MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 471248 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 1709 out of 1885

Result pages: prev   1460 1461 1462 1463 1464 1465 1466 1467 1468 1469 1470 1471 1472 1473 1474 1475 1476 1477 1478 1479 1480 1481 1482 1483 1484 1485 1486 1487 1488 1489 1490 1491 1492 1493 1494 1495 1496 1497 1498 1499 1500 1501 1502 1503 1504 1505 1506 1507 1508 1509 1510 1511 1512 1513 1514 1515 1516 1517 1518 1519 1520 1521 1522 1523 1524 1525 1526 1527 1528 1529 1530 1531 1532 1533 1534 1535 1536 1537 1538 1539 1540 1541 1542 1543 1544 1545 1546 1547 1548 1549 1550 1551 1552 1553 1554 1555 1556 1557 1558 1559 1560 1561 1562 1563 1564 1565 1566 1567 1568 1569 1570 1571 1572 1573 1574 1575 1576 1577 1578 1579 1580 1581 1582 1583 1584 1585 1586 1587 1588 1589 1590 1591 1592 1593 1594 1595 1596 1597 1598 1599 1600 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1612 1613 1614 1615 1616 1617 1618 1619 1620 1621 1622 1623 1624 1625 1626 1627 1628 1629 1630 1631 1632 1633 1634 1635 1636 1637 1638 1639 1640 1641 1642 1643 1644 1645 1646 1647 1648 1649 1650 1651 1652 1653 1654 1655 1656 1657 1658 1659 1660 1661 1662 1663 1664 1665 1666 1667 1668 1669 1670 1671 1672 1673 1674 1675 1676 1677 1678 1679 1680 1681 1682 1683 1684 1685 1686 1687 1688 1689 1690 1691 1692 1693 1694 1695 1696 1697 1698 1699 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1822 1823 1824 1825 1826 1827 1828 1829 1830 1831 1832 1833 1834 1835 1836 1837 1838 1839 1840 1841 1842 1843 1844 1845 1846 1847 1848 1849 1850 1851 1852 1853 1854 1855 1856 1857 1858 1859 1860 1861 1862 1863 1864 1865 1866 1867 1868 1869 1870 1871 1872 1873 1874 1875 1876 1877 1878 1879 1880 1881 1882 1883 1884 1885   next


VAERS ID:471013 (history)  Vaccinated:2012-10-22
Age:14.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 0
Location:Georga  Entered:2012-10-22
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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0101230IMRA
Administered by: Private     Purchased by: Public
Symptoms: Feeling abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient was sitting on exam table, 60 seconds post injection stated he felt "funny", had a syncopal episode which lasted approximately 1 1/2 - 2 min.

VAERS ID:471202 (history)  Vaccinated:2012-10-22
Age:29.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 0
Location:Montana  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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AD IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Musculoskeletal pain, Neck pain, Spinal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (broad)
Write-up: Onset of symptom of neck and shoulder pain started approx 15-20 min after injection. Rated pain 1-2 out of 1-10. Pt stated pain radiated down spine. Pain was subsiding after 30 min.

VAERS ID:471059 (history)  Vaccinated:2012-10-22
Age:76.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 1
Location:Georga  Entered:2012-10-23
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 known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA712AB0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Urticaria at injection site, warmth of skin surrounding injection site (no systemic fever).

VAERS ID:471417 (history)  Vaccinated:2012-10-22
Age:56.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 1
Location:New York  Entered:2012-10-23
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) (AFLURIA)CSL LIMITEDP59107 SYRAR
Administered by: Other     Purchased by: Other
Symptoms: Obstructive airways disorder, Palpitations, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Patient stated: Received shot at 1230pm 10/22. At around 6pm her airways seemed to constrict and heart raced. She then vomited and was shaky until about 830pm. She then felt better and never called for help.

VAERS ID:471421 (history)  Vaccinated:2012-10-22
Age:51.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 1
Location:Ohio  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: None at present
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH748AB IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Patient reports intense itching developed over entire body onset at 1130am 10/22/12, denies any rash, skin irritation or any other symptoms. Itching continues on 10/23/12. BENADRYL taken on 10/22/12 at 6pm and 10pm; and on 10/23/12 taken at 11am.

VAERS ID:471426 (history)  Vaccinated:2012-10-22
Age:72.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 1
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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Dyspnoea, Erythema, Gait disturbance, Headache
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Trouble walking, dizziness, headache started about 2 hours after vaccines and still on next day. Had red face and trouble breathing for about half an hour.

VAERS ID:471450 (history)  Vaccinated:2012-10-22
Age:40.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:Texas  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0077AE0UNLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad)
Write-up: Patient called clinic to report dizziness and a fast heartbeat after receiving MMR vaccine. Advised patient to report to Emergency Room if symptoms worsen.

VAERS ID:471622 (history)  Vaccinated:2012-10-22
Age:13.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 1
Location:Connecticut  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: None
Preexisting Conditions: Asthma; Hyperhidrosis
Diagnostic Lab Data: Urine analysis is negative
CDC 'Split Type': CT201210
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH751AA0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AE0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased, Feeling cold, Nausea, Pallor, Paraesthesia, Peripheral coldness, Urine analysis normal, Vaccination site pain, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: 10am on 10/22/12 vaccinated arm hurt did not go back to school. 11am 10/22/12 felt cold, was pale, ibuprofen given. By 4:30pm pt nauseous and vomiting, index finger (left) 4th finger (right) feeling cold; all fingers left hand tingly. Bad headache all over head. Temp 103.3 at 6:30pm.

VAERS ID:471281 (history)  Vaccinated:2012-10-22
Age:49.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 2
Location:Illinois  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: No
Preexisting Conditions: Allergies to grass pollen
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR492810390150IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cough, Headache, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Wheezing, occasional coughing, and head ache until 2 AM when I finally got to sleep.

VAERS ID:471290 (history)  Vaccinated:2012-10-22
Age:25.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 2
Location:California  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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Injection site erythema, Injection site pruritus, Injection site rash, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Onset of moderate to severe headache approximately 4-5 hours after receiving the second dose of an HPV vaccination. This was accompanied with mild chills and slight fever. Took regular Tylenol before sleeping that night and symptoms did not return the next day. Injection site shows redness and is both bumpy and itchy on 10/24/2012, two days after receiving the vaccine.

VAERS ID:471471 (history)  Vaccinated:2012-10-22
Age:16.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 2
Location:Washington  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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AC1IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AE0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4260AA1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Balance disorder, Feeling hot, Hypersensitivity, Injection site erythema
SMQs:, Angioedema (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Pt was given HPV immunization (1st dose) and advised to wait 20 min in lobby; pt began to feel "hot all over my body and inside my head". Pt became unstable on chair and had to be supported; a large red area appeared at injection site. Pt was escorted back to exam room where he was immediately evaluated by Dr., pt was administered 10mL of Q-DRYL to stop allergic reaction symptoms. Pt. remained in exam room for 20 min more and Dr. re-evaluated pt a final time and then allowed pt to leave clinic as his condition had stabilized.

VAERS ID:471485 (history)  Vaccinated:2012-10-22
Age:3.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 2
Location:Utah  Entered:2012-10-24
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: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ20240IN 
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Feeling abnormal, Hallucination, Moaning, Pyrexia, Restlessness, Skin warm, Tremor, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Mom reports before bed gave respiratory treatment because child was starting to get sick with wheezing. Fever became very high where child was hallucinating, moaning, shaking, kicking his legs and flailing. His hands and feet were very hot. Mom gave ibuprofen and it did seem to calm him down to the point he was able to rest some. In the morning he continued to act very tired like he does not feel good.

VAERS ID:471546 (history)  Vaccinated:2012-10-22
Age:22.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 2
Location:Indiana  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: None
Preexisting Conditions: SINGULAIR; PCN; BACTRIM; Latex
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4472AA0IDRA
Administered by: Private     Purchased by: Private
Symptoms: Axillary pain, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Warmth, pain, red area at site of injection armpit pain 12 hrs after injection cool compress at site of injection.

VAERS ID:471584 (history)  Vaccinated:2012-10-22
Age:53.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 1
Location:Alaska  Entered:2012-10-24, 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: No
Preexisting Conditions: Supraventricular arrythmia-infrequent but symptomatic; Vertigo
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AB3IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0171AE0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Headache, Injection site erythema, Injection site pain, Injection site rash, Oropharyngeal pain, Pain, Respiratory tract congestion
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Sore throat, achiness, congestion, headache, hot at night, symptoms disappeared 10-23-12. Patient took BENADRYL and ADVIL for symptoms. Redness and soreness/rash x1 day rt upper arm injection site.

VAERS ID:471395 (history)  Vaccinated:2012-10-22
Age:73.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-25, Days after onset: 3
Location:North Carolina  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: NO
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR    
Administered by: Other     Purchased by: Public
Symptoms: Abnormal sensation in eye, Chills, Cough, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Corneal disorders (broad)
Write-up: HIGH FEVER; CHILLS; SEVERE HEADACHE; PRESSURE IN EYES; COUGH. 2 ASPIRIN TWO TIMES OVER 8 HOURS.

VAERS ID:471462 (history)  Vaccinated:2012-10-22
Age:58.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Washington  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: NO HEALTHY FEMALE. TAKES NO RX.
Preexisting Conditions: PCN DOXYCYCLINE
Diagnostic Lab Data: Pt seen by pharmacist which sent her straight to MD who consulted ID and will return to clinic in 2 days put on Motrin and antihistamines.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.106091SCLA
Administered by: Other     Purchased by: Public
Symptoms: Body temperature increased, Cellulitis, Erythema, Induration, Injection site erythema, Injection site warmth, Jaundice, Swelling
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 6 inch diameter raised red cellulitis with hard erythemic/icteric 2 inch diameter center, injection site angry /red hot, hot, hot!! Pt with 99.5 temp.

VAERS ID:471506 (history)  Vaccinated:2012-10-22
Age:28.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Illinois  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: None
Preexisting Conditions: Allergic to penicillin and erythomycin. History of bulging disc at C5-6 but has been in maintenance phase of treatment for approximately 3 years at chiropractor.
Diagnostic Lab Data: Examination by chiropractor found swollen lymph nodes, muscle spasms in upper back, and stiffness and subluxations in upper back and neck.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Joint dislocation, Joint range of motion decreased, Lymphadenopathy, Muscle spasms, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Arthritis (broad)
Write-up: Beginning at around 8 pm began feeling the onset of muscle spasms in my upper back. Condition worsened through the night resulting in restricted range of motion in the neck. Required using sick leave the following day in order to care for the neck/back and to receive treatment at the chiropractor. Typically I attend the chiro only every 3 weeks for minor maintenance adjustments and hands on therapy. However, I had to go in for this extra appt 6 days after my previous appt and the only thing that we can think of that might have triggered this flare up was the flu shot. In the past I have had flare ups with the onset of illness. I have had no other symptoms of illness except for the back and neck issues except for minor soreness at the injection site.

VAERS ID:471760 (history)  Vaccinated:2012-10-22
Age:5.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Male  Submitted:2012-10-25, Days after onset: 2
Location:Mississippi  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: None
Preexisting Conditions: Peanut Allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AA0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site rash, Injection site swelling, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Fever to 102 within 24 hours, maculopapular rash on thigh around site of injection, swelling of thigh around site of injection. Rash resolved with po BENADRYL.

VAERS ID:471779 (history)  Vaccinated:2012-10-22
Age:22.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 3
Location:New Mexico  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: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59708 IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0121401SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0072731SCRA
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Dyspnoea, Headache, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Tightness in chest couldn''t breathe, headache, tightness in throat, went to ER was given steroids & BENADRYL.

VAERS ID:471820 (history)  Vaccinated:2012-10-22
Age:73.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Ohio  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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt had PNEUMOVAX / with swelling redness on left arm. No trouble breathing or hypotension. Warm to the touch. Became redder and more painful that night. Saw nurse practitioner who diagnosed cellulitis. Given cephalexin 500mg and MEDROL dose pak.

VAERS ID:471642 (history)  Vaccinated:2012-10-22
Age:64.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Female  Submitted:2012-10-26, Days after onset: 2
Location:Minnesota  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: No
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA730AA IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS 0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed rash on abdomen area and face. She also reports sometimes developing rashes due to anxiety.

VAERS ID:471890 (history)  Vaccinated:2012-10-22
Age:11.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-22, Days after onset: 0
Location:Georga  Entered:2012-10-26, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Body pain; Hx of fever
Preexisting Conditions: Acute pharyngitis; Allergic conjunctivitis; Allergic rhinitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling abnormal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt complained to mom "not feeling good", walked to lobby area and fainted.

VAERS ID:471716 (history)  Vaccinated:2012-10-22
Age:46.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Female  Submitted:2012-10-27, Days after onset: 3
Location:New Jersey  Entered:2012-10-27
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: Penicillin, Mint, Latex, Skelaxtin, TussinDM, #3 Codeine
Diagnostic Lab Data: Labs: Ck, CBC With/Diff, Basic Chemistry Profile, CKMB, Myoglobin Serum, Troponin I, B Natriuretic Peptide, PT/INR, TROPONIN I 2012/10/27 01:54:00, MYOGLOBIN SERUM 2012/10/27 01:54:00. Chest Xrays, 2 Views (Pa+lat), Ct Brain without contrast, 12 lead EKG, IV Insertion. Soarian Order - Repeat EKG 30 minutes after initial EKG, Soarian Order Cardiac Profile 2nd/3rd Set, IV Heplock Insertion (IID) BP in both arms, Oxygen @ 2L/min. Titrate to keep Sa02$g95%. Pain Assessment, Pulse Ox Continuous, Repeat EKG in 30 min, Vital Signs.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1224IP0SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Blood creatine phosphokinase, Blood creatine phosphokinase MB, Cardiac function test, Chest X-ray, Computerised tomogram head, Differential white blood cell count, Dizziness, Dysphonia, Dyspnoea, Electrocardiogram, Full blood count, Heart rate increased, International normalised ratio, Laboratory test, Myoglobin blood, Prothrombin time, Troponin I, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Difficulty Breathing, Hoarseness, wheezing, fast heart beat and dizziness.

VAERS ID:472036 (history)  Vaccinated:2012-10-22
Age:85.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-27, Days after onset: 4
Location:Florida  Entered:2012-10-27
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: Iodinated contrast media
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4530AA1UNLA
Administered by: Other     Purchased by: Other
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: Raised red area around vaccine administration site on shoulder. The site is also warm and painful.

VAERS ID:471743 (history)  Vaccinated:2012-10-22
Age:69.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Male  Submitted:2012-10-28, Days after onset: 5
Location:Alabama  Entered:2012-10-28
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
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0133940SCLA
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient came back to pharmacy and claimed her left arm was swollen, then pulled up the sleeve on her blouse to show the swelling. Patient was directed to see a doctor due to severe erythema and edema in the extremity. Pt had cellulitis.

VAERS ID:474666 (history)  Vaccinated:2012-10-22
Age:45.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-29, Days after onset: 7
Location:Unknown  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': WAES1210USA012769
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 45 years old female patient. The patient was inadvertently vaccinated with PROQUAD (lot number, dose, route not reported) instead of MMR II on 22-OCT-2012. No concomitant medications were reported. No adverse effects reported. It was unspecified if the patient had sought medical attention.

