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Found 485503 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:468223 (history)  Vaccinated:2012-10-08
Age:23.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Florida  Entered:2012-10-08
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH718AA1IMRA
Administered by: Unknown     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: Itching, swelling, erythema at injection site.

VAERS ID:468339 (history)  Vaccinated:2012-10-08
Age:15.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Florida  Entered:2012-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none reported
Preexisting Conditions: none reported
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA688AA IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB591AA1IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0963AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Client fainted, was given water after the episode passed. No injuries seen. Client was sitting at the time of the fainting episode and was held in sitting position until regained consciousness.

VAERS ID:468348 (history)  Vaccinated:2012-10-08
Age:20.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-08, Days after onset: 0
Location:Wisconsin  Entered:2012-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204521 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Hypoaesthesia oral, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Pt received flu shot and seemed ok, but later returned to the clinic and said that his tongue was numb, and had a headache and felt stiff. 911 called but no treatment was given.

VAERS ID:468378 (history)  Vaccinated:2012-10-08
Age:0.2  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Florida  Entered:2012-10-08
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
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B344CA0UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH578AB0UNRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETH9182450UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0059AE0PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Rash macular
SMQs:, Hypersensitivity (narrow)
Write-up: Within 2 hrs of vaccine administration feel pin point red macular rash from neck down on palms & soles confluent rash.

VAERS ID:468382 (history)  Vaccinated:2012-10-08
Age:18.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:North Carolina  Entered:2012-10-08
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 history of seizures; Birth defects; Allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB515BA1UNLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0097960UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4290AA1UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Convulsion, Gaze palsy, Loss of consciousness, Muscle twitching
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: At the end of yearly visit, pt received 3 vaccines: HPV, MENACTRA, and Hep a. Pt started to pass out/when I called out to her. She started having a seizures. Her arms were twitching and her eyes were rolling back in her head.

VAERS ID:468465 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Texas  Entered:2012-10-08
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: None; NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Glossodynia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Tongue burning, swelling.

VAERS ID:468386 (history)  Vaccinated:2012-10-08
Age:64.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-09, Days after onset: 0
Location:California  Entered:2012-10-09
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  UNLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Fever and pain to arm where shot administered and sore throat.

VAERS ID:468419 (history)  Vaccinated:2012-10-08
Age:58.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-09, Days after onset: 1
Location:Tennessee  Entered:2012-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Recieved 2 doses of vaccine (flu)
Preexisting Conditions: Diabetic; Acid reflux; Hyperlipidema; Seasonal allergies
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59407A1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117800IMRA
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: No symptoms, signs or treatment provided.

VAERS ID:468437 (history)  Vaccinated:2012-10-08
Age:33.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:Virginia  Entered:2012-10-09
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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Cough, Eye pain, Eye pruritus, Eye swelling, Feeling cold, Increased upper airway secretion, Ocular hyperaemia, Pain, Pharyngeal oedema, Pyrexia, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Hypersensitivity (narrow)
Write-up: Itchy, swelling throat started first accompanied by coughing and clearing of throat with lots of phlegm. This lasted until close to 9:00pm. Next symptom began around 8:30 with itchy, painful swollen eyes. They were red and sore and eye drops did not help at all. This symptom began to ease around 9:15 and then I got very very cold and my teeth began to chatter violently. I got in bed with all my clothes on and tried to warm up. I also began getting very achy. I went to sleep and throughout the night my fever broke and my body aches abated.

VAERS ID:468464 (history)  Vaccinated:2012-10-08
Age:17.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-09, Days after onset: 1
Location:Kentucky  Entered:2012-10-09
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: Asthma - well controlled
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AB1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Fall, Gaze palsy, Head injury, Seizure like phenomena, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Approx 1 min after vaccination, pt standing, fell to ground and hit head on floor. Pt began seizure like activity including convulsing and eyes rolling back. Ammonia inhalant administered with no response. Episode lasted approx 30-45 seconds. Pt vitals were stable following event and pt was alert and oriented. EMS arrived and pt was transported to local hospital for evaluation.

VAERS ID:468491 (history)  Vaccinated:2012-10-08
Age:33.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:Texas  Entered:2012-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204001 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dysgeusia, Fatigue, Hypoaesthesia oral
SMQs:, Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Received a call from patient stating she had a metallic taste in her mouth, tongue felt numb and felt tired. Physician administered IM-steroid & BENADRYL PO - 2 tabs with relief.

VAERS ID:468495 (history)  Vaccinated:2012-10-08
Age:15.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:California  Entered:2012-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; allergic rhinitis; eczema
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH718AB0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives two hours after getting vaccine.

VAERS ID:468499 (history)  Vaccinated:2012-10-08
Age:63.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:Pennsylvania  Entered:2012-10-09
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: Hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP583061IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site swelling, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient''s arm swelled at the injection site following the injection and she complained of tingling in her abdomen and legs following injection.

VAERS ID:468505 (history)  Vaccinated:2012-10-08
Age:57.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:Florida  Entered:2012-10-09
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AA0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Feeling hot, Paraesthesia, Paraesthesia oral, Speech disorder, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad)
Write-up: FLUZONE vacc. given at 1500. Pt. felt reaction approx. 5 min after injection. Tingling and heat down Lt. arm with redness. Redness and tingling to Rt. side of face including lips. Pt. also complained it felt like her throat was swelling. Pt. had difficulty speaking.

VAERS ID:468508 (history)  Vaccinated:2012-10-08
Age:0.6  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-09, Days after onset: 1
Location:Alabama  Entered:2012-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Runny nose; slight croupy cough without wheezing. no fever.
Preexisting Conditions: None
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEUR 1  
HIBV: HIB (ACTHIB)SANOFI PASTEUR 1  
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Irritability, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea that afternoon, vomiting at 6:30 pm 10/08/12 and fussiness. Continued fussiness through today - 10/09/12.

VAERS ID:468515 (history)  Vaccinated:2012-10-08
Age:75.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-09, Days after onset: 0
Location:California  Entered:2012-10-09
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: Acute Rheumatoid Arthritis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Public
Symptoms: Chills, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 1. Dizzy 2. Nausea 3. Chills

VAERS ID:468517 (history)  Vaccinated:2012-10-08
Age:57.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-09, Days after onset: 0
Location:Michigan  Entered:2012-10-09
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: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12241P0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Eye pain, Facial pain, Lip swelling, Myalgia, Oral herpes
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Patient woke up (10/9/12, 3:00 AM) with generalized muscle aches, a large fever blister (swollen) on top lip, and sharp pain in the cheek/eye area. She called our pharmacy around 2:00 PM on 10/9/12 to tell us about the reaction. We recommended that she see a doctor if the reaction gets worse or does not improve in the next day.

VAERS ID:468597 (history)  Vaccinated:2012-10-08
Age:64.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-09, Days after onset: 1
Location:Louisiana  Entered:2012-10-09
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: Pacemaker; Stents; High Blood Pressure; Prostate BPH; Depression; Liver & Kidney problems; very bad liver
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205301 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0556AE IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Injection site pain, Joint dislocation, Joint swelling, Local swelling, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pain full right arm, can''t move arm, happened night after shot. Fingers, arms, & neck, shoulder swollen. Pain scale of 1-10 he says 12. Feels like shoulder has been dislocated.

VAERS ID:468631 (history)  Vaccinated:2012-10-08
Age:35.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Connecticut  Entered:2012-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Healthy
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP505083IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad)
Write-up: Rapid heart rate - 136. Lasted 5 hours. Normal around 10 PM.

VAERS ID:468663 (history)  Vaccinated:2012-10-08
Age:5.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:Pennsylvania  Entered:2012-10-10
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
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IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER 3UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 2UNRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: At the IPV injection site, it is large (currently the size of an orange), red and swollen. The injection site is warm to the touch and my daughter is complaining that it itches and is sore to the touch.

VAERS ID:468682 (history)  Vaccinated:2012-10-08
Age:2.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-10, Days after onset: 2
Location:Mississippi  Entered:2012-10-10
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: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AB IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: SWELLING OF 4-5CM AROUND SITE OF INJECTION WITH REDNESS, SWELLING, HEAT, AND INDURATION.

VAERS ID:468701 (history)  Vaccinated:2012-10-08
Age:57.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:West Virginia  Entered:2012-10-10
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; Neuralgia; Interstitial colitis; Arthritis; Endometriosis, IBS
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4474AA IDRA
Administered by: Other     Purchased by: Unknown
Symptoms: Headache, Musculoskeletal pain, Neck pain, Oedema peripheral, Swelling face
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Patient reports swelling of hands, feet, and face evening of injection, also extreme pain in head, neck, and shoulder, she took BENADRYL.

VAERS ID:468707 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:Oregon  Entered:2012-10-10, 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: Abnormal Blood Chemistry; Accelerated Essential Hypertension; Allergic Rhinitis; Anxiety Disorder NOS; Atypical Chest pain; Body Mass Index; Breast Palpation Mass; Cervical Pap Smear
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AB1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Contusion, Induration, Injection site urticaria, Pain in extremity, Pruritus, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: (R) deltoid/upper arm rash "like hives" 1/2 way down her arm, itching, warm to touch, extremely painful, bruising and hard spot down her arm, chills. TX: applied cold compress, Ibuprofen.

VAERS ID:468713 (history)  Vaccinated:2012-10-08
Age:64.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:Kansas  Entered:2012-10-10
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':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204801 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Pain in extremity, Rash erythematous, Rash macular, Rash pruritic, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Red, hot to the touch, swollen, splotchy, rash, itchy not about 3" by 2", swollen, Pain from shoulder into armpit.

VAERS ID:468740 (history)  Vaccinated:2012-10-08
Age:66.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:Virginia  Entered:2012-10-10
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 performed
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4499AA0SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling, redness, itching, pain.

VAERS ID:468758 (history)  Vaccinated:2012-10-08
Age:24.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:California  Entered:2012-10-10
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: no
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: I currently breast feed my 13 month son everyday all day and night no he wasn''t sick before and all of a sudden out of no where he gets sick the day after the shot with a fever of 105 yea that''s no concience to me had to take him to the ER screaming all night not eating just breastfeeding and barely sleeping hot cranky yea sounds like the flu to me ass holes say its ok motherfucker I will never get any shots for me or my kids again fuck you guys and your fucking shots better hope my son doesn''t die from this.

VAERS ID:468803 (history)  Vaccinated:2012-10-08
Age:3.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-10, Days after onset: 2
Location:Louisiana  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None, No asthma, No allergies..... Mom was asked if the patient has been coughing or wheezing? Her answer was no, he had pneumonia 2 years ago, but no symptoms since then.
Preexisting Conditions: None
Diagnostic Lab Data: Not sure at this time.
CDC 'Split Type':
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ21430IN 
Administered by: Unknown     Purchased by: Public
Symptoms: Gait disturbance, Intensive care, Paralysis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Paralysis; Patient was crawling instead of walking....Mother brought to Hospital, was admitted to PICU, given I.V. IGE, and not long after receiving fluids (few hours later), he was running around and playing in the room (according to doctor at hospital).

VAERS ID:468805 (history)  Vaccinated:2012-10-08
Age:24.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:Michigan  Entered:2012-10-10
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: Sulfa allergy, PKU
Diagnostic Lab Data: CT scan
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Chest discomfort, Chest pain, Computerised tomogram, Confusional state, Disorientation, Dizziness, Fatigue, Headache, Hypertension
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Headache, Dizziness, Confusion, High Blood Pressure, Disorientation, Chest pain/discomfort, extreme fatigue, Started at 1PM on 10/8/2012, and still having symptoms.

VAERS ID:468811 (history)  Vaccinated:2012-10-08
Age:40.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:Texas  Entered:2012-10-10
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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0359AE0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Glossodynia, Injection site erythema, Injection site rash, Injection site warmth, Oral herpes, Rash
SMQs:, Anaphylactic reaction (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Rash on chest and breast area; 80 mm red spot at injection site that is raised and hot to the touch; sore injection spot; cold sore in corner of mouth (Never had a cold sore before); sore on tip of tongue.

VAERS ID:468864 (history)  Vaccinated:2012-10-08
Age:75.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:Georgia  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no illness at time
Preexisting Conditions: asthma, hypertension, cancer remission
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4524AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Injections site red, swollen, tender to touch, hot...also same symptoms further down the arm and into the shoulder and arm pit.

VAERS ID:468871 (history)  Vaccinated:2012-10-08
Age:64.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-10, Days after onset: 2
Location:Iowa  Entered:2012-10-10
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':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012521 SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness and swelling on right upper arm where vaccine was administered.

VAERS ID:468873 (history)  Vaccinated:2012-10-08
Age:6.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:Iowa  Entered:2012-10-10
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
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B204AA0IMLA
Administered by: Unknown     Purchased by: Public
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 at injection site, warmth and swelling at injection site.

VAERS ID:468875 (history)  Vaccinated:2012-10-08
Age:5.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-10-10, Days after onset: 0
Location:Iowa  Entered:2012-10-10
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
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B204AA0IMLA
Administered by: Private     Purchased by: Public
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, swelling and warmth at injection site (left deltoid).

VAERS ID:468878 (history)  Vaccinated:2012-10-08
Age:12.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:Florida  Entered:2012-10-10
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: None
Diagnostic Lab Data: None. Ice packs were applied to the site.
CDC 'Split Type':
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB605BA1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4268AA1IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4009AA1IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0315AE1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Mother stated that child complained of redness and swelling to left armin the morning.

VAERS ID:468879 (history)  Vaccinated:2012-10-08
Age:74.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:Illinois  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: cancer
Preexisting Conditions: pt stated she has penicillin allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site haematoma, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (broad)
Write-up: On evening of 10/8 patient states right arm sore/hurting, no bruising, no redness, 10/9/12 upon awakening 6:30am on 10/9 patient notice bruising approx 1 in around injection site-she states bruising worsening as day progressed-not red but arm felt warm. On 10/10/12 upon awakening patient states bruise larger about 2 in, redness on arm below injection site, feels warm to touch, some redness on R arm. No fever on any day per pt. Upon examining pt arm on 10/10/12 4:10pm bruise approx 1-2 in, redness below shot on arm, pt states warm to touch. Told pt to ice site, Tylenol pain/fever, and for patient to call MD stat for eval. Benadryl if allergic reaction. Pt called MD not in office 10/10/12 pt says she will call MD 10/11/12. She will notify us of outcome.

VAERS ID:468883 (history)  Vaccinated:2012-10-08
Age:94.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-10-10, Days after onset: 0
Location:Delaware  Entered:2012-10-10
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: a-fib
Diagnostic Lab Data: CARDIAC CONSULTANTS (COUMIDAN LAB)
CDC 'Split Type':
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Anticoagulation drug level above therapeutic
SMQs:
Write-up: IR LEVEL JUMPED FROM 2.2 TO 4.4 AFTER VACCINE (on blood thinner).

VAERS ID:468885 (history)  Vaccinated:2012-10-08
Age:27.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:Mississippi  Entered:2012-10-10
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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pain, 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: Swelling, fever, large area of redness, pain; returned to doctor, prescribed antibiotic and steroid for possible infection.

VAERS ID:468886 (history)  Vaccinated:2012-10-08
Age:52.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-10, Days after onset: 2
Location:Rhode Island  Entered:2012-10-10
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: Unknown
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204521 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Immediate post-injection reaction, Injection site pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Site became itchy right away. Went home. Left arm was red and warm to the touch. Today 10/10/2012 it was reported that redness extended 6-7 inches long and about the width of the arm. Going to doctor today and will start on Benadryl if OK with MD.

VAERS ID:469015 (history)  Vaccinated:2012-10-08
Age:57.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:Colorado  Entered:2012-10-10
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: Allergy - Codeine, cillins, Sulfa, KEFLEX, MIDRIN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH752AB IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010661 IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4247AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt started to get red swelling on (R) deltoid yesterday. Positive warm, positive pain, positive red & swelling.

VAERS ID:469198 (history)  Vaccinated:2012-10-08
Age:16.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-10, Days after onset: 2
Location:Illinois  Entered:2012-10-10
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: Pt allergic to Penicillins.
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206701 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Syncope, Urticaria
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Patient fainted about 5 minutes after the administration of the flu shot. He was taken to the hospital where he was treated. The next day (about 24 hrs later) he broke out in hives and was given a MEDROL dose pak.

