thigh. Per office visit notes: “States has immunizations on 11-2-12 since then has had lump on left thigh. Afebrile, no c/o discomfort, no difficulty moving leg.” “Normal activity, no change in appetite.” “Inspection: Left outer thigh – 1 1/2cm x 2cm grayish, nontender, indurated area.” “Dx: ecchymosis, reassurance offered, symptoms treatment measures reviewed.” “Patient to return on a prn basis.”

VAERS ID:473467 (history)  Vaccinated:2012-11-02
Age:16.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-07, Days after onset: 4
Location:Michigan  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Red rash swelling, sore arm stiff neck headache
Preexisting Conditions: None
Diagnostic Lab Data: EBV test negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH745AD4IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB677BA0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0129730IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Epstein-Barr virus test negative, Headache, Musculoskeletal stiffness, Pain in extremity, Rash erythematous, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Rash and swelling headache and sore arm and stiff neck. Pt given Tylenol and Motrin and given heating pad.

VAERS ID:474612 (history)  Vaccinated:2012-11-02
Age:67.0  Onset:0000-00-00
Gender:Male  Submitted:2012-11-07
Location:Louisiana  Entered:2012-11-07
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: Seasonal allergies; HBP; Thyroid
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1231031UNRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0130231UNLA
Administered by: Other     Purchased by: Private
Symptoms: Incorrect dose administered
SMQs:
Write-up: None -$g no adverse events/symptoms (patient received ZOSTAVAX on 8/30/11, then again on 11/2/12 by accident).

VAERS ID:476433 (history)  Vaccinated:2012-11-02
Age:0.3  Onset:0000-00-00
Gender:Female  Submitted:2012-11-02
Location:Washington  Entered:2012-11-07, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B204AA0IMRL
Administered by: Private     Purchased by: Public
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: 4 mo patient given KINRIX.

VAERS ID:476440 (history)  Vaccinated:2012-11-02
Age:65.0  Onset:2012-11-05, Days after vaccination: 3
Gender:Female  Submitted:2012-11-07, Days after onset: 2
Location:Kansas  Entered:2012-11-07
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
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0139460SCUN
Administered by: Other     Purchased by: Private
Symptoms: Burning sensation, Injection site swelling, Pain, Pruritus, Rash generalised
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Upper body rash, burning itch, swollen injection site, aches.

VAERS ID:477704 (history)  Vaccinated:2012-11-02
Age:64.0  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-07
Location:Unknown  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002415
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1199AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered
SMQs:
Write-up: This spontaneous report as received from a other health professional refers to a 64 years old patient with vaccine for shingles. The patient was vaccinated with ZOSTAVAX on 02-NOV-2012. No other co-suspects were reported. No concomitant medications were reported. On an unknown date the patient experienced expired drug administered. No treatment information was reported. The outcome of expired drug administration is unknown. Expired drug administered is not related to ZOSTAVAX. Lot # 1199AA, expiry date 10/25/2012. No further information available.

VAERS ID:477707 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-07, Days after onset: 5
Location:Unknown  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002646
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a patient of unknown age. The patient was vaccinated with dose 1 ZOSTAVAX in 2009. No other co-suspects were reported. No concomitant medications were reported. On 02-NOV-2012 the patient received a 2nd dose of ZOSTAVAX. The patient is not experiencing any known symptoms. Additional information has been requested.

VAERS ID:473535 (history)  Vaccinated:2012-11-02
Age:67.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 6
Location:Texas  Entered:2012-11-08
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: Zostavax and Pneumovax were administered the same date and time.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105150IMRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Induration, Oedema peripheral, Pain in extremity, Pruritus, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pain, hard lump, red, warm, bruising, entire upper arm swelled up, some itching.

VAERS ID:473695 (history)  Vaccinated:2012-11-02
Age:29.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-08, Days after onset: 5
Location:Nevada  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Admit 10/30 with ascending aortic aneurysm OR for AVR & aortic root repair
Preexisting Conditions: NKDA; Hemochromatosis; Bicuspid aortic valve; Nephrolithiasis; ETOH liver dz; Peptic ulcer dz
Diagnostic Lab Data: Imaging, labs, cultures - negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AB0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0142830IMLA
Administered by: Private     Purchased by: Other
Symptoms: Culture negative, Imaging procedure, Injection site discomfort, Laboratory test normal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever up to 101.8 with some LUE discomfort. ID consulted - imaging, lab, cultures, antibiotics ordered.

VAERS ID:473786 (history)  Vaccinated:2012-11-02
Age:1.3  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-09, Days after onset: 7
Location:Louisiana  Entered:2012-11-09
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) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Decreased appetite, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting began about 6 hours after flu shot. Vomiting lasted for 48 hours. Loss of appetite also began at the same time and lasted for 36 hours. He would drink but he would not eat anything.

VAERS ID:476589 (history)  Vaccinated:2012-11-02
Age:3.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-07, Days after onset: 4
Location:West Virginia  Entered:2012-11-09, 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: (Cold) stuffy nose
Preexisting Conditions: Autism spectrum
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC51413146AA3IMLL
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 24 hours after vaccination redness, swelling, warmth at injection site - 36 hours after vaccination vomiting x 3 - mother reports no fever - (ADVIL given warm compress to leg).

VAERS ID:473840 (history)  Vaccinated:2012-11-02
Age:52.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-10, Days after onset: 7
Location:California  Entered:2012-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hospitalized for 2 days for chest pain, nausea, vomiting and vertigo (Nov. 1 through Nov. 2, 2012)
Preexisting Conditions: COPD, Hepatitis C with ESLD, chronic chest pain (hx of cocaine-induced myocardial infarction x2), hypertension, depression, thrombocytopenia, obstructive sleep apnea, pulmonary hypertension
Diagnostic Lab Data: WBC 8.4 w/ 17 bands on 11/4. Was 3.4 on 11/1 and 2.8 on 11/2. Blood cultures x2 were "NO GROWTH". No drainage at injection site to culture.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AB IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010916 SCLA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Band neutrophil count increased, Blood culture negative, Injection site erythema, Injection site pain, Injection site warmth, Pyrexia, White blood cell count normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain, warmth, erythema and tenderness over site of injection (lateral aspect of left deltoid), fever of 102.5, area of redness is not quite cirucular but approximately 5 to 6 inches in size around site of injection. Also complained of severe back pain onset concurrent with fever and left deltoid pain and redness.

VAERS ID:473841 (history)  Vaccinated:2012-11-02
Age:38.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-10, Days after onset: 7
Location:Virginia  Entered:2012-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Military
Symptoms: Discomfort, Insomnia, Mobility decreased, Musculoskeletal pain, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Arthritis (broad)
Write-up: Left shoulder pain and pain in neck lower left side. Mobility limited by 20%. Discomfort disrupts sleep. Taking ibuprofen with little affect.

VAERS ID:473866 (history)  Vaccinated:2012-11-02
Age:48.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-12, Days after onset: 10
Location:North Carolina  Entered:2012-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Unstable Diabetic
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH718AA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Lip swelling, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Pt receive vaccine at pharmacy, about 30 minutes after getting home her tongue and lips began to swell.

VAERS ID:474224 (history)  Vaccinated:2012-11-02
Age:83.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-12, Days after onset: 10
Location:Michigan  Entered:2012-11-12
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: Penicillin allergy per pt.; Pt is blind
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4490AA3UNRA
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Lacrimation increased, Sensation of foreign body
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Lacrimal disorders (narrow)
Write-up: Pt reported runny eyes, felt like a mass was in her throat, weakness. Pt. went to ER where she received "an IV with steroids".

VAERS ID:477978 (history)  Vaccinated:2012-11-02
Age:66.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-12, Days after onset: 10
Location:Unknown  Entered:2012-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002084
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 66 years old female patient. The patient was vaccinated with, .5 ml PNEUMOVAX23 (route unknown, dose 0.5 ml, product Lot number H013581, expiry 03-MAR-2014) on 02-NOV-2012. No other co-suspects were reported. Concomitant medications Baby Aspirin. On 02-NOV-2012 the patient experienced little was swelling around injection site and induration around injection site, both after receiving PNEUMOVAX23. No treatment information was reported. The outcome of little swelling around injection site and induration around injection site was reported as not recovered/not resolved. The reporters relatedness for little swelling around injection site and induration around injection site is unknown for PNEUMOVAX23. Additional information is not expected.

VAERS ID:473994 (history)  Vaccinated:2012-11-02
Age:54.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-13, Days after onset: 11
Location:Texas  Entered:2012-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: EKG, Troponin, Liver function Test, CBC
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1225NP IM 
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Dyspnoea, Electrocardiogram, Flushing, Full blood count, Liver function test, Troponin
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Weakness, flushing of skin, shortness of breath, Hydration with 1 liter of normal saline, Decadron IV, Benadryl IV and Pepcid IV.

VAERS ID:474134 (history)  Vaccinated:2012-11-02
Age:4.0  Onset:2012-11-13, Days after vaccination: 11
Gender:Male  Submitted:2012-11-14, Days after onset: 1
Location:Oklahoma  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Blister, Scab
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: 20-30 2-3mm vesicles that ruptured and crusted.

VAERS ID:474554 (history)  Vaccinated:2012-11-02
Age:50.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-06, Days after onset: 4
Location:Washington  Entered:2012-11-14, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH730AB0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Eye pruritus, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad)
Write-up: Complained of itchy bloodshot eyes 2 hours after vaccine administration. Had symptoms throughout evening. Next morning, symptoms were resolved.

VAERS ID:478088 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-14, Days after onset: 12
Location:Unknown  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002493
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a patient of unknown age. The patient was vaccinated with dose 1 VAQTA on 20-FEB-2009. And the patient was received the second dose and third dose of VAQTA on 31-MAR-2010 and 02-NOV-2012, respectively. No other co-suspects were reported. No concomitant medications were reported. No adverse symptoms were reported. It was unknown if the patient sought medical attention. At the time of report, the patient''s status was unknown. Additional information has been requested.