VAERS ID:472101 (history)  Vaccinated:2012-10-22
Age:77.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Female  Submitted:2012-10-30, Days after onset: 6
Location:Missouri  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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204601 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dysgeusia, Hypoaesthesia, Hypoaesthesia oral, Motor dysfunction, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Pt woke up experiencing: numb bottom lip on right side, right hand numbness, fingers on right hand tingle, and taste altered. Pt presented today 10/30/12 still having numbness in lip and dexterity issues with right hand and finger.

VAERS ID:472220 (history)  Vaccinated:2012-10-22
Age:46.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 8
Location:California  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None, yet
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA689BA1IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Heart rate increased, Local swelling, Neck pain, Tongue disorder
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Heart was beating fast, my tongue felt thick and left side of neck was hurting and the next day it was swollen and very painful.

VAERS ID:472246 (history)  Vaccinated:2012-10-22
Age:72.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Delaware  Entered:2012-10-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AA5UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1706AA1UNRA
Administered by: Military     Purchased by: Military
Symptoms: Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, warm to the touch, painful on (R) arm.

VAERS ID:472278 (history)  Vaccinated:2012-10-22
Age:0.3  Onset:2012-10-23, Days after vaccination: 1
Gender:Male  Submitted:2012-10-23, Days after onset: 0
Location:Washington  Entered:2012-10-30, 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: See #7 above
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B330BA0IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH573AA0IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH9181311IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0209AE1PO 
Administered by: Private     Purchased by: Public
Symptoms: Emotional distress, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (broad)
Write-up: Fussy, acting "blah", and runny nose x2-3 days per mother. Vaccines administered yesterday at 4pm and this morning at 9am had 103 fever and acted inconsolable. Gave acetaminophen and temp came down to 101.

VAERS ID:472288 (history)  Vaccinated:2012-10-22
Age:17.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 0
Location:Virginia  Entered:2012-10-30, 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: C/O of cough. No specific illness. Client afebrile (temp. 97.8 degrees F)
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AD IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB515BA1IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH13304IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM11051 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dyskinesia, Fall, Loss of consciousness, Pallor, Seizure like phenomena
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), Convulsions (narrow), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Around 2:25 PM client head dropped/appeared to slump forward after last shot given. 2 jerks/seizure-like activity observed in Rt arm & chest. Pt "came to" and on inquiry verbalized "feeling week". Complexion pale, sitting in chair, legs raised and transferred to stretcher. Vitals on stretcher at 2:33 PM - B/P 113/75. Pulse 58. Pulse Ox 97%. Pt transferred to EMS squad after vitals. Complexion improved, pink on EMS transfer out of bldg.

VAERS ID:472354 (history)  Vaccinated:2012-10-22
Age:11.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 0
Location:Hawaii  Entered:2012-10-30, 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: Sinusitis diagnosed in ER
Preexisting Conditions:
Diagnostic Lab Data: X-ray; no labs
CDC 'Split Type': HI1204
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206001 UNLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Fatigue, Headache, Sinusitis, X-ray
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: 0911 Received TIV 0925 c/o dizziness & headache. No resp diff. T 98.3 BP 100/72 AP-96. 0936 ate 1/2 cracker & sip water 0950 c/o (L) leg pain. 1100 to ER c/o (L) arm & (L) leg pain. MD was told (L) jaw was drooping but not seen by MD. Very fatigued. BENADRYL (po) given & started talking more. Given oral Penicillin for sinusitis. Discharged home.

VAERS ID:472528 (history)  Vaccinated:2012-10-22
Age:6.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-30
Location:Texas  Entered:2012-10-30
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: Otitis media with effusion. Child has been referred to ENT.
Diagnostic Lab Data: Blood culture neg; WBC, 27.8; Hemoglobin, 13.1; HCT, 37.5; Platelets, 254; 82 N; 8 L; 9 M, E
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH75AA1IMLL
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1518AA0IMLL
Administered by: Private     Purchased by: Public
Symptoms: Blood culture negative, Injection site erythema, Injection site induration, Injection site pain, Leukocytosis, Pyrexia, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Child developed fever less than 24 h after vaccines with temperature max greater than or equal to 104 degrees F. Area of induration and erythema (L) lower ant. thigh c/w influenza site. 48h after vaccine Tmax 103-104 with increase in induration, erythema and exquisite tenderness non fluctuant. CBC D/P, Blood Cx done. Leukocytosis with WBC 21,000. B Cx - neg. Treated with PO Clindamycin at 25mg/kg/d. Resolving & afebrile after 48-72h medication.

VAERS ID:472556 (history)  Vaccinated:2012-10-22
Age:97.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 8
Location:California  Entered:2012-10-30
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) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA SYRAR
Administered by: Other     Purchased by: Private
Symptoms: Injection site haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Pt said she had bruising at site of injection. The bruise spread down her arm to elbow. She said she''s had the high dose last year but did not have the same reaction. The pt reported this today on 10/30/12.

VAERS ID:472565 (history)  Vaccinated:2012-10-22
Age:62.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 8
Location:California  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: No
Preexisting Conditions: AODM
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12059010IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Headache, Muscular weakness, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Approx. 12 hr. after vaccine was given I developed muscle aches/pain/weakness (& some minor tingling in fingers & toes occurring approx 7 days after vaccine). Joints (fingers, wrists, knees, feet) ache along with generalized muscle aches & weakness. Headache almost continuous as well. NSAID''s help but does not eliminate symptoms. Symptoms continuing & getting worse.

VAERS ID:474866 (history)  Vaccinated:2012-10-22
Age:29.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 8
Location:Unknown  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions: Penicillin, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011229
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Maternal exposure during pregnancy, Wrong drug administered
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This spontaneous prospective pregnancy report as received from a 29 years old female patient refers to herself, for GARDASIL, a pregnancy registry product. The patient had allergy to penicillin. The patient''s history of previous pregnancies and live births is not known. The patient went to her doctor for two shots. She was given GARDASIL (route, dose and lot # were unknown) instead of a shot for whooping cough accidentally on 22-OCT-2012. No other co-suspects were reported. Concomitant medications included: prenatal vitamins. The Pregnant Gestation was 24 weeks. The patient was exposed to GARDASIL during trimester 2. The patient had performed lab diagnosis studies blood work a few months ago. Additional information has been requested.

VAERS ID:474871 (history)  Vaccinated:2012-10-22
Age:0.6  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 8
Location:California  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA012612
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0555AE IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed visiting nurse refers to a 7 months old female patient. The patient was inadvertently vaccinated intramuscularly with a 0.5 ml dose of GARDASIL (lot # 0555AE: expiration date 14-DEC-2014) on 22-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effects were reported. Additional information has been requested.

VAERS ID:472933 (history)  Vaccinated:2012-10-22
Age:39.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-31, Days after onset: 8
Location:California  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: None
Preexisting Conditions: Diabetes
Diagnostic Lab Data: Mono screen; Comprehensive metabolic panel; CBC; Blood culture
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105150IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blood culture, Cellulitis, Full blood count, Headache, Metabolic function test, Mononucleosis heterophile test, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: (L) arm pain, swelling, cellulitis, headaches. BACTRIM, KEFLEX 500 mg, ibuprofen 600 mg, triamcinolone acetonide, ROCEPHIN gram, ketorolac tromethamine, IV hydration.

VAERS ID:475497 (history)  Vaccinated:2012-10-22
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-31
Location:Illinois  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA010734
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Gastrointestinal disorder
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 18 years old female patient. The patient had no pertinent medical history and no history of drug reactions/allergies. The patient was vaccinated intramuscularly with dose 1 GARDASIL (lot number not specified) in approximately October 2008 ("about 4 years ago"). The patient was vaccinated intramuscularly with dose 2 GARDASIL (lot number not specified) on 22-OCT-2012. The patient used no concomitant medications. After the first dose of GARDASIL the patient experienced a gastrointestinal complaint. No treatment was given for the event. The patient had recovered. The physician did not know when after the vaccination the complaint occurred or the exact date the patient recovered. The relatedness for gastrointestinal complaint was not reported for GARDASIL. Additional information has been requested.

VAERS ID:476986 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-31, Days after onset: 9
Location:Pennsylvania  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': WAES1210USA012283
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0548AA PO 
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered
SMQs:
Write-up: Information has been received from a registered nurse concerning a patient, who on 22-OCT-2012 was vaccinated with an expired dose of ROTATEQ, 2 ml, orally, lot # 669529/0548AA (expired 20-SEP-2012). No adverse effect was reported. Additional information has been requested.

VAERS ID:476987 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 9
Location:Unknown  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': WAES1210USA010954
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0613AA SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: Information has been received from a pharmacist concerning a female patient, who on 22-OCT-2012 was inadvertently vaccinated with an expired dose of ZOSTAVAX, subcutaneously, lot # 669639/0613AA (expiry date 30-JUN-2012). No adverse effects reported. This is one of two reports from the same source. The other linked report is 1210USA013212. Additional information has been requested.

VAERS ID:472492 (history)  Vaccinated:2012-10-22
Age:32.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Female  Submitted:2012-11-01, Days after onset: 8
Location:Texas  Entered:2012-11-01
Life Threatening? Yes
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
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP599085IMLA
Administered by: Other     Purchased by: Military
Symptoms: Chest discomfort, Dyspnoea, Fatigue, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: SHORTNESS OF BREATH, SWOLLEN AREA TO SITE, HOT, ITCHY, RED, TIGHTNESS OF CHEST, TIRED.

VAERS ID:477101 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-01, Days after onset: 10
Location:New Jersey  Entered:2012-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: 08/--/2012, immunisation; 08/--2012, influenza virus vaccine inactivated (unspecified)
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA012627
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Headache, Injection site erythema, Injection site mass, Injection site pain, Injection site pruritus, Injection site rash, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a consumer refers to herself a female patient of unknown age with no pertinent drug reactions. On 22-OCT-2012, the patient was vaccinated with ZOSTAVAX (dose, route and lot provided). No concomitant medications were reported. The consumer stated that on 22-OCT-2012 she received ZOSTAVAX at a local pharmacy and a few hours after receiving the vaccine the injection site became hot, red, and developed a little lump in a circle about 3 inches in diameter, the lump was itchy, and painful. The patient also developed a headache. The patient was put on treatment with ibuprofen for headache. The patient did not sought medical attention and did not performed any laboratory tests. On 25-OCT-2012, the patient explained that she was feeling better. At the time of the report, the patient''s outcome was reported as recovering/resolving. The relatedness for adverse events was unknown for ZOSTAVAX. Additional information is not expected.

VAERS ID:477187 (history)  Vaccinated:2012-10-22
Age:76.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-11-01, Days after onset: 10
Location:Unknown  Entered:2012-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011788
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012521 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a 76 years old male patient. On 22-OCT-2012, the patient was vaccinated subcutaneously, back of left arm with, 0.65 ml ZOSTAVAX (lot H012521 Exp: 09-OCT-2013). No concomitant medications were reported. The pharmacist stated that on 22-OCT-2012, the patient was vaccinated with improperly stored ZOSTAVAX vaccine. No adverse effects reported. Additional information is not expected.

VAERS ID:477075 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-01, Days after onset: 10
Location:Unknown  Entered:2012-11-02, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA013212
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0613AA SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: Information has been received from a pharmacist concerning a patient, who on 22-OCT-2012 was inadvertently vaccinated with an expired dose of ZOSTAVAX, subcutaneously, lot # 669639/0613AA (expiry date 30-JUN-2012). No adverse effects reported. This is one of two reports from the same source. The other linked report is 1210USA010954. Additional information has been requested.

VAERS ID:472814 (history)  Vaccinated:2012-10-22
Age:49.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Male  Submitted:2012-11-04, Days after onset: 12
Location:Missouri  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Not yet
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR  IDRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Spinal disorder
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: Severe back ache that continues. 12 days after and my spine is still killing me.

VAERS ID:473262 (history)  Vaccinated:2012-10-22
Age:72.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Louisiana  Entered:2012-11-04, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12067013UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0556AE0UNLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site reaction, Injection site warmth, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient received PNEUMOVAX on 10-22. On 10-23-12, she developed a rash from shoulder to elbow in the left arm. Rash was red, raised and warm and covered arm - not just injection site.

VAERS ID:472898 (history)  Vaccinated:2012-10-22
Age:46.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Male  Submitted:2012-11-05, Days after onset: 12
Location:Nebraska  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions:
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Injection site pain, Pain, Pain in extremity
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Extreme soreness in left deltoid where shot was administered. Still sore as of 11/5/2012. Pain when lifting arm over shoulder. Difficulty putting shirts on over head. Feels like someone repeatedly punching me in the arm. No treatment.

VAERS ID:472916 (history)  Vaccinated:2012-10-22
Age:38.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 3
Location:Illinois  Entered:2012-11-05, Days after submission: 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: Mold; Dust; Pollen; Shellfish
Diagnostic Lab Data: MRI; Labs; EMG; Spinal tap; EKG
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12232P0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Electrocardiogram, Electromyogram, Hypoaesthesia, Injection site swelling, Laboratory test, Lumbar puncture, Muscular weakness, Musculoskeletal pain, Nuclear magnetic resonance imaging, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: (R) arm pain, swelling at site, pain into (R) scapula, leg weakness, tingling in feet, fingertips off and on then weakness in leg like jelly then numb leg, stops at pubic area.

VAERS ID:473054 (history)  Vaccinated:2012-10-22
Age:15.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 13
Location:Mississippi  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH713AB IMRA
Administered by: Military     Purchased by: Military
Symptoms: Oedema peripheral, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Face and arm became itchy, a few hours later hives developed. Hives increased in frequency after soccer practice, hand and feet were swollen and hives on soles of her feet.

VAERS ID:473071 (history)  Vaccinated:2012-10-22
Age:45.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 13
Location:Texas  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205101 IM 
Administered by: Public     Purchased by: Other
Symptoms: Back pain, Hypoaesthesia, Oedema peripheral, Pain, Vaccination complication
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient felt arm got swollen and started experiencing pain. She went to emergency clinic when pain continued. Was told that it was probably a reaction to vaccine and for her to take ibuprofen and put warm compression. Patient says as of 11/5/2012 pain continues and she is now she is feeling numbness in 3 of her fingers and that her back hurts. Says Ibuprofen does not relieve pain.

VAERS ID:473446 (history)  Vaccinated:2012-10-22
Age:4.0  Onset:2012-10-29, Days after vaccination: 7
Gender:Male  Submitted:2012-11-05, Days after onset: 7
Location:Connecticut  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B204AA0UNUN
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH712AA2UNUN
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0128AE1UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0136421UNUN
Administered by: Private     Purchased by: Public
Symptoms: Blister, Rash papular
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: 4 yo male with scattered, erythematous papules & vesicles on trunk.