VAERS ID:469202 (history)  Vaccinated:2012-10-08
Age:77.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:New Hampshire  Entered:2012-10-10
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: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Muscle mass, Myosclerosis
SMQs:
Write-up: Hardened mass in muscle. Significant pain. No redness.

VAERS ID:469206 (history)  Vaccinated:2012-10-08
Age:63.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:North Carolina  Entered:2012-10-10
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
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0114270UNLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red area where vaccine was administered. Itchy, somewhat swollen, happen a day later after injection - MD Called deemed local reaction. Suggested by MD BENADRYL.

VAERS ID:468990 (history)  Vaccinated:2012-10-08
Age:52.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:Oklahoma  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: Asthma
Diagnostic Lab Data: unknown
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH721AB3IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0087AE0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Axillary pain, 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: Experience soreness @ injection site and under right arm pit, with soreness developing into pain, redness and swelling of right arm from shoulder to elbow. Treatment with Benadryl and Tylenol without resolution of symptoms. Advised to see private physician.

VAERS ID:469053 (history)  Vaccinated:2012-10-08
Age:15.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Idaho  Entered:2012-10-11, Days after submission: 3
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: Allergies - unknown type, but patient gets allergy shots
Diagnostic Lab Data: None
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA697AA1IMRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Pruritus generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient''s (R) arm started itching around 1200. At 1500, patient came to clinic with small hives on bilateral arms, chest and back. Patient had taken 50mg BENADRYL at 1430. Patient was given 0.3mg Epi 1:1000 IM (R) thigh. Patient observed for 30 minutes, itching stopped, redness receded, hives decreased. Patient left clinic. Patient does receive allergy injections weekly.

VAERS ID:469083 (history)  Vaccinated:2012-10-08
Age:41.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:California  Entered:2012-10-11
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:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Hyperaesthesia, Pain, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: Left arm started to tingle. Then skin started to get very sensitive. By 8 PM on 10/9/2012, I had a full blown fever, aches, pains, extreme fatigue. No vomiting or diarrhea. Symptoms still ongoing as of 10/11/12 and visiting doctor this afternoon.

VAERS ID:469085 (history)  Vaccinated:2012-10-08
Age:36.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:Colorado  Entered:2012-10-11
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:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dizziness, Dysphonia, Eye discharge, Eye pruritus, Headache, Lacrimation increased, Pain, Pharyngeal oedema, Pyrexia, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Started at 2 PM with Scratchy, hoarse, swollen throat, itchy watery eyes with discharge, headache, dizziness... By 4pm body aches by 6pm chills by 8 pm low grade fever 100 degrees. Symptoms were gone the next morning.

VAERS ID:469090 (history)  Vaccinated:2012-10-08
Age:56.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:New York  Entered:2012-10-11
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: Tobacco abuse; HTN
Diagnostic Lab Data: Treatment was provided for possible cellulitis and for symptomatic treatment of vertigo.
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FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4475AA IDLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117800IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site swelling, Injection site warmth, Local reaction, Oedema peripheral, Skin warm, Vertigo
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (narrow), Hypersensitivity (broad)
Write-up: Patient began to experience local reaction within 24 hours of vaccination at both injection site (left deltoid) but also around left elbow, with erythema, warmth, and swelling. Swelling extended down to left wrist and up to axilla over 48 hours following vaccination and seemed to be worsening, not improving. 36 hours after vaccination, patient also reported abrubpt onset of vertigo while sleeping that did not resolve. Was seen for evaluation of arm swelling and vertigo on 10/10/12.

VAERS ID:469132 (history)  Vaccinated:2012-10-08
Age:29.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:Pennsylvania  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Lupus; Scoliosis
Preexisting Conditions: Lupus; Scoliosis
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH733AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117800SCLA
Administered by: Unknown     Purchased by: Other
Symptoms: Inflammation, Injection site erythema, Injection site haematoma, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Patient''s arm became hot and red around the area where the injection was given. Over the course of two days redness spread until almost the entire posterior area of her left upper arm was affected. Additionally, patient developed a quarter-sized bruise in the immediate area where the injection was given. Patient was advised to use cold compressed to decrease inflammation, Benadryl for itching and to return to the clinic if symptoms worsen or fail to clear within 48 hours.

VAERS ID:469136 (history)  Vaccinated:2012-10-08
Age:57.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:North Dakota  Entered:2012-10-11
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:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AD20IMRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0113320SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Injection site erythema, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red and itchy on 10/9/2012. Progressed to more pain and itching. Swollen and red on 10/11/2012. Size of reddened are is 4.5 x 5 inches on left tricep area.

VAERS ID:469140 (history)  Vaccinated:2012-10-08
Age:29.0  Onset:2012-10-11, Days after vaccination: 3
Gender:Male  Submitted:2012-10-11, Days after onset: 0
Location:Massachusetts  Entered:2012-10-11
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: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH718AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709AE0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site swelling, Laboratory test, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Male patient went to MD office due to swollen left arm, above elbow and fever. MD gave him prescriptions for Keflex 500mg QID #40 and Percocet 10/325mg for pain. He also is running test for cellulitis.

VAERS ID:469158 (history)  Vaccinated:2012-10-08
Age:41.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:Florida  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: NKA
Diagnostic Lab Data: Employee went to ER on 10/10/12 pm - difficulty breathing, red skin, heart racing meds unknown at this time
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB909AB2IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Dyspnoea, Erythema, Injection site rash, Palpitations, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Started evening of 10/8/12 - she began itching, fever & chills, rash on upper arms & leg. Went to (medical walk-in) given an injection of DECADRON, ZANTAC 150 mg. po BID x 5 days & Methylprednisolone 4 mg. po dosepak.

VAERS ID:469164 (history)  Vaccinated:2012-10-08
Age:23.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-09, Days after onset: 1
Location:Texas  Entered:2012-10-11, Days after submission: 2
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:
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MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA110770IMLA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Dizziness, Eye colour change, Hyperhidrosis, Hypoaesthesia, Injection site erythema, Injection site swelling, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Patient experienced sweating, lightheadedness, nausea, vomiting, diarrhea, fever and numbness throughout his body. Patient also noticed his eyes were white without the normal coloring. Patient also had a site-reaction of swelling, and redness to his left arm.

VAERS ID:469210 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:Colorado  Entered:2012-10-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: GERD; Fibromyalgia; Anxiety; Vit D deficiency; NKDA; NKA
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1417AA0IMLA
Administered by: Private     Purchased by: Unknown
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: (L) arm has multi raised red areas appox 3cm x 3cm on upper arm from site of injection to elbow pt states "painful" started appox. 1 hour after injection continued at visit today 10/10/12.

VAERS ID:469211 (history)  Vaccinated:2012-10-08
Age:73.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-11, Days after onset: 2
Location:Pennsylvania  Entered:2012-10-11
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: HTN; HL; Anxiety; H/O prostate CA
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0109160IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, 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: Pt. received PNEUMOVAX 10/8/12 - and on 10/9 had orthostatic rxn seen 10/10/12; 10/11/12 presented with 11'' x 12" erythematous indurated area (L) up. lat. arm.

VAERS ID:469265 (history)  Vaccinated:2012-10-08
Age:36.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:New York  Entered:2012-10-11, 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: Asthma
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA716BA0UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0126500UNLA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Dyspnoea, Pain, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: 1 hr after vaccine noticed pain and swelling. Overnight temp 101. Felt SOB but responded to inhaler.

VAERS ID:469267 (history)  Vaccinated:2012-10-08
Age:37.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:Illinois  Entered:2012-10-11
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':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AA UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURUH421AA UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 4-5 inch area of redness & swelling going down left arm. Using ice pack on & off TYLENOL & MOTRIN PRN.

VAERS ID:469269 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-10-10, Days after onset: 0
Location:South Carolina  Entered:2012-10-11, 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: Pt does not list any
Diagnostic Lab Data:
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012578 SCLA
Administered by: Other     Purchased by: Unknown
Symptoms: Local swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt called 10-10-12. Said he had a shingles shot on 10-8-12 and had a swollen place on back of his arm the size of a lemon. No pain or itching at site. Recommended him call MD & to take BENADRYL & ice the site.

VAERS ID:469272 (history)  Vaccinated:2012-10-08
Age:73.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:Oregon  Entered:2012-10-11
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: Diabetes; Afib; Gastritis; Hypothyroid; High cholesterol; Neuropathy
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4489AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 15 x 7 cm area of warmth and redness on left shoulder at site of recent flu shot. Close observation, patient instructed to call if sxs worsen, or do not resolve in few days.

VAERS ID:469275 (history)  Vaccinated:2012-10-08
Age:32.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:Massachusetts  Entered:2012-10-11
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: Asthma; Sensitivity to aspirin; Sinus headaches
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA731AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives over torso & neck - progressed over 2 days before reported. BENADRYL 25 mg x 2 doses resolved.

VAERS ID:469284 (history)  Vaccinated:2012-10-08
Age:2.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:Missouri  Entered:2012-10-11
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':
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DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B157BA3IMRL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4544EA0IMLL
HEPA: HEP A (VAQTA)MERCK & CO. INC.0669AE1IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 4 x 4 cm indurated erythematous area to injection site at (RT) outer thigh.

VAERS ID:469285 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-11, Days after onset: 1
Location:New York  Entered:2012-10-11
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: Unknown
Diagnostic Lab Data: Physical evaluation at md office
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4525AA0UNRA
Administered by: Other     Purchased by: Private
Symptoms: Cellulitis, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt came into pharmacy at 8pm on 10/10/12, claiming she was diagnosed with cellulitis, which she stated that her doctor claimed was from the flu shot she received on 10/8/12. Pharmacist on duty on 10/10 stated that pts arm was majorly swollen & hot.

VAERS ID:469294 (history)  Vaccinated:2012-10-08
Age:5.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:Washington  Entered:2012-10-11
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
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B208AA0IMLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AD2IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1760AA1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0609AA1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Bilateral upper arm redness, warmth and itching at site of Varicella and MMR vaccine. Treated with warm compresses, TYLENOL and BENADRYL.

VAERS ID:469361 (history)  Vaccinated:2012-10-08
Age:66.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness or sickness
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA IMUN
Administered by: Unknown     Purchased by: Other
Symptoms: Erythema, Pruritus, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Hot to touch, swollen and red, itchy and tender to touch.

VAERS ID:473130 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-11, Days after onset: 3
Location:Oregon  Entered:2012-10-11
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': WAES1210USA004216
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1765Y UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report was received from a registered nurse refers to a patient of unknown age who on 08-OCT-2012, was vaccinated with a dose of ZOSTAVAX (lot number 665522/1765Y) (dose and route not reported) that was expired. The vaccine expired on 15-MAR-2011. No adverse effects were reported. Additional information has been requested.

VAERS ID:469231 (history)  Vaccinated:2012-10-08
Age:31.0  Onset:2012-10-12, Days after vaccination: 4
Gender:Female  Submitted:2012-10-12, Days after onset: 0
Location:Unknown  Entered:2012-10-12
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
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B072AA IMLA
Administered by: Public     Purchased by: Other
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: Swelling redness pain and tenderness at the injection site.

VAERS ID:469235 (history)  Vaccinated:2012-10-08
Age:57.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 3
Location:New York  Entered:2012-10-12
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
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP502084IMLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Chills, Decreased appetite, Dyspnoea, Fatigue, Hyperhidrosis, Malaise, Pyrexia, Somnolence, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: Fever to 101.5 for 2 days, shortness of breath when I walk short distance, shaking chills, sweating, severe joint pains, fatigue, malaise, loss of appetite, need to sleep constantly. Treated with Tylenol, Aleve and sleep. Felt too sick to go out to the doctor''s office.

VAERS ID:469240 (history)  Vaccinated:2012-10-08
Age:1.8  Onset:2012-10-11, Days after vaccination: 3
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:New Mexico  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Private     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt recieve flu mist at providers office - recieved cutaneous rash to face and body - hives.

VAERS ID:469274 (history)  Vaccinated:2012-10-08
Age:1.4  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:South Dakota  Entered:2012-10-12, 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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B138AA3IMRL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4488FA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH575AA3IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF42903IMLL
Administered by: Private     Purchased by: Unknown
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, swelling, and warmth to touch on area around injection site. (Right thigh). No treatment necessary as beginning to heal.

VAERS ID:469335 (history)  Vaccinated:2012-10-08
Age:12.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-11, Days after onset: 3
Location:Texas  Entered:2012-10-12, 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: Wellness visit
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4375AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4395AA0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0117231SCLA
Administered by: Private     Purchased by: Private
Symptoms: Eye pain, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad)
Write-up: Severe headache, eyes hurting, nausea, vomiting, no fever, no vomiting, no diarrhea.

VAERS ID:469391 (history)  Vaccinated:2012-10-08
Age:59.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 3
Location:North Carolina  Entered:2012-10-12
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: hx of chronic heart disease No drug allergies known
Diagnostic Lab Data: no lab testing done
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4521AA1IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC528AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site infection, Injection site inflammation, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Tdap given in Lt Deltoid client noted extreme swelling and redness the following morning at infectioon site. The redness and swelling progressed down the lower arm toward the bend of the arm. Client taken to MD on 10/10/12 and was told the area was infected and client placed on amoxicillin. Client is being encouraged to apply hot and cold compresses to the inflamed site. Will do follow up call Monday 10/15/2012.

VAERS ID:469395 (history)  Vaccinated:2012-10-08
Age:85.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 3
Location:Nevada  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No acute illnesses. But she did state that she had chronic back pain.
Preexisting Conditions: Iodides, sulfa drugs Not sure of medical conditions.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4491AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Blood pressure increased, Pain in extremity
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)
Write-up: She is saying that she is having a shooting pain down her arm. She went to the doctor yesterday and her blood pressure was elevated.

VAERS ID:469398 (history)  Vaccinated:2012-10-08
Age:51.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-12, Days after onset: 2
Location:New Jersey  Entered:2012-10-12
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
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP504081IMLA
Administered by: Other     Purchased by: Other
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: PATIENT RECEIVED FLU SHOT ON 10/08/12 AND STARTED GETTING RASH ALL OVER HER BODY ON 10/10/12 AFTER SUPPER. PATIENT TRIED BENADRYL TABLET AND BENADRYL SPRAY. IT TOOK A WHILE FOR PATIENT TO FEEL BETTER.

VAERS ID:469490 (history)  Vaccinated:2012-10-08
Age:21.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 3
Location:New York  Entered:2012-10-12
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: EKG; CXR; Cardiology appt 10/17/12.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AE0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest X-ray, Chest pain, Electrocardiogram abnormal, Injection site erythema, Injection site warmth
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Site red & warm. C/O chest pains. Went to PMD had EKG done $g abnormal. Chest x-ray ordered. Going to see cardiologist. Not sure if related to GARDASIL or not.

VAERS ID:469508 (history)  Vaccinated:2012-10-08
Age:15.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:Georgia  Entered:2012-10-12, 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 known
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ21430IN 
Administered by: Private     Purchased by: Public
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria, pruritus 1 hour after vaccine administered. Given BENADRYL with good response. Hives returned at school the next day. Hives over face, axillae, arms.

VAERS ID:469519 (history)  Vaccinated:2012-10-08
Age:18.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-12, Days after onset: 3
Location:Arizona  Entered:2012-10-12
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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0121400SCRA
Administered by: Public     Purchased by: Private
Symptoms: Body temperature increased, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt presented to campus health urgent care 10/11/12 at 4:35 pm. Presented with red, raised, rash to arms, back, & chest which started 10/9/12. Rash is somewhat itchy and is improving (per pt) Pt. presented with abnormal vital signs: oral temp 101.4 degrees, BP 139/69, pulse 131, RR 20, SPO2 97%. Treated with TYLENOL and given instructions to return if symptoms do not improve.

VAERS ID:469524 (history)  Vaccinated:2012-10-08
Age:0.2  Onset:2012-10-12, Days after vaccination: 4
Gender:Male  Submitted:2012-10-12, Days after onset: 0
Location:North Carolina  Entered:2012-10-12
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
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B351AB0UNLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.H0106530UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF429020UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.H0118100PO 
Administered by: Private     Purchased by: Private
Symptoms: Haematochezia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)
Write-up: Speaks of blood in stool 4 d after ROTATEQ.