VAERS ID:478093 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-14, Days after onset: 12
Location:Unknown  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002404
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a other healthcare worker refers to a patient of unknown age and gender who on 02-NOV-2012, was vaccinated with a dose of VARIVAX (Merck) (dose and lot number not reported) instead of ZOSTAVAX (Merck) due to human error. No other co-suspects were reported. No concomitant medications were reported. No treatment information was reported. No adverse effect reported. At the time of the report, the patient outcome for adverse events was unknown. Additional information has been requested.

VAERS ID:478141 (history)  Vaccinated:2012-11-02
Age:60.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-14, Days after onset: 12
Location:California  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Antibody test, Negative
CDC 'Split Type': WAES1211USA002782
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0069AE SCAR
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report was received from a physician refers to a 60 years old patient(gender unspecified). The patient had a negative history of chicken pox and negative varicella time. On 02-NOV-2012, the patient was vaccinated with a dose of ZOSTAVAX (lot # and route not reported) instead of VARIVAX due to a human error. No concomitant medications were reported. No adverse effect was reported. It was unspecified if the patient had sought medical attention. Additional information has been requested.

VAERS ID:474300 (history)  Vaccinated:2012-11-02
Age:55.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-15, Days after onset: 13
Location:California  Entered:2012-11-15
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: The Doctor put me on Doxycycline 100mg twice a day for 7 days
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 5UNRA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Erythema, Pain in extremity, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Fever, which varied for three days, up to 103, severe pain in the left arm, chills, redness and swelling in the left arm. The left arm is where the pneumonia shot was administered.

VAERS ID:474413 (history)  Vaccinated:2012-11-02
Age:23.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-16, Days after onset: 14
Location:Mississippi  Entered:2012-11-16
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: Latex allergy
Diagnostic Lab Data:
CDC 'Split Type': MS12023
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURUH716AD IDLA
Administered by: Public     Purchased by: Unknown
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Hypoaesthesia, Lip swelling, Tremor
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Received shot around 3:20 PM. Dizziness was first symptom followed by shaking, tightness of chest, shortness of breath, swelling of lips, numbness in face. Symptoms appeared around 3:40-3:45 PM.

VAERS ID:474572 (history)  Vaccinated:2012-11-02
Age:55.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-06, Days after onset: 4
Location:Michigan  Entered:2012-11-16, Days after submission: 10
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: Hypothyroid; High cholesterol
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4481CF UNLA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Fall, Headache, Hypersomnia
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Sudden onset HA at lunchtime after vac. administered. Had to nap after work. Slept all day Sat, very weak when got up to urinate Sat afternoon. Fell in bathroom. Slept Sun. feels "reasonably okay" today.

VAERS ID:474582 (history)  Vaccinated:2012-11-02
Age:43.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-16, Days after onset: 13
Location:Virginia  Entered:2012-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions: None.
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 1IN 
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Dizziness postural, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)
Write-up: Extreme dizziness when I sat down in the couch. My head is spinning so hard. This is the first time I''ve experienced such a feeling. It is so severe. It is so scary. Then as the days progressed it mellowed down but this time the dizziness happens when I''m about to lay down in bed. When I raise or lower down my head from or to down position. After waking up in the morning to turn off the alarm clock my head will moderately spin. And when I get up, I will feel dizziness which I have never experienced in my life. I am a very healthy person and for the first time in my life I am experiencing this dizziness. I am very disappointed and sad if this dizziness will not leave me. It is like incapacitating. When I do stretch out in bed or I am in extreme sigh of relief, my head will spin. Its like when you are experiencing a sexual arousal my head will feel dizziness. It is triggered by head movement and feeling of arousal.

VAERS ID:477015 (history)  Vaccinated:2012-11-02
Age:58.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 5
Location:Idaho  Entered:2012-11-16, Days after submission: 9
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4056BA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Back pain, Headache, Nausea, Neck pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: High fever over 3 1/2 days, nausea, painful joints, pain in neck, lower back, headache.

VAERS ID:474805 (history)  Vaccinated:2012-11-02
Age:33.0  Onset:2012-11-05, Days after vaccination: 3
Gender:Female  Submitted:2012-11-19, Days after onset: 14
Location:South Dakota  Entered:2012-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Pregnancy
Diagnostic Lab Data: Ultrasound done 11/6/2012, no fetal heartbeat. Subsequent spontaneous miscarriage.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Abortion spontaneous, Foetal death, Maternal exposure during pregnancy, Ultrasound antenatal screen abnormal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Pregnancy loss.

VAERS ID:478316 (history)  Vaccinated:2012-11-02
Age:60.0  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-19
Location:Unknown  Entered:2012-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002564
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a other health professional refers to a 60 years old patient. The patient was vaccinated with, 1 DF VARIVAX (Merck) subcutaneous (Lot number was not provided) on 02-NOV-2012. The patient also received Influenza Virus Vaccine (manufacturer unknown). No concomitant medications were reported. On an unknown date the patient received VARIVAX instead of ZOSTAVAX. The patient is not experiencing any known symptoms. The outcome of received VARIVAX instead of ZOSTAVAX and the patient is not experiencing any unknown symptoms is unknown. Additional information has been requested.

VAERS ID:475236 (history)  Vaccinated:2012-11-02
Age:41.0  Onset:2012-11-05, Days after vaccination: 3
Gender:Female  Submitted:2012-11-12, Days after onset: 7
Location:Rhode Island  Entered:2012-11-20, 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: Cold & sinus stuffiness
Preexisting Conditions: Stress
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12263P2IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Injection site erythema, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 3 days after vaccination developed redness at site, plus vomiting & sweats.

VAERS ID:475248 (history)  Vaccinated:2012-11-02
Age:83.0  Onset:2012-11-07, Days after vaccination: 5
Gender:Male  Submitted:2012-11-12, Days after onset: 5
Location:New York  Entered:2012-11-20, Days after submission: 8
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: ACE inhibitors; Omeprazole; ALPHAGAN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA735AA IMRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H013943 SCLA
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster
SMQs:
Write-up: Pt developed zoster 10 days post ZOSTAVAX.

VAERS ID:475099 (history)  Vaccinated:2012-11-02
Age:14.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-21, Days after onset: 19
Location:West Virginia  Entered:2012-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: Per physician notes, no known drug or other allergies
Diagnostic Lab Data: Per nurse, no tests were performed as of this date.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH729AB IMLA
Administered by: Other     Purchased by: Private
Symptoms: Breakthrough pain, Injection site pain, Injection site swelling, Musculoskeletal pain, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Mother reports that child experienced pain and swelling in the arm of the influenza vaccination administration (LD). Child was see by Dr. on 11/05/2012 for left arm pain. Per physician report "left shoulder pain; s/p flu shot. Plan Motrin, local heat. Probably self limiting but could involve deltoid nerve. Will give it time and tx as described. If Sx persist we can do an EMG w/Peds Neurology. Tylenol ok for breakthrough pain. Call or Return if symptoms worsen or persist.

VAERS ID:475353 (history)  Vaccinated:2012-11-02
Age:64.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-22, Days after onset: 20
Location:Illinois  Entered:2012-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cervical stenosis
Diagnostic Lab Data: X-rays.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Other     Purchased by: Unknown
Symptoms: Jaw disorder, Sleep disorder, Swelling face, Toothache, X-ray
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Took flu shot on 11/2/12. That night my tooth began to bother me. The next day it was swollen & hurting badly. The left side of my jaw began to swell. By night it began to swell my chin and the right side of my face. I could not sleep and went to the hospital. If it were just my tooth on my left side, my whole head should not swell up.

VAERS ID:478509 (history)  Vaccinated:2012-11-02
Age:71.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2012-11-22, Days after onset: 19
Location:Unknown  Entered:2012-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA003812
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This spontaneous report was received from a pharmacist concerning 71 years old female patient without drug reactions or allergies. (pertinent medically history was not reported). On 02-NOV-2012, the patient was vaccinated with a dose of PNEUMOVAX23 (lot H010515 exp 13-FEB-2014) intramuscular (dose and indication were not reported). No other co-suspects were reported. No concomitant medications were reported. On 03-NOV-2012, the patient developed a fever, pain and decreased arm mobility after receiving PNEUMOVAX23. The patient was treated with ice and TYLENOL. Laboratory tests were not performed. At the time of report, the patient had not recovered from fever, pain and decreased arm mobility. Additional information has been requested.

VAERS ID:475484 (history)  Vaccinated:2012-11-02
Age:31.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:2012-11-26
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 PASTEURUH716AC1IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB532AA0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURG15420IMRA
Administered by: Public     Purchased by: Public
Symptoms: Incorrect route of drug administration, No adverse event
SMQs:
Write-up: No adverse events reported by client. TUBERSOL (PPD solution) .5cc administered IM in right deltoid.

VAERS ID:475535 (history)  Vaccinated:2012-11-02
Age:32.0  Onset:0000-00-00
Gender:Male  Submitted:2012-11-26
Location:California  Entered:2012-11-26
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: No HX pos. PPD; No LTBI; No other
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AC IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHABV532A0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURG1542 IMLA
Administered by: Public     Purchased by: Public
Symptoms: No adverse event
SMQs:
Write-up: No adverse events reported by client. Tubersol (PPD solution) .5 cc administered IM in left deltoid.

VAERS ID:478648 (history)  Vaccinated:2012-11-02
Age:0.2  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-27
Location:Unknown  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA010655
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0210AE PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a nurse, She states that doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. The patients were vaccinated with M-M-R II. Other suspect therapies included ROTATEQ, Oral. No concomitant medications were reported. On an unknown date the patient experienced doses of MMR II and ROTATEQ that were exposed to 50f for 48 hours were administered to patients. No treatment information was reported. Doses of MMR II and ROTATEQ that were exposed to 50f for 48 hours were administered to patients is not related to M-M-R II and ROTATEQ. At the time of the call, she does not know who received the doses of improperly stored vaccine, but she would like to know if they should be revaccinated. She will call to provide the details when she is able to retrieve the information. SR # provided. It is not know at this time if there have been any adverse effects. Rotavirus vaccine Date given 11/02/2012. Lot # 0210AE. Additional information has been requested.