VAERS ID:473145 (history)  Vaccinated:2012-10-22
Age:9.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Male  Submitted:2012-11-06, Days after onset: 14
Location:Georga  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Biopsy
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA733BA2IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Biopsy, Injection site rash, Injection site vasculitis, Rash
SMQs:, Anaphylactic reaction (broad), Vasculitis (narrow), Hypersensitivity (narrow)
Write-up: Rash left arm with vasculitis mildly raised eruption about 1 cm superior to site of flu vaccination, no TTP.

VAERS ID:473279 (history)  Vaccinated:2012-10-22
Age:56.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-06, Days after onset: 15
Location:South Carolina  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH759AB IMLA
Administered by: Public     Purchased by: Other
Symptoms: Confusional state, Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)
Write-up: Lighheadedness, temporary confusion.

VAERS ID:473306 (history)  Vaccinated:2012-10-22
Age:6.0  Onset:2012-10-31, Days after vaccination: 9
Gender:Male  Submitted:2012-11-06, Days after onset: 6
Location:Georga  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Ear infection, asthma flare up, coughing
Preexisting Conditions: Seasonal allergies, asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Anxiety, Obsessive-compulsive disorder, Pharyngitis streptococcal, Tic
SMQs:, Agranulocytosis (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal infections (narrow)
Write-up: Motor tic in neck and shoulders followed by signs of OCD and separation anxiety. Was found to have strep throat on 11/05/2012.

VAERS ID:473623 (history)  Vaccinated:2012-10-22
Age:58.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-11-01, Days after onset: 10
Location:Wisconsin  Entered:2012-11-06, 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: Sulfa drug allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH746AA14IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138470IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Left shoulder pain, pt. was given narcotics for the pain on 10-22-12. Dr. gave pt. a cortisone injection on 10-25-12.

VAERS ID:473631 (history)  Vaccinated:2012-10-22
Age:4.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-26, Days after onset: 4
Location:California  Entered:2012-11-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: URI - noted otitis media on 10/23
Preexisting Conditions: None
Diagnostic Lab Data: CXR - negative; pt seen in Emergency Dept 10/22, office 10/23 -$g noted otitis media, 10/23
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B193CA IMLA
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA712BA3IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0184AE1IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0610AE1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Chest X-ray normal, Convulsion, Otitis media, Pyrexia
SMQs:, 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: Fever 104-105 degrees - brief (less than 1 minute) generalized seizure.

VAERS ID:474661 (history)  Vaccinated:2012-10-22
Age:67.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Male  Submitted:2012-11-01, Days after onset: 8
Location:Nevada  Entered:2012-11-06, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011331 SCLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Injection site induration, Injection site swelling, 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: 10/22/12 1015 (1) - Slight swelling, redness with size of 40 mm x 40 mm noted OCT-24/12 by Pt. BENADRYL .25 mg prescribed by PCP. (2) - Pt. rechecked at clinic 10/24/12 - redness of 45 mm x 65 mm. Area slightly swollen, little hardness around the site, BENADRYL 25 mg, KEFLEX prescribed. (3) Oct-26/12 - Pt. checked by phone. No/report of/itching, swelling feels better, Pt did not take antibiotics anymore.

VAERS ID:473403 (history)  Vaccinated:2012-10-22
Age:60.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 16
Location:South Carolina  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Mitral Valve Prolapse, HBP, hearing loss, migraines, tape sensitivity
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH732AB IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red, warmth, and soreness at the injection site.

VAERS ID:473405 (history)  Vaccinated:2012-10-22
Age:56.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-11-07, Days after onset: 15
Location:South Carolina  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Lupus, Rhematoid Arthritis, HBP, environmental allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH732AB IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Migratory left upper chest soreness.

VAERS ID:474500 (history)  Vaccinated:2012-10-22
Age:66.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-10-26, Days after onset: 4
Location:Louisiana  Entered:2012-11-07, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207201A IMRA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Patient states she had itching all over body after the vaccination. She has never had a reaction before.

VAERS ID:477705 (history)  Vaccinated:2012-10-22
Age:75.0  Onset:2012-10-31, Days after vaccination: 9
Gender:Male  Submitted:2012-11-07, Days after onset: 7
Location:Texas  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: Blood cholesterol increased; Diabetes mellitus
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA001334
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0423AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 75-year-old male patient with no drug reactions/allergies. Current conditions included diabetes and high cholesterol. On 22-OCT-2012 the patient was vaccinated with a dose of ZOSTAVAX (lot #0423AE in verification process, expiration date 02-APR-2013) dose and route not reported. Concomitant medications included unspecified medication for diabetes and high cholesterol. The physician reported that the patient developed shingles following vaccination with ZOSTAVAX on 31-OCT-2012. Treatment was not given for the event. No laboratory diagnostic studies were performed. The patient sought medical attention by contacting the office. The event did not resolve at the time of this report. Additional information has been requested.

VAERS ID:476451 (history)  Vaccinated:2012-10-22
Age:13.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Minnesota  Entered:2012-11-08, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0692AA0IMUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B094AA0IMUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0120431SCUN
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Oedema peripheral, Pruritus, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red, swollen, warm, itchy area on right arm about the size of a baseball.

VAERS ID:474023 (history)  Vaccinated:2012-10-22
Age:46.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-01, Days after onset: 10
Location:Oregon  Entered:2012-11-09, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT480AB IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling, Malaise, 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: Swelling pain at injection site. Fever illness that led patient to go to ER. Vaccination PPV23 given 8 yrs after previous PPV23.

VAERS ID:477954 (history)  Vaccinated:2012-10-22
Age:83.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Female  Submitted:2012-11-10, Days after onset: 17
Location:Unknown  Entered:2012-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA002633
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Seborrhoea, Skin odour abnormal
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: This spontaneous report was received from a 83 years old female consumer refers to herself. The patient was vaccinated with a dose of ZOSTAVAX (dose, route, anatomical location and lot# not reported) on 22-OCT-2012. On 24-OCT-2012, reported also as within 48 hour after vaccination, the patient noticed wet, greasy, sweaty spot under left breast. When she ran her finger through it had an offensive odor. She stated that it was a really red spot halfway up her breast and down under her breast onto her chest. She stated that the red spot was now fading. She sought unspecified medical attention. No treatment was given for adverse events. At the time of the report patient''s status was reported as recovering. Additional information is not expected.

VAERS ID:474236 (history)  Vaccinated:2012-10-22
Age:76.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-12, Days after onset: 21
Location:D.C.  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:
Preexisting Conditions: Penicillin; insect stings
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207201 IMAR
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives commencing 10/22/12 (date of vaccine) and recurring 3 more times to date.

VAERS ID:476775 (history)  Vaccinated:2012-10-22
Age:4.0  Onset:2012-11-03, Days after vaccination: 12
Gender:Female  Submitted:2012-11-05, Days after onset: 2
Location:Illinois  Entered:2012-11-13, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B305AA2IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0405AA0SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0420AA0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Malaise, Pyrexia, Rash generalised
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever, malaise, rash that started from the belly & spread all over her body. Treated w/ BENADRYL & TYLENOL as needed.

VAERS ID:478084 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-14, Days after onset: 23
Location:Missouri  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011261
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a physician refers to a patient of unknown age. On 22-OCT-2012, the patient was vaccinated with a dose of VARIVAX(Merck)(lot number unspecified) instead of ZOSTAVAX due to human error. No other co-suspects were reported. No concomitant medications were reported. No adverse effect reported. The outcome of the patient was unknown. It was unknown if the patient had sought medical attention. Additional information has been requested.

VAERS ID:474297 (history)  Vaccinated:2012-10-22
Age:67.0  Onset:2012-10-31, Days after vaccination: 9
Gender:Female  Submitted:2012-11-15, Days after onset: 15
Location:New York  Entered:2012-11-15
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: HTN, hyperlipidemia, asthma, scoliosis
Diagnostic Lab Data: bleed/infarct/hematoma L sphenoid, ethmoid and frontal sinus disease. CTc/a/p: No evidence of aortic dissection or aneurysm. Large L pelvic possibly adnexal cyst in a postmenopausal female that raises concern for ovarian malignancy. Nonemergent pelvic sonography advised for further evaluation. No GI or GU tract obstruction. Cholelithiasis. Hepatic cysts. MRI: abnormal hyperintense T2 signal w/in spinal cord at C4-7 may represent contusion of myelomalacia CXR: clear lungs No MRA spine or CTA spine as per neuro rads Pelvic US: L adnexal cyst w/ loculation B12-486, folate-12.9, ESR-32, lyme- neg Comprehensive anti-Phos screen Hep panel neg, CSF oligoclonal B detected, MBP neg, Zinc 58 NMO neg
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206101 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Adnexa uteri cyst, Antibody test negative, Antiphospholipid antibodies negative, Blood folate normal, Blood zinc decreased, Borrelia test negative, CSF myelin basic protein normal, CSF oligoclonal band present, Chest X-ray normal, Chest pain, Computerised tomogram abdomen abnormal, Hepatitis viral test negative, Motor dysfunction, Muscular weakness, Nuclear magnetic resonance imaging spinal cord abnormal, Paraplegia, Plasmapheresis, Red blood cell sedimentation rate increased, Sensory loss, Spinal cord disorder, Ultrasound pelvis abnormal, Vitamin B12 normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Acute onset chest pain followed by paraplegia and L arm weakness. Treated 11/12 with plasmapheresis, recovered some arm function, but remained with loss of use both legs and no sensation from mid-back down. Pt d/c to rehab after hospitalization for two weeks.

VAERS ID:474307 (history)  Vaccinated:2012-10-22
Age:49.0  Onset:2012-10-28, Days after vaccination: 6
Gender:Female  Submitted:2012-11-15, Days after onset: 18
Location:New York  Entered:2012-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to Sudafed, latex, and Zantac
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Public     Purchased by: Other
Symptoms: Activities of daily living impaired, Herpes zoster, Pain, Paraesthesia, Pruritus, Skin lesion
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Itchy lesions noted on arm, same side as injection, followed on November 1st by primary outbreak of shingles lesions on left rib area, pain, tingling, med with acyclovir, out of work 2 weeks.

VAERS ID:474567 (history)  Vaccinated:2012-10-22
Age:26.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-16, Days after onset: 25
Location:Delaware  Entered:2012-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus infection
Preexisting Conditions: Seasonal, household chemicals and mold allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH712AB IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0895AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site rash, Injection site swelling, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Soreness in (L) arm 1 hour after vaccination. By end of evening - had severe pain and weakness in (L) arm - "felt like someone was hitting arm with a hammer" patchy red rash from (L) shoulder to (L) elbow developed at same time and became progressively worse for 2 days. Arm was also swollen from (L) shoulder to (L) elbow during this time - "looked like fluid under the skin". Symptoms began improving after 2 days pain-free 10/27/12 pm. Rash, redness, and swelling were all gone 10/28/12 morning.

VAERS ID:475008 (history)  Vaccinated:2012-10-22
Age:58.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-11-19, Days after onset: 28
Location:Massachusetts  Entered:2012-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Hypothyroidism; Hypercholesterolemia; Anxiety
Diagnostic Lab Data: CPK normal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP504080UNLA
Administered by: Other     Purchased by: Private
Symptoms: Activities of daily living impaired, Blood creatine phosphokinase normal, Immediate post-injection reaction, Mobility decreased, Pain in extremity
SMQs:, Dementia (broad), Parkinson-like events (broad), Hypersensitivity (narrow)
Write-up: Patients arm was extremely sore immediately after vaccination and for a few days after. It seemed to improve somewhat, but recently pain has returned. Pain is so bad he has trouble using and lifting arm. No swelling, just pain.

VAERS ID:475073 (history)  Vaccinated:2012-10-22
Age:53.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-15, Days after onset: 24
Location:D.C.  Entered:2012-11-20, 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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED5108P UNLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Activities of daily living impaired, Fatigue, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Within 24 hrs - significant fatigue. Then body aches developed, then significant abdominal pain, feverish, no vomiting, fatigue, symptoms lasted about a week. Missed day of work.

VAERS ID:475453 (history)  Vaccinated:2012-10-22
Age:70.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-17
Location:South Carolina  Entered:2012-11-25, 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: See above
Preexisting Conditions: Shingles
Diagnostic Lab Data: No MD follow up I would like to suggest that for those who have PHN shingles there should be some pt. information. I believe the intensification of pain was immune system response related. I am a nurse & believe you should evaluate the efficacy of flu vaccine for older persons with PHN shingles.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS217201 IMAR
Administered by: Other     Purchased by: Unknown
Symptoms: Neuralgia
SMQs:, Peripheral neuropathy (narrow)
Write-up: Last year I had a very severe case of shingles and have PHN. About 24 hrs after vaccine my neuralgia became very intense and painful around the waist area - I had not had this level of pain in over 6 mos. This lasted about 2 1/2 days.

VAERS ID:475253 (history)  Vaccinated:2012-10-22
Age:39.0  Onset:2012-10-25, Days after vaccination: 3
Gender:Male  Submitted:2012-11-26, Days after onset: 32
Location:South Carolina  Entered:2012-11-26
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Blood pressure medications (unsure of type)
Current Illness: N/A
Preexisting Conditions: HX of HTN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA716BA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Blood pressure increased, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow)
Write-up: Elevated blood pressure, verbal report of tingling and numbness in left hand and fingers.

VAERS ID:475643 (history)  Vaccinated:2012-10-22
Age:70.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-06
Location:New York  Entered:2012-11-28, Days after submission: 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR44531AA UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709AS UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Fatigue, Headache, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever, arm swelled up - fatigue, headache, chills - went to ER. Suggested by my doctor - BENADRYL & MOTRIN (should be given in 2 arms not in 1 arm).

VAERS ID:479160 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 39
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': WAES1211USA011083
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 22-OCT-2012 10:29, 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:479172 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 39
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': WAES1211USA011211
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 22-OCT-2012 14:26, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479173 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 39
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': WAES1211USA011212
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 22-OCT-2012 15:59, 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:479728 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Male  Submitted:2012-12-04, Days after onset: 43
Location:Unknown  Entered:2012-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011210
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 22-OCT-2012 03:39, 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:476663 (history)  Vaccinated:2012-10-22
Age:35.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-12-05, Days after onset: 44
Location:Alabama  Entered:2012-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: History of seizures
Preexisting Conditions: History of seizures: evaluated by neurologist and he states that the vaccine lowered the seizure threshold
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH755AB1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Condition aggravated, Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Treatment sought in the Emergency Department after seizure activity during the PM hours after receiving the flu shot; Evalauted by neurologist and he states that the vaccine lowered the seizure threshold.

VAERS ID:478017 (history)  Vaccinated:2012-10-22
Age:62.0  Onset:2012-10-23, Days after vaccination: 1
Gender:Female  Submitted:2012-12-13, Days after onset: 51
Location:Arizona  Entered:2012-12-13
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: MRI Left Shoulder 12/01/2012
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Insomnia, Neuropathy peripheral, Nuclear magnetic resonance imaging normal, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain injection site next day Left Arm. Pain intensified upper arm difficult to sleep. Pain intensified and tingling developed down arm. Dr visit said I had neuropathy. Predinsone given 2 weeks. Pain less still painful at night x4 Advil per night. MRI shoulder done no structure abnormalities(per office normal wear in shoulder). PT ordered for x3 weeks and need to Follow up after with PCP (first week in January). Have had x2 therapies so far so far.