VAERS ID:469767 (history)  Vaccinated:2012-10-08
Age:3.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-12, Days after onset: 2
Location:New York  Entered:2012-10-12
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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH756AA3IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cough, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Developed sore throat, low grade fever, congestion/rhinorrhea & cough 48 hrs after visit on 10/8.

VAERS ID:469403 (history)  Vaccinated:2012-10-08
Age:1.0  Onset:2012-10-12, Days after vaccination: 4
Gender:Female  Submitted:2012-10-13, Days after onset: 1
Location:Nebraska  Entered:2012-10-13
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: Environmental allergies
Diagnostic Lab Data: None at this time
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNUN
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever started around 10:30 AM on 10/12/2012 and progressed. She was given Infants Advil around 12:00 PM. That helped lower the temp for a little while. At 5:00 PM her temp was 104*F. Her fever then went down to 99.8*F when taken at 11 PM.

VAERS ID:469423 (history)  Vaccinated:2012-10-08
Age:4.0  Onset:2012-10-13, Days after vaccination: 5
Gender:Female  Submitted:2012-10-13, Days after onset: 0
Location:Maryland  Entered:2012-10-13
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: Healthy, No known allergies
Diagnostic Lab Data: Normal kidney and liver function tests, normal finger stick glucose. EEG and MRI pending.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Unknown     Purchased by: Other
Symptoms: Blood glucose normal, Cough, Electroencephalogram, Grand mal convulsion, Liver function test normal, Nasal congestion, Nuclear magnetic resonance imaging, Renal function test normal
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Generalized tonic-clonic seizure lasting less than one minute. No fever, but nasal congestion and coughing started about 48 hours after the flu vaccine was administered.

VAERS ID:469580 (history)  Vaccinated:2012-10-08
Age:71.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-14, Days after onset: 6
Location:Florida  Entered:2012-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR492810391650UNLA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal discomfort, Back pain, Body temperature increased, Chills, Feeling hot, Headache, Hyperhidrosis, Nausea, Oropharyngeal pain, Pain of skin
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: On Monday, October 08, 2012 at approximately 2:00PM, my wife and I had our annual flu shot at the pharmacy. Around 4:00PM, that afternoon, I experienced mild stomach discomfort and felt nauseous. At 6:00PM ate a light supper after which I came down with a sore throat. Around 7:00PM, I experienced severe body chills and skin sensitivity to touch along with lower back pain and mild headache. Following the ceasing of the chills, became hot and sweaty. Temperature rose to 100.2F. Around 11:00PM, took two TYLENOL and went to sleep. Upon awakening the next morning, all of the previous symptoms with exception of the mild stomach discomfort & headache, were gone. That afternoon, around 2:00PM, I experienced a very strong burning sensation in my middle abdominal area. I took two doses of ZANTAC and MAALOX liquid. However, they did not give any relief. That evening, around 8:00PM, the abdominal pain diminished, but was replaced by severe lower back pain. Again, became hot & sweaty. Temperature rose to 100.1F. Again, took two TYLENOL and went to sleep. On Wednesday morning awoke with none of the previous symptoms. Since then, everything appears to be normal. Interesting note: My wife, age 69, only experienced a sore throat the first evening after receiving her flu shot. I hope this information can be of some assistance to you.

VAERS ID:469656 (history)  Vaccinated:2012-10-08
Age:60.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-13, Days after onset: 5
Location:North Carolina  Entered:2012-10-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMRA
Administered by: Other     Purchased by: Public
Symptoms: Hypersensitivity, Injection site erythema, Injection site pain, Injection site swelling, Vaccination complication
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Patient experienced extreme pain swelling and redness around the injection site from shoulder to elbow reaction 1 hour of receiving vaccine. Patient was seen by her physician and the doctor stated that the patient experienced an allergic reaction to vaccine. She was treated with fluid and steroid shot.

VAERS ID:469702 (history)  Vaccinated:2012-10-08
Age:14.0  Onset:2012-10-14, Days after vaccination: 6
Gender:Female  Submitted:2012-10-15, Days after onset: 1
Location:Washington  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cold - slight nasal congestion although I blew my nose so was clear prior to vaccination. little bit of cough.
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Abdominal pain upper, Diarrhoea, Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Stomach ache and diarrhea began 1st. Then next day still had more severe abdominal pain followed by diarrhea and then vomiting and dizziness. Abdominal pain lasted all day. Diarrhea lasted all day. Vomiting started at 4 PM and occurred several times. I am submitting this at 7pm my time, and my last vomiting was 6pm. My stomach still hurts but I am no longer dizzy.

VAERS ID:469709 (history)  Vaccinated:2012-10-08
Age:83.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-15, Days after onset: 7
Location:Georgia  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Shingles
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1733AA0UNRA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Disorientation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Pt had active shingles outbreak & pt was immunized. Pt believes it caused him to get disoriented & weak & was taken to ER & spent 4 days in the hospital.

VAERS ID:469808 (history)  Vaccinated:2012-10-08
Age:51.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:Texas  Entered:2012-10-15
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: Diabetes
Diagnostic Lab Data: Unknown if any performed
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12040010UNLA
Administered by: Other     Purchased by: Other
Symptoms: Lip swelling, Oedema mouth, Rash generalised, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: 24+ hours after receiving vaccine; S&S: burning rash all over the body, swelling of lips, tongue, mouth. Pt went to urgent care clinic & was given: steroid shot; MEDROL dose pack & KEFLEX. Recommended OTC diphenhydramine. Shot given: afternoon 10/8/12 reaction: evening 10/9/12 spoke w/ pt 10/12/12. Swelling gone decreased rash.

VAERS ID:469843 (history)  Vaccinated:2012-10-08
Age:8.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-09, Days after onset: 1
Location:Minnesota  Entered:2012-10-15, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH712AB3IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1168AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 10/9 full body hives that noc. Given BENADRYL by father. Hives back in morn. - given more BENADRYL. School nurse phoned father & stated hives coming back - seemed worse on (R) side (flu shot given) 10/10 hive still on face & neck.

VAERS ID:469853 (history)  Vaccinated:2012-10-08
Age:18.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Oklahoma  Entered:2012-10-15, 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: No
Preexisting Conditions: Allergies: amitriptyline, TOPAMAX, TREXIMET
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS502011A1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling abnormal, Hypoaesthesia, Nausea, Panic attack
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Onset approx 2 min post vacc admin of pt stating "I don''t feel right". Pt unable to describe how she feels. Denies difficulty breathing, nausea, and/or dizziness. VS BP 140/80 R 20 P 97 SpO2 99% on Rm air. Pt was observed for approx 1 1/2 hours and released. No Tx given. Pt told initial nurse she experienced numbness on Lt side after 1st dose of RABAVERT on 10/1/12 as well as some nausea lasting overnight. Pt did not report this until visit on 10/8/12. Provider talked with state health dept. & Novartis. All in agreement to cont. with pre. exp series. Provider Dx''ed 10/8/12 episode as panic attack.

VAERS ID:469909 (history)  Vaccinated:2012-10-08
Age:13.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-08, Days after onset: 0
Location:Arkansas  Entered:2012-10-15, 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: Anaphylaxis
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204301 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)
Write-up: Patient given 1 dose each of FLUVIRIN and PNEUMOVAX 23. Patient developed immediate anaphylaxis reaction. Treated with EPIPEN and promptly recovered.

VAERS ID:470532 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-15, Days after onset: 7
Location:Unknown  Entered:2012-10-15
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': WAES1210USA004302
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)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 Licensed Vocational Nurse (LVN) refers to a patient of unknown age. In 2007 the patient was vaccinated with the first does of GARDASIL. In 2008 the patient was vaccinated with the second dose of GARDASIL. The patient received the first two doses of vaccine on time. on 08-OCT-2012 the patient was vaccinated with the third dose of GARDASIL in the office. No adverse effects reported. Additional information has been requested.

VAERS ID:473372 (history)  Vaccinated:2012-10-08
Age:77.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 7
Location:Texas  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA004765
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a medical assistant refers to a 77 years old female patient with PEN-VEE K and PERCODAN allergies. The patient was vaccinated IM into the left arm with a 0.5 ml dose of PNEUMOVAX 23 (Lot # reported as H013581, exp 03-MAR-2014) on 08-OCT-2012. No other co-suspects were reported. Concomitant medications included simvastatin (manufacturer unknown), ropinirole, NEXIUM, levothyroxine sodium, and citalopram. On the same date, few hours after administration of PNEUMOVAX 23, the patient developed swelling and a mild rash at the injection site. The patient was seen at the physician''s office on 09-OCT-2012 and was prescribed CELEBREX for 2 days, no lab/diagnostic studies were performed. The outcome of the events was reported as not recovered. The relationship between the events and PNEUMOVAX 23 was not reported. Additional information has been requested.

VAERS ID:473380 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-15, Days after onset: 7
Location:Unknown  Entered:2012-10-15
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': WAES1210USA004274
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012521 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered pharmacist refers to a patient of unknown age. On 08-OCT-2012 the patient was vaccinated SC with a 0.65 ml dose of ZOSTAVAX (lot # was reported as H012521, exp date: 09-OCT-2013) exposed to temperature that could not be supported. No adverse effects reported. It was unknown if the patient sought medical attention. Additional information has been requested.

VAERS ID:469892 (history)  Vaccinated:2012-10-08
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-16
Location:Pennsylvania  Entered:2012-10-16
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: Quionine
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12245P0IMRA
Administered by: Public     Purchased by: Other
Symptoms: Abnormal sensation in eye, Headache, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Arthritis (broad)
Write-up: Severe non stop headache for the last 3 days. Periodic headaches since 10/10/12. Eye pressure with eye movements. stiff neck. Feel side to side head movements increases headache.

VAERS ID:469893 (history)  Vaccinated:2012-10-08
Age:35.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-10-16, Days after onset: 6
Location:Maryland  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLU709AA SYR 
Administered by: Unknown     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Shingles- started 2 days after injection. Started Valtrex.

VAERS ID:470048 (history)  Vaccinated:2012-10-08
Age:78.0  Onset:2012-10-11, Days after vaccination: 3
Gender:Male  Submitted:2012-10-15, Days after onset: 4
Location:Vermont  Entered:2012-10-16, 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: HTN; Hyperlipidemia; Depression; Anxiety
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA739AA IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4034AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Local reaction, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Local reaction - erythema, swelling, itching. Treatment - ibuprofen, BENADRYL, cold packs.

VAERS ID:470093 (history)  Vaccinated:2012-10-08
Age:43.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-15, Days after onset: 6
Location:Nebraska  Entered:2012-10-16, 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: None
Diagnostic Lab Data: Clinical diagnosis
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA726EA IMAR
Administered by: Private     Purchased by: Other
Symptoms: Erythema multiforme, Headache, Myalgia, Pyrexia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Hypersensitivity (narrow)
Write-up: 10/9/12 - 10AM headache and myalgia -$g Rx with OTC pain med. 10/12/12 - Vertiginous, fevers, headache - bedrest and OTC nausea meds and TYLENOL. 10/14/12 - Erythema multiforme involving skin; (R) buccal cavity.

VAERS ID:470097 (history)  Vaccinated:2012-10-08
Age:27.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:Nebraska  Entered:2012-10-16, Days after submission: 6
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: Allergic to sulfa drugs and AUGMENTIN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Chest pain, Costochondritis
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Sharp stabbing pain felt at bottom of sternum; acute onset, lasting approximately 3 hours. I am an RN and would describe by symptoms as being like costochondritis. Took ibuprofen. Pain resolved an hour later; chest felt tight for the rest of the evening. Symptoms occurred approximately 7-8 hours after getting the flu shot.

VAERS ID:470106 (history)  Vaccinated:2012-10-08
Age:85.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:Florida  Entered:2012-10-16, Days after submission: 6
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: Hyperlipidemia; Osteopenia; Hypothyroidism; Vitamin B-12 Def
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0125760SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Received ZOSTAVAX injection 10-8-12. On 10-10-12 noticed 28 mm x 40 mm area at site of injection that was red, warm, & itchy. No tx indicated.

VAERS ID:470108 (history)  Vaccinated:2012-10-08
Age:28.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:Virginia  Entered:2012-10-16, 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: No
Preexisting Conditions: Asthma; Latex allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07549221A0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Cough, Oropharyngeal pain, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Began w/ sore throat - tickle - then tight. Kept coughing. Used own albuterol inhaler.

VAERS ID:470112 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:2012-10-16
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLU690BA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117800IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Red raised - hive. Not at injection site but 2 inches below.

VAERS ID:470123 (history)  Vaccinated:2012-10-08
Age:11.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-11, Days after onset: 1
Location:Michigan  Entered:2012-10-16, 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
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B085CA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 2/3 of (L) upper arm red and swollen.

VAERS ID:470171 (history)  Vaccinated:2012-10-08
Age:63.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:South Carolina  Entered:2012-10-16, Days after submission: 5
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
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012138 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: Patient presented with red swollen spot where injection was given 3 days ago. Injection was given to subcutaneous at left upper arm, and swelling went almost down to he elbow.

VAERS ID:470172 (history)  Vaccinated:2012-10-08
Age:66.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:Colorado  Entered:2012-10-16, 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: None
Preexisting Conditions: Mercury; Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site pain, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Erythema, tenderness/pain, itching at injection site beginning immediately after injection continuing through $g 48 hrs.

VAERS ID:470177 (history)  Vaccinated:2012-10-08
Age:66.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 1
Location:North Carolina  Entered:2012-10-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0467AE0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Arm is warm to touch, red around injection side.

VAERS ID:470178 (history)  Vaccinated:2012-10-08
Age:12.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-10, Days after onset: 1
Location:North Carolina  Entered:2012-10-16, 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: None
Preexisting Conditions: Mild persistent asthma
Diagnostic Lab Data:
CDC 'Split Type':
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB646BA2UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM120130UNRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Skin warm, Swelling, Wrong drug administered
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red, swelling, warm area bout 5x5 began about 12 hours after vaccine and slowly increased in size. Accidentally given a 3rd Hep A.

VAERS ID:470264 (history)  Vaccinated:2012-10-08
Age:24.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:Wisconsin  Entered:2012-10-16, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB225AA IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4170AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever up to 104.0 within 12 hours of TWINRIX & ADACEL vaccines given.

VAERS ID:470273 (history)  Vaccinated:2012-10-08
Age:68.0  Onset:2012-10-12, Days after vaccination: 4
Gender:Female  Submitted:2012-10-16, Days after onset: 4
Location:Colorado  Entered:2012-10-16
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: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURLU4489AA0SYRAR
Administered by: Other     Purchased by: Public
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Patient had rash a few inches below injection site. She thought it was from flu shot.

VAERS ID:470296 (history)  Vaccinated:2012-10-08
Age:46.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-16, Days after onset: 6
Location:North Carolina  Entered:2012-10-16
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: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AD IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0653AE IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Occurred 3 days after receiving vaccine was seen by MD. Area of erythema to (R) arm. Treated with KEFLEX 500mg 1 cap TID x 20 days.

VAERS ID:470078 (history)  Vaccinated:2012-10-08
Age:48.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 8
Location:Georgia  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Red welt the diameter of a typical lemon, swelling, and itching for 5 days after intradermal Fluzone injection.
Preexisting Conditions: Allergic to iodine, shellfish, betadine.
Diagnostic Lab Data: n/a; use OTC Benadryl 25 mg as needed for itching for 5 days
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4467AA0IDRA
Administered by: Unknown     Purchased by: Other
Symptoms: Erythema, Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swelling, redness the size of a lemon, and intense itching. I had to take Benadryl 25mg to alleviate the itching symptom.

VAERS ID:470137 (history)  Vaccinated:2012-10-08
Age:73.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-17, Days after onset: 9
Location:Texas  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No known illness.
Preexisting Conditions: No allergies were listed. The patient has Crohn''s Disease.
Diagnostic Lab Data: Patient was given Bactrim for Cellulitis. The problem resolved.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205801 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117801IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The arm was red and hurt about 1 inch below the injection site. The patient went to the ER and was diagnosed with cellulitis.