VAERS ID:478649 (history)  Vaccinated:2012-11-02
Age:1.0  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-27
Location:Unknown  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA010662
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1571AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a nurse, She states that doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. The patients were vaccinated with M-M-R II. Other suspect therapies included ROTATEQ, Oral. No concomitant medications were reported. On an unknown date the patient experienced doses of MMR II and ROTATEQ that were exposed to 50f for 48 hours were administered to patients. No treatment information was reported. Doses of MMR II and ROTATEQ that were exposed to 50f for 48 hours were administered to patients is not related to M-M-R II and ROTATEQ. At the time of the call, she does not know who received the doses of improperly stored vaccine, but she would like to know if they should be revaccinated. She will call to provide the details when she is able to retrieve the information. SR # provided. It is not know at this time if there have been any adverse effects. Additional information received 13Nov2012: MMR vaccine Date given 11/02/2012. Lot # 1571AA. Additional information has been requested.

VAERS ID:478661 (history)  Vaccinated:2012-11-02
Age:0.5  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-27
Location:Unknown  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA010656
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.  PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a nurse. She states that doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. The patients were vaccinated with MMR II. Other suspect therapies included ROTATEQ. No concomitant medications were reported. On an unknown date the patient experienced doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. No treatment information was reported. Doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients is not related to MMR II nd ROTATEQ. At the time of the call, she does not know who received the doses of improperly stored vaccine, but she would like to know if they should be revaccinated. She will call to provide details when she is able to retrieve the information. SR # provided. It is not known at this time if there have been any adverse effects. Rotavirus vaccine Date given 11/02/2012. Lot # 0210AE. Additional information has been requested.

VAERS ID:478666 (history)  Vaccinated:2012-11-02
Age:0.2  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-27
Location:Unknown  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA010657
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0210AE PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a nurse, She states that doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. The patients were vaccinated with M-M-R II. Other suspect therapies included ROTATEQ, oral. No concomitant medications were reported. On an unknown date the patient experienced doses of MMR II and ROTATEQ that were exposed to 50f for 48 hours were administered to patients. No treatment information was reported. Doses of MMR II and ROTATEQ that were exposed to 50f for 48 hours were administered to patients is not related to M-M-R II and ROTATEQ, Oral. At the time of the call, she does not know who received the doses of improperly stored vaccine, but she would like to know if they should be revaccinated. She will call to provide the details where she is able to retrieve the information. SR # provided. It is not know at this time if there have been any adverse effects. Rotavirus vaccine Date given 11/02/2012. Lot # 0210AE. Additional has been requested.

VAERS ID:475590 (history)  Vaccinated:2012-11-02
Age:71.0  Onset:2012-11-04, Days after vaccination: 2
Gender:Male  Submitted:2012-11-27, Days after onset: 23
Location:Tennessee  Entered:2012-11-28, 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: None
Preexisting Conditions: Ibuprofen; Codeine; Muscle relaxers
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12052010IMLA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Joint stiffness, Mobility decreased
SMQs:, Parkinson-like events (broad), Arthritis (broad)
Write-up: Joint pain and stiffness. Hip pain. Could not raise arms.

VAERS ID:475640 (history)  Vaccinated:2012-11-02
Age:66.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Male  Submitted:2012-11-28, Days after onset: 25
Location:West Virginia  Entered:2012-11-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Mass, mid-back refer to surgery for excision
Preexisting Conditions: PMH; COPD; Colonoscopy 2011 w/tubular adenoma (polyp)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1235031UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138471UNLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pain in extremity, Skin warm, Tenderness, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Left arm pain. This is a 66 yo male, came to ER with: being 1 day s/p PNEUMOVAX in left arm, (flu in right) with some pain and swelling shortly after immunization, and awoke this morning with increased pain, swelling & redness distal to site of vaccination. No itching, no constitutional sx. Allergies: WELLBUTRIN XL. Cardiovascular: None, no chest pain. Pulmonary: None, chronic SOB unchanged. Physical exam: Temp: 98.5 F [36.9C (11/03/2012 09:49) BP: 112/75 (11/03/2012 09:49) Resp: 20 (11/03/2012 09:49) Pulse: 108 (11/03/2012 09:49) Pain: 5 (11/03/2012 09:49) Ambulatory, awake, alert. Left arm dorsal aspect from mid triceps to mid forearm is tender to palpation, +1 non-pitting edema, hot, and erythematous. Distal pulses & sensation intact, active ROM of elbow reduced to 90 degrees of flexion. Assessment: 1) PNEUMOVAX adverse reaction. Plan: 1) ice 2) elevation 3) SOLUMEDROL 125 IM 4) prednisone taper.

VAERS ID:475582 (history)  Vaccinated:2012-11-02
Age:49.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-27, Days after onset: 25
Location:Arizona  Entered:2012-11-29, 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:
Current Illness:
Preexisting Conditions: The subject had no reported medical history. She had no reported concomitant therapies.
Diagnostic Lab Data: Laboratory investigations were not reported.
CDC 'Split Type': 201210766
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR 0IDUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache
SMQs:
Write-up: Initial report received on 14 November 2012 from an investigator participating in a study. A 49-year-old female subject had severe headache on 02 November 2012 after receiving first dose of the study vaccine QIV-ID. This vaccine is thimerosal-free) or control product TIV-ID1. This vaccine is thimerosal-free) or control product TIV-ID2. This vaccine is thimerosal-free) on 02 November 2012 (Route and site of administration and batch number not reported). The subject had no reported medical history. The subject had no reported concomitant therapies. The subject experienced the associated symptom of severe headache on 02 November 2012. The subject went into the hospital with complaint of severe headache as a reaction to TOPAMAX. Hence she was hospitalized on 03 November 2012. The subject stayed two days in the hospital. Hospital discharge reports were awaited at the time of this report. Laboratory investigations and corrective treatments were not reported. Outcome of the event of severe headache was not reported. According to the investigator, the event was related to the study vaccine and it was not related to the trial procedures. It was not reported whether the event led to the termination of the subject from the study or not. List of documents held by sender: None. Medical Assessment: This case of "severe headache" experienced by a 49 year old female subject on the same day of vaccination was assessed as related by investigator based on temporal relationship. The event of headache within seven days of vaccination is also captured as solicited systemic event in this study. The subject went into the hospital with complaint of severe headache as a reaction to TOPAMAX. It is not clear if TOPAMAX was given because of partial seizure (its indicated use) or for cluster headache (investigational use), when it was given in relation to the vaccine (before or after) and the reason for giving it and by whom, since there is no reported medical history of seizure or prior therapies. Further details on the pre-existing medical history, especially of the medication of TOPAMAX as well as diagnostic test results (if any) during hospitalization may be informative in the assessment of alternative etiologies. The sponsor assesses this event as related to study vaccine based on temporal relationship. Cumulative Assessment: This is the fourth case of severe headache as the main manifestation reported from any clinical study of FLUZONE vaccines (FLUZONE IM, HD, ID and QIV) conducted by the sponsor. The other three cases of severe headache as the main manifestation occurred more than 7 days post vaccination and were considered as unrelated by investigators. There were 34 cases of severe headache event reported as co-manifestation of other diseases in the clinical studies of FLUZONE vaccines (FLUZONE IM, HD, ID and QIV) conducted by the sponsor and all events were considered as unrelated to study vaccine by investigators. There were 75 cases of severe headache received from spontaneous sources after administration of standard FLUZONE or FLUZONE High Dose or FLUZONE Intradermal seasonal vaccine during the period of around 2 decades i.e. from 1993 to 2012.

VAERS ID:478959 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011272
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 at 10:43, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not provided. Two lot # were involved and the lot # were reported as: 0294AE, expiry date on 06-SEP-2014; and 0395AE, expiry date on 08-NOV-2014. It was unspecified which lot # the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478962 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011274
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 at 11:58, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478966 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011270
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn female patient of unknown age. On 02-NOV-2012 at 08:39, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperature below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478969 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011273
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn female patient of unknown age. On 02-nOV-2012 at 11:03, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not provided. Two lot # were involved and the lot # were reported as: 0294AE, expiry date on 06-SEP-2014; and 0395AE, expiry date on 08-NOV-2014. It was unspecified which lot # the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479137 (history)  Vaccinated:2012-11-02
Age:  Onset:0000-00-00
Gender:Male  Submitted:2012-11-30
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011276
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 at 12:41, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479140 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011275
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 at 12:26, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479143 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011076
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 12:02, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479158 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011077
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn patient of unknown age(unspecified gender). On 02-NOV-2012 20:51, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479165 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011279
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 18:34, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479166 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011278
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 17:44, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479167 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011277
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn female patient of unknown age. On 02-NOV-2012 at 13:01, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479169 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 28
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011280
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 at 19:53, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479265 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-10, Days after vaccination: 8
Gender:Male  Submitted:2012-12-01, Days after onset: 21
Location:Unknown  Entered:2012-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011321
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 10-NOV-2012 18:30, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:476152 (history)  Vaccinated:2012-11-02
Age:9.0  Onset:2012-11-06, Days after vaccination: 4
Gender:Male  Submitted:2012-12-03, Days after onset: 27
Location:Georga  Entered:2012-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: None
Diagnostic Lab Data: + ANA. Decreased C3 and C4 levels. Normal CBC, CMP, UA. Negative RF, HLA-B27, Celiac antibodies, dsDNA.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Private
Symptoms: Antinuclear antibody positive, Arthralgia, Complement factor C3 decreased, Complement factor C4 decreased, Double stranded DNA antibody, Full blood count normal, Laboratory test normal, Metabolic function test normal, Rash, Rheumatoid factor negative, Serum sickness, Tonsillectomy, Urine analysis normal
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Rash and joint pain. Subsequently diagnosed as serum sickeness. Currently on steroid therapy and with joint pain. Most likely had same adverse event in 2011 - misdiagnosed at that time as JIR vs JRA vs Strep induced arthritis. Pt completely recovered after tonsillectomy and case of serum sickness with Omnicef.