VAERS ID:479574 (history)  Vaccinated:2012-10-22
Age:0.2  Onset:2012-10-24, Days after vaccination: 2
Gender:Male  Submitted:2012-12-27, Days after onset: 64
Location:New York  Entered:2012-12-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEUR 0IMLG
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IMLG
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 0IMLG
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC. 0PO 
Administered by: Private     Purchased by: Other
Symptoms: Dehydration, Diarrhoea, Eating disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Vomiting, diarrhea, stopped eating, dehydration.

VAERS ID:480939 (history)  Vaccinated:2012-10-22
Age:72.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 39
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:
Diagnostic Lab Data:
CDC 'Split Type': 2012033805
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP585071SYRLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This medically confirmed spontaneous report (initial receipt: 25-Oct-2012) concerns a 72-year-old female patient, who was administered two doses of AFLURIA injection within 2 weeks time. The first dose was administered on 07-Oct-2012 and the second dose (batch number: P58507) was administered in upper left arm on 22-Oct-2012. No adverse effect was reported.

VAERS ID:481615 (history)  Vaccinated:2012-10-22
Age:70.0  Onset:0000-00-00
Gender:Male  Submitted:2013-01-15
Location:Arizona  Entered:2013-01-16, 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: MICARDIS; HCTZ; LOVASO; TRILIPIX; ULORIC; PRORENALVITAL
Current Illness: None; Allergic: Hydrocodone & Oxycodone
Preexisting Conditions: AMI with 3 stents; Pseudogout; Bilateral total knee secondary to injury
Diagnostic Lab Data: Sed rate; CRP; RA factor
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA733AA3IMRA
Administered by: Other     Purchased by: Private
Symptoms: Activities of daily living impaired, C-reactive protein, Musculoskeletal pain, Pain in extremity, Pelvic pain, Red blood cell sedimentation rate, Rheumatoid factor
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad)
Write-up: Soreness in shoulders, arms, hands progressed to pelvic area & by 12/4/12 had difficulty getting out of bed. Felt better with exercise & normal activity. Spoke with MD 12/14 & saw MD 1/4, 1/11, 1/18 when he began Methylprednisolone orally. Cardiologist also called him about lab results.

VAERS ID:482653 (history)  Vaccinated:2012-10-22
Age:14.0  Onset:0000-00-00
Gender:Female  Submitted:2013-01-25
Location:Pennsylvania  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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Pregnancy test, Negative
CDC 'Split Type': WAES1301USA011144
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Amenorrhoea, Inappropriate schedule of drug administration, Pregnancy test negative
SMQs:, Fertility disorders (broad)
Write-up: This spontaneous report was received from a physician concerning a 14 years old female patient. The patient was vaccinated with the first 0.5 ml dose of GARDASIL (lot not reported) on 22-OCT-2012. The patient was vaccinated with the second 0.5 ml dose of GARDASIL (lot not reported) on 28-NOV-2012. No other co-suspects were reported. No concomitant medications were reported. The physician reported that the patient''s last menstrual cycle was on September 2012 and it had not come back. Physician reported that the patient had a negative pregnancy test. She still had not had cycle. The outcome of the event was not recovered/not resolved. The relatedness for the event was unknown for GARDASIL. Additional information has been requested.

VAERS ID:483073 (history)  Vaccinated:2012-10-22
Age:  Onset:2012-10-22, Days after vaccination: 0
Gender:Unknown  Submitted:2013-01-31, Days after onset: 101
Location:Unknown  Entered:2013-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1301USA014270
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0294AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse refers to a patient of unknown age and gender. The patient was vaccinated with RECOMBIVAX HB (lot # 669597/0294AA and expiry date was 06-SEP-2014, route and dose were not reported) that was exposed to 25 Fahrenheit for an unknown period of time on 22-OCT-2012. No concomitant medications were reported. No adverse symptoms reported. This is one of several reports received from the same reporter. Follow up information was received from the licensed practical nurse who confirmed that none of the patients complained of any adverse experiences after receiving the above vaccines that had been stored incorrectly. Additional information is not expected.

VAERS ID:483126 (history)  Vaccinated:2012-10-22
Age:74.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2013-01-31, Days after onset: 101
Location:Florida  Entered:2013-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH721AD IMRA
Administered by: Public     Purchased by: Private
Symptoms: Joint range of motion decreased, Pain in extremity
SMQs:, Arthritis (broad)
Write-up: Patient describes very painful range of motion movement. Patient states right arm is very painful to move since October.

VAERS ID:483334 (history)  Vaccinated:2012-10-22
Age:73.0  Onset:2012-11-05, Days after vaccination: 14
Gender:Female  Submitted:2013-01-29, Days after onset: 85
Location:North Carolina  Entered:2013-02-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: High blood pressure; Thyroid
Diagnostic Lab Data: CBC; Sed rate; Basic metabolic panel; CPK; C Reactive Protein; TSH; ANA/9 profile; Rheumatoid factor/3 Panel; Anti-CCP; AB
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B094AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Anti-cyclic citrullinated peptide antibody, Antibody test, Antinuclear antibody, Blood creatine phosphokinase, Blood thyroid stimulating hormone, C-reactive protein, Full blood count, Injection site pain, Metabolic function test, Mobility decreased, Musculoskeletal pain, Myalgia, Neck pain, Pain in extremity, Red blood cell sedimentation rate, Rheumatoid factor
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Severe muscle pain all over body. Later settled in arms & legs. Right arm (injection site) very painful event after rx of steroids. Started and continues shortly after injection. Pain like a tooth ache. Difficulty getting out of bed and in & out of a car. Various lab work by two doctors-cannot determine cause of pain. Started in the neck & shoulders on left side a few days after injection.

VAERS ID:485118 (history)  Vaccinated:2012-10-22
Age:16.0  Onset:2012-11-13, Days after vaccination: 22
Gender:Male  Submitted:2013-02-14, Days after onset: 93
Location:Michigan  Entered:2013-02-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC
Current Illness: None
Preexisting Conditions: Seasonal allergies; HA & vertigo since 3/2012 The following information was obtained through follow-up and/or provided by the government. 3/12/13. Hospital records. PMH: asthma; hydronephrosis. Allergy: peanuts; tree nuts; fish.
Diagnostic Lab Data: LP; CMP; Drug screen; ANA reflex; TSH; CMV; Brain MRI; MRA; Mono The following information was obtained through follow-up and/or provided by the government. 3/12/13. labs/diagnostics. Infectious disease panel neg. MRI brain: minimal mucosal thickening of R maxillary sinus. MRA brain: neg. MRV brain neg. MRA neck neg. EKG: sinus bradycardia c sinus arrhythmia; nonspecific intraventricular conduction delay.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714AA7IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Angiogram, Antinuclear antibody, Anxiety, Blood thyroid stimulating hormone, Cognitive disorder, Confusional state, Cytomegalovirus test, Depressed level of consciousness, Disturbance in attention, Dizziness, Drug screen, Fatigue, Feeling jittery, Gait disturbance, Headache, Illusion, Irritability, Lumbar puncture, Memory impairment, Metabolic function test, Migraine, Mononucleosis heterophile test, Muscle spasms, Muscular weakness, Neck pain, Nuclear magnetic resonance imaging brain, Paraesthesia, Photophobia, Sensory loss, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Drug abuse and dependence (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Hostility/aggression (broad), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: MENACTRA & FLUZONE vaccines given 10/22/2012 symptoms reported 11/13/2012. C/O fatigue, vertigo, headaches, cognitive and sensory deficits, photophobia. The following information was obtained through follow-up and/or provided by the government. 3/12/13. Hospital records ER visit 11/15/12. DX: Anxiety. CC: jitteriness; episodic confusion; irritability; anxiety; occasional paraesthesias to hands c carpal spasms; dizziness. PE: NAD. Released to f/u c PCP. Hospitalized DOS 12/20-22/2012. DX: HA, improved; asthma, stable; fatigue, improved; cognitive deficits, improved. CC: weak knees, difficulty walking; neck pain; head pressure; head migraine; photophobia; perception difficulties cloudy thinking; memory difficulty; fatigue; jittery; irritability; difficulty concentrating; . Uneventful hospitalization. DC in stable condition to f/u c PCP et specialists. Returned to ER 1/7/13. DX: multiple symptoms of unknown aetiology. CC: persistence of symptoms; requesting EEG. Arrangements made for outpt EEG.

VAERS ID:487804 (history)  Vaccinated:2012-10-22
Age:56.0  Onset:2012-10-24, Days after vaccination: 2
Gender:Female  Submitted:2013-03-26, Days after onset: 153
Location:New Hampshire  Entered:2013-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium + D; COLACE; EFFEXOR; Fexofenadine HCL; MAXALT; Multivitamins; MOBIC; VERAMYST; VOLTAREN; Vitamin C; PROCTOSOL HC; Glucosamine-chondroitin; Fish oil; Niacin; VICODIN
Current Illness: None
Preexisting Conditions: Allergy to sulfa & amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4366AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site cellulitis, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient developed a localized red and warm area below the site of immunization measuring approximately 6 inches by 3 to 4 inches. Patient c/o pain at the injection site. Cellulitis evident. Pt started on cephalexin 500mg PO Q6 hours x 10 days.

VAERS ID:488421 (history)  Vaccinated:2012-10-22
Age:71.0  Onset:2012-10-22, Days after vaccination: 0
Gender:Female  Submitted:2013-02-24, Days after onset: 125
Location:Michigan  Entered:2013-04-03, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 UNLA
Administered by: Other     Purchased by: Private
Symptoms: Pain in extremity
SMQs:
Write-up: Patient experienced a very sore arm for greater than one month post vaccination.

VAERS ID:488870 (history)  Vaccinated:2012-10-22
Age:64.0  Onset:0000-00-00
Gender:Male  Submitted:2013-04-08
Location:Unknown  Entered:2013-04-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOCOR; LYRICA; CATAPRES; KLONOPIN; Aspirin Low
Current Illness: Allergy - Shellfish.
Preexisting Conditions: Elevated homocysteine
Diagnostic Lab Data:
CDC 'Split Type': 2013035240
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP51208 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Blood thyroid stimulating hormone, Glycosylated haemoglobin, Haemoglobin, Joint range of motion decreased, Laboratory test, Limb discomfort, Muscular weakness, Musculoskeletal pain, Nuclear magnetic resonance imaging, Pain in extremity, Sensory disturbance, White blood cell count
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)
Write-up: This medically confirmed report (initial receipt: 25-Mar-2013) concerns a 64-year old male patient who had a medical history of drug reaction/allergy to shellfish and elevated homocysteine. On 22-Oct-2012, the patient received AFLURIA (batch number: P51208) intramuscularly in the left deltoid. On 05-Feb-2013, the patient had an office visit and complained of arm pain. He had intermittent sensation in the left arm. The discomfort was very severe when swimming and limited the patient''s activities. He had weakness, pain and reduced range of motion. There was no tingling and no numbness. On 18-Feb-2013 the patient had a magnetic resonance imaging (MRI) of the brachial plexus. The patient''s physician and radiologist were reviewing the MRI results which were not available at time of reporting. Follow-up lab work included chem panel, hemoglobin, A1C, thyroid stimulating hormone (TSH) and white blood count (WBC), results were not provided. On 20-Mar-2013, the patient returned to the office with progressive left arm and shoulder pain and loss of motion. No further information was available.

VAERS ID:522881 (history)  Vaccinated:2012-10-22
Age:0.1  Onset:2012-11-05, Days after vaccination: 14
Gender:Male  Submitted:2014-02-17, Days after onset: 469
Location:Ohio  Entered:2014-02-17
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: 7 swallow studies, 3 impedance studies, feeding tubes (ng&nj) many X-rays, 1 MRI, speech therapy, ot, pt, neurologist, neuromuscular docs, muscle function test, pulmonologist, ent, pneumonia, croup, ftt, aspirations, stridor, hypotonia, 6 hospital stays.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B351AB0IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0188AE0IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG131830IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0381AE0PO 
Administered by: Unknown     Purchased by: Private
Symptoms: Aspiration, Barium swallow, Croup infectious, Decreased appetite, Failure to thrive, Gastrointestinal tube insertion, Hypotonia, Nuclear magnetic resonance imaging, Oesophageal motility test, Pneumonia, Screaming, Stridor, Weight decreased, X-ray
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad), Neonatal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad)
Write-up: Started to scream while feeding instead of eating normally. Then started to lose weight from not feeding despite all attempts to get him to eat.

VAERS ID:470987 (history)  Vaccinated:2012-10-23
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-23
Location:Unknown  Entered:2012-10-23
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': 317
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12066011UNLA
Administered by: Other     Purchased by: Private
Symptoms: Pain in extremity
SMQs:
Write-up: So far regular symptoms- arm is sore. Concern is that first needle inserted, I thought I was finished. Then he said that one was empty. Then gave another shot. Concerned why one was empty? Why it wasnt logged, was it used before. Very concerned.

VAERS ID:471039 (history)  Vaccinated:2012-10-23
Age:12.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-23, Days after onset: 0
Location:Michigan  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: None reported by parent
Preexisting Conditions: None reported by parent
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4O19AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52BO75DA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Activities of daily living impaired, Dizziness, Gait disturbance, Posture abnormal, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: Student reported to school office complaining of blurry vision, dizziness, and his head appeared to be weaving. Parent called to pick student up and he walked down the hall with the parent bumping into her as they walked. He was unable to locate the door handle as he tried to open the car door.

VAERS ID:471043 (history)  Vaccinated:2012-10-23
Age:40.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-23
Location:Virginia  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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206501 IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Chest discomfort
SMQs:, Anaphylactic reaction (broad)
Write-up: Client received the flu vaccine, and approxiamtely an hour later, complained of chest tightness radiating to and under her left breast. Her vital signs were stable, but EMS was called. She was transported to the hospital for evaluation.

VAERS ID:471048 (history)  Vaccinated:2012-10-23
Age:29.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:North Carolina  Entered:2012-10-23
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) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA733AA0SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Cough, Palpitations, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Wheezing, chest pressure, racing heart, coughing - 45 minutes later, better with water and cough drops, pressure still in chest.

VAERS ID:471054 (history)  Vaccinated:2012-10-23
Age:35.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:Maryland  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Military     Purchased by: Military
Symptoms: Dyspnoea, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Tounge swelling. Difficulty breathing.

VAERS ID:471351 (history)  Vaccinated:2012-10-23
Age:39.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-23, Days after onset: 0
Location:New Hampshire  Entered:2012-10-23
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 at present
CDC 'Split Type': NH1023201216
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4329AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, 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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 11:20 - Felt lightheaded w/ driving. 11:30 - Blacked out w/ driving. EMS - vitals; pt. declined ED visit went to Police Dept. to rest/wait called office 12:12.

VAERS ID:471402 (history)  Vaccinated:2012-10-23
Age:0.2  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:Michigan  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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B330BA0UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH685AA0UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF880440UNRL
Administered by: Private     Purchased by: Private
Symptoms: Crying, Decreased appetite, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Bilateral leg swelling from hips to knees. Bilateral legs warm to touch. Decreased appetite. Crying inconsolably.