VAERS ID:470184 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 9
Location:Texas  Entered:2012-10-17
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: Seasonal allergies; Asthma
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1203901 UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 UNUN
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased, Discomfort, Malaise, Mobility decreased, Muscle spasms, Myalgia, Pain, Serum sickness
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: My wife and I each had flu vaccinations at the same time, on the same date, and at the same facility. My wife is a life-long asthmatic and, as such, decided to take the pneumonia vaccine. The vaccinations were obtained on Monday, October 8, 2012. The first day, she experienced only very mild "serum sickness" symptoms of temperature of 99 degrees, generalized muscle aches, and mild malaise. The second day, there was the onset of more-severe muscle pain which was localized to the neck, shoulders, and upper trunk. The pain was present at rest but became much greater with motion, simulating the severe muscle cramps that occur with athletic endeavors. By the late afternoon, she was extremely uncomfortable with the muscle pains which had begun to limit any activity related to motion of the neck and arms. There was no headache, the temperature remained only slightly elevated, but the muscle pains continued to increase in severity. I took it upon myself to start her on a 4 mg MEDROL dose pack in order to block the pain. She also was given one ROBAXIN tablet and one-half of a 7.5 mg VICODIN so that she could sleep. The third day was the worst with the muscle pain. The same muscle groups were involved with constant but increasing pain at rest with very severe (crying out) pain with the slightest motion. Movement of only millimeters triggered intense muscle spasm that continued until the muscles were again released and placed at rest, with the pain not disappearing but returning to the "baseline." In all my years in medicine, the closest clinical picture to that which I was witnessing was a full-blown case of Tetanus when I was a sophomore medical student in 1952. She remained as motionless as possible, out of bed only with great pain and a large amount of help for trips to the bathroom. I continued the oral steroids, ROBAXIN in larger doses, and a small amount of VICODIN for help with sleep. Due to a missed communication, I was unable to report to the Minor Emergency facility where she had received the injections. Beginning with the fourth day, all of the symptoms began to subside to the point that she remained in a great deal of muscle pain, but could, with help move about and show some very minimal improvement. The only significant change was that, as the pain improved in the upper part of the body, it began to involve the trunk, pelvis, and legs. In subsequent days, all of the symptoms have improved but, even at this time (10th day), she remains symptomatic with pain in the pelvis, legs, and strap muscles of the neck. She saw our local internist yesterday, and he believes that this pattern was and is a reaction to the flu vaccine and warned her to not take another, and he will give her TAMIFLU should she become exposed or symptomatic in the future.

VAERS ID:470326 (history)  Vaccinated:2012-10-08
Age:36.0  Onset:2012-10-16, Days after vaccination: 8
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Missouri  Entered:2012-10-18
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: GERD; NKA
Diagnostic Lab Data: Was given steroid shot & put on Solu-Medrol pack. No lab. (10/18/2012)
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA710BA0IMLA
Administered by: Military     Purchased by: Private
Symptoms: Dizziness, Hypoaesthesia, Pallor, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Working @ desk, began to feel lightheaded, tingling in arms, felt like was going to pass out and turned very pale. Denies diaphoresis. Also, face & arms felt numb. Arms & face are still feeling numb today, 10/18/12. Saw a nurse practitioner today and is taking a cortisone pack. States she had numbness of face and arms last year about 2 days after receiving vaccine, but went away after a couple of days.

VAERS ID:470483 (history)  Vaccinated:2012-10-08
Age:60.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-10-12, Days after onset: 2
Location:Illinois  Entered:2012-10-18, Days after submission: 6
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: Allergic to phenobarbitol and DONNATAL
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Feeling hot, Gait disturbance, Grip strength decreased, Headache, Musculoskeletal pain, Neck pain, Sinus congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: 10/8/12 8:30 A - Rec''d flu shot. 10/10/12 6:30 A Felt reaction starting. Sinuses blocked off and felt hot. Noticed some dizziness by afternoon. Wed. night Very bad headache and pain in neck and shoulders. 10/11/12 6:30 A Thursday pain, dizziness and grip problems w/ both arms and hands. Pencils and objects slipping from hands, stumbling. 10/12/12 5 AM Feeling normal w/ slight shoulder pain.

VAERS ID:470494 (history)  Vaccinated:2012-10-08
Age:12.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 10
Location:Michigan  Entered:2012-10-18
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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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB522BA1IMUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.0692AA0IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4040AA0IMUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B078BA0IMUN
Administered by: Public     Purchased by: Public
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt was here for 8:30 am nurse visit for imms - pt did not eat breakfast prior to appt - pt rec''d 4 shots and approx 3-4 mins after injections, pt passed out. Ammonic inhalant used & pt came to right away.

VAERS ID:470507 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 10
Location:Michigan  Entered:2012-10-18
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: Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH753AA IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Insomnia, Pain, Pain in extremity
SMQs:
Write-up: Patient came in complaining of arm soreness from flu shot given 10/8/12. Claims shot was given too high on shoulder. He has alot of arm pain causing insomnia for last 11 days. When sitting in chair he has to use other arm to lift the arm where shot was given but can move it okay when up doing things, just has soreness then. He has appt with his physician this afternoon.

VAERS ID:470464 (history)  Vaccinated:2012-10-08
Age:71.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 10
Location:Massachusetts  Entered:2012-10-19
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: none
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4499AA IMAR
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709AE SCAR
Administered by: Other     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site swelling, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), 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: Patient states she woke up and she had 101.5 fever and chills. She also described the injected area as scarlet red and swollen. No pain. She applied hydrocortisone 1% on the area for a few days and the rash went away along with the fever.

VAERS ID:470552 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-19, Days after onset: 10
Location:Florida  Entered:2012-10-19
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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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AB UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 UNUN
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Pain, 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: Within 12 hrs; redness, swelling, fever, body aches. Lasted 48 hrs; red/swelling about 5 days.

VAERS ID:470572 (history)  Vaccinated:2012-10-08
Age:6.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 10
Location:New Jersey  Entered:2012-10-19
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: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
Administered by: Unknown     Purchased by: Other
Symptoms: Cough, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: High fever for 24 hours; cough that lasted for more than 7 days.

VAERS ID:470607 (history)  Vaccinated:2012-10-08
Age:44.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-19
Location:Washington  Entered:2012-10-19
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:
Diagnostic Lab Data: Encouraged person to see provider.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  IM 
Administered by: Public     Purchased by: Unknown
Symptoms: Hypoaesthesia, Malaise, Nasal congestion, Respiratory tract congestion
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Stated 2 days post injection, numbness and tingling down legs. Congestion (chest & nasal), general malaise.

VAERS ID:470774 (history)  Vaccinated:2012-10-08
Age:1.4  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-10-11, Days after onset: 1
Location:California  Entered:2012-10-19, 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: Asthma; Umbilical Hernia
Diagnostic Lab Data: None
CDC 'Split Type':
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DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4154AA3IMLL
Administered by: Private     Purchased by: Private
Symptoms: Convulsion, Cough, Grand mal convulsion, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: More than 2 days after DTAP, fever 102 T max followed by seizure (generalized) tonic clonic. Seizures: occurred (2x). (5 hours apart). Cough barking & seal like cough. Given ALBUTEROL & PULMICORT inhalation. (+) relief. Next day better. Painful. No history of AE''s seizure in the past.

VAERS ID:470782 (history)  Vaccinated:2012-10-08
Age:1.2  Onset:2012-10-17, Days after vaccination: 9
Gender:Female  Submitted:2012-10-19, Days after onset: 2
Location:Massachusetts  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ? allergic rhinitis sx
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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Dose
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DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4211AA IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4481BA1IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH563AA IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0136420SCRL
Administered by: Private     Purchased by: Public
Symptoms: Activities of daily living impaired, Blister, Rash vesicular
SMQs:, Severe cutaneous adverse reactions (broad), Dementia (broad), Hypersensitivity (narrow)
Write-up: (R) cheek w/2-3 mm vesicular lesion. (R) mid thigh area with a cluster of vesicles no d/c - appear to be varicella per MD. Nontender.

VAERS ID:470957 (history)  Vaccinated:2012-10-08
Age:84.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 11
Location:California  Entered:2012-10-19
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: No known allergies
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4499BA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Body temperature increased, Diarrhoea, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt reported that she had shaking, 103 degrees temperature, and diarrhea 2 hrs after she received the vaccine and that she went to the hospital afterwards. She dropped by the pharmacy, appearing to be fully recovered, to report her symptoms on 10/17/12.

VAERS ID:475567 (history)  Vaccinated:2012-10-08
Age:62.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 10
Location:Ohio  Entered:2012-10-19
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': WAES1210USA007397
Vaccination
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site reaction, Injection site vesicles, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a physician refers to a 62 years old female patient. The patient was vaccinated with 0.65 ml ZOSTAVAX (once, lot number not provided) on approximately 08-OCT-2012, a week ago. No other co-suspects were reported. No concomitant medications were reported. The following day, on 09-OCT-2012 the patient came back to the office because the injection site was red and hot. The next day, on 10-OCT-2012 the patient came back again because the reaction area was larger and there was a white spot in the middle, which the doctor thought could be an infection. The doctor also stated that there were vesicles and that it could be rash. Antibiotics and steroids were given as treatment for adverse event. Adverse event improved after stopping therapy. Additional information has been requested.

VAERS ID:470627 (history)  Vaccinated:2012-10-08
Age:33.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-21, Days after onset: 13
Location:Texas  Entered:2012-10-21
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Mobility decreased, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad)
Write-up: Severe pain in shoulder, limited movement, possible nerve damage.

VAERS ID:471014 (history)  Vaccinated:2012-10-08
Age:1.8  Onset:2012-10-19, Days after vaccination: 11
Gender:Female  Submitted:2012-10-22, Days after onset: 3
Location:Montana  Entered:2012-10-22
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: Allergy to Amox
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B155BA3IMUN
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4526AA2IMUN
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0425AE0SCUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0077040SCUN
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash.

VAERS ID:471027 (history)  Vaccinated:2012-10-08
Age:35.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:Kansas  Entered:2012-10-22, Days after submission: 11
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) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA689AA1UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0492AE UNLA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Injection site erythema, Injection site rash, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt states area red, hot to touch, et has a rash all at the injection site. Pt states had flu like symptoms on Tuesday. Ice 20 min/1-2 hours, MOTRIN 800mg TID with food until seen, cancel appt if resolves.

VAERS ID:471181 (history)  Vaccinated:2012-10-08
Age:10.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:Iowa  Entered:2012-10-22, Days after submission: 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: ADHD; Insomnia
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AA2IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0459AE2IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Injection site erythema, Injection site warmth, Pain in extremity, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: 10/9/12 left arm slightly red, itchy and slightly painful. 10/10/12 positive fever, increased redness and warmth to (L) deltoid area, still itchy. Started on BENADRYL and cephalexin for questionable cellulitis.

VAERS ID:471186 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 2
Location:California  Entered:2012-10-22, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic to latex
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12058011IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA1IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Rubber sensitivity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling (L) upper arm, burning of upper arm. Allergic to latex.

VAERS ID:471192 (history)  Vaccinated:2012-10-08
Age:0.3  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-12, Days after onset: 4
Location:Pennsylvania  Entered:2012-10-22, 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: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B326AA1UNRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH430AA1UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF309211UNLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FB27BA1PO 
Administered by: Private     Purchased by: Public
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: S/s: Diarrhea, vomiting x 2, fever 101 degrees. Tx: Tylenol for fever. ER if fever above 101 degrees of s/s of dehydration.

VAERS ID:472152 (history)  Vaccinated:2012-10-08
Age:14.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-22, Days after onset: 14
Location:New Jersey  Entered:2012-10-22
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': WAES1210USA004597
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2IMRA
Administered by: Private     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a healthcare worker refers to a female patient of unknown age. The healthcare worker reported the patient was vaccinated with her second dose of GARDASIL 0.5 ml, intramuscularly, in her right arm at her OB/GYN office on 08-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. The healthcare worker reported they did not know the patient had her second dose of GARDASIL, so the patient was again vaccinated with her third dose of GARDASIL at their office on 08-OCT-2012. No adverse effects were reported. No other information was provided. Additional information has been requested.

VAERS ID:476033 (history)  Vaccinated:2012-10-08
Age:44.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-22, Days after onset: 14
Location:Arizona  Entered:2012-10-22
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': WAES1210USA008662
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from an office administrative staff member refers to a 44 years old female patient with no medical history and no known drug reactions/allergies. The patient was vaccinated intramuscularly with the first 0.5 ml dose of PNEUMOVAX 23 on 08-OCT-2012. Lot # H0123972 (in validation), exp. date 09-MAR-2014. No other co-suspects were reported. Concomitant medications included hydrocodone, metformin, lisinopril, ARMOUR THYROID TABLETS, methotrexate and cyclosporine. On 08-OCT-2012, the patient''s arm became very hard around the injection site, as well as very warm, and hot to the touch after receiving PNEUMOVAX 23. The patient was also unable to lift her arm above her head. The patient sought medical attention. No laboratory tests were performed. Treatment included KEFLEX. At the time of reporting the patient was recovering. Additional information has been requested.

VAERS ID:470951 (history)  Vaccinated:2012-10-08
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-19
Location:New Mexico  Entered:2012-10-23, Days after submission: 4
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 patient had no physician diagnosed allergies, medical conditions or illness at the time of vaccination. The patient has a history of receiving yearly flu vaccinations in the past.
Diagnostic Lab Data: None
CDC 'Split Type': 201209483
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AC IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Malaise, Rash generalised, 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: Initial case received from a health care professional on 11 October 2012. The female patient, age 42, with no pre-existing allergies or medical conditions had received a dose of FLUZONE vaccine intramuscularly on 08 October 2012 (lot number UH717AC, expiry 30 June 2013) into the left deltoid. Concomitant medications were not reported. It was reported that the patient received yearly flu vaccinations in the past. The patient developed hives and generalized body rash with redness, swelling and itching at the injection site and generalized malaise at an unspecified time. The patient was self treated with BENADRYL 50 mg every 6 hours, duration not specified. The patient was administered an unspecified steroid shot by their physician on an unreported date. No further information was available at the time of report. The symptoms were reported as beginning to resolve on 09 October 2012. Documents held by sender: None.

VAERS ID:471056 (history)  Vaccinated:2012-10-08
Age:8.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-23, Days after onset: 15
Location:Florida  Entered:2012-10-23
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: Bipolar disorder and ADHD
Diagnostic Lab Data: Blood test and chest x-ray
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Abdominal pain upper, Activities of daily living impaired, Blood test normal, Chest X-ray, Cough, Fatigue, Incorrect dose administered, Injection site erythema, Injection site swelling, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: It was later determined that my son already had all his shots but the doctors did not have that updated in their system - so the DTaP, MMR, Polio and Chickpox vaccines were administered and were extra doses. Extreme fatigue, body aches began the evening of the vaccine. Swelling and redness at injection site. Symptoms worsened over the next week and included a low grade fever, stomach pain and continued on for over 2 weeks now. Patient has missed 5 days of school, had developed a serious cough and was prescribed breathing treatments for asthma (though he doesn''t have asthma). Blood tests showed no infection, but his health continues to be poor.

VAERS ID:471358 (history)  Vaccinated:2012-10-08
Age:58.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 9
Location:Maryland  Entered:2012-10-23, 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
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4472AA IDLA
Administered by: Private     Purchased by: Unknown
Symptoms: Hypoaesthesia, Injection site erythema, Injection site induration, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness, indurated area approximately 8cm at IM site with associated shooting pain & transient numbness of (L) arm & hand.