VAERS ID:479620 (history)  Vaccinated:2012-11-02
Age:59.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-12-03, Days after onset: 31
Location:North Carolina  Entered:2012-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA004150
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a nurse refers to a 59 years old patient. The patient was vaccinated with a dose of VARIVAX (Merck) on 02-NOV-2012 (lot number, dose and route not provided). No other co-suspects were reported. No concomitant mediations were reported. On 02-NOV-2012 the patient received VARIVAX (Merck) instead of ZOSTAVAX due to human error. No adverse event was reported. Additional information has been requested.

VAERS ID:479760 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2012-12-04, Days after onset: 32
Location:Unknown  Entered:2012-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011348
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 02-NOV-2012 at 20:02, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot # were involved and the lot # were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot # the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:476626 (history)  Vaccinated:2012-11-02
Age:45.0  Onset:2012-11-08, Days after vaccination: 6
Gender:Female  Submitted:2012-12-05, Days after onset: 27
Location:South Dakota  Entered:2012-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH756AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Joint range of motion decreased, Pain in extremity
SMQs:, Arthritis (broad)
Write-up: Arm is sore with decrease overhead ROM.

VAERS ID:476953 (history)  Vaccinated:2012-11-02
Age:26.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-12-06, Days after onset: 34
Location:Pennsylvania  Entered:2012-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
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) (FLUZONE)SANOFI PASTEURUH719AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site rash, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Developed a large red raised area at injection site, followed by rash and fever.

VAERS ID:477791 (history)  Vaccinated:2012-11-02
Age:4.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-26, Days after onset: 24
Location:Georga  Entered:2012-12-12, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH733AC3IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Arm swelling, redness, induration of (L) arm. Went to ER. Tx is antibiotic.

VAERS ID:479249 (history)  Vaccinated:2012-11-02
Age:38.0  Onset:2012-11-06, Days after vaccination: 4
Gender:Female  Submitted:2012-12-24, Days after onset: 48
Location:Ohio  Entered:2012-12-24
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: N.K.D.A.; Med: Goiter; hand paresthesias
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC111AA UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B080DA UNLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site macule, Injection site pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Mildly pruritic macular rash on left shoulder (vacc. admin. site) 3-5 days after vaccine administration. Rash then spread to chest, upper back, Rt. upper shoulder.

VAERS ID:479380 (history)  Vaccinated:2012-11-02
Age:65.0  Onset:2012-12-03, Days after vaccination: 31
Gender:Female  Submitted:2012-12-13, Days after onset: 10
Location:Ohio  Entered:2012-12-27, Days after submission: 14
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: Lab lymphocytes <.7x10 9/L resulting in 0.39
CDC 'Split Type': METROHEALTHESP201257647
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Private     Purchased by: Unknown
Symptoms: Lymphocyte count decreased
SMQs:, Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad)
Write-up: Lymphocytes on 2012-12-03.

VAERS ID:480541 (history)  Vaccinated:2012-11-02
Age:60.0  Onset:2012-12-13, Days after vaccination: 41
Gender:Female  Submitted:2012-12-27, Days after onset: 14
Location:Unknown  Entered:2012-12-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions: SULFA, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1212USA007509
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Blister, Burning sensation, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad)
Write-up: This spontaneous report as received from a 60-year-old female patient regarding herself who has allergy to sulfa. Pertinent medical history was none. Patient weight was reported as 150 (units unknown). Approximately on an unspecified date in November 2012 (reported as a little over 2 weeks). The patient was vaccinated with a dose of ZOSTAVAX (Lot number, expiry date, dose and route were not reported) in left arm. Concomitant medications included high blood pressure, thyroid and cholesterol medications, niacinamide and cyanocobalamin. On 13-DEC-2012, the patient had blisters on her hands, started with itching and burning on her hands resulting in blisters which stops on the side of her thumbs being a dime size may be little smaller. The patient sought no medical attention and no treatment was provided. The outcome of all the reported events was unknown. Additional information is not expected.

VAERS ID:479808 (history)  Vaccinated:2012-11-02
Age:74.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-11-15, Days after onset: 13
Location:Unknown  Entered:2012-12-28, Days after submission: 43
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: PM Hx CAD; GERD; DM II; ASHD w/bypass; BPH; AFib
Diagnostic Lab Data: US of left arm - No evidence of DVT; subcutaneous fat edema in the forearm
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.A013394 IMAR
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Musculoskeletal stiffness, Oedema peripheral, Ultrasound scan abnormal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: PPV23 0.5 ml IM given in deltoid - 11/3/12 pt called to report redness & swelling & stiffness in the arm shoulder to wrist - instructed to use cold compresses and Ibuprofen - resolved 2-3 days

VAERS ID:480613 (history)  Vaccinated:2012-11-02
Age:51.0  Onset:2012-11-03, Days after vaccination: 1
Gender:Female  Submitted:2013-01-03, Days after onset: 61
Location:Ohio  Entered:2013-01-08, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP58406 UNLA
Administered by: Other     Purchased by: Public
Symptoms: Malaise, Paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Received inj. 5:35 PM on 11/2/2012 - within a few hours became very ill 3:05 AM 11/3/2012 on the floor unable to move paralyzed from the chest down ER visit admitted to hospital stayed in the hospital from 11-3 - 11-9. Transferred to Rehab nursing facility. Released on 11-28-2012.

VAERS ID:480780 (history)  Vaccinated:2012-11-02
Age:26.0  Onset:2013-01-07, Days after vaccination: 66
Gender:Female  Submitted:2013-01-09, Days after onset: 2
Location:Indiana  Entered:2013-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA736AA IM 
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster
SMQs:
Write-up: Shingles.

VAERS ID:481183 (history)  Vaccinated:2012-11-02
Age:0.2  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2013-01-11, Days after onset: 70
Location:Illinois  Entered:2013-01-11
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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B357AA0IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH689AA0IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG150740IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.H0121170PO 
Administered by: Private     Purchased by: Private
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Short spell of emesis without any other symptoms.

VAERS ID:481349 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:2013-01-15, Days after onset: 74
Location:California  Entered:2013-01-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1301USA003192
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a patient of unknown age. The patient was vaccinated with first dose of GARDASIL (lot number unspecified) on 16-JUN-2011 and second dose on 02-NOV-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effects reported. It was unknown if the patient had sought medical attention. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.

VAERS ID:484395 (history)  Vaccinated:2012-11-02
Age:  Onset:0000-00-00
Gender:Male  Submitted:2013-02-13
Location:Unknown  Entered:2013-02-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Antibiotics; Oxygen
Current Illness: Drop in blood oxygen; Ingrown hair
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0965921B
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Condition aggravated, Cough, Dyspnoea, Influenza, Oxygen saturation decreased, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: This case was reported by a consumer via literature and described the occurrence of influenza in an elderly male subject who was vaccinated with Influenza vaccine (manufacturer unspecified). A physician or other health care professional has not verified this report. Concurrent medical conditions included ingrown hair. Co-suspect medication included ADVAIR multi dose powder inhaler and Albuterol. Concurrent medications included antibiotics and Oxygen. On unknown dates, the patient started Fluticasone propionate+salmeterol xinafoate (unknown), unknown dosing. In November or December 2012 the subject received unspecified dose of Influenza vaccine unspecified (unknown). At an unknown time after starting Fluticasone propionate+salmeterol xinafoate and Albuterol, and approximately, three months after vaccination with Influenza vaccine unspecified, the subject experienced influenza, vaccination failure, weakness, hard to breath, heavy cough and blood oxygen really drops [low oxygen saturation aggravated]. The subject reported "I got a flu shot some months back, I think maybe November/December some time, but it only goes to show you that even the flu vaccination doesn''t always work, because I''m battling it right now, very weak, hard to breathe, heavy coughing, but no fever. This last couple days it seems the more I lie down the more my blood oxygen goes down. When I have a bowel movement under normal circumstance my blood oxygen drops, but now it really drops so I have to be especially careful when I go. I glad that I''m in a nursing home right now, but they always can''t do much for you. Fortunately I started antibiotic on Friday for a different related problem, an infected ingrown hair on my but...LOL. Hopefully it will help both ways, my doctor won''t be back until Monday to do anything for me, like ROXYNAL for air starvation, I now have my oxygen at 5 units and it makes my canulas tubing at my nose soooo loud I can''t stand it. This is the type flu that scares me, because it can easily take my life." This case was assessed as medically serious by GSK. At the time of reporting the influenza, weakness, hard to breath, heavy cough and low oxygen saturation aggravated were unresolved.

VAERS ID:485195 (history)  Vaccinated:2012-11-02
Age:1.8  Onset:2012-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-14, Days after onset: 12
Location:Kansas  Entered:2013-02-20, Days after submission: 98
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2012SE84316
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2109 IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: A report has been received from a Health Professional concerning a 1 year old, male subject, who had been receiving Nasal FLUMIST. FLUMIST started on 02-Nov-2012. The nurse INADVERTENTLY ADMINISTERED A HALF-DOSE OF FLUMIST TO A 22 MONTH-OLD PATIENT which started on 02-Nov-2012. The patient recovered from the event of INADVERTENTLY ADMINISTERED A HALF-DOSE OF FLUMIST TO A 22 MONTH-OLD PATINET on 06-Nov-2012. The report was considered to be non-serious by the reporter. Corrected report on 28-Nov-2012: the vaccine was administered by the nurse, the reason was oversight. Outcome of the adverse event added.

VAERS ID:485765 (history)  Vaccinated:2012-11-02
Age:60.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2013-02-23, Days after onset: 113
Location:West Virginia  Entered:2013-02-28, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same~Influenza (Seasonal) (no brand name)~1~45.00~Patient
Other Medications: Losartan; simvastatin; clopidogrel; chlorthalidone; amlodipine; potassium; carvedilol
Current Illness: No
Preexisting Conditions: CHD; Bypass
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP585071IMUN
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Chills, Dyspnoea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Fever, anxiety, chills, in bed for few days after rapid breathing.