VAERS ID:471428 (history)  Vaccinated:2012-10-23
Age:57.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-23, Days after onset: 0
Location:New Jersey  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None per patient
Preexisting Conditions: None per patient
Diagnostic Lab Data: None; EMS Dispatch
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP583060IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dyskinesia, Dyspnoea, Foaming at mouth, Gaze palsy, Hyperhidrosis, Musculoskeletal stiffness, Seizure like phenomena
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: Patient experienced seizure-like symptoms a few minutes following flu vaccine. The patient''s body became stiff with minor jerking movements throughout his body. The mouth had minor foaming and body was mildly sweaty. Patient had difficulty breathing but did not lose consciousness. Patient''s wife state that patient''s eyes rolled back. No treatment were given. 911 was called and EMS arrived. Protocol MD also contacted.

VAERS ID:471437 (history)  Vaccinated:2012-10-23
Age:40.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:Pennsylvania  Entered:2012-10-23
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) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12046010IMUN
Administered by: Other     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient fainted for a few seconds (briefly) after shot was administered. She quickly woke up and was given a cool compress, ibuprofen, and Gatorade. She stayed seated for 1/2 hour afterwards. No serious injuries occurred.

VAERS ID:471125 (history)  Vaccinated:2012-10-23
Age:12.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-24, Days after onset: 0
Location:Michigan  Entered:2012-10-24
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: Allergic to Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4275AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B088AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0136411SCRA
Administered by: Public     Purchased by: Public
Symptoms: Feeling abnormal, Feeling hot, Headache, Hypoaesthesia, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Client received vaccines on 10/23/12 am. About 2:30 am on 10/24/12 patient awoke and complained of being hot, his head felt "funny" and had a headache, said his legs felt "funny" like he couldn''t feel them. He was able to walk to his aunt''s bedroom. She gave him extra strength Tylenol at about 3:30 am. Patient then took a warm bath because his legs were still feeling "funny". He went back to bed after his bath and fell asleep. He woke at 6:30 am for school but was still not feeling well so he stayed home. He now feels nauseated. His aunt said that his legs are feeling better as is his head. He is still hot and generally not feeling well. Explained to his aunt that he needs to be seen by a physician.

VAERS ID:471180 (history)  Vaccinated:2012-10-23
Age:7.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Wisconsin  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: None
Diagnostic Lab Data: None. Mother will continue with Benadryl.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AB4IMRL
HEPA: HEP A (VAQTA)MERCK & CO. INC.0628AE0IMRL
Administered by: Private     Purchased by: Other
Symptoms: Injection site pruritus, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Child started itching when she go to the care after injection. 8:15 PM patient was itching more, mother noticed hives on side of left rib cage(about 10 of them) and 2-3 hives in axilla area. Mother treated patient with Benadryl 8:15 PM and 0615 AM. No problems with breathing. Mother is ER nurse.

VAERS ID:471199 (history)  Vaccinated:2012-10-23
Age:16.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 1
Location:Michigan  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: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4274AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4383AA IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.HD10854 SCRA
Administered by: Other     Purchased by: Other
Symptoms: Hyperhidrosis, Pallor, Posture abnormal, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Student was given Tdap, Varicella and then Meningococcal immunization. As soon as shots given, student was sitting in chair and head fell forward onto chest and student was unresponsive for approx. 15-20 seconds. Came to on his own but was very pale and diaphoretic. Didn''t realize what had happened. Mother stated afterwards that this had happened to student last time he had a Tdap immunization.

VAERS ID:471247 (history)  Vaccinated:2012-10-23
Age:30.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 0
Location:Pennsylvania  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: No
Preexisting Conditions: Pennicillin, Amoxicillin
Diagnostic Lab Data: Patient is 36 Weeks pregnant
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR 0IDLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Bone pain, Chills, Headache, Hyperhidrosis, Maternal exposure during pregnancy, Myalgia, Piloerection, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Arthritis (broad)
Write-up: Woke with chills & goosebumps, then woke an hour later drenched in sweat. Alternated between chills & sweating for remainder of sleep. Woke in the morning & bones, joints & muscles throughout body feel achey. Headache & low grade fever.

VAERS ID:471265 (history)  Vaccinated:2012-10-23
Age:52.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 0
Location:Washington  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: No
Preexisting Conditions: Only allergies to air-borne pollens, pet dander, dust
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: Private
Symptoms: Chills, Dysphagia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (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), Hypersensitivity (broad)
Write-up: Tightening in throat, more difficult to swallow, chills.

VAERS ID:471280 (history)  Vaccinated:2012-10-23
Age:89.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Illinois  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: No, At 6:30pm, she experienced a fever, vomiting and diarrhea
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4499AA IMLA
Administered by: Other     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: Fever, diarrhea, vomiting.

VAERS ID:471286 (history)  Vaccinated:2012-10-23
Age:13.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 0
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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH733AA   
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA11071   
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives.

VAERS ID:471296 (history)  Vaccinated:2012-10-23
Age:19.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 1
Location:Texas  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: None
Diagnostic Lab Data: A-Fib on EKG
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB538BA1IMUN
Administered by: Military     Purchased by: Military
Symptoms: Atrial fibrillation, Chest pain, Dyspnoea, Electrocardiogram abnormal, Heart rate irregular
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)
Write-up: Shortness of breath, A Fib, chest pain, irregular pulse.

VAERS ID:471495 (history)  Vaccinated:2012-10-23
Age:66.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 1
Location:Tennessee  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205301 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site swelling, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling (slight) in arm after 4-5 hrs. Used ice/overnight. Swelling to elbow in AM after approximately 18 hrs.

VAERS ID:471545 (history)  Vaccinated:2012-10-23
Age:62.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 0
Location:Oklahoma  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 IMUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 IMUN
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site red, swollen, painful. Pt will contact PCP.

VAERS ID:471547 (history)  Vaccinated:2012-10-23
Age:70.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:New York  Entered:2012-10-24, 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: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0130170SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Lip swelling, Oropharyngeal discomfort
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Patient''s lower lip swelled. Described throat pressure. Remained conscious. EPIPEN given x1 dose - EMT arrived - pt transported to hospital for eval.

VAERS ID:471573 (history)  Vaccinated:2012-10-23
Age:3.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 1
Location:Arkansas  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:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B151AA3IMLA
Administered by: Public     Purchased by: Public
Symptoms: Body temperature increased, Injection site erythema, Injection site swelling, Injection site warmth, Restlessness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Mother states patient''s arm started swelling 1 hr after vaccines. Pt had low grade temp. This a.m. mom states arm is swollen, red, & hot to the touch where vaccine was given. Also states pt was restless last night.

VAERS ID:471580 (history)  Vaccinated:2012-10-23
Age:14.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:California  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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH745AB0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Blood glucose normal, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: At 5:30 pm, I gave pt. Influenza vaccine, after about 5 minutes pt. started walking and fainted and hitting her head on floor. Pt. was out for about 10-15 seconds. We checked B/P, pulse, glucose, all was WNL. Pt. had a bump on back of head, put ice pack. Pt. to f/u in 1 day.

VAERS ID:471293 (history)  Vaccinated:2012-10-23
Age:56.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Minnesota  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: Chronic sinusitis, seasonal allergies
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA727AB10IMLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Development of huge, hot red welts with smaller red areas surrounding some, but not all, of the welts. Use of antihistamines and Aveeno.

VAERS ID:471396 (history)  Vaccinated:2012-10-23
Age:41.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Illinois  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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Musculoskeletal stiffness, Myalgia, Pain, Pain of skin, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Fever of 101 and severe soreness/stiffness. Skin sore to the touch and muscles sore with any movement.

VAERS ID:471403 (history)  Vaccinated:2012-10-23
Age:51.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-25, Days after onset: 1
Location:Nebraska  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: Slight cold/nasal congestion
Preexisting Conditions: n/a
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12057010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 2 inch diameter red area around vaccine site, warm to touch.

VAERS ID:471497 (history)  Vaccinated:2012-10-23
Age:53.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-25, Days after onset: 2
Location:California  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: No
Preexisting Conditions: Sulfa, Penicillin, latex, naprosyn, strawberries, bi-polar d/o, COPD, hx DVT
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AD5IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0133941IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Fatigue, Induration, Injected limb mobility decreased, Pain, 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 c/o redness, induration, swelling, pain, inability to elevate right arm over horizontal, acute fatigue, Temp 99.0.

VAERS ID:471502 (history)  Vaccinated:2012-10-23
Age:71.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Michigan  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: No
Preexisting Conditions: No allergies, pt has hyperlipidemia and restless leg syndrome
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138471SCLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt states that a couple hours after vaccination her arm became sore. Later that evening it started to become red. She was seen at the ER on 10/24/2012 and was given a prescription for cephalexin 500mg qid for 10 days. She reports on 10/25/2012 that the soreness is improving but her arm is still red.

VAERS ID:471504 (history)  Vaccinated:2012-10-23
Age:13.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-25, Days after onset: 2
Location:Florida  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: NONE KNOWN
Preexisting Conditions: ALLERGIC TO AMOXICILLIN AND TO CEPHALOSPORINS.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0022AE0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4242AA IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3941AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.HO146261SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: MOTHER CALLED NURSE ON 10/25/12 AT 12:15 PM AT HD TO REPORT CHILD DEVELOPING A HIVE ON RIGHT UPPER ARM AT 6PM ON 10/23/12. ON 10/24/12 MOTHER GAVE CHILD IBUPROFEN 200MG X 2. AT 8:30 AM AND TYLENOL X 2 AT 11:30 PM. THE HIVE IS NOW DOUBLE THE SIZE: 2 1/2 INCHES X4 1/2 INCHES PER THE MOTHER. MOTHER ALSO GAVE CHILD BENADRYL 25 MG. AT 9PM ON 10/24/12 AND 50MG ON 10/25/12 AT8:30 AM. IBUPROFEN 200MG X 2 TABLETS WAS ALSO GIVEN ON 10/25/12 PER THE MOTHER.

VAERS ID:471508 (history)  Vaccinated:2012-10-23
Age:17.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 1
Location:Oklahoma  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: No
Preexisting Conditions: No
Diagnostic Lab Data: No
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB515A0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4275AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3976AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0096351SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red raised solid area approx 30x40 cm, not hot left arm where Varicella was listed as given at that site.

VAERS ID:471510 (history)  Vaccinated:2012-10-23
Age:44.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 1
Location:Massachusetts  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: No
Preexisting Conditions:
Diagnostic Lab Data: Upper extremity ultra sound - wnl, negative for abscess, fluid collection, hematoma
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Military     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site oedema, Injection site warmth, Ultrasound scan normal
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Erythema, induration, warmth, edema around site of injection and edema + mild erythema extending to top of shoulder to elbow.

VAERS ID:471519 (history)  Vaccinated:2012-10-23
Age:30.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 1
Location:Tennessee  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: Sinus drainage
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Diarrhoea, Fatigue, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Nausea, vomiting, diarrhea, fatigue, weakness, fever 101.1. Symptoms lasted until 10/25/2012 11:00 AM.

VAERS ID:471543 (history)  Vaccinated:2012-10-23
Age:62.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:New York  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: No
Preexisting Conditions: Heart Disease; COPD; Thyroid
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50608 IMUN
Administered by: Other     Purchased by: Public
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Patient had trouble breathing tightness in chest.

VAERS ID:471614 (history)  Vaccinated:2012-10-23
Age:49.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Alabama  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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA695BA UNRA
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Cough, Eye swelling, Eyelid oedema, Nasal congestion, Photosensitivity reaction, Sneezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Systemic lupus erythematosus (broad), Dementia (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Eyes began to swell, sneeze, nasal congestion, cough - photo sensitive - eyes more swelling took BENADRYL -$g bed. 10/24/12 eyes swollen shut - went to MD - steroid shot, more BENADRYL, missed work 10/24/12.

VAERS ID:471618 (history)  Vaccinated:2012-10-23
Age:56.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:D.C.  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: None
Preexisting Conditions: NKDA, no food or environmental allergies; Thyroid and anxiety
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12059010IMLA
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: Redness, warmth, mild itching, swelling at site 4 inch x 4 inch. Ice applied to site, topical anti itch cream (BENADRYL cream) applied. PMD notified.

VAERS ID:471655 (history)  Vaccinated:2012-10-23
Age:0.2  Onset:0000-00-00
Gender:Male  Submitted:2012-10-24
Location:Pennsylvania  Entered:2012-10-25, 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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B340A0IMRL
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0293AE1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETH9181740IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0577HE0PO 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Wrong drug administered
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: While I intended to order PEDIARIX and Hib, I incorrectly wrote PEDIARIX, Hep B on the order to the MA, who administered them 10/23. Thus the pt received two Hep B. I called his mother who said she saw no reaction or fever. She has sched. him to come in to get the Hib Iz.

VAERS ID:471656 (history)  Vaccinated:2012-10-23
Age:4.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-25, Days after onset: 1
Location:Pennsylvania  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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B178CB0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0682AE1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, 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: Erythema, warmth & swelling at inject site. Tenderness of affected area & mild temp/fever.

VAERS ID:471765 (history)  Vaccinated:2012-10-23
Age:28.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Pennsylvania  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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06549221A IMAR
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Patient felt lightheaded and dizzy. She was unsteady on her feet. Symptoms began within 5 minutes of receiving vaccine.

VAERS ID:471792 (history)  Vaccinated:2012-10-23
Age:10.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Wisconsin  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: None
Preexisting Conditions: Has allergies - trees/grass/pollen per mom.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12263P IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Dizziness, Fatigue, Flushing, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: 10/23/12 2:40pm Pt. c/o dizziness, cheeks flushed and c/o stomach "hurt" - states he vomited (not witnessed). Layed down on cot at school and flushing improved and stated stomach was better. Talked with mom today 10/25/12 and he is "fine" did feel "tired" the evening of flu shot. Mom states he is ok today (10/25/12).

VAERS ID:471811 (history)  Vaccinated:2012-10-23
Age:62.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-25, Days after onset: 1
Location:Florida  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: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH728AA3UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105150UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Cellulitis
SMQs:
Write-up: Cellulitis (L) arm 1 day post pneumonia vaccine.

VAERS ID:471615 (history)  Vaccinated:2012-10-23
Age:61.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 1
Location:Massachusetts  Entered:2012-10-26, 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: DDAVP; Prednisone; Calcium; Hydrochlorothiazide; Lisinopril; FOSAMAX; Omeprazole; CRESTOR
Current Illness: FU only
Preexisting Conditions: Sarcoidosis; HTN
Diagnostic Lab Data: See sheets
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA707BA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0225AE IMRA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Chills, Dizziness, Erythema, Fasciitis, Hypersensitivity, Nausea, Oedema peripheral, Pyrexia, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Patient''s left arm. 61 year old female with chief complaint of severe rxn to vaccine administered in clinic yesterday. Pt presents with complaint of fever, chills, nausea, dizziness, L arm swelling massively over 24 hours, red, tender, hot. No shortness of breath. Fasciitis/Cellulitis vs. allergic reaction. Temp 99 oral now, BP 108/62 normally 128/81.