VAERS ID:471191 (history)  Vaccinated:2012-10-08
Age:72.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-24
Location:Unknown  Entered:2012-10-24
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': WAES1210USA009753
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR  UNAR
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709AE SCAR
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site rash, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a registered pharmacist concerning a female patient in her 70''s who on an unknown date was vaccinated with a dose of PNEUMOVAX23, subcutaneous (dose not provided) (lot # 0709AE, expiration date on 04-JAN-2014). Secondary suspect therapy included flu vaccine (manufacturer unknown but AFLURIA could not ruled out) (dose, route and lot # not provided) administered on the same date on the same arm with PNEUMOVAX23. On an unknown date, the patient came down with fever and rash around injection site with color of scarlet red. No treatment was given for the events. The patient spoke to pharmacist. At the time of the report, the outcome of the events was unknown. A lot check investigation was initiated. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:471212 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 16
Location:Florida  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No, was done at the time of my annual physical
Preexisting Conditions: None
Diagnostic Lab Data: To my knowledge the doctor did not do any diagnostic tests.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1SCLA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Chills, Erythema, Headache, Injection site erythema, Injection site haemorrhage, Injection site infection, Injection site necrosis, Injection site pain, Injection site reaction, Injection site swelling, Myalgia, Oedema peripheral, Pain, Pyrexia, Rash erythematous
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 102 fever, chills, headache, muscle ache, joint ache, red rash at injection site. Went back to the doctor Wednesday morning. He prescribed antibiotics and prednisone. By then my arm was swollen, red, and fever was 100.8, ached all over. Went back to the doctor 10/17. Injection site infection was approximately 2" by 3", severely red, swollen, painful. The antibiotics and prednisone were finished by then. He prescribed antiinflammatory and provided topical erythromycin and referred me to a wound specialist because the wound was necrotic and bleeding and very painful. The wound specialist could not see me for 2 weeks so I went to the Hospital and got an appointment for Friday October 19. Dr. took me off of anti-inflammatory and prescribed silvadene. My next appointment is October 26. The wound bled for one week, stopped one day ago. Deep crevices in my arm where flesh deteriorated through necrosis. Wound is not healed over yet, but is better.

VAERS ID:471308 (history)  Vaccinated:2012-10-08
Age:45.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 16
Location:California  Entered:2012-10-24
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': WAES1210USA006685
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS  UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Headache, Injection site pain, Malaise, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a 45 years old male field representative refers to himself with no pertinent medical history and no drug reactions/allergies. The patient was vaccinated with 0.5 ml PNEUMOVAX23 (lot number, route not reported) on 08-OCT-2012. On 03-OCT-2012 he received the yellow fever vaccine (manufacturer unspecified) and also started taking a capsule every other day for 7 days as the typhoid fever vaccine (manufacturer unspecified). On 08-OCT-2012, he also got MENVEO (Novartis) and FLUZONE. Other concomitant medications included SINGULAIR, CLARINEX, AXIRON and Finasteride. The patient experienced pain at the injection site on 08-OCT-2012 and was not feeling well (with a headache) on 09-OCT-2012. On 10-OCT-2012 the patient developed rash. The patient talked to a pharmacist for medical attention. No treatment or laboratory diagnostics studies were given. The outcome of the events was reported as not recovered/not resolved. Additional information is not expected.

VAERS ID:471445 (history)  Vaccinated:2012-10-08
Age:66.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:2012-10-24
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:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0125770SCUN
Administered by: Other     Purchased by: Public
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Patient developed a 2 inch x 2 inch rash around injection site within 24 hours of vaccination. Patient self-treated with hydrocortisone cream.

VAERS ID:471304 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-11, Days after vaccination: 3
Gender:Female  Submitted:2012-10-25, Days after onset: 14
Location:New York  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008834
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Rash, Rash vesicular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a physician refers to a 70 years old female patient with no pertinent medical history. The patient was vaccinated with ZOSTAVAX in the left arm on approximately 08-OCT-2012 "about a week and a half ago". Lot# was unspecified. Other suspect therapy included influenza virus vaccine (manufacturer unknown) in right arm on 08-OCT-2012, the same day that she received ZOSTAVAX. On approximately 11-OCT-2012, "about 3 days after receiving ZOSTAVAX", the patient developed a vesicular, urticarial rash on her right shoulder and right side of her neck. Unspecified topical cream was given as treatment. The outcome of patient was reported as not recovered/not resolved. The patient sought medical attention via office visit. Additional information has been requested.

VAERS ID:471826 (history)  Vaccinated:2012-10-08
Age:12.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 16
Location:California  Entered:2012-10-25
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: Unknown results - normal per mother (no anemia)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720B0UNRA
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSAHPVA113AA2UNLA
Administered by: Other     Purchased by: Public
Symptoms: Abdominal pain, Blood test normal, Epistaxis, Laboratory test normal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 10/10/12: Received phone call from mother: Child woke on 10/9/12 with nosebleed and abdominal pain. Nosebleed intermittent, abdominal pain intermittent. Denies: fever, "cold", cough, rhinorrhea, nausea, vomiting, diarrhea, other symptoms. Unable to return to this clinic so mother took child to a nearby clinic.

VAERS ID:472438 (history)  Vaccinated:2012-10-08
Age:12.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 17
Location:Unknown  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Milk allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA005725
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0097461UNUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This spontaneous report as received via a company representative from a registered nurse refers to a 12 years old female patient with milk allergy. The patient was vaccinated with dose 2 GARDASIL; (reported lot number H009746, expiry date 11-JAN-2015, route and dose not reported) on 08-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. On 08-OCT-2012 the patient fainted after receiving the 2nd dose of GARDASIL. The patient had previously received her first dose (date, dose and route not reported) without experiencing an adverse event. The patient did not receive any treatment. No relevant tests were performed. The patient seemed recovered after a few minutes. A reporter causality for fainted was not provided for GARDASIL. The registered nurse reported about 2 patients (sisters) who fainted after receiving the 2nd dose of GARDASIL: Linked case report is 1210USA008937. Additional information is not expected.

VAERS ID:472511 (history)  Vaccinated:2012-10-08
Age:14.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 17
Location:Unknown  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Milk allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008937
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0097461UNUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This spontaneous report as received via a company representative from a registered nurse refers to a 14 years old female patient with milk allergy. The patient was vaccinated with dose 2 GARDASIL (reported lot number H009746, expiry date 11-JAN-2015, route and dose not reported) on 08-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. On 08-OCT-2012 the patient fainted after receiving the 2nd dose of GARDASIL. The patient had previously received her first (date, dose and route not reported) without experiencing an adverse event. The patient did not receive any treatment. No relevant tests were performed. The patient seemed recovered after a few minutes. A reporter causality for fainted was not provided for GARDASIL. The registered nurse reported about 2 patients (sisters) who fainted after receiving the 2nd dose of GARDASIL: Linked case report is 1210USA005725. Additional information is not expected.

VAERS ID:476550 (history)  Vaccinated:2012-10-08
Age:68.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 17
Location:Unknown  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to arthropod sting; Drug hypersensitivity
Preexisting Conditions: Tetracycline, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008178
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a consumer refers to herself, a 68 years old female psychologist. The patient was vaccinated with ZOSTAVAX (dose, route and Lot# not reported) on 08-OCT-2012. No other co-suspects were reported. Concomitant medications included LEVOXYL, estradiol and NASACORT. On 08-OCT-2012 the patient experienced itchiness at injection site, slight swelling at injection site, warmth at injection site and redness at injection site. No treatment information was reported. The outcome of itchiness at injection site, slight swelling at injection site, warmth at injection site and redness at injection site was reported as not recovered/not resolved. The relatedness for itchiness at injection site, slight swelling at injection site, warmth at injection site and redness at injection site was not reported for ZOSTAVAX. Additional information is not expected.

VAERS ID:471627 (history)  Vaccinated:2012-10-08
Age:60.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-10-26, Days after onset: 18
Location:Delaware  Entered:2012-10-26
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) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12058010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient complains that arm still hurts where injection given like someone punched him in the arm.

VAERS ID:471640 (history)  Vaccinated:2012-10-08
Age:49.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-26, Days after onset: 18
Location:Minnesota  Entered:2012-10-26
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: Latex allergy
Diagnostic Lab Data: Flu vaccine given in opposite arm.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Erythema, Mobility decreased, Oedema peripheral, Pain, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: My arm from shoulder to elbow turned red, hot, and was swollen up to double size. My arm was extremely painful and I was unable to move my arm. My entire body ached, including my back and legs, and neck. I had a low-grade temperature.

VAERS ID:471920 (history)  Vaccinated:2012-10-08
Age:81.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-21, Days after onset: 13
Location:Texas  Entered:2012-10-26, Days after submission: 5
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: Healthy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4491AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1477AA UNLA
Administered by: Military     Purchased by: Other
Symptoms: Asthenia, Cellulitis, Erythema, Induration, Pain, Pain in extremity, Poor quality sleep, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad)
Write-up: Terrible pain - redness, swollen, feverish, that was going down my arm. It reached below my elbow, when I went to the ER room. 10-8-12 Took flu-pneumonia shot at clinic 6:15 PM I only went for flu shot nurse suggested/recommended pneumonia also which I did both in same left arm. Before I went to bed I told my husband my arm was hurting - little red and hard. 10-9-12 4 hr. choir rehearsal at church. My arm was redder, larger area and had moved more redness toward my elbow. In PM took pain pill and put Epsom salts compress on it - then later because of pain soaked in a hot Epsom salts bath. Didn''t sleep well - woke up about 1:00AM w/ pain. Decided to go to ER 5:00 AM. 10-8-12 Saw Dr. she said cellulitis got prescription for BACTRIM and NORCO. She drew sharpie lines on my arm top and bottom and said if redness got any more to come back to ER. Also for me to to go pharmacy and report it and also Dr. which I did. Called Health Dept they referred me to: 10-11 called Dr. the local Health officer - (Private Practice) I left message - (no call back). Fri 10-12 - got a call from VAERS and they are sending me paperwork to fill out to report it. 10-19 - Received paperwork from VAERS. 10-21 - Completed paperwork and included copies from clinic where I got the shots and also ER room - mailed back. I am still not up to par - my energy level is so low I have to push myself to do everything. Before shots I was very active.

VAERS ID:471929 (history)  Vaccinated:2012-10-08
Age:75.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-21, Days after onset: 12
Location:New York  Entered:2012-10-26, Days after submission: 5
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 known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLAA733AA3UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138471UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt received injection on 10-8-12 on 10-9-12 pt woke with area red, warm, and pruritic and painful.

VAERS ID:471930 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:Texas  Entered:2012-10-26, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12057010IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105150IMRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Headache, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient''s arm turned red and swollen. Patient got a fever and headache. Stated feeling better the following day.

VAERS ID:474665 (history)  Vaccinated:2012-10-08
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-29
Location:New York  Entered:2012-10-29
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': WAES1210USA009976
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AE0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Adverse event
SMQs:
Write-up: This spontaneous report as received from a physician refers to a patient of unknown age. The patient was vaccinated with GARDASIL (lot # unknown) on an unknown date. No other co-suspects were reported. No concomitant medications were reported. The physician stated he had a patient who experienced an adverse event while taken GARDASIL on an unknown date. It was unknown that if the patient had sought medical attention. The outcome was unknown. Additional information has been requested.

VAERS ID:472255 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-20, Days after vaccination: 12
Gender:Female  Submitted:2012-10-20, Days after onset: 0
Location:Kentucky  Entered:2012-10-30, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP591070IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site vesicles
SMQs:
Write-up: Patient received vaccine on 10-8-12 and noticed a small blister on arm on morning of 10-20-12 that was where she received injection. No signs of infection and no other symptoms. She said she wouldn''t have even noticed it but saw it in mirror.

VAERS ID:472265 (history)  Vaccinated:2012-10-08
Age:67.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 3
Location:Missouri  Entered:2012-10-30, Days after submission: 18
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: Trigeminal Neuralgia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12072010IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0895AA0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site swelling, Neck pain, Oedema peripheral, Pain in extremity
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), Arthritis (broad)
Write-up: Patient called pharmacy stating that her entire left arm was red, swollen and pain that was radiating to neck. Pt saw doctor on 10/10/12 who prescribed Cephalexin and Prednisone.

VAERS ID:472428 (history)  Vaccinated:2012-10-08
Age:55.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-30, Days after onset: 21
Location:Kansas  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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59507 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Musculoskeletal stiffness, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: 2 days after shot, pt called saying her arm was still sore/stiff she thought the shot was given too high on arm. Suggested ADVIL around the clock to help. On 10/19/12 pt came into warehouse & filled out incident report stating still having issues with arm pain.

VAERS ID:472727 (history)  Vaccinated:2012-10-08
Age:30.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-23, Days after onset: 14
Location:Wisconsin  Entered:2012-10-31, Days after submission: 8
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: Latex allergy
Diagnostic Lab Data: Negative stroke scale
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA735BA UNLA
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Hypoaesthesia, Laboratory test normal, Migraine, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: 25 hrs after vaccine given noticed vision changes and dizziness. 2 hrs later noticed right sided facial numbness and tingling, then right arm numbness. Admitted to ER and received IV BENADRYL & IV Droperidol. Sx resolved. Diagnosed with complex migraine caused by inflammatory response.

VAERS ID:472754 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-15, Days after onset: 6
Location:Iowa  Entered:2012-10-31, Days after submission: 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: Hypertension; high cholesterol
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH715AA SYRUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0110490SCRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Induration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt developed a 5 inch red circle the day after receiving ZOSTAVAX. Also had a band-aid-sized area in the middle of red circle that was hard and swollen. Reaction was decreasing slowly on its own over next several days. Told pt. to use hydrocortisone cream if needed.

VAERS ID:476974 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-31, Days after onset: 23
Location:Ohio  Entered:2012-10-31
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': WAES1210USA004416
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0784Z SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report was received from a physician refers to a patient of unknown age and gender. The patient was vaccinated with 0.5 ml of expired dose of VARIVAX subcutaneously (lot # 667490/0784Z, expiry: 08-OCT-2012) on 08-OCT-2012. No concomitant medications were reported. No adverse effect were reported. Additional information has been requested.

VAERS ID:472989 (history)  Vaccinated:2012-10-08
Age:49.0  Onset:2012-10-11, Days after vaccination: 3
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Ohio  Entered:2012-11-01, Days after submission: 21
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: Allergy: PCN - Codeine; Increased B/P; Migraines; Diabetes
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH7474IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Received Flu shot 10-8-12. On 10-11-12 developed fine red rash on neck & arms with pruritis. Sts had similar reaction 2 years ago & Tx with antibiotics & BENADRYL. VAERS form completed 2 yrs ago. Sts. her personal MD would not sign exemption form.

VAERS ID:473005 (history)  Vaccinated:2012-10-08
Age:19.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 2
Location:California  Entered:2012-11-01, Days after submission: 21
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: Obesity; Anemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12043010IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: One day after the flu vaccine given patient states she broke out with hives on her abdomen. Patient took BENADRYL and hives resolved.

VAERS ID:473007 (history)  Vaccinated:2012-10-08
Age:33.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 3
Location:Ohio  Entered:2012-11-01, Days after submission: 20
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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH759AB0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Nasal congestion, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Morning after flu shot awoke with itchy rash anterior neck, chin, lower face. Nasal congestion. Evaluated in E.R. Tx: Prednisone - PEPCID - VISTARIL.

VAERS ID:473225 (history)  Vaccinated:2012-10-08
Age:64.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Delaware  Entered:2012-11-02, Days after submission: 25
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) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12052010IMAR
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Malaise
SMQs:, Dementia (broad)
Write-up: Patient said she felt sick from date of administration until today (11/2/12). She was home in bed.

VAERS ID:477316 (history)  Vaccinated:2012-10-08
Age:  Onset:0000-00-00
Gender:Unknown  Submitted:2012-11-05
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': WAES1211USA000961
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1233Z SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: The primary reporter is a medical assistant who administers vaccines. This medical assistant noted that patient was inadvertently administered an expired dose of VARIVAX (1233Z; 09/24/2012) on 10/08/2012. The medical assistant noted this is the first and only dose of VARIVAX the patient has received. No adverse effect reported. No further information is available.

VAERS ID:473615 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Virginia  Entered:2012-11-06, Days after submission: 29
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: CVA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA1UNRA
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Stiff arm (right) trouble moving it.

VAERS ID:474531 (history)  Vaccinated:2012-10-08
Age:65.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 3
Location:Georgia  Entered:2012-11-06, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SOTALOL; PREVACID; Lisinopril; Metformin
Current Illness: None
Preexisting Conditions: Contrast media for x-rays; INDOCIN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA726DA UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood pressure increased, Chills, Dizziness, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Symptoms occurred within 3 hours or less of injection. Elevated B/P, dizzy, chills (temp 95.5), achy. Went to M.D. Given med for dizziness, B/P medicine. Still having symptoms of chills and achy with dizziness as of 10/11/12.