VAERS ID:490446 (history)  Vaccinated:2012-11-02
Age:43.0  Onset:2012-11-29, Days after vaccination: 27
Gender:Female  Submitted:2013-04-30, Days after onset: 151
Location:Florida  Entered:2013-04-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium; Clarinex-D; Lipitor; Wellbutrin
Current Illness: None
Preexisting Conditions: Allergic--Augmentin
Diagnostic Lab Data: CBC, CMP, ANA, MRI, NVC
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59307 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Antinuclear antibody, Ear pain, Fatigue, Full blood count, Hypoaesthesia, Metabolic function test, Myelitis, Nerve conduction studies, Nuclear magnetic resonance imaging, Paraesthesia, Sensation of heaviness, Sinusitis
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: EE experienced numbness and tingling of left leg. EE states after receiving the flu shot she became ill several days later with a sinus infection, ear ache and fatigue. She was treated in an urgent care clinic and given antibiotics. She states she had good response to the medication however the following weekend (11/11) left leg heaviness, foot numbness and decrease sensation to left foot. She then followed up with her (11/15/13) PCP who prescribed a steroid. On f/u visit (week later) she showed no significant improvement so labs were ordered. Because of previous elevated ANA she is being followed by a Rheumatologist who then referred her to a neurologist for evaluation. NCS was performed to r/o MS along with other exams to r/o autoimmune diseases. EE continues with neurologist follow-up but has improved. Dx. Inflammatory Myelitis T3 secondary to flu vaccine.

VAERS ID:492892 (history)  Vaccinated:2012-11-02
Age:0.5  Onset:2012-11-02, Days after vaccination: 0
Gender:Male  Submitted:2013-05-29, Days after onset: 208
Location:Mississippi  Entered:2013-05-30, 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: None
Current Illness: Acute sinusitis; FIT; abnormal stool; conjunctivitis
Preexisting Conditions: AOM; Sinusitis; FIT; Tear duct occlusion; GERD; Colic; Ankyloglossia; Lacotse intolerance
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B351AB2UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG107842UNLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0050AE2PO 
Administered by: Public     Purchased by: Public
Symptoms: Ankyloglossia congenital, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Congenital, familial and genetic disorders (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Pt presented for his 12 mo WCC and mother reported that patient had fine hand tremors that occurred 5x weekly for a month after his 6 mo WCC and shots. These episodes lasted for a couple of seconds. He did not have a loss of consciousness. Patient has no residual symptoms.

VAERS ID:492950 (history)  Vaccinated:2012-11-02
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-30
Location:Florida  Entered:2013-05-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1305USA011724
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant refers to a patient of unknown demographics. On an unknown date, the patient was vaccinated with a dose of improperly stored GARDASIL (Lot number, expiry date, route and dose were not reported). The certified medical assistant reported that the vaccine was exposed to temperature of 26 F(Fahrenheit)for a total of 135 hours. No adverse effects reported. Follow-up received. Certified Medical assistant stated that other 104 children received GARDASIL. Follow up information has been received from the certified medical assistant regarding a 13 years old, female patient with no pertinent medical history reported. On 28-AUG-2012 the patient was vaccinated with the first dose of GARDASIL (lot number and expiration date not reported) (intramuscular on the right arm, dose not reported). On 02-NOV-2012 the patient received the second dose of GARDASIL (lot number and expiration date not reported) (intramuscular on the left arm, dose not reported). It was reported that the patient did not seek medical attention. This is one of the several reports from the same source. Additional information is not expected.

VAERS ID:494467 (history)  Vaccinated:2012-11-02
Age:56.0  Onset:2012-11-11, Days after vaccination: 9
Gender:Male  Submitted:2013-06-18, Days after onset: 218
Location:Florida  Entered:2013-06-18
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No The following information was obtained through follow-up and/or provided by the government. Started strenuous exercise program.
Preexisting Conditions: No The following information was obtained through follow-up and/or provided by the government. PMH: severe osteoarthritis spine Tx''d w/ narcotics. Allergies: pineapple, apples, milk.
Diagnostic Lab Data: Lumbar punture and culture The following information was obtained through follow-up and/or provided by the government. 7/5/2013 lab/diagnostic records received for DOS 11/13/2012-1/8/2013. Blood: WBC 23.8 K/mm3 (H), polys 88% (H), lymphs 12% (L), Hgb 9.1 g/dL (L), Hct 27.8% (L), Plt 53 K/mm3 (L), Ca 7.9 mg/dL (L), Na 134 mEq/L (L), K 5.4 mEq/L (H), Cl 110 mEq/L (H), CK 367 U/L (H), glucose 441 mg/dL (H), BUN 49 mg/dL (H), creatinine 1.4 mg/dL (H), AST 122 U/L (H), LDH 364 U/L (H), uric acid 3.4 mg/dL (L), protein 5.7 g/dL (L), albumin 2.5 g/dL (L). CSF: WBC 10 (H), RBC 717 (H), protein 90 mg/dL (H). ABGs, swallow study abnormal. Blood/CSF cx, respiratory virus cx, C. diff, Legionella, MRSA, HSV, HIV, flu A/B, WNV (-). Urine/sputum cx: (+)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12052010IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abasia, Adjustment disorder, Anaemia, Angiogram abnormal, Anxiety, Aortic arteriosclerosis, Aortic valve incompetence, Aspartate aminotransferase increased, Barium swallow abnormal, Bladder catheterisation, Blood albumin decreased, Blood calcium decreased, Blood chloride increased, Blood creatine phosphokinase increased, Blood creatinine increased, Blood culture negative, Blood gases abnormal, Blood glucose increased, Blood lactate dehydrogenase increased, Blood potassium increased, Blood sodium decreased, Blood urea increased, Blood uric acid decreased, Bronchoscopy, CSF culture negative, CSF protein increased, CSF white blood cell count increased, Central venous catheterisation, Chest X-ray abnormal, Clostridium test negative, Coma, Computerised tomogram abdomen abnormal, Corneal opacity, Culture, Culture urine positive, Drug screen positive, Echocardiogram abnormal, Ejection fraction decreased, Electromyogram abnormal, Endotracheal intubation, Extubation, Gait disturbance, Gastrostomy, Guillain-Barre syndrome, HIV test negative, Haematocrit decreased, Haemoglobin decreased, Herpes simplex serology negative, Hypoaesthesia, Hypoaesthesia oral, Hyporeflexia, Hypoxia, Immunoglobulin therapy, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Intensive care, Legionella test, Lumbar puncture, Lymphocyte percentage decreased, Major depression, Mechanical ventilation, Memory impairment, Muscular weakness, Neutrophil percentage increased, Nitrite urine present, Nuclear magnetic resonance imaging brain abnormal, Nuclear magnetic resonance imaging spinal abnormal, Pain, Paraesthesia, Platelet count decreased, Protein total decreased, Pseudomonas infection, Pseudomonas test positive, Pyrexia, Quadriparesis, Rash, Red blood cells CSF positive, Red blood cells urine positive, Respiratory failure, Sinus tachycardia, Sputum culture positive, Staphylococcus test negative, Thrombocytopenia, Tracheobronchitis, Tracheostomy, Urinary tract infection, Urine abnormality, Urine leukocyte esterase positive, Viral test negative, West Nile virus test negative, White blood cell count increased, White blood cells urine positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (broad), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Dystonia (broad), Parkinson-like events (broad), Drug abuse and dependence (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (narrow), Demyelination (narrow), Corneal disorders (narrow), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (narrow)
Write-up: Guillain Barre Syndrome. Tingling in fingers and toes. Progressed to muscle weakness. Emergency room. IgG started. Respirator for 3 monthes. Coma for 1 month. Painful physical therapy until present. The following information was obtained through follow-up and/or provided by the government. 7/5/2013 hospital records received for DOS 11/13/2012-1/11/2013. D/c Dx''s: 1) severe GBS; 2) severe functional decline 2^ to GBS; 3) respiratory insufficiency s/p tracheostomy w/ Passy-Muir valve; 4) sinus tach, stable; 5) major depressive disorder; 6) functional decline & gait disturbance; 7) adjustment disorder w/ mixed emotional features. Pt c/o abrupt onset UE/LE numbness/tingling/weakness (progressively worsening), slight oral numbness. PE: anxious, unable to walk. Admitted. Tx''t: foley. Complications: fever, ascending paralysis, decreased LE reflexes, respiratory failure, hypoxemia, possible aspiration, thrombocytopenia, rt corneal opacification, tracheobronchitis w/ multiple drug resistant bacteria, P. aeruginosa UTI. Tx''t: ICU, intubation, trache, mechanical ventilation, bronchoscopy w/ removal of secretions, PICC, IVIG, steroids, PT, OT, ST, PEG tube, ABX. Developed rash to PCN, meropenem. Pt d/c''d to inpt rehab facility, extubated, limited mobility. 7/5/2013 rehab hospital records received for DOS 1/11/2013. D/c Dx''s: 1) severe GBS; 2) adjustment disorder; 3) functional decline; 4) gait disturbance; 5) respiratory failure; 6) osteoarthritis; 7) anemia; 8) quadriparesis. Pt transferred w/ hx above. Tx''t: PT, OT, ST. Trache reversed, PEG removed. Developed memory impairment of unclear etiology, improved over time. Pt d/c''d home w/ Rx, care, & f/u instructions.

VAERS ID:495763 (history)  Vaccinated:2012-11-02
Age:46.0  Onset:2012-12-16, Days after vaccination: 44
Gender:Female  Submitted:2013-07-02, Days after onset: 197
Location:Wisconsin  Entered:2013-07-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Do not know date and time of vaccination. Pt received approximately 1-2 weeks prior to admissionto hospital on 12/20/2012
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Back pain, Dysphagia, Dyspnoea, Guillain-Barre syndrome, Hypoaesthesia, Mechanical ventilation, Neck pain, Respiratory failure, Tracheostomy
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Demyelination (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Do not know date and time of event--pt reported symptoms started approximately 4 days prior to admission to hospital on 12/20/2012 symptoms: back and neck pain, generalized weakness, numbness, shortness of breath, difficulty swallowing--$g diagnosed with Guillain Barre syndrome with respiratory failure requiring mechanical ventilation/tracheostomy, prolonged rehabilitation.