VAERS ID:471626 (history)  Vaccinated:2012-10-23
Age:16.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-26, Days after onset: 2
Location:Maryland  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: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0628AE1IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110461IMRA
Administered by: Private     Purchased by: Public
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: AREA OF INJECTION STARTED AS RED, RAISED AREA ABOUT 3cm. ON 10/25/12 THE RED, RAISED AREA HAD INCREASED TO ABOUT 3" IN DIAMETER. THE AREA WAS HOT TO TOUCH AND TENDER. NO RED STREAKS, PATIENT REMAINED AFEBRILE.

VAERS ID:471628 (history)  Vaccinated:2012-10-23
Age:63.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-26, Days after onset: 3
Location:New Mexico  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: 2 previous angioplasty operations for stents placed in coronary artery
Preexisting Conditions:
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: Other
Symptoms: Arthralgia, Movement disorder, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Arthritis (broad)
Write-up: Extreme arthritic type pain in left shoulder joint. Could not raise arm. Pain has not yet subsided.

VAERS ID:471632 (history)  Vaccinated:2012-10-23
Age:1.2  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-26, Days after onset: 2
Location:Minnesota  Entered:2012-10-26
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: Benign non-epileptic myoclonic spells, IgA deficiency, allergic rhinitis
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4531BA1IMRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF451353IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Papule, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Quarter sized erythema, warmth, tenderness - rapid progression over one hour from initial small red papule.

VAERS ID:471646 (history)  Vaccinated:2012-10-23
Age:34.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-26, Days after onset: 3
Location:Missouri  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 that I was aware of.
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UN 
Administered by: Other     Purchased by: Public
Symptoms: Abdominal pain, Diarrhoea, Pain, Pyrexia, Respiratory disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Vomiting, Diarrhea, high fever, aches, abdominal pain, upper respiratory last from 10:00 pm on 10/23 to 6:00 am on 10/25. Only treatment was Tylenol and Mucinex.

VAERS ID:471692 (history)  Vaccinated:2012-10-23
Age:44.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-26, Days after onset: 3
Location:California  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: No
Preexisting Conditions: Diabetes, Hypo-thyroid, Vitiligo
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Cold sweat, Lethargy, Nausea, Pain, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Lethargy, aches, cold sweat, shaking, nausea.

VAERS ID:471850 (history)  Vaccinated:2012-10-23
Age:12.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-25, Days after onset: 1
Location:Georga  Entered:2012-10-26, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1397AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Pt received vaccine on 10/23/12 and has had fever and stiff neck for two days since HPV vaccine. Pt also dizzy.

VAERS ID:471855 (history)  Vaccinated:2012-10-23
Age:42.0  Onset:2012-10-25, Days after vaccination: 2
Gender:Female  Submitted:2012-10-26, Days after onset: 1
Location:Massachusetts  Entered:2012-10-26
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2025 IN 
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:471917 (history)  Vaccinated:2012-10-23
Age:66.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-26, Days after onset: 3
Location:Florida  Entered:2012-10-26
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: Allergy to Codeine, Latex
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4530AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Headache, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: She started vomiting at about 11 PM after receiving the shot. She also had headache and on 10/25/12 starting having body ache. She received treatment at ER (anti emetic) and injection for pain at urgent care.

VAERS ID:472007 (history)  Vaccinated:2012-10-23
Age:58.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-26, Days after onset: 3
Location:Wisconsin  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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH732AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left deltoid with sore hot area about 50 cent size. Area is red with lump.

VAERS ID:476570 (history)  Vaccinated:2012-10-23
Age:5.0  Onset:0000-00-00
Gender:Male  Submitted:2012-10-26
Location:Unknown  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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011267
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0127AE1SCLA
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 nurse concerning to a patient who, on an unspecified day, was vaccinated with an improperly stored dose of MMR II which was exposed to 67 F for 63 hours. No adverse effect reported. It was unknown if the patient sought medical attention. At the time of report, the patient''s status was unknown. Additional information has been requested.

VAERS ID:476574 (history)  Vaccinated:2012-10-23
Age:5.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-26, Days after onset: 3
Location:South Dakota  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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011268
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 5 years old male patient. The patient was vaccinated with ZOSTAVAX (lot number not reported) on 23-OCT-2012. No concomitant medications were reported. The patient received a dose of ZOSTAVAX on 23-OCT-2012 instead of his second dose of VARIVAX (Merck). The patient received his first dose of VARIVAX (Merck) (lot number not reported) in March 2008. No adverse symptoms reported. Additional information has been requested.

VAERS ID:471722 (history)  Vaccinated:2012-10-23
Age:67.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-27, Days after onset: 4
Location:Vermont  Entered:2012-10-27
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 0SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Fatigue, Injection site erythema, Injection site haematoma, Injection site pruritus, Injection site rash, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Dizziness first evening. Next morning woke with shoulder pain, trouble breathing and fatigue. Used heating pad on shoulder still having trouble breathing. Rested all day. Felt relief next day. Then had a large 2-3" itchy, red blotchy area at injection site. Itchiness lasted 3 days. Still have a bruise type area remaining but itching is gone. I have had many flu shots and NEVER had any reaction whatsoever. This is a complete mystery.

VAERS ID:472038 (history)  Vaccinated:2012-10-23
Age:67.0  Onset:2012-10-26, Days after vaccination: 3
Gender:Female  Submitted:2012-10-27, Days after onset: 1
Location:West Virginia  Entered:2012-10-27
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: High BP; GERD; Lower back pain; High cholesterol
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4383AA0UNRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0110490UNLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Mass, Oedema peripheral, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Patient called on 10/27/12 and said her left arm was swollen, red, and itching. She said the area was 3 inches big and there was a lump under the skin. It starting bothering her on 10/26/12 but only when she was sitting around doing nothing (not busy). She started putting AVEENO lotion on the rash and she said it did help the itching.

VAERS ID:471732 (history)  Vaccinated:2012-10-23
Age:65.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-28, Days after onset: 4
Location:Florida  Entered:2012-10-28
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: tetanus toxoid, doxycycline; Medical problems: HTN, hyperlipidemia, occipital neuralgia, BPH.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA727CA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0135810IMLA
Administered by: Private     Purchased by: Other
Symptoms: Cough, Oedema peripheral, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm was very swollen and tender next day. He may have had low grade fever later the same day that he got it. Had sore throat, cough, some rhinorrhea, achiness which cleared by 10/26/2012.

VAERS ID:471748 (history)  Vaccinated:2012-10-23
Age:53.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-28, Days after onset: 4
Location:Wisconsin  Entered:2012-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergic to penicillin and other antibiotics.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Itching and hives on chest, stomach, back, upper arms and thighs.

VAERS ID:471819 (history)  Vaccinated:2012-10-23
Age:95.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-26, Days after onset: 2
Location:North Carolina  Entered:2012-10-29, Days after submission: 3
Life Threatening? No
Died? Yes
   Date died: 2012-10-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: CHF; Aortic aneurysm; Advanced age
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH732AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Cardiac failure congestive, Condition aggravated, Nausea
SMQs:, Cardiac failure (narrow), Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Patient hospitalized 10/16-10/21 with CHF exacerbation and increased weakness. Assessment by HH 10/23/12 and vaccine given. Patient developed nausea later in the day. Called EMS morning of 10/24 and patient taken to E.R.

VAERS ID:471868 (history)  Vaccinated:2012-10-23
Age:35.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-29, Days after onset: 6
Location:Wisconsin  Entered:2012-10-29
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: Aspirin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0611AE1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain, swelling, marked erythema at injection site.

VAERS ID:471988 (history)  Vaccinated:2012-10-23
Age:70.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-29, Days after onset: 5
Location:Missouri  Entered:2012-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICSQ2037   
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Dizziness, Fatigue, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Nausea, abdominal cramping, fatigue, dizziness.

VAERS ID:472136 (history)  Vaccinated:2012-10-23
Age:37.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-29, Days after onset: 5
Location:North Carolina  Entered:2012-10-29
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: ?? egg
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS122202 UNRA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Chest pain, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Over period of 3 days c/o "scratchy" throat -$g chest tightness -$g chest pain - seen in ED 10/26/12 - obs x 24 hrs.

VAERS ID:472161 (history)  Vaccinated:2012-10-23
Age:55.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-25, Days after onset: 2
Location:California  Entered:2012-10-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Lisinopril; clindamycin
Diagnostic Lab Data: Labs
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AD0UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0129720UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Laboratory test, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Painful red 3 inch circle left upper arm & vomiting.

VAERS ID:472177 (history)  Vaccinated:2012-10-23
Age:73.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-29, Days after onset: 6
Location:Texas  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:
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.NDC0000496341 UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Swelling, Thermal burn
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red sore puffed looks like burned hot to touch.

VAERS ID:472183 (history)  Vaccinated:2012-10-23
Age:48.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Colorado  Entered:2012-10-29, 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: Sulfa; Asthmatic; Stated had reaction to latex a few years ago.
Diagnostic Lab Data: None performed
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12040010IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Pruritus, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Received vaccine 30 m later became SOB, itchy and face swelled, 911 called transported to ER received BENADRYL and Prednisone. She is ok per TC 10/24/12.

VAERS ID:472188 (history)  Vaccinated:2012-10-23
Age:76.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 0
Location:Washington  Entered:2012-10-29, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP501080UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1489AA0UNRA
Administered by: Other     Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red, hot, swollen arm down to elbow. Recommended ice and BENADRYL - if not improved within a few hours, contact physician. Tx w/ ice and BENADRYL - improved next day.

VAERS ID:472190 (history)  Vaccinated:2012-10-23
Age:66.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 1
Location:Florida  Entered:2012-10-29, Days after submission: 4
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: Penicillin; Iodine; Fish; Strawberry; Ragweed
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0106610IMAR
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Local swelling, Nausea, Neck pain, Oedema peripheral, Pain in extremity, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Swelling and pain of the arm and neck, redness on the arm and surrounding tissues. Nausea and vomiting once in the morning. Was given a steroid shot by the MD on 10/25/12.

VAERS ID:476646 (history)  Vaccinated:2012-10-23
Age:65.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-29, Days after onset: 6
Location:Unknown  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': WAES1210USA011795
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0614AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a patient of unknown age. The patient was vaccinated with an expired dose of PNEUMOVAX 23 on 23-OCT-2012 (lot# 669776/0614AA; expiration date 27-SEP-2012; dose and route not reported). No other co-suspects were reported. No concomitant medications were reported. No adverse symptoms were reported. Additional information has been requested.

VAERS ID:472206 (history)  Vaccinated:2012-10-23
Age:28.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-26, Days after onset: 3
Location:New York  Entered:2012-10-30, Days after submission: 4
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: ZOFRAN allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AA IMAR
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Cold sweat, Feeling cold
SMQs:, Anaphylactic reaction (broad)
Write-up: Patient complained of feeling cold and clammy and her chest felt a little heavier.

VAERS ID:472208 (history)  Vaccinated:2012-10-23
Age:69.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 7
Location:Florida  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204801 IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Injection site reaction, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Large welt below injection site, pain, warm to touch.

VAERS ID:472242 (history)  Vaccinated:2012-10-23
Age:7.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:New York  Entered:2012-10-30, 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: URI
Preexisting Conditions: Mild RAD; Allergy to apples, cherries
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4481AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives 2 hrs. after vaccine given.

VAERS ID:472248 (history)  Vaccinated:2012-10-23
Age:53.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Montana  Entered:2012-10-30, 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: Sulfa; Latex; Doxycycline
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AC IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Arthralgia, Musculoskeletal stiffness, Nausea, Respiratory tract congestion, Sinus congestion, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Wheezing, nausea, congestion, joint pain, neck stiffness, severe sinus congestion.

VAERS ID:472264 (history)  Vaccinated:2012-10-23
Age:27.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 2
Location:Maryland  Entered:2012-10-30, 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: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06749211A0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Periorbital oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Periorbital edema, urticaria, pruritis 3 hrs. post injection. IM and PO Diphenhydramine and Albuterol inhaler. Symptom duration: 5-6 hrs.

VAERS ID:472578 (history)  Vaccinated:2012-10-23
Age:11.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-25, Days after onset: 2
Location:Louisiana  Entered:2012-10-30, 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: Well child
Preexisting Conditions: NKA; No birth defects noted; Childhood asthma and exercise induced bronchospasm
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4412BA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4395AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Head injury, Induration, Laceration, Skin warm, Suture insertion, Swelling, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt. received ADACEL and MENACTRA to LD, syncoped and hit head on window sill in room. Received staples for laceration to head in ER. Returned on 10/25 for possible concussion and vaccine reaction to LD. Raised induration 11 cm x 11 cm and warm.

VAERS ID:474874 (history)  Vaccinated:2012-10-23
Age:  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 7
Location:Unknown  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011224
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 Medical Assistant refers to a female patient of unknown age. The patient was vaccinated with her first dose of GARDASIL (route, dose and lot # were unknown) on 09-MAR-2011, her second dose of GARDASIL (route, dose and lot # were unknown) on 11-JUN-2011 and her third dose of GARDASIL (route, dose and lot # were unknown) on 23-OCT-2012. No adverse symptoms provided. Additional information has been requested.

VAERS ID:476833 (history)  Vaccinated:2012-10-23
Age:52.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-30
Location:Unknown  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA013031
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012523 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a pharmacist refers to a 52 years old female patient with no pertinent medical history and no drug reactions/allergies. The patient was subcutaneously vaccinated with a dose of 0.65 ml ZOSTAVAX (Lot# reported as H012523, Exp date: 09-OCT-2013) on 23-OCT-2012. There was no concomitant medications therapy. Subsequently on an unknown date in October 2012 the patient developed redness at the injection site. The affected area was the size of a softball. The patient had sought medical attention and it was stopped by at the pharmacy. No lab diagnostics studies performed and no treatment was given for the event. The outcome of redness at the injection site was reported as not recovered. Additional information is not expected.

VAERS ID:472230 (history)  Vaccinated:2012-10-23
Age:6.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-31, Days after onset: 7
Location:Michigan  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergies and asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B151AA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Inflammation, Middle insomnia, Pruritus, Rash erythematous, Sleep talking
SMQs:, Anaphylactic reaction (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: Patient woke up talking in his sleep and saying his feet itched. He had large, red, inflamed bumps all over the tops of each foot and the itching was enough to wake him up. Took him to Emergency Room for review and evaluation.