VAERS ID:477691 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-07, Days after onset: 30
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': WAES1210USA004231
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)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 nurse refers to a pediatric patient of unknown age. The pediatric patient received the third dose of RECOMBIVAX HB (dose and lot # were unknown) today (on 08-OCT-2012) which was early. The second dose was given on 06-SEP-2012. No other co-suspects were reported. No concomitant medications were reported. No symptoms reported. At the report time the outcome of event was unknown. It was unknown if the patient sought medical attention. Additional information has been requested.

VAERS ID:473639 (history)  Vaccinated:2012-10-08
Age:43.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 31
Location:Tennessee  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: No acute illness
Preexisting Conditions: Anxiety, insomnia, fibromyalgia, chronic pain
Diagnostic Lab Data: Initial blood glucose: 11 mg/dl; After 3 amps of 50% dextrose (one hour after arrival) glucose level 55 mg/dl.
CDC 'Split Type': TN1213
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA735BA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Balance disorder, Blood glucose decreased, Gait disturbance, Hypoglycaemia, Syncope, Unresponsive to stimuli
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), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient and husband received IM influenza vaccination at clinic. After leaving, within an hour of injection, they drove a short distance to a family member''s home; patient was unsteady walking and collapsed, unresponsive, outside. Husband also was found unresponsive in car. Emergency services personnel responded: patient''s blood glucose level was documented at 11 mg/dl. Treated with 3 ampoules of 50% dextrose in the field at 3:15PM, followed by D10 in ER. Patient blood glucose normalized and patient was admitted to an outside hospital (accompanied husband, who required a higher level of care) about 7pm. Husband also extremely hypoglycemic: his report is separate. Do not have records from hospital.

VAERS ID:473669 (history)  Vaccinated:2012-10-08
Age:48.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-11-08, Days after onset: 31
Location:Tennessee  Entered:2012-11-08
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: COPD, Coronary artery disease, hypertension, congestive heart failure, gastroesophageal reflux, hyperlipidemia
Diagnostic Lab Data: Insulin level at 6:50 PM on 10/8 (about 6 hours after injection): 30 munits/L (High) (normal range given is 3-25). Insulin level at 9 AM on 10/9 is normal at 16.6. A proinsulin level test was reported as an insufficient sample, but the level detected was very low.
CDC 'Split Type': TN1212
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA735BA IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Accidental overdose, Acute respiratory failure, Blood glucose decreased, Blood insulin increased, Blood proinsulin decreased, Endotracheal intubation, Hypoglycaemic coma, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (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), Drug abuse and dependence (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Lipodystrophy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Review of the ambulance report and Hospital reports document that the patient and his wife (state VAERS record TN-12-13) were found unresponsive in their vehicle at a residence about an hour after they had been to the clinic and received influenza vaccinations. The doses were reportedly the last two doses out of a multidose vial; no other patients had reported any adverse events. Insulin is stored in the same refrigerator as the influenza vaccine; the clinic staff deny pre-drawing syringes or inadvertently administering insulin. The patient''s blood glucose was undetectable by the EMT staff and the patient was given IV dextrose, intubated, and transported to the ER. The patient was transferred to another hospital for admission, along with his wife (TN-12-13). The hospital discharge summary documented a final diagnosis of coma due to hypoglycemia secondary to accidental insulin overdose and acute respiratory failure secondary to coma.

VAERS ID:473696 (history)  Vaccinated:2012-10-08
Age:59.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-11-08, Days after onset: 29
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 10/6/12 with ACS required cath/stents
Preexisting Conditions: NKDA; Cholecystectomy; Dyslipidemia; Back surgery; Elbow surgery; Appendectomy
Diagnostic Lab Data: Blood Cx negative; Imaging negative
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AB0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138780IMRA
Administered by: Private     Purchased by: Other
Symptoms: Blood culture negative, Imaging procedure, Injection site erythema, Injection site warmth, Laboratory test normal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Fever up to 102.7 degrees F with RUE warmness/erythema: ID consulted. Imaging, lab, cultures, antibiotics ordered.

VAERS ID:474356 (history)  Vaccinated:2012-10-08
Age:71.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 31
Location:Ohio  Entered:2012-11-09, 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 listed
Preexisting Conditions: None listed
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AC0SYRLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left shoulder pain. Started 1 hr after flu shot, has continued since, approximately 3 wks. Dr prescribed MOBIC and physical therapy.

VAERS ID:477985 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-12, Days after onset: 35
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': WAES1211USA000608
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0595AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered pharmacist refers to a patient of unknown age. On 08-OCT-2012, the patient was vaccinated with a dose of 0.5 ml PNEUMOVAX 23 (lot # 669579/0595AA) that expired on 30-AUG-2012. No other co-suspects and no concomitant medications were reported. No adverse effect reported. It was unspecified if the patient had sought medical attention. This case has been cross referenced with case 1210USA004308 and 1211USA000607, which concerned 2 patients who received the same expired vaccine (no adverse event was reported in these 2 cases either). Additional information is not expected.

VAERS ID:473964 (history)  Vaccinated:2012-10-08
Age:49.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-11-09, Days after onset: 32
Location:Unknown  Entered:2012-11-13, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2012033857
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood test, Chest pain, Dysphagia, Immediate post-injection reaction, Injection site rash, Insomnia, Malaise, Mobility decreased, Musculoskeletal pain, Neck pain, Nervous system disorder, Oropharyngeal pain, Streptococcus test, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: This consumer report (initial receipt: 31-Oct-2012) concerns a 49-year-old male patient. Concomitant medication included testosterone. On 08-Oct-2012 the patient received AFLURIA (batch number was not provided) injection intramuscularly. Within minutes after vaccination, the patient started immediately with a small rash at the injection. He got extremely sick and developed a sore throat that lasted 5 - 6 days. His throat was so sore that he could not swallow his own saliva. On 15-Oct-2012 he saw his NP (nurse practitioner), was tested for Strep throat and blood work and put on unspecified antibiotics. Later he felt like spikes were being driven through his shoulders and chest. On 25-Oct-2012 he went to the ER (Emergency Room) because the pain was so severe that he could not sleep. At the ER he was given PERCOCET and VALIUM. He had the shakes but no fever. His neck now had the spikes of pain and he could not move his neck. He still had a nerve problem with tremors and shakes every now and then. The events improved slowly. The event outcome was not recovered.

VAERS ID:474387 (history)  Vaccinated:2012-10-08
Age:72.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-11-13, Days after onset: 36
Location:Illinois  Entered:2012-11-13
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
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4490AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt received FLUZONE HD vaccine on 10/08/2012. Pt had tingling in the arm occur and as a result went to ER that night. It''s been about more than a month and pt still tingling & numb.

VAERS ID:474600 (history)  Vaccinated:2012-10-08
Age:54.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-11-13, Days after onset: 34
Location:Florida  Entered:2012-11-13
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: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA689AA2IMLA
Administered by: Public     Purchased by: Other
Symptoms: Lymph node pain, Lymphadenopathy, Myalgia, Oedema peripheral
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Regional lymph nodes enlarged temporarily (& tender), (L) arm "swollen", "muscle aches". As of report date lymph nodes are no longer tender, one in the posterior cervical chain is enlarged. No other symptoms remain.

VAERS ID:476777 (history)  Vaccinated:2012-10-08
Age:72.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-11-06, Days after onset: 28
Location:Florida  Entered:2012-11-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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VARZOS: ZOSTER (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Pain, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Shingles rash began less than 24 hours after vaccine. Area was (L) upper chest, (L) shoulder, (L) scapular area and (L) neck. Very painful. It has taken 1 month for rash to subside. Area is still painful.

VAERS ID:477996 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-13, Days after onset: 36
Location:California  Entered:2012-11-13
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': WAES1211USA002138
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from an other health professional refers to a patient of unknown age. The patient was vaccinated with VAQTA on 08-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. It was reported that the patient received a dose of VAQTA which was exposed to 22.6 Fahrenheit for 13 hours. No adverse effect reported. No further information is available. Additional information is not expected.

VAERS ID:476853 (history)  Vaccinated:2012-10-08
Age:79.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-14
Location:Missouri  Entered:2012-11-14
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: Hx q TIA''s; HTN; Bradycardia
Diagnostic Lab Data: None
CDC 'Split Type':
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Syncope episode past 3 years within 3 days of receiving shot.

VAERS ID:474639 (history)  Vaccinated:2012-10-08
Age:1.3  Onset:2012-10-22, Days after vaccination: 14
Gender:Female  Submitted:2012-11-17, Days after onset: 26
Location:Illinois  Entered:2012-11-17
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Mild URI (child attends daycare)
Preexisting Conditions: None
Diagnostic Lab Data: CRP 69; ESR 20s; WBC 11, 16% bands; Blood culture negative; BMP, LFTs, PT/PTT all normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4483BA2UNLL
HEPA: HEP A (VAQTA)MERCK & CO. INC.H0126420UNLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0120440UNRL
Administered by: Private     Purchased by: Private
Symptoms: Activated partial thromboplastin time normal, Band neutrophil percentage increased, Blood culture negative, C-reactive protein increased, Erythema multiforme, Feeling abnormal, Gait disturbance, Injection site joint swelling, Injection site urticaria, Liver function test normal, Metabolic function test normal, Oedema peripheral, Prothrombin time normal, Rash generalised, Red blood cell sedimentation rate increased, Serum sickness-like reaction, Skin lesion, Urticaria, White blood cell count increased
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Child developed a serum-sickness like reaction on 10/22/2012. Started as hives, then rapidly progressed to swollen knees, refusal to walk. Hands and feet swollen the following day. Child miserable. Rash progressed to erythema multiforme with classic coalescing target lesions covering 50% of her body surface area. See by ER and Rheumatology. Labs drawn with CRP 69. Started on prednisone, 1mg/kg x 10 days, then tapered. Rash worse on 10/23/2012, with dusky centers of the lesions. Seen by burn/plastics. Concerned that she could progress to Stevens-Johnson and need skin grafting, but marked improvement by 10/25 on steroids. OF NOTE, child first noticed to have a "sentinel hive" on her left thigh, the site of two immunizations given on 10/8/2012 (influenza and Hep A). Serum sickness, when caused by an injectable protein based drug, is known to produce this sentinel hive prior to the full body rash. (She also received a varicella vaccine the same day, but in the opposite leg). Seen by allergy in follow-up, believes influenza vaccine potentially to blame. Please note, mother of child is a physician (hence the vocabulary used in this report).

VAERS ID:474978 (history)  Vaccinated:2012-10-08
Age:68.0  Onset:2012-10-14, Days after vaccination: 6
Gender:Male  Submitted:2012-11-19, Days after onset: 36
Location:Pennsylvania  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: None
Preexisting Conditions: None
Diagnostic Lab Data: C-spine MRI (-); EMG consistent with GBS
CDC 'Split Type':
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Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA707AA UNAR
Administered by: Military     Purchased by: Private
Symptoms: Clumsiness, Electromyogram, Feeling hot, Hypoaesthesia, Muscular weakness, Nuclear magnetic resonance imaging normal, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: At 6 days - numbness, tingling in feet, weakness (L) hip extensor muscle, then clumsy (L) hand, (R) hip weakness, L-1 numbness (saddle numbness) couldn''t feel urine stream. Peaked at 7 days. At 21 days noted heat sensation in legs. Sxs slowly resolving.

VAERS ID:475167 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-11-01, Days after vaccination: 24
Gender:Female  Submitted:2012-11-21, Days after onset: 20
Location:North Carolina  Entered:2012-11-26, Days after submission: 5
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 patient had no known allergies (NKA) and no illness at the time of vaccination.
Diagnostic Lab Data: Cervical spine and left shoulder x-ray were within normal limits (WNL)
CDC 'Split Type': 201210730
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AB IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ear pain, Headache, Musculoskeletal pain, Nodule, Pain in extremity, Spinal X-ray normal, X-ray limb normal
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Initial report was received from a health care professional on 15 November 2012. A female patient (age and date of birth not reported) had received an intramuscular injection in the left deltoid of FLUZONE, lot number UH731AB, on 08 October 2012. On 01 November 2012, the patient developed left shoulder pain and arm pain to hand, left ear pain and knots behind left ear that got progressively worse and a headache. Treatment included steroids and anti-inflammatories. The patient continued to complain of symptoms. Cervical spine and left shoulder x-ray were within normal limits (WNL). The patient had no known allergies (NKA) and no illness at the time of vaccination. Outcome was not recovered. Documents held by sender: None.

VAERS ID:475284 (history)  Vaccinated:2012-10-08
Age:4.0  Onset:2012-11-07, Days after vaccination: 30
Gender:Female  Submitted:2012-11-26, Days after onset: 19
Location:Ohio  Entered:2012-11-26
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: None - Regarding box 9, patient is still symptomatic, but is expected to recover
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AA5IMUN
Administered by: Unknown     Purchased by: Private
Symptoms: Gait disturbance, Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Presented to primary physician on 11/21/2012 with abnormal gait which had been evolving over ~ 10-14 days prior. Exam and history consistent with Guillain-Barre syndrome, which was agreed upon by the pediatric neurologist who then got involved and continues to follow her.

VAERS ID:478606 (history)  Vaccinated:2012-10-08
Age:81.0  Onset:2012-10-22, Days after vaccination: 14
Gender:Female  Submitted:2012-11-26, Days after onset: 35
Location:Unknown  Entered:2012-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity, Adverse event/Allergy to cephalosporins, tramadol; Drug hypersensitivity, Adverse event/Allergy to penicillin; Drug hypersensitivity
Preexisting Conditions: 11/--/2008, Lymphoma, Not currently receiving any treatments or medication for lymphoma; tramadol, Drug hypersensitivity; penicillin (unspecified), Drug hypersensitivity; SULFA, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA005611
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 nurse practitioner refers to an 81 years old female patient. The patient''s medical history included drug reactions/allergies to penicillin, sulfa, cephalosporins and tramadol hydrochloride. The patient also had a lymphoma 4 years ago, for which she was not currently receiving any treatment or medication. On 08-OCT-2012 the patient was vaccinated with ZOSTAVAX (vial 19400). Information regarding dose, dose number, route and lot number was not provided. No other co-suspects were reported. Concomitant medications included: ZOMETA. Two weeks after receiving ZOSTAVAX (approximately 22-OCT-2012) the patient experienced shingles. The patient had sought medical attention (office visit). No relevant tests were performed. The patient received VALTREX as treatment for the event. On 07-NOV-2012 the patient recovered from the event. A reporter causality for shingles was not provided for ZOSTAVAX. Additional information has been requested.

VAERS ID:475411 (history)  Vaccinated:2012-10-08
Age:67.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-11-27, Days after onset: 50
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: Drug hypersensitivity
Preexisting Conditions: Penicillin, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA009928
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H011780 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Incorrect dose administered, Pain, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 67 years old female patient with allergy to penicillin. The patient was vaccinated with PNEUMOVAX 23 (lot number reported as H011780, expired date 16-FEB-2014) (0.5 ml, intramuscular) on 08-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. On 08-OCT-2012 the patient experienced severe swelling. Pharmacist followed up with patient today on 21-NOV-2012 and patient was still experiencing some pain and due to arm pain, patient missed some work. Patient told the pharmacist that she thought she received another dose of PNEUMOVAX 23 about two years ago in approximately November 2010. Treatment VOLTAREN and diclofenac were given for adverse event. The patient was still experiencing some pain and arm pain. The outcome of severe swelling was unknown. The reporter considered that the pain caused the disability as missed work. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:475409 (history)  Vaccinated:2012-10-08
Age:61.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-11-28, Days after onset: 49
Location:Virginia  Entered:2012-11-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: Type II diabetes
Diagnostic Lab Data: Patient seen by private dermatologist. Testing unknown.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH730AB IMLA
Administered by: Public     Purchased by: Private
Symptoms: Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Generalize raised, red, itching rash on bilateral arms, bilateral hands, trunk, upper back.