VAERS ID:519965 (history)  Vaccinated:2012-11-02
Age:55.0  Onset:2012-11-05, Days after vaccination: 3
Gender:Female  Submitted:2014-01-17, Days after onset: 438
Location:Missouri  Entered:2014-01-21, 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:
Preexisting Conditions:
Diagnostic Lab Data: Was told there is no conclusive tests to say it was positive to flu vaccine.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06649221A IMRA
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Hypoaesthesia, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Received vaccine and 48 hrs later, lost feeling in hands then body from a blackout. Had felt exhausted after shot for months. Exhaustion for that year.

VAERS ID:520687 (history)  Vaccinated:2012-11-02
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2014-01-26
Location:Unknown  Entered:2014-01-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Blood test, low in iron, not provided
CDC 'Split Type': WAES1401USA010319
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blood iron decreased, Menometrorrhagia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: This spontaneous report as received from a health care worker refers to an approximately 14 year old female patient. The patient had no pertinent medical history or drug allergies. On 16-AUG-2012, the patient was vaccinated with GARDASIL dose 1. Subsequent does of GARDASIL were administered on 02-NOV-2012 dose 2 and 08-NOV-2013 dose 3. No concomitant medications were reported. On an unknown date approximately in 2013, the patient experienced abnormal periods. The reporter stated that the patient first reported abnormal periods on 03-DEC-2013 and mentioned that the patient was bleeding for 27 days. The patient had some blood work done and diagnosed to be low in iron. The patient received treatment with iron supplement. The outcome of abnormal periods and low in iron was reported as not recovered/not resolved. The patient sought medical attention by visiting the doctor''s office. Additonal informatkon has been requested.

VAERS ID:529879 (history)  Vaccinated:2012-11-02
Age:16.0  Onset:2012-12-10, Days after vaccination: 38
Gender:Female  Submitted:2014-05-01, Days after onset: 506
Location:North Carolina  Entered:2014-05-01
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: NKA; Depression
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH713AB IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0176981IMRA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Headache, Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Nausea, vomiting, syncope, fatigue, headaches 12/2012 - present.

VAERS ID:474845 (history)  Vaccinated:2012-11-02
Age:5.0  Onset:2012-11-05, Days after vaccination: 3
Gender:Female  Submitted:2012-11-19, Days after onset: 14
Location:Foreign  Entered:2012-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Activated partial thromboplast, Nov2012, 23s; Alanine aminotransferase, Nov2012, 0.25ukat/l; Aspartate aminotransferase, Nov2012, 0.43ukat/l; Basophils, Nov2012, 1.4%; Blood glucose, Nov2012, 5.13mmol/L; Calcium, Nov2012, 2.59mmol/l; Chloride, Nov2012, 107.7mmol/l; Computerized tomogram, 05ov2012, See text; Creatinine, Nov2012, 23.5umol/L; Electroencephalogram, Nov2012, See text; Electroencephalogram, 06Nov2012, See text; Eosinophils, Nov2012, 3.5%; Fibrin D dimer, Nov2012, 172.908ng/ml, Fibrin D dimer, Nov2012, 3.58g/L; Heart rate, 05Nov2012, 120bpm; Hematocrit, Nov2012, 0.350-0.371; Hemoglobin, Nov2012, 126-127g/L; International normalized ratio, Nov2012, 1.08; MCH, Nov2012, 28.5-30pg; MCHC, Nov2012, 360g/L; MCV, Nov2012, 83.1-83.3g/L; Ma
CDC 'Split Type': B0844861A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURERAC20B209AC IMRA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERAC20B209AC IMRA
Administered by: Other     Purchased by: Other
Symptoms: Activated partial thromboplastin time shortened, Alanine aminotransferase, Altered state of consciousness, Aspartate aminotransferase normal, Basophil percentage, Blood calcium normal, Blood chloride normal, Blood creatinine, Blood fibrinogen normal, Blood glucose normal, Blood magnesium decreased, Blood phosphorus normal, Blood potassium normal, Blood prolactin increased, Blood sodium normal, Blood urea, Computerised tomogram head, Computerised tomogram normal, Dyskinesia, Electroencephalogram abnormal, Eosinophil percentage, Epilepsy, Eye movement disorder, Facial paresis, Fibrin D dimer normal, Grand mal convulsion, Haematocrit normal, Haemoglobin normal, Hemiparesis, International normalised ratio normal, Leukocytosis, Mean cell haemoglobin concentration, Mean cell haemoglobin normal, Mean cell volume normal, Moaning, Mobility decreased, Monocyte percentage, Monoplegia, Muscle twitching, Neurological examination abnormal, Neurone-specific enolase, Ophthalmological examination normal, Platelet count normal, Procalcitonin increased, Prothrombin time, Prothrombin time normal, Red blood cell count normal, Restlessness, Tongue biting, Tremor, Urine analysis, White blood cell count increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This case was reported by a physician via a sales representative and described the occurrence of generalized tonic clonic epileptic seizure in a 5-year-old female subject who was vaccinated with INFANRIX-polio (GlaxoSmithKline). The subject''s medical history included that she was a child of the 1st pregnancy, full term baby, born by vacuum extractor (No resuscitation, weight 3850 g, height 52 cm). She was at the hospital due to her head and had some "shadow in her head" (?). A follow-up examination showed no pathology. Psychomotor development was appropriate. The subject was not breastfed, no neurological monitoring, no diseased was noted. She was not seen by any specialist so far. She did not take any medications on long-term basis, had no allergies. Subject''s parents and brother were healthy. Epidemiological history was negative. She might have had a tick in last summer, but no spot was seen. On 2 November 2012, the subject received an unspecified dose of INFANRIX-polio (intramuscular, right deltoid). On 5 November 2012, 3 days after vaccination with INFANRIX-polio, the subject experienced generalised tonical clonical seizures, consciousness disorder and left-side hemiparesis. Before the adverse events, on the same day, the subject had no headache, no vomiting, no injury and did not fall. The subject started trembling. Series of seizures of upper and lower limbs, more intensive on the right side were noticed. The seizures on the muscles started as mild twitching and gradually increased to severe seizures. The intensity of twitching was gradually increasing in several episodes, approximately 5 times. It lasted about 13 minutes, the girl did not react, had unconscious glance and was moaning. The emergency number was called. Meanwhile, the seizures have spontaneously subsided. She had blood on her lips (it was noticed that her tongue was bitten). She could open her mouth on one side only. She could not move her left arm and leg. When the doctor arrived, the eyes were not fixing, a deviation of the neck and eyes to the right side and a paresis were noted. There was a plegia of the left arm and a mild facial paresis was noted. The child received 5 mg of DENSITIN rectally. Her vital functions were normalized during the transport. The subject did not vomit and had no seizure activity. She was brought to the hospital and was admitted. On admission, the patient was fully conscious, well oriented, had no fever, no meningeal signs, and hydration was appropriate. Cardiopulmonary was well compensated, breathing was clear, abdomen was without pathology. Initially mild leucocytosis was recorded, haemocoagulation was normal, D-dimers normal, biochemical parameters including minerals were normal, and low inflammatory activity was detected. Eye fundus revealed no stasis of the papilla on both sides, neurological examination revealed moderated left-side hemiparesis, central lesion of the facial nerve on the left side. A status post clonical generalised epiparoxysm with left-side central hemiparesis was diagnosed. The subject was hospitalised for 3 days (from 5 November 2012 to 7 November 2012). On 5 November 2012, according to the recommendation of the neurologist, a Computed Tomography scan was carried out, both narrative and post-contrast which showed no pathology. Vital functions were observed and they were regular. Scans were partially deteriorated by artefacts due to the child''s restlessness. Brain parenchyma of both infratnetorial and supratentorial, native and post-contrast was of normal density, no focal signs of density or expansive process. The chamber system was of regular size and shape, positioned in the middle plane. Subarachnoidal space at the base and in the area of convexity are of regular configuration. Middle structures were not dislocated. No pathology was found. Ophthalmological examination showed optic nerve target with normal margin, coloured, within the level, irregular vessels, Foveal Reflex missing in macula, the reti

VAERS ID:475230 (history)  Vaccinated:2012-11-02
Age:  Onset:2012-11-06, Days after vaccination: 4
Gender:Male  Submitted:2012-11-21, Days after onset: 15
Location:Foreign  Entered:2012-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Travel to foreign country
Diagnostic Lab Data: Body temperature, 06Nov2012, up to 39.6degC; Urinalysis, Nov2012, normal; Weight loss, 12Nov2012, 4kg
CDC 'Split Type': D0077837A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA739AC UNUN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Chills, Headache, Hyperaesthesia, Hyperpathia, Mobility decreased, Night sweats, Pollakiuria, Pyrexia, Tachycardia, Type IV hypersensitivity reaction, Urine analysis normal, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: This case was reported by a physician and described the occurrence of delayed type hypersensitivity in an elderly male subject of unspecified age who was vaccinated with INFLUSPLIT (GlaxoSmithKline). The reporter, a retired physician, was also the consumer. Last travel to a foreign country was about half a year prior to vaccination with INFLUSPLIT. At the time of vaccination, on 02 November 2012, the subject showed no signs of pharyngitis, bronchitis or rhinitis and therefore possible underlying viral disease was very unlikely. Urinalysis was normal. On 02 November 2012 the subject received a dose of INFLUSPLIT (0.5 ml, unknown). During the first three days post vaccination with INFLUSPLIT, the subject experienced no adverse events. Approximately four days post vaccination with INFLUSPLIT, on 06 November 2012, the subject experienced severe clinical symptoms of possible delayed type hypersensitivity with severe shaking chills, high fever of up to 39.6 degC, mild to short time moderate moving headache, severe night sweat, inability to get up without help (decreased mobility), mild tachycardia, pollakisuria, hyperpathia/hyperesthesia skin, mild ankle joint arthralgia and weight loss of 4 kg. This case was assessed as medically serious by a GSK physician. After about one week, on 12 November 2012, the clinical symptoms were improved. Follow-up information has been requested.