VAERS ID:472335 (history)  Vaccinated:2012-10-23
Age:59.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 8
Location:Missouri  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: No
Preexisting Conditions: Hypertension, Diabetes Mellitus Type II, Diabetic peripheral neuropathy, Hypothyroidism, Incontinence of Urine, Osteoarthritis, Obstructive Sleep Apnea, Asthma
Diagnostic Lab Data: Pt had CT of brain on 10/30/2012 @ 0923. Pt went to walk in clinic at 1300pm for eye pain.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AB5IMRA
Administered by: Private     Purchased by: Other
Symptoms: Computerised tomogram head, Dysarthria, Eye pain, Hypoaesthesia, Hypoaesthesia oral, Pain in jaw, Trismus
SMQs:, Peripheral neuropathy (broad), Dystonia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Osteonecrosis (broad)
Write-up: Pt states that it first started with her jaw locking up while brushing teeth/tongue. She states that she had to release her tongue to relieve the sx. Pt states that she developed what she describes as a "charlie-horse like pain in jaw." Sx calmed down and pt went to bed, upon that morning pt noted that her right side of her face felt numb and is if she had anesthesia from dental work on the right side of her face. Pt denies any facial drooping at this time. Pt does state that she has some slurring of speech occasionally, no drooling. She states that when she presses her tongue she can not feel her teeth with it. Pt denies any blurred vision, dizziness/lightheadedness. Pt was advised to not take anymore of this medication. Pt verbalizes understanding. Pt was given a f/u appt with Dr. on 10/29/2012 at 1600. We discussed reasons that pt should seek immediate medical attention. Pt verbalizes understanding.

VAERS ID:472337 (history)  Vaccinated:2012-10-23
Age:61.0  Onset:2012-10-26, Days after vaccination: 3
Gender:Female  Submitted:2012-10-31, Days after onset: 5
Location:Pennsylvania  Entered:2012-10-31
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: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA707AA20IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anxiety, Lip swelling, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: States she became very anxious, then developed itchiness in left hand which spread to trunk, feet, lower lip and "all over". Denies any shortness of breath. Took Benadryl, but anxiousness increased with lip swelling, so sought treament at local hospital emergency department.

VAERS ID:472368 (history)  Vaccinated:2012-10-23
Age:73.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 8
Location:Texas  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fever, flu like symptoms, hallucinations, lethargic, severe memory loss, all of that was for 4 days straight. Injection site: severe swelling, blistering, oozing pus, heat, redness, bruising, injections site hardness.
Preexisting Conditions: High blood pressure.
Diagnostic Lab Data: Emergency Room doctors administered blood tests, MRI on her brain, and a unine analysis. All the tests they did came back okay.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUHC7338AD1IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0098261IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Amnesia, Blood test normal, Hallucination, Influenza like illness, Injection site discharge, Injection site erythema, Injection site haematoma, Injection site induration, Injection site swelling, Injection site vesicles, Injection site warmth, Lethargy, Nuclear magnetic resonance imaging brain normal, Pyrexia, Urine analysis normal, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Symptoms: Fever, Flulike symptoms, lethargic, SEVERE memory loss, SEVERE hallucinations, vomiting. Injection site reactions: Severe swelling, redness, bruising, blistering at the injection site, oozing, injection site very hard. She was taken to the emergency room Friday night 10/26/2012 at 6:00 for these symptoms. Injections were given Tuesday morning 10/23/2012. Followed up with physician who administered injections the following Monday 10/29/2012. The hallucinations, memory loss, and injections site problems started Tuesday night are continuing through today 10/31/2012.

VAERS ID:472371 (history)  Vaccinated:2012-10-23
Age:53.0  Onset:2012-10-25, Days after vaccination: 2
Gender:Male  Submitted:2012-10-31, Days after onset: 6
Location:California  Entered:2012-10-31
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURU4474BA IDLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Feeling abnormal, Headache, Pain
SMQs:, Dementia (broad)
Write-up: Headache was worst symptom, also body aches, slight chills, "felt hungover".

VAERS ID:472398 (history)  Vaccinated:2012-10-23
Age:1.1  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-31, Days after onset: 8
Location:California  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: None
Preexisting Conditions: Pts mother states that he has a heart murmur
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB515AA IM 
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0188AE IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H012139 SC 
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF95942 IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H015135 SC 
Administered by: Military     Purchased by: Military
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt has swelling on his Left thigh.

VAERS ID:472421 (history)  Vaccinated:2012-10-23
Age:65.0  Onset:2012-10-29, Days after vaccination: 6
Gender:Female  Submitted:2012-10-31, Days after onset: 2
Location:Washington  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNLA
Administered by: Unknown     Purchased by: Private
Symptoms: Chills, Decreased appetite, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fever, aches, pains, nausea, chills, loss of appetite.

VAERS ID:472638 (history)  Vaccinated:2012-10-23
Age:78.0  Onset:2012-10-25, Days after vaccination: 2
Gender:Female  Submitted:2012-10-30, Days after onset: 5
Location:New Hampshire  Entered:2012-10-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type': NH10312012
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714 IMUN
Administered by: Public     Purchased by: Other
Symptoms: Rash erythematous, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: On 10/25/12 pt developed a raised, red, itchy rash with hives which continues on 10/30. Pt taking BENADRYL & Hydrocortisone cream. Rash persists.

VAERS ID:472737 (history)  Vaccinated:2012-10-23
Age:69.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 7
Location:Florida  Entered:2012-10-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0UNRA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Influenza like illness, Injection site erythema, Injection site swelling, Injection site warmth, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: 3 days of flu-like symptoms - severe aching, headache, stiff neck; swollen, red and hot arm at injection site - nurse prescribed ice and pain meds.

VAERS ID:472738 (history)  Vaccinated:2012-10-23
Age:8.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-25
Location:Colorado  Entered:2012-10-31, 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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AD0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: None. Pt had received FLUMIST 10-19-12, then on 10-23-12 received FLUZONE IM 0.5 ml. No reaction.

VAERS ID:472744 (history)  Vaccinated:2012-10-23
Age:92.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Virginia  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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site discolouration, Injection site haematoma, Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: Patient on warfarin. Had large red-blue bruised area with golf-ball sized welt at injection site.

VAERS ID:472750 (history)  Vaccinated:2012-10-23
Age:11.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 1
Location:California  Entered:2012-10-31, 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: None
Diagnostic Lab Data: Strep (-)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4527EA6IMLA
Administered by: Private     Purchased by: Private
Symptoms: Oropharyngeal pain, Pyrexia, Rhinorrhoea, Streptococcus test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Within 12 hours of flu shot patient had 4 episodes of vomiting, fever to 103 for 24 hours and sore throat and runny nose.

VAERS ID:472920 (history)  Vaccinated:2012-10-23
Age:71.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 7
Location:California  Entered:2012-10-31, 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
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0133940UNLA
Administered by: Private     Purchased by: Public
Symptoms: Pain in extremity
SMQs:
Write-up: Pt. describes her arm becoming very sore to the extent of almost going to the E.R. This happened 3 hrs after the shot and resolved several hrs later.

VAERS ID:472940 (history)  Vaccinated:2012-10-23
Age:67.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-31, Days after onset: 8
Location:Wisconsin  Entered:2012-10-31
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.H0098261SYRAR
Administered by: Other     Purchased by: Other
Symptoms: Grip strength decreased, Injection site pain, Injection site swelling, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient received vaccine at about 10:15 am on 10/23/12 at about 7 pm pt reported a swollen, throbbing arm (arm was arm of injection) that was not red. Patient reported not being able to grip keys w/finger. Pt went to ER where he found out he had received the same vaccine about 2 years ago. Patient symptoms were improved when followed up on 10/24/12.

VAERS ID:473178 (history)  Vaccinated:2012-10-23
Age:0.3  Onset:2012-10-27, Days after vaccination: 4
Gender:Female  Submitted:2012-10-31, Days after onset: 4
Location:Wisconsin  Entered:2012-11-01, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B344DA1IMLG
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0419AE1IMLG
PNC: PNEUMO (PREVNAR)PFIZER/WYETH9182451IMLG
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0381AE1PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Rash, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash to bilateral thighs noticed 10/27/12. Small red bumps to entire upper legs treatment - TYLENOL, cool compresses.

VAERS ID:473213 (history)  Vaccinated:2012-10-23
Age:3.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-25, Days after onset: 1
Location:California  Entered:2012-11-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF940014IMUN
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, 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, induration, pain at injection site.

VAERS ID:472675 (history)  Vaccinated:2012-10-23
Age:1.3  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-31, Days after onset: 8
Location:New York  Entered:2012-11-02, Days after submission: 2
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: Patient has a history of eczema, facial rash with egg whites, but tolerates egg yolks.
Diagnostic Lab Data: None
CDC 'Split Type': 201209987
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4186AA IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4531BA IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHG10784 IMRL
Administered by: Other     Purchased by: Other
Symptoms: Breath holding, 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), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Initial case received from a consumer on 23 October 2012. A male patient age 15 months received a dose of DAPTACEL Lot # C4186AA, intramuscularly into the left thigh, a dose of FLUZONE Lot # U4531BA, intramuscularly into the left thigh and a dose of PREVNAR, Lot # G10784 manufactured by Wyeth, intramuscularly into the right thigh on 23 October 2012. The patient had a history of eczema, facial rash with egg whites, but tolerates egg yolks. Concomitant medications and lab results were not reported. On an unspecified time after administration of vaccines, the patient held his breath for 10 seconds and then passed out for 1 to 2 seconds. The patient was described to be easily awakened by the nurse practitioner. No further details were available at the time of this report. The patient outcome was not reported. Documents held by sender: None.

VAERS ID:473029 (history)  Vaccinated:2012-10-23
Age:62.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-02
Location:Unknown  Entered:2012-11-02
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': WAES1210USA013928
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  UNUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0257AE SCAR
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a registered pharmacist refers to a 62 years old female patient. The patient was vaccinated subcutaneously with a 0.65 ml dose of ZOSTAVAX (Lot # reported as 02557AE, exp 15-MAR-2013) on 23-OCT-2012. No other co-suspects were reported. Concomitant medications included: FLUVIRIN. The patient went to the pharmacy within less than 48 hours after vaccination with her arm being red, swollen and hard at the injection site. The patient also experienced burning. The patient was told to put an ice pack on her arm that had the swelling. No labs/diagnostic studies were performed. It was reported that the burning stopped but the redness and hardness were still there. The outcome for the swelling was not reported. The relatedness for the events was unknown for ZOSTAVAX. Additional information has been requested.

VAERS ID:473211 (history)  Vaccinated:2012-10-23
Age:1.1  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-11-02, Days after onset: 10
Location:Washington  Entered:2012-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4481BA2IMLL
Administered by: Public     Purchased by: Public
Symptoms: Blister, Injection site vesicles, Irritability
SMQs:, Severe cutaneous adverse reactions (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (broad)
Write-up: Blisters (fluid filled) appeared on thigh area where shot was given & on chest during the evening after receiving flu shot that day at approx. 2 P.M. No fever or difficulty breathing noted, but child was cranky. Blisters disappeared within 4 days. No treatment necessary.

VAERS ID:473242 (history)  Vaccinated:2012-10-23
Age:5.0  Onset:0000-00-00
Gender:Male  Submitted:2012-10-24
Location:Maine  Entered:2012-11-02, Days after submission: 9
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 (Dtap localized reaction moderate) 4/8/09
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4214BA5IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Vaccination site swelling, Vaccination site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Increased redness swelling at vaccine site. Site hot to touch swelling from vaccine site to elbow.

VAERS ID:477105 (history)  Vaccinated:2012-10-23
Age:60.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-02, Days after onset: 10
Location:Unknown  Entered:2012-11-02
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': WAES1210USA013914
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0571AE SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse refers to a patient of unknown age and gender. The patient was inadvertently vaccinated subcutaneously with a dose of VARIVAX (Merck) (dose and lot # not reported) instead of ZOSTAVAX on 23-OCT-2012. No adverse effect was reported. Additional information has been requested.

VAERS ID:472797 (history)  Vaccinated:2012-10-23
Age:65.0  Onset:2012-10-30, Days after vaccination: 7
Gender:Male  Submitted:2012-11-03, Days after onset: 4
Location:California  Entered:2012-11-03
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: My husband was Diagnosed with viral meningoencephalitis Patient has received 2EEG''s, CT scan of brain, MRI of spine, 2 spinal taps, Urine cultures and blood cultures. He has a PICC line in is upper right arm. He is on four point restraints. He is now being fed with oroesophogeal tube and continues with intravenous medications and fluids.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4490AA IMUN
Administered by: Private     Purchased by: Other
Symptoms: Activities of daily living impaired, Altered state of consciousness, Blood culture, CSF white blood cell count increased, Central venous catheterisation, Computerised tomogram head, Culture urine, Electroencephalogram, Encephalitis, Encephalitis viral, Gastrointestinal tube insertion, Incoherent, Intensive care, Laboratory test normal, Lumbar puncture, Malaise, Mechanical ventilation, Moaning, Nuclear magnetic resonance imaging spinal, Pain, Pyrexia, Tremor
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: My husband went home early from work because he was feeling achy all over on Tuesday 10/30/12. That afternoon I found him in what appeared to be deep sleep on his recliner. I went upstairs, thinking that he was asleep but then I heard noises. I immediately went down and found my husband with severe shaking of his whole body and he was moaning but he did not recognize me nor did he sound coherent. I called 911 and he was rushed to the emergency room. He had a high fever and his level of consciousness was extremely altered. He was evaluated for stroke, heart attack and other ailments. My husband received many antibiotics that he did not really need because the doctors did not know immediately what was going on. The doctors told me that some of the antibiotics have severe side effects. Everything came back negative except the cerebrospinal fluid was high in white blood cells. He continues to be on antibiotics, blood pressure medications and is being assisted on a ventilator. Heis being cared for by specialists in Neurology, Pulmonary Disease, and Infectious Disease. He is still very ill in the intensive care unit. I told all of his doctors about the flu vaccine that was administered exactly 7 days before the onset of this adverse reaction.

VAERS ID:472903 (history)  Vaccinated:2012-10-23
Age:44.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 13
Location:Ohio  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: This was my second year of getting flu shot. About 30 seconds after I got the shot, my heart beats raised up to 90s from 70s. I felt my body was hot, my head is tight, and my left chest felt tight too. The nurse told me to sit down. And I drank a cup of warm water. after 15 minutes later, I felt much better.
Preexisting Conditions: About 8 years ago, I got my first flu shot. I didn''t have any reaction right after I got the shot. But, when I got sick of flu after I got the shot, my symptom was more serious than I did before got flu shot. That''s why I hesitate to get flu shot again until this year I want to give it a try. And it still didn''t give me any good experience.
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204201 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chest discomfort, Feeling hot, Heart rate increased, Muscle tightness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad)
Write-up: Heart beats raised from 70s to 90s. Body felt hot, head felt tight, left chest felt tight.

VAERS ID:473452 (history)  Vaccinated:2012-10-23
Age:58.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:2012-10-31, Days after onset: 7
Location:Pennsylvania  Entered:2012-11-05, 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: Type II DM with neuropathy; Traumatic amputation of (L) leg; HTN; Hyperlipidemia; AVAPRO; Statins; VYTORIN
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4422AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Cellulitis (L) arm and generalized rash patient given antibiotic - KEFLEX 500mg 1 QID x 7 days.

VAERS ID:473600 (history)  Vaccinated:2012-10-23
Age:64.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-05
Location:Nevada  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: No meds
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714AA UNLL
Administered by: Other     Purchased by: Private
Symptoms: Contusion, Immediate post-injection reaction, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow)
Write-up: Bruising lasting $g 2 weeks. Bruising was immediate. Soreness lasting couple of days.