VAERS ID:475516 (history)  Vaccinated:2012-10-08
Age:62.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2012-11-28, Days after onset: 50
Location:New York  Entered:2012-11-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness
Preexisting Conditions: Penicillin allergy
Diagnostic Lab Data: Assessment by orthopedist; X-ray of left shoulder/arm.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH711AD IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site reaction, Muscular weakness, Pain, X-ray limb
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Left upper arm - close to shoulder - was felt weak, difficult to raise arm, along with a throbbing pain. This pain has persisted, and weakness has persisted as well, somewhat lessened.

VAERS ID:475553 (history)  Vaccinated:2012-10-08
Age:51.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-11-28, Days after onset: 49
Location:Nevada  Entered:2012-11-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None identified by employee
Preexisting Conditions: Not known
Diagnostic Lab Data: Not known
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH712AB IMRA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Pain in extremity
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Right arm pain and weakness - ''shooting pains down my arm to my hand.''

VAERS ID:478856 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 52
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': WAES1211USA011099
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 08-OCT-2012 11:54, 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:476519 (history)  Vaccinated:2012-10-08
Age:11.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-10-15, Days after onset: 5
Location:Michigan  Entered:2012-11-30, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness/sickness reported
Preexisting Conditions: Patient is allergic to PCN; No other conditions
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB646AA1IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4289AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B085CA5IMRA
Administered by: Private     Purchased by: Public
Symptoms: Burning sensation, Rash erythematous, Rash generalised, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: Patient broke out with red bumps all over. They were itching and burning. They looked like hives. Patient''s symptoms lasted about a week and a half. Patient was treated with ATARAX 25mg, CLARITIN 10 mg and was sent home with Epi Pen Jr.

VAERS ID:478958 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 53
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': WAES1211USA011102
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 08-OCT-2012 17:43, 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 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:478987 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 53
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': WAES1211USA011101
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 08-OCT-2012 12:42, 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:478992 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 53
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': WAES1211USA011100
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 08-OCT-2012 12:35, 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:478995 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 53
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': WAES1211USA011103
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 08-OCT-2012 17:33, 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:476110 (history)  Vaccinated:2012-10-08
Age:63.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Male  Submitted:2012-12-03, Days after onset: 54
Location:Michigan  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:
Preexisting Conditions:
Diagnostic Lab Data: Blood screen
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMAR
Administered by: Private     Purchased by: Private
Symptoms: Blood test, Burning sensation, Dyspnoea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Body Ache, breathing difficulty with burning sensation, intermittent low grade fever. Treatment rest, fluids, regular perspiration.

VAERS ID:476278 (history)  Vaccinated:2012-10-08
Age:67.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-11-27, Days after onset: 48
Location:Tennessee  Entered:2012-12-04, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Nortriptyline; AUGMENTIN; ALEVE; Gabapentin; UROBLUE; FLEXERIL; BENTYL; BACTRIM
Diagnostic Lab Data: No tests
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138471UNUN
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Immediate post-injection reaction, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Right upper arm area immediately became painful turning to pink color on third day. Visited Dr. who diagnosed full-blown Cellulitis. Took Cephalexin 500 3 times a day for 10 days. Recovered.

VAERS ID:476486 (history)  Vaccinated:2012-10-08
Age:60.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-19, Days after onset: 10
Location:Tennessee  Entered:2012-12-04, Days after submission: 46
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
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0097790SCLA
Administered by: Other     Purchased by: Other
Symptoms: Feeling hot, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt received vaccine in left arm (sub-q, triceps area) and complained of warmth & pain next day. The arm then swelled down to finger tips. He visited his doctor the next day and was prescribed BACTRIM DS. twice daily x 5 days.

VAERS ID:477228 (history)  Vaccinated:2012-10-08
Age:56.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2012-12-07, Days after onset: 58
Location:Minnesota  Entered:2012-12-07
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH753AA SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Pain in extremity
SMQs:
Write-up: Patient is complaining her arm still hurts one month post vaccination. Does not hurt all of the time but has soreness intermittently & sporadically.

VAERS ID:477389 (history)  Vaccinated:2012-10-08
Age:8.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2012-12-10, Days after onset: 63
Location:Wisconsin  Entered:2012-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206901 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Loss of consciousness, Malaise, Nausea, Posture abnormal, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: PATIENT WAS SITTING IN ONE OF OUR WAITING CHAIRS WHILE HIS MOTHER PAID FOR OTHER MEDICATIONS. HE THEN TOLD HIS MOTHER HE WASN''T FEELING WELL. HIS HEAD WENT BACK AND IT LOOKED LIKE HE PASSED OUT. HIS MOTHER WENT OVER AND TRIED TO WAKE HIM UP. PATIENT THEN STARTED RESPONDING TO HER. WE GAVE HIM SOME WATER AND IMMEDIATELY LOOKED AND STARTED FEELING BETTER. HE COMPLAINED OF NAUSEA, DIZZINESS, BLURRED VISION. THE MOTHER STATED HE HAD BEED SWIMMING BEFORE THE VACCINATION AND HAD NOT EATEN SINCE BREAKFAST. I CALLED HIS MOTHER ABOUT AN HOUR LATER AND SHE SAID HE WAS DOING FINE. I BELIEVE HE FAINTED IN THE CHAIR.

VAERS ID:478773 (history)  Vaccinated:2012-10-08
Age:80.0  Onset:2012-10-11, Days after vaccination: 3
Gender:Female  Submitted:2012-12-19, Days after onset: 69
Location:Indiana  Entered:2012-12-19
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: CAD, GERD, IBS, Osteoporosis, Depression, Hypothyroidism
Diagnostic Lab Data: as above
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714AB IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Blood creatine phosphokinase normal, C-reactive protein increased, Gait disturbance, Musculoskeletal pain, Myofascial pain syndrome, Polymyalgia rheumatica, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vasculitis (narrow), Arthritis (broad)
Write-up: Patient developed hip and shoulder pain three days after vaccination which gradually worsened. She had weakness to the point of difficulty walking. Was seen in the ED on 11/18, ESR 32 and was diagnosed with myofascial pain. Was seen in office 12/4 with suspicion for polymyalgia rheumatica. ESR at that time was 54 and CRP 7.8 with normal CPK. Started on prednisone 15mg daily with complete resolution in her symptoms by follow up visit 12/19.

VAERS ID:479014 (history)  Vaccinated:2012-10-08
Age:54.0  Onset:2012-10-11, Days after vaccination: 3
Gender:Female  Submitted:2012-12-21, Days after onset: 71
Location:Kansas  Entered:2012-12-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported.
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA330AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Impaired healing, Injection site discharge, Injection site erythema, Injection site vesicles, Local reaction, Presyncope
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Injection site with approx 2 cm "blister" filled with serous drainage, surrounded by reddened area, perhaps as large as 10 cm. Reported light-headed and near-syncope. Afebrile. Taken to ARNP in clinic. He did not feel that near-syncope was related to vaccine and referred pt to ER. See in ER by Dr., who also stated that there was probably no relation between local reaction on arm and near-syncope. Patient has apparently been treating wound on left arm at home and recently visited Dr. due to non-healing. He anticipates several weeks of treatment to wound.

VAERS ID:479032 (history)  Vaccinated:2012-10-08
Age:52.0  Onset:2012-10-11, Days after vaccination: 3
Gender:Female  Submitted:2012-12-22, Days after onset: 72
Location:California  Entered:2012-12-22
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: Allergy to Penicillin and Sulfa Drugs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AA1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Activities of daily living impaired, Discomfort, Injection site pain, Insomnia, Musculoskeletal pain, Musculoskeletal stiffness, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: I experienced a sore and stiff neck on shoulder on my left side. This did not go away and after 10 days it moved to my right side. Then after several days moved back to my left side again while slowly fading away from my right side. It lasted over 6 weeks until the end of November 2012. I had difficulty working and sleeping due to the discomfort.

VAERS ID:479184 (history)  Vaccinated:2012-10-08
Age:38.0  Onset:2012-11-11, Days after vaccination: 34
Gender:Male  Submitted:2012-12-24, Days after onset: 43
Location:Washington  Entered:2012-12-24
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, Catapres, Zoloft
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Inconclusive
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12051210IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthritis, Autoimmune disorder, Fatigue, Granuloma, Pneumonia, Pyrexia, Raynaud's phenomenon, Skin lesion
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (narrow)
Write-up: Auto-immune symptoms, Raynaud''s, arthritis, pneumonia, granulomas, skin lesions, fatigue, fever.

VAERS ID:481096 (history)  Vaccinated:2012-10-08
Age:69.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 53
Location:Unknown  Entered:2013-01-10, Days after submission: 41
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: Allergy to penicillin; Allergy to codeine; Allergy to few unspecified antibiotics
Diagnostic Lab Data:
CDC 'Split Type': 2012033678
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  SYRUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Lip swelling, Rash pruritic, Rhinorrhoea, Swelling, Upper respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous consumer report (initial receipt 12-Oct-2012) concerns a 69-year-old female patient, who had no pertinent medical history or taking any concomitant medication. She was allergic to penicillin, codeine and a few unspecified antibiotics. On 08-Oct-2012, the patient received AFLURIA (batch number was not provided) injection as flu shot. On 08-Oct-2012 the patient''s lips swelled up and she had a rash that was itching on her arms and back. The next morning she was congested, nose was running and it felt swollen in her nose. No lab diagnostic study was performed. The patient sought medical attention by visiting to physician office and phone call to the pharmacy. The patient did not received any treatment for the events. At the time of reporting the patient''s lips were still swollen but recovering.

VAERS ID:481199 (history)  Vaccinated:2012-10-08
Age:51.0  Onset:2012-11-04, Days after vaccination: 27
Gender:Female  Submitted:2013-01-14, Days after onset: 71
Location:California  Entered:2013-01-14
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: I had EMG studies, nerve conduction tests and MRI''s which confirmed Parsonage-Turner Syndrome (brachial plexopathy) as a result of the flu shot.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Unknown     Purchased by: Other
Symptoms: Electromyogram abnormal, Impaired work ability, Monoplegia, Musculoskeletal pain, Neck pain, Nerve conduction studies abnormal, Neuralgic amyotrophy, Nuclear magnetic resonance imaging abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad)
Write-up: I woke up in excrutiating neck, shoulder, and scapula pain. I iced, heated and massaged the area all day to no avail. I finally had to go to the ER on 11/5/2012 about 1:00 AM. They gave me 2 different shots in both arms and oral medication which did not help. Then slowly throughout the day I lost function of my arm. I haven''t been able to work since. I am still in pain and the paralysis is still there.

VAERS ID:482572 (history)  Vaccinated:2012-10-08
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2013-01-25
Location:Texas  Entered:2013-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Allergy to PCN, not clear if physician diagnosed
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IM 
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS 1IM 
Administered by: Other     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Neuropathy peripheral
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: Patient received Tdap vaccine while she was ins the hopsital in August. She came to the pharmacy in October for a flu vaccine and reported that she had a newborn. Pharmacist recommended that if she had a young child at home she should get a Tdap booster for pertussis prevention. Patient did not recall having received a TDaP vaccine in the hospital. She got the TDaP vaccine. States that she now has neuropathy due to receiving the vaccine a second time.

VAERS ID:482952 (history)  Vaccinated:2012-10-08
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2013-01-30
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:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1301USA010649
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site inflammation, Injection site pain, Injection site pruritus, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a pharmacist refers to a 54 years old male patient. The patient had no history of drug reactions/allergies. He never had chickenpox. The patient was vaccinated with a dose of ZOSTAVAX (lot number not specified) on 08-OCT-2012. Route was not reported. No other co-suspects were reported. No concomitant medications were reported. On an unknown date the patient developed an injection site reaction after vaccination with ZOSTAVAX. The patient had a quarter size area which was inflamed at the injection site and had burning and itching. No treatment was given for the events. The patient had sought medical attention by contacting the pharmacist. At the time of report the patient had not recovered. The reporter did not provide a causality assessment. Additional information is not expected.

VAERS ID:483670 (history)  Vaccinated:2012-10-08
Age:64.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2013-02-07, Days after onset: 121
Location:Ohio  Entered:2013-02-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Injection site hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA004083
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0SCLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Inflammation, Injection site hypersensitivity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a registered nurse refers to a 65-year-old female patient. On 08-OCT-2012 at 2:30 p.m. the patient was vaccinated with a dose of ZOSTAVAX (lot # H012578, expiration date not reported) in the left arm subcutaneously. No concomitant medications were reported. On 15-JAN-2013 call was placed to the registered nurse. The nurse stated that the patient was hypersensitive to injections. Approximately on 08-OCT-2012 (reported as the day after she received ZOSTAVAX) she had a 4 inch by 6 inch area that was red and inflamed. Approximately on 10-OCT-2012 (reported as the following day) she saw her physician as it had spread to her entire arm. She then went to the Emergency Room (ER). The patient had not followed up with her physician since that time. It was unknown if the patient had recovered. Additional information is not expected.

VAERS ID:485014 (history)  Vaccinated:2012-10-08
Age:8.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 0
Location:Unknown  Entered:2013-02-20, Days after submission: 135
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': 2012SE77265
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2109 IN 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered
SMQs:
Write-up: A report has been received from a Health Professional concerning an 8 year old, Female subject, who had been receiving Nasal FLUMIST. FLUMIST started on an unknown date. The patient experienced patient received a full dose of FLUMIST in one nostril which started on 08-Oct-2012. The outcome of the event of patient received a full dose of FLUMIST in one nostril is unknown. The report was considered to be non-serious.

VAERS ID:487299 (history)  Vaccinated:2012-10-08
Age:70.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2013-03-20, Days after onset: 162
Location:Michigan  Entered:2013-03-20
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: HYPERTENSION
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4497AA2IMRA
Administered by: Public     Purchased by: Private
Symptoms: Activities of daily living impaired, Joint range of motion decreased, Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad), Arthritis (broad)
Write-up: Sore sholder and upper arm with impaired range of motion 3-20-13 PC from her to lodge a complaint about high dose flu vaccine. She said her arm was sore the next day and just keeps getting more and more sore. Now it is impairing her snow shoveling ability and she wanted to report it. Said it was her first dose of High Dose flu however our records indicate it was her third. She said she mentioned this to her doctor during her regular appointment and was diagnosed with possible tendonitis and physical therapy was recommended. She complained she has no transportation and decided not to go. I strongly recommended she see her doctor and do the PT.

VAERS ID:488473 (history)  Vaccinated:2012-10-08
Age:34.0  Onset:2012-10-10, Days after vaccination: 2
Gender:Female  Submitted:2013-04-02, Days after onset: 174
Location:North Carolina  Entered:2013-04-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Not reported.
Diagnostic Lab Data: Follow-up received 29 March 2013: The patient had a magnetic resonance imaging (MRI) on 7 November 2012 and results showed Teres minor tendinosis and thickening of left subscapularis tendon.
CDC 'Split Type': 201300362
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AB SYRUN
Administered by: Private     Purchased by: Unknown
Symptoms: Musculoskeletal pain, Nuclear magnetic resonance imaging abnormal, Tendon disorder
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Initial case was received from a healthcare professional on 04 January 2013. The reporter for this case is the same as for cases: 2012-10730, 2013-00361 and 2013-00363. A patient (age, birth date, and gender not reported), whose medical history was not reported, received an injection of INFLUENZA VACCINE (manufacturer unknown, (lot number, route, site, side and dose in series not reported) on an unspecified date. On an unspecified date, the patient experienced unspecified "symptoms post flu shot". Laboratory, diagnostic testing or treatments were not reported. The patient''s outcome was not reported. Follow-up information received on 29 March 2013 from a healthcare professional. A 34-year-old female patient received an injection of FLUZONE, Sanofi Pasteur (lot number UH731AB) on 08 October 2012. On 10 October 2012, the patient experienced left shoulder pain. The patient had a magnetic resonance imaging (MRI) ON 7 November 2012 and results showed Teres minor tendinosis and thickening of left subscapularis tendon. The patient had an office visit on 12 November 2012. A MEDROL DOSEPAK and physical therapy were prescribed by personal physician on 12 November 2012. The patient was released by personal physician on 18 December 2012 and full recovery was confirmed on 18 December 2012. The patient''s outcome was recovered on 18 December 2012. Documents held by sender: None.