VAERS ID:479690 (history)  Vaccinated:2012-11-02
Age:81.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2012-12-28, Days after onset: 56
Location:Foreign  Entered:2012-12-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Thrombocyte count, 26Nov2012, 98
CDC 'Split Type': B0855322A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  IMUN
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Anaemia, Dizziness, Dyslipidaemia, Dyspnoea, Glaucoma, Hypertension, Hypertonia, Muscular weakness, Pallor, Platelet count decreased, Pruritus generalised, Thrombocytopenia, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Dyslipidaemia (narrow), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Lipodystrophy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: This case was reported by a nurse via a regulatory authority (# FI-FIMEA-20121684) and described the occurrence of glaucoma in a 81-year-old female subject who was vaccinated with TWINRIX ADULT (GlaxoSmithKline), FLUARIX. On 2 November 2012, the subject received 2nd dose of TWINRIX ADULT (intramuscular, unknown injection site; lot number not provided), unspecified dose of FLUARIX (intramuscular, unknown injection site; lot number not provided). On 2 November 2012, less than one day after vaccination with FLUARIX and TWINRIX ADULT, the subject experienced vaccination site pain (in the site of FLUARIX - injection), itching of the skin overall in the body, weakness in the legs, and dizziness during the night. On 11 November 2012, 9 days after vaccination with FLUARIX and TWINRIX ADULT, the subject experienced pallor and anemia was detected. On 15 November 2012, 13 days after vaccination with FLUARIX and TWINRIX ADULT, the subject experienced dyspnea. On 26 November 2012, 24 days after vaccination with FLUARIX and TWINRIX ADULT the subject experienced thrombocytopenia, her thrombocytes level was of 98. The subject was diagnosed with hypertension, hypertonia nos, dyslipidaemia and glaucoma. The subject was hospitalised. The subject was treated with XALACOM. At the time of reporting the outcome of the events was unspecified.

VAERS ID:482888 (history)  Vaccinated:2012-11-02
Age:44.0  Onset:0000-00-00
Gender:Male  Submitted:2013-01-29
Location:Foreign  Entered:2013-01-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0862751A
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA722AD IMUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Inflammation, Respiratory tract congestion, Sinus disorder, Sinus headache
SMQs:, Guillain-Barre syndrome (broad)
Write-up: This case was reported by a pharmacist and described the occurrence of sinus problem in a 44-year-old male subject who was vaccinated with FLUARIX (GlaxoSmithKline) and FLUARIX (GlaxoSmithKline). Concurrent medications included Vitamin supplements. The subject had no relevant medical history. Before the vaccination, the subject was healthy. On 22 November 2011, the subject received an unspecified dose of FLUARIX (intramuscular, unknown injection site). In November 2011, within days of vaccination with FLUARIX, the subject experienced mild sinus pain. The subject also experienced congestion and inflammation. At the time of reporting, the outcome of the events was unspecified. On 2 November 2012, the subject received an unspecified dose of FLUARIX (intramuscular, unknown injection site). In November 2012, within days of vaccination with FLUARIX, the subject experienced severe sinus problem. The subject also experienced loss of energy. The subject was hospitalised. At the time of reporting, the events were unresolved.

VAERS ID:485108 (history)  Vaccinated:2012-11-02
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-28
Location:Foreign  Entered:2013-02-20, Days after submission: 84
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2012SE90576
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AF2105 IN 
Administered by: Other     Purchased by: Other
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: A report has been received from a physician via sales representative concerning 14 year-old female patient. The patient''s medical history, concomitant medications and concurrent diseases were not reported. On an unspecified date the patient received nasal FLUENZ. The patient experienced intense myalgia. At reporting time the myalgia had considerably decreased but the patient had not yet recovered from the event. The report was considered to be non-serious by company physician.

VAERS ID:496434 (history)  Vaccinated:2012-11-02
Age:26.0  Onset:2012-11-02, Days after vaccination: 0
Gender:Female  Submitted:2013-07-10, Days after onset: 250
Location:Foreign  Entered:2013-07-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergy; Hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': PHHY2012DE107195
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FOREIGN)NOVARTIS VACCINES AND DIAGNOSTICS031011A IMLA
Administered by: Other     Purchased by: Other
Symptoms: Anaphylactic reaction, C-reactive protein normal, Urticaria, White blood cell count normal
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)
Write-up: Case number PHHY2012DE107195 is an initial spontaneous report received from the Health Authority (PEI, reference number: DE-PEI-PEI2012059409) on 22 Nov 2012, and with non-significant follow up received on 07 Feb 2013, with a follow-up received from a Quality Assurance department (reference number: 209125) on 02 Jul 2013. This report refers to a 26-year-old female patient. Past medical history included allergy against birch pollen, apple and hazelnut. Concomitant medication was not provided. On 02 Nov 2012 at 12 am, she was vaccinated with OPTAFLU (batch number: 031011A) intramuscularly into the left upper arm. On 02 Nov 2012 soon after the vaccination, she presented with anaphylactic reaction and wheels at trunk and limbs lasting for 3-days. She was hospitalized and treated with SOLU-DECORTIN 500-mg/day intravenously and FENISTI 4-mg/day. The C-reactive protein and leucocytes showed normal values. The outcome of the events was reported as recovered. The doctor reported that, the events were suspected to be related to vaccination with OPTAFLU. Based on the document review, it was stated that the concerned OPTAFLU (batch number: 031011A) was manufactured in accordance with approved internal procedures and it was in compliance with the current good manufacturing practices (cGMP) requirements. Non significant follow up received on 07 Feb 2013. QA reference number 209125 was added. Follow-up was received on 02 Jul 2013: Batch review was updated.

VAERS ID:472804 (history)  Vaccinated:2012-11-03
Age:25.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Male  Submitted:2012-11-03, Days after onset: 0
Location:Indiana  Entered:2012-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: NA
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP595070IMRA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Hyperhidrosis, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Pale, sweaty, headache, nausea.

VAERS ID:472819 (history)  Vaccinated:2012-11-03
Age:37.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Female  Submitted:2012-11-04, Days after onset: 0
Location:Florida  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red, swelling, pain, lump at injection site.

VAERS ID:472826 (history)  Vaccinated:2012-11-03
Age:62.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-04, Days after onset: 1
Location:New York  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No, patient was asked to wait 15-20 min. and had no reaction at the time of administration
Preexisting Conditions: Pt reported asthma, not sick at the time of administration and not having any asthma issues
Diagnostic Lab Data: None
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H014366 SCLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Pain, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Apr. 6 hours after vaccine pt had SOB, racing heart, dizzy, aches and pains, lasted for 2 hours, did not go to ER.

VAERS ID:472828 (history)  Vaccinated:2012-11-03
Age:37.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Male  Submitted:2012-11-04, Days after onset: 1
Location:Washington  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205301 IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Headache, Injection site pain, Injection site reaction, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Severe, debilitating headache, now continuing on for over 24 hours after vaccination. Patient not normally prone to headaches. Injection site sore. Muscle underlying injection site stiff.

VAERS ID:472830 (history)  Vaccinated:2012-11-03
Age:15.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-04, Days after onset: 1
Location:Texas  Entered:2012-11-04
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: Will go to the doctor if continues tonight.
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Epistaxis
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: My daughter received a flu shot about an hour and half or so after getting the injection her nose started bleeding. She was not in the heat or doing anyting that would cause er nose to bleed. Today 11/04/12 she experienced nose bleed again.

VAERS ID:473258 (history)  Vaccinated:2012-11-03
Age:33.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Male  Submitted:2012-11-04, Days after onset: 1
Location:California  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 03 Nov 12 evening, no previous illness
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B094DA0IMRA
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07049221A0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Injection site pain, Injection site swelling, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient seen 4 Nov 2012 for suspected vaccine reaction from DTaP given 3 Nov 12. On 3 Nov 12 evening patient developed nausea, chills & not feeling well. No SOB, swelling lips or tongue. Patient (R) arm deltoid painful. On day of exam, patient still with (R) deltoid pain 5x2cm swelling. No chills but did not feel well. No meds taken. Recommend BENADRYL 50mg at HS & CLARITIN 10mg or ZYRTEC QD x 7D.

VAERS ID:472970 (history)  Vaccinated:2012-11-03
Age:35.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 1
Location:Missouri  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Urgent care clinic dx with cellulitis. Called Dr office to report and was told multiple other patients have developed cellulitis as well.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Unknown     Purchased by: Private
Symptoms: Cellulitis, Chills, Cold sweat, Injection site erythema, Injection site pruritus, Injection site swelling, Muscular weakness, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Cold sweats, chills, red, itchy, swollen arm from injection site down to elbow, weakness in arm, shooting pains down into fingers, fever.

VAERS ID:472974 (history)  Vaccinated:2012-11-03
Age:37.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Male  Submitted:2012-11-05, Days after onset: 2
Location:California  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV308  RA
Administered by: Military     Purchased by: Military
Symptoms: Flushing, Injection site erythema, Injection site swelling, Injection site urticaria, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: UPPPER RIGHT-ARM: REDNESS SPREAD-OUT 7"x5" BELOW THE INJECTION SITE, SWELLING, SKIN FLUSH AND HOT TO THE TOUCH, MULTIPLE NICKLE AND DIME SIZED HIVES ON SHOULDERS AND ON THE BACK OF THE UPPER RIGHT ARM.

VAERS ID:472975 (history)  Vaccinated:2012-11-03
Age:36.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 1
Location:Oregon  Entered:2012-11-05
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: History of MS
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH712AB IMLA
Administered by: Public     Purchased by: Other
Symptoms: Eye swelling, Lip swelling, Oedema mouth, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Facial swelling around eyes, mouth, upper lip and under tongue.

VAERS ID:473073 (history)  Vaccinated:2012-11-03
Age:74.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Male  Submitted:2012-11-05, Days after onset: 2
Location:New York  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Yes
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR2012-130IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Chill 1 hour later severe chills 3 to 4 hrs later. Muscle ache and head ache following day with lesser chilling.

VAERS ID:473461 (history)  Vaccinated:2012-11-03
Age:61.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 2
Location:Connecticut  Entered:2012-11-05
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: No Allergies
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP505081IMRA
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Flushing, Headache, Nausea, Nervousness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: 11/3/12 730 Headache, flushed, queasy, shaky, lightheaded. 11/4/12 Temp 99 degrees F. Flushed.