VAERS ID:477315 (history)  Vaccinated:2012-10-23
Age:66.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-11-05, Days after onset: 12
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': WAES1210USA012795
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011427 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a pharmacist refers to a 66 years old female patient with no known pertinent medical history and no known drug allergies. On 23-OCT-2012, the patient was vaccinated with a dose of ZOSTAVAX subcutaneously (lot # reported as H011427, exp date 12-SEP-2013). No other co-suspects were reported. There was no concomitant medication. On 24-OCT-2012 the patient developed itch, redness, warmth, and pain at the site of injection. The patient went to see the pharmacist to seek medical attention. No treatment was given for the events. No lab diagnostics studies were performed. At the time of the report, the outcome of the events was reported as not recovered. Additional information is not expected.

VAERS ID:473613 (history)  Vaccinated:2012-10-23
Age:61.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 7
Location:Michigan  Entered:2012-11-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12242 UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Public     Purchased by: Private
Symptoms: Chills, Dizziness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Chills/fever/body ache and dizziness.

VAERS ID:473616 (history)  Vaccinated:2012-10-23
Age:26.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 1
Location:Rhode Island  Entered:2012-11-06, Days after submission: 13
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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA762AB0SYRLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling & pain at injection site. Onset approx 8 hrs after injection. Patient self administered "ADVIL", applied cold compress the following morning.

VAERS ID:473628 (history)  Vaccinated:2012-10-23
Age:43.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-10-30, Days after onset: 6
Location:Nebraska  Entered:2012-11-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Sulfa antibiotics; mushrooms
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4483AC IMLA
Administered by: Private     Purchased by: Other
Symptoms: Contusion, Erythema, Induration, Nodule, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: 3-4 cm area of induration (redness, warmth, firm nodule), itching, bruising 24 hours after injection lasting $g 7 days.

VAERS ID:473727 (history)  Vaccinated:2012-10-23
Age:21.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:Rhode Island  Entered:2012-11-06, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: IgA Deficiency
Diagnostic Lab Data: HR 80; BP 124/74
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFFLA726AB IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Feeling cold, Hyperhidrosis, Loss of consciousness, Pallor, Unresponsive to stimuli, Urinary incontinence
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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt received flu vaccine 15 min later felt faint, had LOC for 2 min, pale, diaphoretic, cool for 2 sec. Became responsive. Pt voided with loss of bladder control. 50mg of BENADRYL given PO. EMS called. VSS now recovered. Walked back to dorm.

VAERS ID:473750 (history)  Vaccinated:2012-10-23
Age:70.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 8
Location:Texas  Entered:2012-11-06, 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: URI
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH745AA UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site induration, Injection site pain, Injection site pruritus, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Rash, induration, pain & itching initially at site then, 2-3 days later antecubital fossa on left arm. Finally 1 wk later occurred on left back (shoulder). Treated with BENADRYL & Hydrocodone.

VAERS ID:473763 (history)  Vaccinated:2012-10-23
Age:17.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Rhode Island  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH712AB UNLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient received vaccination early at school. Dizziness reported about 15 min after. Fever reported by mother after return home 100 degrees fever continued to following morning reported 99 degrees.

VAERS ID:473833 (history)  Vaccinated:2012-10-23
Age:50.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-01, Days after onset: 9
Location:Wisconsin  Entered:2012-11-06, 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 known
Preexisting Conditions: Allergic Rhinitis; Hypertension; Asthma; Esophageal Reflux; Irregular Menstruation; Myofascial Pain; Migraine Headache; Sleep apnea; Hyperlipidemia; Hypothyroidism; Diabetes mellitus type II
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH746AC UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0135810SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: Erythema, pain, swelling at injection site (Right deltoid). Patient also experienced diarrhea.

VAERS ID:476174 (history)  Vaccinated:2012-10-23
Age:4.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-10-30, Days after onset: 7
Location:Wisconsin  Entered:2012-11-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Constipation; Speech delay; ADM; NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B178CB0UNRL
Administered by: Private     Purchased by: Other
Symptoms: Emotional distress, Immediate post-injection reaction, Injection site discomfort, Injection site erythema, Injection site pain, Injection site vesicles, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: See attached. Patient here with his mother and younger sister. Patient had KINRIX given yesterday for 4 year well child check. The event was upsetting to patient and he really tensed up at the time of the shot. Mother reports that the area immediately developed a bubble lateral to the actual injection site. Patient was upset following the shot and periodically complained of pain to this area. As his mother did not feel that this was unexpected she consoled as needed. At bath time in the evening she noticed a very large area of warmth and redness spreading out from the area that initially bubbled up. At bedtime she gave him some ibuprofen and the area looked better the morning, sufficiently so the she contemplated canceling the visit but over course of the morning the area seemed to get worse again. Patient periodically complains of discomfort and does not want the area touched but overall his appetite, his energy and play levels are quite normal.

VAERS ID:476210 (history)  Vaccinated:2012-10-23
Age:2.0  Onset:2012-10-25, Days after vaccination: 2
Gender:Male  Submitted:2012-11-01, Days after onset: 7
Location:Montana  Entered:2012-11-06, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B323BA0IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1873AA0SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0110740SCLL
Administered by: Public     Purchased by: Private
Symptoms: Injection site mass, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Bumpy rash and lump at injection site on left leg. Advised to continue to give BENADRYL for comfort and apply topical BENADRYL other antihistamine for comfort.

VAERS ID:477598 (history)  Vaccinated:2012-10-23
Age:62.0  Onset:2012-10-25, Days after vaccination: 2
Gender:Female  Submitted:2012-11-06, Days after onset: 12
Location:Unknown  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA012797
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site pruritus, 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 pharmacist refers to a 62 years old female patient with no known drug allergies. On 23-OCT-2012, the patient was vaccinated with a dose of ZOSTAVAX (lot # reported as H012579, exp date 28-SEP-2013) subcutaneously in the "back of the arm in the axilla space, the part of the arm that jiggles." No other co-suspects were reported. No concomitant medications were reported. On 25-OCT-2012 the patient developed "a red, raised, itchy area about the size of her palm at the injection site". The patient called the pharmacist to seek medical attention. No treatment was given for the events. No lab diagnostics studies were performed. At the time of the report, the outcome of a red, raised, itchy area about the size of her palm at the injection site was reported as not recovered. The outcome of "Received ZOSTAVAX subcutaneously in the back of the arm in the axilla space the part of the arm that jiggles" was unknown. Additional information is not expected.

VAERS ID:473387 (history)  Vaccinated:2012-10-23
Age:28.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 0
Location:Unknown  Entered:2012-11-07, Days after submission: 15
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: Denies allergies to eggs. Has received Flu shot in past.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dehydration, Dizziness, Hypoaesthesia, Palpitations, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Employee developed lightheadedness with tingling & numbness to BUE with palpitations 20 minutes after receiving Flu vaccine. Symptoms did not subside after laying flat for 30 minutes so was taken to ED for monitoring. Given one liter of fluid for dehydration & discharged.

VAERS ID:473421 (history)  Vaccinated:2012-10-23
Age:42.0  Onset:2012-10-30, Days after vaccination: 7
Gender:Male  Submitted:2012-11-07, Days after onset: 8
Location:Washington  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Dysgraphia, Dyskinesia, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: Felt ferverish (without a fever). Muscle soreness, muscle weakness, lack of fine muscle control (had trouble writing/typing). Symptoms got worse and gradually subsided by 11/06/2012 (1 week).

VAERS ID:473518 (history)  Vaccinated:2012-10-23
Age:81.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-02, Days after onset: 10
Location:Illinois  Entered:2012-11-07, 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 an allergy to amoxicillin and a history of atrial fibrillation and breast cancer in 1997 with lymph node removal and right side lumpectomy. The patient was no acutely ill at the time of vaccination.
Diagnostic Lab Data: No culture performed to determine bacterial cause of possible cellulitis.
CDC 'Split Type': 201210243
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH729AB IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site vesicles, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Initial report was received from a healthcare professional on 29 October 2012. An 81-year-old female patient had received an intramuscular injection in the right deltoid of FLUZONE, lot number UH729AB, on 23 October 2012 and the same day experienced erythema, pain, blistering, and warmth at the injection site. The patient was evaluated on 23 October 2012 and 24 October 2012 and prescribed BACTRIM DS and prednisone for possible cellulitis. No culture performed to determine bacterial cause of possible cellulitis. The patient had an allergy to amoxicillin and a history of atrial fibrillation and breast cancer in 1997 with lymph node removal and right side lumpectomy. The patient was no acutely ill at the time of vaccination. The patient''s outcome was not reported. Documents held by sender: None.

VAERS ID:474546 (history)  Vaccinated:2012-10-23
Age:33.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 15
Location:Missouri  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06649221A IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain at injection site - right arm deltoid region. Began after injection on 10-23-12 until reported 11-7-12. Referred to primary care physician for treatment.

VAERS ID:473593 (history)  Vaccinated:2012-10-23
Age:72.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 16
Location:Louisiana  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
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1SYRRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Injection site rash, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Arm was red. Rash angry looking site of injection was swollen and arm from shoulder down to elbow. Put cold packs and Benadryl every 4hrs around clock for 24hrs still red and swollen for 7 days. Went to Dr on 26 of Oct.

VAERS ID:476360 (history)  Vaccinated:2012-10-23
Age:71.0  Onset:2012-11-01, Days after vaccination: 9
Gender:Male  Submitted:2012-11-07, Days after onset: 6
Location:Texas  Entered:2012-11-08, 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: Prostate CA treated 10-10 with 8 wks. radiation and hormone; Allergic rhinitis; Drug allergies: EMYCIN, PCN, FLAGYL, NSAIDS
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Private     Purchased by: Other
Symptoms: Herpes zoster, Hyperaesthesia
SMQs:
Write-up: Varicella zoster onset 11/01/12 over right anterior thigh, right buttock. Hyperesthesia over right flank and RLQ of abdomen. Being treated with Acyclovir, Lidoderm patches, and Vicodin.

VAERS ID:476565 (history)  Vaccinated:2012-10-23
Age:  Onset:2012-10-23, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-10, Days after onset: 18
Location:California  Entered:2012-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011259
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 certified medical assistant refers to a patient of unknown age. The patient was vaccinated with the first and second dose of GARDASIL (dose, route and lot number not provided) respectively on 28-SEP-2011 and 16-FEB-2012. No other co-suspects were reported. No concomitant medications were reported. On 23-OCT-2012 "today" the patient was to get the third dose. No adverse effect reported. It was unspecified if the patient had sought medical attention. Additional information has been requested.

VAERS ID:473978 (history)  Vaccinated:2012-10-23
Age:44.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-11-13, Days after onset: 21
Location:Maryland  Entered:2012-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH713AB21IMLA
Administered by: Military     Purchased by: Military
Symptoms: Angioedema, Chest discomfort
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Chest tightness without shortness of breath followed by angioedema of the lips and tongue -- symptoms progressed from 3:00 PM to 6:00 PM. 50 mg of diphenhydramine resolved symptoms 30 minutes after administration. Symptoms resolved by 6:30 PM.

VAERS ID:474357 (history)  Vaccinated:2012-10-23
Age:4.0  Onset:2012-10-25, Days after vaccination: 2
Gender:Male  Submitted:2012-10-30, Days after onset: 5
Location:Michigan  Entered:2012-11-13, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Urinary frequency (no UTI)
Preexisting Conditions: Urinary frequency
Diagnostic Lab Data: See attached; lead level still pending
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B208AA IMLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH728AA2IMRA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.H0156311SCLA
Administered by: Private     Purchased by: Private
Symptoms: Blood lead, Discomfort, Full blood count normal, Laboratory test normal, Scrotal oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria - 10/25 - minimal urticaria, ? scrotal discomfort advised use of OTC antihistamines. Pt seen in UC 10/26 US of scrotum showed edema - not orchitis or torsion. Labs drawn, no DM, CBC normal. Pt seen by Dr 10/30 scrotal swelling resolved, 3 hives left. No follow up needed unless recurs.

VAERS ID:474091 (history)  Vaccinated:2012-10-23
Age:52.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-14, Days after onset: 22
Location:California  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: DM; GERD; Dyslipidemia; Drug hypersensitivity; Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data: 10/23/2012, Body temperature, 102 F
CDC 'Split Type': WAES1211USA001403
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER12099D9UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0133990UNLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Injection site urticaria, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from another health professional who refers to a 52 years old female patient with dyslipidemia, diabetes mellitus, sulfur allergy and GERD. The patient was vaccinated into left deltoid with a first dose of PNEUMOVAX23 (dose and route not reported) (lot# reported as H013399) on 23-OCT-2012 09:30. Other suspect therapies included FLUAD administered into left deltoid (dose, route not reported, lot # 12099d) on 23-OCT-2012. Concomitant medications included metformin, NEXIUM and atorvastatin. On 23-OCT-2012 the patient experienced localized severe deltoid pain, wheals on out upper left arm and 102 F fever. It was reported that the patient required ER/doctor visit (unspecified). The outcome of all adverse events was reported as unknown. Additional information has been requested.

VAERS ID:474119 (history)  Vaccinated:2012-10-23
Age:4.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 8
Location:Unknown  Entered:2012-11-14, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Spastic paresis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2012SE83522
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AF1205 IN 
Administered by: Other     Purchased by: Other
Symptoms: Bronchitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: A report has been received from a physician via sales representative, concerning a 4 year old, female patient. The patient''s concurrent disease included cerebral spastic paresis. No concomitant medication was reported. The patient had been receiving FLUENZ, for vaccination which was started on 23-Oct-2012. The lot number was AF1205. The physician reported that the child who received FLUENZ for vaccination on 23-Oct-2012. On the same day she suffered from fever and later on from severe bronchitis. Influenza vaccine was discontinued on 23-Oct-2012. At the time of reporting, the event of fever and bronchitis was ongoing. The company physician assessed the events of fever and bronchitis to be serious due to important medical event.

VAERS ID:474509 (history)  Vaccinated:2012-10-23
Age:52.0  Onset:2012-10-23, Days after vaccination: 0
Gender:Male  Submitted:2012-11-15, Days after onset: 23
Location:Minnesota  Entered:2012-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12059011IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Pruritus, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Redness at site. Pruritic rash shoulder to shoulder across neck and back. Itching worse after shower. Given BENADRYL/IM injection.

VAERS ID:474590 (history)  Vaccinated:2012-10-23
Age:63.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:North Carolina  Entered:2012-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA66BB0IMUN
Administered by: Other     Purchased by: Private
Symptoms: Ageusia, Chills, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad)
Write-up: Within 5 hr. lost taste, then within 12 hours chills (+) fever. Body pain. Lasted for about 36 hours. After 3 days he was fine.

VAERS ID:474977 (history)  Vaccinated:2012-10-23
Age:48.0  Onset:2012-10-24, Days after vaccination: 1
Gender:Female  Submitted:2012-11-19, Days after onset: 26
Location:Illinois  Entered:2012-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Diabetic
Diagnostic Lab Data: Ultrasound - no clot
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA732AA