VAERS ID:488624 (history)  Vaccinated:2012-10-08
Age:63.0  Onset:2012-11-18, Days after vaccination: 41
Gender:Female  Submitted:2013-04-05, Days after onset: 137
Location:Pennsylvania  Entered:2013-04-05
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, calcium, potassium chloride, gabapentin, furosemide, senna-docusa, omeprazole, amlodipine, Pro-air, Spiriva, Vicodin
Current Illness:
Preexisting Conditions: Has COPD and emphysema
Diagnostic Lab Data: EMG 02/15/2013 LP 02/18/2013
CDC 'Split Type':
Vaccination
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Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA707AA1IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Abasia, Electromyogram, Hypoaesthesia, Lumbar puncture, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Legs and hands going numb and couldn''t lift legs to walk, very shaky.

VAERS ID:490001 (history)  Vaccinated:2012-10-08
Age:27.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Female  Submitted:2013-04-23, Days after onset: 196
Location:North Carolina  Entered:2013-04-25, Days after submission: 2
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 patient had no illness at the time of vaccination and had no known allergies. Follow-up on 10 April 2013, reported the patient had a past medical history (PMH) on 31 July 2012 of pain, right (R) shoulder (acromioclavicular (A-C) joint and scapula) and left (L) sternoclavicular (S-C) joint, reported as apparently self-limited.
Diagnostic Lab Data: Not reported. Follow-up information on 10 April 2013, reported no laboratory or diagnostic tests were performed.
CDC 'Split Type': 201210829
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AB IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Fatigue, Headache, Injection site pain, Insomnia, Muscular weakness, Myalgia, Myositis, Sleep disorder, Tenderness, Trigeminal neuralgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Demyelination (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Initial report received from a healthcare professional on 15 November 2012. A female patient, whose age, date of birth and concomitant medications were not reported and who had no known allergies or illness at the time of vaccination, had received an intramuscular dose of FLUZONE (lot number: UH731AB) in the right deltoid on 08 October 2012. On 10 October 2012, 2 days after the vaccination, the patient developed headache, right shoulder pain and weakness to fingertips. Corrective medications and laboratory investigations were not reported. At the time of this report, the patient had not recovered. Follow-up information was received from a healthcare professional on 10 April 2013. The reporter for this case is also the same as for cases 2012-10730, 2013-00362, 2013-00363, and (2013-00361, which was found to be a duplicate). Upon receipt of follow-up information a healthcare professional on 10 April 2013, it was determined that this case is a duplicate of case number 2013-00361. All information has been included in reference case number 2012-10829 and the duplicate case 2013-00361 will be deleted. The duplicate case 2013-00361 information included: On an unspecified date, the patient experienced unspecified "symptoms post flu shot". Based upon the new information provided, this case has been upgraded to serious. The patient, a surgical technician (tech) was 27-years-old at time of immunization and onset of adverse event. She was 28-years-old at date of examination by doctor. Onset of experienced symptoms post flu shot was reported as 09 October 2012, one day post vaccination, the patient experienced pain and tenderness of right (R) trapezius, suprascapularis, deltoid, biceps and triceps muscles (previously reported as 10 October 2012). The patient was seen by physician on 20 November 2012. According to reporter Physician''s Notes, she developed pain/tenderness on R side of neck to shoulder, pectorals, intercostals, extending down into hip, same side as flu shot given, R deltoid on 08 October. Symptoms began next day with headache (HA), also involved weak R hand. On 14 November 2012, the patient called physician and TYLENOL Arthritis two (ii) every (Q) 8 hours (hr) was prescribed with no help and Ibuprofen was prescribed (no dose, route or frequency reported) with result of mild decrease in pain, three to four hours. She complained of being fatigued, can not sleep as usual (on front), but able to work full shifts. The exam was limited as no exam table in RN Office. The patient''s gait and station were reported as normal. the R deltoid had no cellulitis. She had full range of motion (ROM at major and minor joints, but tenderness of trapezius, suprascapularis, deltoid, biceps and triceps on R. She had no tenderness to palpation (TTP) on left (L), thorax and R hip were not tender. Assessment and Plan (A/P) were reported as post flu shot myositis, with no evidence of infection. The duration of symptoms and muscle tenderness were reported as unusual, but likely to respond to Prednisone, prescribed as 40 milligram (mg)/day times (x) five days, with no refills. Other treatments included: over the counter (OTC) BENADRYL 25 mg each bedtime x 10 days; Amitriptyline 10-20 mg each bedtime x 10 days; followed by acetaminophen 650 mg, two every eight hours (hrs), discontinued on 05 December 2012; and switched to OTC Motrin. Per Physician''s Notes, she had "not done a ''ROII'', needs to." On 04 February 2013, the patient was diagnosed with R trigeminal (trigem) neuralgia. The patient had a past medical history (PMH) on 31 July 2012 of pain, right (R) shoulder (acromioclavicular (A-C) joint and scapula) and left (L) sternoclavicular (S-C) joint, reported as apparently self-limited. At the time of the report, according to the reporter, no laboratory or diagnostic tests were performed. The stop date of symptoms was reported as still symptomatic on 15 February 2013. The later course of Prednisone was reported as also of no benefit, as was Amitriptyline

VAERS ID:492107 (history)  Vaccinated:2012-10-08
Age:35.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-22
Location:Massachusetts  Entered:2013-05-20, Days after submission: 210
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL; Iron supplements
Current Illness:
Preexisting Conditions: Patient denied any illness at the time of the vaccination. The patient had no past medical history history. Patient is allergic to Amoxicillin. The patient had received Tdap in 2004. The concomitant medication included iron supplement and TYLENOL.
Diagnostic Lab Data: None per reporter.
CDC 'Split Type': 201209464
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMAR
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Headache, Hyperhidrosis, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Initial report received from a consumer who is also the patient, on 10 October 2012. A 35-year-old female patient had received a dose of intramuscular Tdap (Manufacturer unknown, Lot number unknown) in deltoid on 08 October 2012. Patient denied any illness at the time of the vaccination. The patient had no past medical history. Patient is allergic to Amoxicillin. The patient had received Tdap in 2004. The concomitant medication included iron supplement and TYLENOL. The patient had menses at the time of vaccination. On 08 October 2012 after 8 hours of vaccination, the patient had headache, body aches, chills, nausea nad sweats. Temperature was not recorded. The patient had received Tdap in 2004 but was informed that Tdap was not licensed until 2005. Corrective treatment was not reported. Laboratory investigations were none as per reporter. The reporter stated that the symptoms were resolving. The patient''s outcome was unknown. List of documents held by the sender: None.

VAERS ID:494958 (history)  Vaccinated:2012-10-08
Age:86.0  Onset:2012-10-09, Days after vaccination: 1
Gender:Male  Submitted:2012-10-09, Days after onset: 0
Location:Iowa  Entered:2013-06-24, Days after submission: 258
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Complaints to dr after 6 mo when realized it wasn''t going to heal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Private
Symptoms: Insomnia, Pain
SMQs:
Write-up: Ached that I could not get a good nights sleep.

VAERS ID:496556 (history)  Vaccinated:2012-10-08
Age:37.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2013-05-13, Days after onset: 217
Location:Unknown  Entered:2013-07-12, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins; Calcium with vitamin D; Fish oil
Current Illness: Delivery of baby
Preexisting Conditions: Gestational diabetes
Diagnostic Lab Data: UNK
CDC 'Split Type': A0999480A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, In vitro fertilisation, Pain in extremity
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Fertility disorders (narrow)
Write-up: This prospective pregnancy case was reported by a consumer and described the occurrence of arm pain in a 37-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). A physician or other health care professional has not verified this report during pregnancy. The subject''s medical history included one previous pregnancy that resulted in a normal birth complicated by gestational diabetes. Concurrent medications included Prenatal vitamin, Calcium + D and Fish oil. On 8 October 2012 the subject received unspecified dose of FLUARIX (unknown, left arm). Her last menstrual period was on 25 September 2012 and estimated date of delivery was 02 July 2013. This pregnancy was by in vitro fertilization. At the time of the report, no testing has been performed. The subject was exposed to FLUARIX at two weeks gestation, during the first trimester. On 8 October 2012, at the time of vaccination with FLUARIX, the subject experienced vaccine exposure during pregnancy. On 8 October 2012, 3 hours after vaccination with FLUARIX, the subject experienced arm pain. By mid day on 09 October 2012, the arm pain resolved. The outcome of the pregnancy was unknown. The subject considered the arm pain related to vaccination with FLUARIX.

VAERS ID:506876 (history)  Vaccinated:2012-10-08
Age:56.0  Onset:2012-10-12, Days after vaccination: 4
Gender:Female  Submitted:2013-10-10, Days after onset: 363
Location:Florida  Entered:2013-10-10
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: Vaginal swabs for infection negative 10/12/2012
CDC 'Split Type':
Vaccination
Manufacturer
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Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0567AE0SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Smear vaginal normal, Vaginal inflammation, Vulval disorder
SMQs:
Write-up: Vaginal inflammation, vulvar sensitivity.

VAERS ID:518617 (history)  Vaccinated:2012-10-08
Age:29.0  Onset:2012-10-08, Days after vaccination: 0
Gender:Female  Submitted:2014-01-07, Days after onset: 456
Location:Alabama  Entered:2014-01-07
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
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Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1 LA
Administered by: Private     Purchased by: Other
Symptoms: Dysphagia, Dyspnoea, Heart rate increased, Ocular hyperaemia, Pain, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: BEGINNING AROUND 11:00 AM, SOME DIFFICULTY SWALLOWING & SEVERE ACHES. LATER IN THE DAY, AROUND 1:00 PM, RAPID HEARTBEAT, TROUBLE BREATHING & SEVERE BLOODSHOT EYES. VISITED EMERGENCY ROOM FOR TREATMENT WITH SYMPTOMS AROUND 2:30 PM. E.R. VISIT (TREATMENT SEGMENT) LASTED 6+ HOURS. A FEW DAYS LATER, DEVELOPED HIVES THAT LASTED NEARLY ONE WEEK.

VAERS ID:518994 (history)  Vaccinated:2012-10-08
Age:7.0  Onset:2013-11-19, Days after vaccination: 407
Gender:Male  Submitted:2014-01-12, Days after onset: 54
Location:Wisconsin  Entered:2014-01-12
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
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) (FLUZONE)SANOFI PASTEURUH896AB UNUN
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Neck pain, Pain in extremity, Spinal epidural haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic cerebrovascular conditions (narrow), Retroperitoneal fibrosis (broad), Accidents and injuries (broad), Arthritis (broad)
Write-up: Symptoms started early morning on 11-19-13 with arm pain, then neck pain, back pain and leg pain. Symptoms quickly became worse. 11-20-2013 He was diagnosed with Cervical Epidural Hematoma of the spine.

VAERS ID:519201 (history)  Vaccinated:2012-10-08
Age:52.0  Onset:0000-00-00
Gender:Female  Submitted:2013-12-11
Location:Illinois  Entered:2014-01-14, Days after submission: 34
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) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13403P0SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Injection site pain, Insomnia, Local swelling, Pain, Pain in extremity
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Extended length of soreness in injection site and swelling. Pain, numbness and swelling in arm and hand that the shot was given in. Unable to sleep due to pain that is both a dull ache and a shooting pain. A cortisone shot was given and anti-inflammatories.

VAERS ID:525096 (history)  Vaccinated:2012-10-08
Age:  Onset:2012-10-08, Days after vaccination: 0
Gender:Male  Submitted:2013-06-10, Days after onset: 245
Location:Foreign  Entered:2014-03-06, Days after submission: 269
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: 21-Jan-2013: The patient was seen in the Respiratory Department when he was informed that the results of his heart and lung investigations were OK. Blood investigations, 10/26/12; Chest x-ray, 10/26/2012; Further blood investigations, 11/??/12; Further urinary investigations, 11/??/12; Breathing tests, 12/17/12; Blood investigations, 12/17/12; Electrocardiogram, 01/11/13; CT scan, 01/11/13
CDC 'Split Type': 2013SE42547
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER23049521A UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blindness transient, Blood test, Chest X-ray, Computerised tomogram, Decreased appetite, Dyspnoea, Electrocardiogram, Hyperhidrosis, Influenza, Malaise, Oral candidiasis, Pain, Temporal arteritis, Tonsillitis, Ultrasound scan, Urinary tract infection, Urine analysis
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Oropharyngeal infections (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Vasculitis (narrow)
Write-up: A report was received from a physician and a consumer via MHRA. The patient''s medical history and concurrent diseases were not reported. Concomitant medications included: penicillin, cefelexin, nystatin, steroid antibacterials and prednisolone. On 06-Oct-2013, the patient received influenza virus vaccine (initially reported as Crucell). (Although follow-up revealed that the brand of vaccine was not known, the report does not specify a nasal route of administration, and the lot identifier, 23049521A, does not correspond to a FLUMIST or FLUENZ lot.) On 08-Oct-2012, two days following the flu vaccination, the patient became very unwell and developed giant cell arteritis at an unspecified time after vaccination. The consumer also reported that at 08:00 hours on the same day he developed very unpleasant flu symptoms with sweats and aches. On 15-Oct-2012 he developed tonsillitis and was prescribed penicillin. On 26-Oct-2012 the patient developed heavy sweating and lost all appetite. The penicillin was stopped on 27-Oct-2012. Blood investigations and a chest x-ray were performed (results awaited). On 01-Nov-2012 a urinary tract infection was diagnosed and Cephalexin prescribed which was stopped on 08-Nov-2012. Further blood and urinary investigations and an ultrasound scan were undertaken during the month of November (results awaited). On 12-Nov-2012 oral thrush was diagnosed and the patient was started on Nystan which was stopped on 19-Nov-2012 as the oral thrush did not appear to be responding to this treatment. On 15-Nov-2012 the patient lost his sight in the left right, partially on the right, for about 5 minutes. His sight was reported to have returned to normal afterwards. Temporal arteritis was suspected at this time. On 18-Nov-2012 the patient was seen in Emergency Department when he was prescribed unspecified steroids 60 mg. On 19-Nov-2012 was once again seen in the Emergency Department and prescribed unspecified steroids 60 mg. On that day (19-Nov-2012) the patient was referred to the Rheumatology Department where he was diagnosed with suspected giant cell arteritis. The patient was prescribed further medication including prednisolone 60 mg daily for three weeks. On 04-Dec-2012 he attended the rheumatology department for a follow-up consultation and was prescribed a 13-month course of steroids for his giant cell arteritis. At 09:30 hours on 17-Dec-2012, the patient attended the emergency department with ongoing breathlessness. Breathing tests and blood investigations were performed (results awaited). On 11-Jan-2013 the patient underwent an electrocardiogram and on 16-Jan-2013 a CT scan. On 21-Jan-2013 the patient was seen in the Respiratory Department when he was informed that the results of his heart and lung investigations were ok. However, there were no explanation for his breathlessness and the patient was discharged back to his general practitioner. The general practitioner reported that a different influenza vaccine to Crucell''s VIROFLU had been used this season. The brand of Influenza vaccine used on 06-Oct-2012 had not been noted down but the lot number was 23049521A. This is not a Crucell lot number. It was also confirmed that Crucell''s Influenza vaccine from last season (ie an out of date vaccine) had not been used. The physician stated that he was rather doubtful about a causal association between the events and the influenza vaccination. Report nullified (by another manufacturer) as it was not a Crucell Influenza vaccination that had been administered to this patient. At the time of reporting the outcome of the event of giant cell arteritis, generally unwell, unpleasant flu symptoms, heavy sweating, lost all appetite, urinary tract infection, oral thrush and tonsillitis were unknown. According to the reporter the adverse event of giant cell areteritis and generally unwell was considered to be serious with the serious criteria of important medical event and according to company physician the adverse event of unpl

VAERS ID:468665 (history)  Vaccinated:2012-10-09
Age:24.0  Onset:2012-10-09, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:New York  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported and none observed
Preexisting Conditions: none reported
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1221030IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Nausea, dizziness, chest tightness, diaphoretic, short of breath. She did not report symptoms until later though at 2:30pm and was then sent to the ER.

VAERS ID:468667 (history)  Vaccinated:2012-10-09
Age:54.0  Onset:2012-10-09, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:North Carolina  Entered:2012-10-10
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: Demerol
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP599080IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Facial pain, Local swelling, Neck pain, Pain in jaw,