VAERS ID:473147 (history)  Vaccinated:2012-11-03
Age:58.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Female  Submitted:2012-11-06, Days after onset: 2
Location:Virginia  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Taking over the counter allergy medication 10mg loratadine tablets
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Cough, Lacrimation increased, Respiratory tract congestion, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Lacrimal disorders (narrow)
Write-up: Runny nose, watery eyes cough & congestion.

VAERS ID:473611 (history)  Vaccinated:2012-11-03
Age:70.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Male  Submitted:2012-11-06, Days after onset: 2
Location:Arizona  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA; HTN; Hyperlipidemia; Hypothyroid; GERD; Gout
Diagnostic Lab Data: 782.1
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site rash, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pain occurred w/in 12 hours of injection. 3 days later red rash to left arm (upper) and edema noted from shoulder to mid forearm.

VAERS ID:473401 (history)  Vaccinated:2012-11-03
Age:56.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 4
Location:Maryland  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: Celiac disease
Diagnostic Lab Data: Negative
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011047 SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Dysphonia, Pallor
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Dizziness, weakness, paleness, hoarseness.

VAERS ID:473406 (history)  Vaccinated:2012-11-03
Age:57.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 4
Location:Virginia  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: None noted
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP510088IMLA
Administered by: Military     Purchased by: Military
Symptoms: Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Rapid onset pain and muscle weakness.

VAERS ID:473411 (history)  Vaccinated:2012-11-03
Age:73.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Female  Submitted:2012-11-07, Days after onset: 3
Location:Oklahoma  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.000064963410UNLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Body temperature decreased, Body temperature increased, Headache, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: RASH ON ARMS BACK FACE CHEST AND LEGS DOWN TO ANKLES. HEAD ACHES. RUNNING A TEMP FROM 95.5 TO 101.1. FEELING WEAK.

VAERS ID:476425 (history)  Vaccinated:2012-11-03
Age:64.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Female  Submitted:2012-11-04, Days after onset: 0
Location:Maryland  Entered:2012-11-07, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011430SCRA
Administered by: Other     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient received shingles vaccine on 11/3/12, then broke out in rash on arms and legs the next day. No other symptoms experienced, patient improving.

VAERS ID:477709 (history)  Vaccinated:2012-11-03
Age:69.0  Onset:2012-11-05, Days after vaccination: 2
Gender:Female  Submitted:2012-11-05, Days after onset: 0
Location:Texas  Entered:2012-11-07, 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:
Current Illness: None
Preexisting Conditions: Diabetes
Diagnostic Lab Data:
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0130180SCUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Skin reaction, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt was administered vaccine 11/03/2012 (ZOSTAVAX). Pt came back Monday 11/05/12 with area red, swollen and warm. Pt was recommended BENADRYL & ibuprofen.

VAERS ID:474017 (history)  Vaccinated:2012-11-03
Age:28.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Male  Submitted:2012-11-03, Days after onset: 0
Location:Washington  Entered:2012-11-09, 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: No
Preexisting Conditions: Listed no allergies or current medications
Diagnostic Lab Data: Unknown
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50908 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Blood pressure increased, Cough, Dizziness, Dry throat, Eye pruritus, Ocular hyperaemia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Red itchy eyes, throat dry, coughing more. BP elevated from normal range 149/93 Pulse 113; earlier BP checked was much lower during dental visit, dizziness/lightheaded. During PHA screening, BP 122/77.

VAERS ID:474018 (history)  Vaccinated:2012-11-03
Age:27.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-03, Days after onset: 0
Location:Virginia  Entered:2012-11-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergies
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP592072UNLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB456AA1UNRA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Palpitations
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Pt reported feeling like her heart was racing and dizziness. No c/o shortness of breath, or chest pain. VS BP 100/75 HR 78. Pt was brought to ED for further eval & documentation. (Per pt normal BP is 80s/50s).

VAERS ID:474032 (history)  Vaccinated:2012-11-03
Age:24.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-03, Days after onset: 0
Location:Alabama  Entered:2012-11-09, 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: No
Preexisting Conditions: Lactose; nuts; Dx cervical CA 1 month ago
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50908 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Dysphonia, Dyspnoea, Vision blurred
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: Pt stated trouble breath after 5 hours of having flu vaccine IM. Pt stated allergies to lactose & nuts. Pt states dizzy, blurred vision. Pt voice hoarse, taken across the street Medical Center by personnel and nurse.

VAERS ID:473822 (history)  Vaccinated:2012-11-03
Age:57.0  Onset:2012-11-06, Days after vaccination: 3
Gender:Male  Submitted:2012-11-10, Days after onset: 4
Location:Maryland  Entered:2012-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergies-Penicillin, clindamycin
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Soreness in arm shot was given, followed by rash and soreness to chest area.

VAERS ID:473844 (history)  Vaccinated:2012-11-03
Age:32.0  Onset:2012-11-07, Days after vaccination: 4
Gender:Male  Submitted:2012-11-10, Days after onset: 3
Location:Florida  Entered:2012-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None thus far. Waiting to see results of blood work.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Blood test, Discomfort, Nodule
SMQs:
Write-up: Pea-sized nodule above collar bone on same side as shot. Experienced discomfort. Nodules also discovered in throat after examination.

VAERS ID:474228 (history)  Vaccinated:2012-11-03
Age:56.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-06, Days after onset: 3
Location:New Mexico  Entered:2012-11-12, Days after submission: 6
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':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Cough, Erythema, Feeling hot, Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Received vaccines on Saturday 1130 AM. That evening arm felt hot & pt got chills & fever. Pt treated w/ APAP & cold pack. Took shower & noticed redness. Red spots went down midway on the arm. Pt developed cough on Sunday, fever & chills.

VAERS ID:474502 (history)  Vaccinated:2012-11-03
Age:10.0  Onset:2012-11-05, Days after vaccination: 2
Gender:Male  Submitted:2012-11-06, Days after onset: 1
Location:Wisconsin  Entered:2012-11-15, Days after submission: 9
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: None
Diagnostic Lab Data: Emergency room evaluation review of bumps/hives - couldn''t say
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 10SYRUN
Administered by: Public     Purchased by: Unknown
Symptoms: Nasal congestion, Rash generalised, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Shot was administered on a Saturday. Early Monday morning, child woke up with hives/bumps on body. Along with having throat irritation & nasal congestion.

VAERS ID:474793 (history)  Vaccinated:2012-11-03
Age:51.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-19, Days after onset: 16
Location:Maine  Entered:2012-11-19
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':
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TDAP: TDAP (ADACEL)SANOFI PASTEURC4149AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Headache, Pain in extremity, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Extreme headache, pain in upper arm, cold chills, itchy rash.

VAERS ID:474807 (history)  Vaccinated:2012-11-03
Age:2.0  Onset:2012-11-05, Days after vaccination: 2
Gender:Female  Submitted:2012-11-19, Days after onset: 14
Location:Alabama  Entered:2012-11-19
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: Asthma and bronchitis
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LL
Administered by: Unknown     Purchased by: Other
Symptoms: Dysphonia, Eating disorder, Irritability, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Hoarseness; Fever 102.4; Runny nose; Not eating; Whiny.

VAERS ID:477057 (history)  Vaccinated:2012-11-03
Age:16.0  Onset:2012-11-05, Days after vaccination: 2
Gender:Female  Submitted:2012-11-05, Days after onset: 0
Location:Illinois  Entered:2012-11-19, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4238AA1UNRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Pain
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Redness started 11-05-12 (ass ask pain) ab. 7 am (diameter ab 4 x 4 cm) (ab. 41 hrs after vacc) all symptoms resolved 11-08-12.

VAERS ID:474936 (history)  Vaccinated:2012-11-03
Age:54.0  Onset:2012-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-11-19, Days after onset: 16
Location:California  Entered:2012-11-20, 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: Wheezing, aches, chills, dizziness, nausea
Preexisting Conditions: Slight outbreak of fever blisters.
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR492810390150IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Dizziness, Nausea, Pain, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Wheezing, aches, chills, dizziness, nausea.

VAERS ID:478650 (history)  Vaccinated:2012-11-03
Age:0.4  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-27
Location:Unknown  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA010658
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RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0057AE PO 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a nurse. She states that doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. The patients were vaccinated with MMR II. Other suspect therapies included ROTATEQ. No concomitant medications were reported. On an unknown date the patient experienced doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. No treatment information was reported. Doses of MMR II and ROTATEQ that were exposed to 50 F for 48 hours were administered to patients is not related to MMR II and ROTATEQ. At the time of the call, she does not known who received the doses of improperly stored vaccine, but she would like to know if they should be revaccinated. She will call to provide the details when she is able to retrieve the information. SR # provided. It is not known at this time if there have been any adverse effects. Rotavirus vaccine Date given 03Nov2012. Medical records # 140652. Lot # 0057AE. Additional information has been requested.

VAERS ID:478652 (history)  Vaccinated:2012-11-03
Age:1.0  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-27
Location:Unknown  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA010663
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1571AA SCUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a nurse. She states that doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. The patients were vaccinated with MMR II. Other suspect therapies included ROTATEQ. No concomitant medications were reported. On an unknown date the patient experienced doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients. No treatment information was reported. Doses of MMR II and ROTATEQ that were exposed to 50F for 48 hours were administered to patients is not related to MMR II nd ROTATEQ. At the time of the call, she does not know who received the doses of improperly stored vaccine, but she would like to know if they should be revaccinated. She will call to provide details when she is able to retrieve the information. SR # provided. It is not known at this time if there have been any adverse effects. Additional information 13Nov2012: MMR vaccine Date given 11/03/2012. Lot # 1571AA. Additional information has been requested.

VAERS ID:475644 (history)  Vaccinated:2012-11-03
Age:3.0  Onset:2012-11-04, Days after vaccination: 1
Gender:Male  Submitted:2012-11-14, Days after onset: 10
Location:Hawaii  Entered:2012-11-28, 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:
Current Illness: None - had had vesicular illness thought to be Coxsackie 10/15/2012
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA709AA2IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0411AE1SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0077041SCLL
Administered by: Other     Purchased by: