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Found 480754 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:468874 (history)  Vaccinated:2012-10-10
Age:11.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:Michigan  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4481AA3IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB64AA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4240AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4103AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Syncope.

VAERS ID:468884 (history)  Vaccinated:2012-10-10
Age:67.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:California  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Anemia, HTN, IDDM, high cholesterol
Preexisting Conditions: No known allergies
Diagnostic Lab Data: MD notified. Benadryl administered PO.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.HO109160IMLA
Administered by: Public     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: Redness, swelling, warm to touch, and mild pain (3/10) at the injection site.

VAERS ID:468888 (history)  Vaccinated:2012-10-10
Age:30.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-10, Days after onset: 0
Location:Maryland  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0386AE 0IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0532AE 0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B099AA IMLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH350AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Loss of consciousness, Muscle twitching, Pallor, Posture abnormal, Skin discolouration, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (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: Patient said he felt like he was going to pass out, went to get him juice, when returned patient was leaning back in chair with his head flung back. Patients skin was pale and greenish, was non-responsive. Patient twitched once or twice, and then came to. Patient drank juice and ate some chocolate and said was feeling ok. Color came back and he said he felt fine before leaving the office.

VAERS ID:469280 (history)  Vaccinated:2012-10-10
Age:10.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:Arizona  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS 0UNRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling and redness.

VAERS ID:469370 (history)  Vaccinated:2012-10-10
Age:36.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:Ohio  Entered:2012-10-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS123105 UNLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives & chills 2 hrs post injection. 50mg PO (liquid) diphenhydramine.

VAERS ID:469467 (history)  Vaccinated:2012-10-10
Age:66.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:Minnesota  Entered:2012-10-12
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: MS
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH722AA6IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0109160IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B094AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Bacteraemia, Injection site cellulitis, Injection site induration, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Fever, LUE cellulitis/induration, bacteremia onset 24h after injection.

VAERS ID:469644 (history)  Vaccinated:2012-10-10
Age:60.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 1
Location:Connecticut  Entered:2012-10-14, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Codeine allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP504080IMLA
Administered by: Public     Purchased by: Private
Symptoms: Lip swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Swelling of facial area & lips few hours after vaccine administration. Went away on its own. Patient did not treat.

VAERS ID:469646 (history)  Vaccinated:2012-10-10
Age:61.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Female  Submitted:2012-10-14, Days after onset: 2
Location:California  Entered:2012-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: MD at urgent care: possible cellulitis
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH746AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Inflammation, Injection site warmth, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Left arm: painful, redness, swelling & inflammation. Hot to the touch around the site of injection. Swelling improve after 1 day. Treatment: BACTRIM DS.

VAERS ID:469652 (history)  Vaccinated:2012-10-10
Age:65.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-13, Days after onset: 3
Location:Tennessee  Entered:2012-10-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0556AE0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Insomnia, Pain in extremity
SMQs:
Write-up: Patient woke up before midnight with pains in both arms, feeling unable to move either. Patient called 24 hour pharmacy and after taking ibuprofen and TYLENOL pain was still too intense to sleep. Pain eventually went away next morning before noon with no residual pain.

VAERS ID:469657 (history)  Vaccinated:2012-10-10
Age:68.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-14, Days after onset: 3
Location:Florida  Entered:2012-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4530AA UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0135870UNLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Inflammation, Malaise, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: Fell sick w/fever for 2 days post vaccination arm is red & inflamed & hot to touch.

VAERS ID:469473 (history)  Vaccinated:2012-10-10
Age:69.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-14, Days after onset: 4
Location:Nevada  Entered:2012-10-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4489AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dyspnoea, Ocular hyperaemia, Pharyngeal oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Swelling in throat, red eyes & difficulty breathing. Went to ER then admitted to hosp stat.

VAERS ID:469558 (history)  Vaccinated:2012-10-10
Age:60.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-13, Days after onset: 3
Location:New Hampshire  Entered:2012-10-15, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12050011IMUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0130210SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Injection site swelling/rash. Pt cannot take BENADRYL so went to hospital ED. Pt. given prednisone, hydroxyzine, & BACTRIM DS.

VAERS ID:469564 (history)  Vaccinated:2012-10-10
Age:34.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 5
Location:Tennessee  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Whelps and itching on body
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206101 UNRA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Went to urgent care. Steroid shot and BENADRYL tabs.

VAERS ID:469617 (history)  Vaccinated:2012-10-10
Age:66.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 5
Location:Texas  Entered:2012-10-15
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: ragweed, rosacea
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12265P IMLA
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Injection site pruritus, Injection site reaction, Injection site urticaria, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: 15 minutes after injection, employee felt hives welt on injection site, with intense itching. Hives did not spread systemically. Later she started vomiting with diarrhea prn over 3 days.

VAERS ID:469622 (history)  Vaccinated:2012-10-10
Age:32.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 5
Location:Washington  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA710BA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Grip strength decreased, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: Extreme muscle soreness, weakness extending down arm, decreased grip strenth. Taken Ibuprofen, applied heat/cold. Minimal relief provided X5 days.

VAERS ID:469629 (history)  Vaccinated:2012-10-10
Age:76.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 5
Location:Michigan  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: GERD, Excersized induced Bronchospasm
Preexisting Conditions: Allergies to PCN and Bees GERD, Atherosclerosis, Hyperlipidemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF429021IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Patient was given Pneumococcal Prevnar 13 on 10/09/2012 IM in left deltoid. Prior to this she was seen 09/14/2012 for Bee Sting reaction in the left arm near the area of the IM injection. There was no apparent reaction remaining on her left arm prior to the vaccine administration. Called office 10/15/2012 to report rash on left arm near injection site, was seen that same day for evaluation, approximately a 3” non-raised rash on left deltoid area, patient stated it was “getting better”, she had not used any OTC meds to treat it, but mentioned it did itch. Advised to use OTC Benadryl and/or topical steroid cream if desired for itching, and to return if the area gets worse.

VAERS ID:469636 (history)  Vaccinated:2012-10-10
Age:53.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-15, Days after onset: 5
Location:Florida  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: None noted
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12052010IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Dysphagia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Vestibular disorders (broad)
Write-up: Patient left prior to 15 minute wait. When he got to his car he felt dizzy and trouble swallowing. Returned inside to notify of symptoms. Immediately assessed, EMS called, Epipen 0.3mg given IM into left thigh. Taken to ER for evaluation and treatment by EMS.

VAERS ID:469681 (history)  Vaccinated:2012-10-10
Age:34.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 5
Location:Idaho  Entered:2012-10-15
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: YES, DEMEROL
Diagnostic Lab Data: NO
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Blood pressure increased, Dyspnoea, Sneezing, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: SCRATCHY THROAT/SNEEZING/INCREASED BLOOD PRESSURE/HIVES/SOB. BENADRYL.

VAERS ID:469703 (history)  Vaccinated:2012-10-10
Age:21.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Male  Submitted:2012-10-15, Days after onset: 3
Location:Rhode Island  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07049211A IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010916 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Vaccination site pain, Vaccination site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Developed swelling redness and pain at vaccine site at right deltoid/biceps where Pneumovax was administered. Worse with touching or movement of the arm.

VAERS ID:469810 (history)  Vaccinated:2012-10-10
Age:1.5  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 5
Location:Tennessee  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
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HPV4: HPV (GARDASIL)MERCK & CO. INC.H0158630IMRL
Administered by: Private     Purchased by: Private
Symptoms: Eye movement disorder, Hyperphagia, Irritability, Pain, Wrong drug administered
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Ocular motility disorders (narrow)
Write-up: Note: Pt was mistakenly given HPV instead of Hep A vaccine. Now with polyphagia and eye blinking when fatigued injecting site soreness and fussiness/irritability resolved. Still with blinking when tired only. * Exam 10/15/12 normal.

VAERS ID:469812 (history)  Vaccinated:2012-10-10
Age:59.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-13, Days after onset: 2
Location:Michigan  Entered:2012-10-15, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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TDAP: TDAP (ADACEL)SANOFI PASTEURU4329AA IMAR
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red, hot, swollen, hard at injection site. As of 10/15/12, getting better per patient.

VAERS ID:469906 (history)  Vaccinated:2012-10-10
Age:41.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-10, Days after onset: 0
Location:North Carolina  Entered:2012-10-15, 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: Blood pressure 95/70
CDC 'Split Type':
Vaccination
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Gait disturbance, Hyperhidrosis, Pallor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt got shot at 11:25AM. At 11:30AM came to me stumbling, lightheaded, sweating, pale. Stumbled into wall. Called 911. They came and check BP, was 95/70. Pt refused care. Sat and drank juice and started to feel better so left. Applied ice pack to neck.

VAERS ID:469933 (history)  Vaccinated:2012-10-10
Age:60.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Female  Submitted:2012-10-15, Days after onset: 3
Location:Arizona  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH746AC0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea, 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: Started 10-12-10 fever, chills, headache, sore throat, runny nose throwing up.

VAERS ID:469939 (history)  Vaccinated:2012-10-10
Age:11.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Male  Submitted:2012-10-15, Days after onset: 4
Location:California  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cough/PNA/Asthma
Preexisting Conditions: Asthma; Obesity
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AA9UNRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0109150UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4285AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Condition aggravated, Cough, Injection site erythema, Pneumonia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Seen cough 10/10/12 dx asthma, PNA Rx Albuterol/Z-PAK. Vaccines - FLUZONE, HPV, MENACTRA given. 10/11 Redness 4x5 in (L) deltoid. Seen 10/12 possible cellulitis. Rx KEFLEX, but Mom did warm compress and resolved in few hours. No fevers.

VAERS ID:469705 (history)  Vaccinated:2012-10-10
Age:59.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 6
Location:California  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: hemorrhoid, hypothyroidism, GERD/hiatal hernia
Diagnostic Lab Data: I am still hoping the pain will subside by itself soon and have not scheduled any tests or doctor visit. When I contacted my doctor''s office, vaccine administrator told me that my concerns were not flu vaccine related.
CDC 'Split Type':
Vaccination
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Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SCLA
Administered by: Unknown     Purchased by: Other
Symptoms: Back pain, Muscle spasms, Pain
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad)
Write-up: I had the vaccine in my left arm about 11:30 a.m. and started to feel a cramp behind my left knee that afternoon. I took Motrin that evening and again the next day but stopped after Thursday and the pain worsened. I is like a charley horse that will not go away. It is now the following Tuesday and I still have much pain walking and now feel lower back pain as well.

VAERS ID:469884 (history)  Vaccinated:2012-10-10
Age:32.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-16, Days after onset: 5
Location:Illinois  Entered:2012-10-16
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: Environmental allergies, mild asthma
Diagnostic Lab Data: Between 10/11PM and 10/12AM, chest xrays for pneumonia, blood pressure, and temperature.
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Chest X-ray, Chills, Headache, Hyperaesthesia, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: I got a flu shot in my right arm and pneumonia shot in my left arm. Extreme chills, muscle aches, and headaches developed and progressed from 2PM on. Subsequently fever kicked by 5PM (when I could check it) and rose to 103.3 (by 8PM). Checked into ER around 9PM with a 102+ fever and remained there until 6AM, receiving Tylenol and fluids. Injection site on my left arm (pneumonia) was incredibly red and sore by the 10/11AM, prior to onset of other symptoms. The site (1 4-square inch blotch and another 3-square inch blotch below) was red, sore, hard, swollen, and extremely sensitive to the touch until 10/15.

VAERS ID:469921 (history)  Vaccinated:2012-10-10
Age:12.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Male  Submitted:2012-10-16, Days after onset: 4
Location:North Dakota  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': ND1223
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AA2IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURUL253AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3974AA5IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal discomfort, Dizziness, Headache, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: FEVER, HEADACHE, DIZZINESS, FRIDAY 10:29 AM; SAT AM 10:15 STILL SICK. SUNDAY 10:30 FEVER DOWN, THROAT DNA-STOMACH UPSET. EATING AND DRINKING.

VAERS ID:469962 (history)  Vaccinated:2012-10-10
Age:35.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-16, Days after onset: 5
Location:Alabama  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: Penicillin allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AB0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site urticaria, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient reported approximately 24 hours later that clusters of hives developed on her upper and lower arms, and on her thighs. She presented to her primary care physician, and received a steroid shot as treatment. Six days later, she presented to vaccine provider. Approximately 10 to 15 welts 1 cm in diameter were present in clusters on her right arm, and also reportedly on her legs. No other adverse reactions were reported.

VAERS ID:470121 (history)  Vaccinated:2012-10-10
Age:86.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Male  Submitted:2012-10-12, Days after onset: 1
Location:New York  Entered:2012-10-16, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709AE IMLA
Administered by: Other     Purchased by: Private
Symptoms: Infection, Pain in extremity
SMQs:
Write-up: Patient received vaccine, and reported no reaction at that time. Then later that day patient called complaining of arm pain. Next day the patient''s son called the pharmacy to report that his father/patient was in the hospital with an infection.

VAERS ID:473540 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-16, Days after onset: 6
Location:Unknown  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA005376
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a Doctor of pharmacy refers to an adolescent male patient of unknown age. The patient was vaccinated with an expired 0.5 ml dose of RECOMBIVAX HB (Lot # not reported, expiration date 09-OCT-2012) SQ on 10-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effects were reported. Additional information is not expected.

VAERS ID:470062 (history)  Vaccinated:2012-10-10
Age:21.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 7
Location:Michigan  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: none that we are aware of; allergic to Bactrim and penicillin
Diagnostic Lab Data: See describe adverse events;
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50208 IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Alanine aminotransferase normal, Antinuclear antibody negative, Aspartate aminotransferase normal, Blood folate normal, Blood magnesium normal, Blood thyroid stimulating hormone normal, Eyelid ptosis, Full blood count normal, Hypoaesthesia, Metabolic function test normal, Nuclear magnetic resonance imaging normal, Urine analysis normal, VIIth nerve paralysis, Vitamin B12 normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: Patient states 15 mins after influenza vaccine was administered she had numbness down the left side that didn''t go away. She went to ED on 10/10/12 at 1821. Provider ordered labs which were negative CBC, urinanlyasis, ALT, AST, BMP which were all within normal limits. Encouraged to f/u if symptoms got worse. Patient went to clinic and was seen on 10/11/12 with symptoms of numbness of left side which patient states has gotten worse with left eye drooping. Mg, B12, Folate, TSH and Antinuclear lab testing ordered and all are within normal limits. She was instructed to f/u the next day if condition check. She came on 10/12/12, patient state same however left side cheek and eye was drooping. Neurologist was consulted and pt was started on Neurontin on 10/12 and MRI of brain was ordered. MRI was negative.

VAERS ID:470067 (history)  Vaccinated:2012-10-10
Age:78.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-17, Days after onset: 7
Location:Mississippi  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKA
Diagnostic Lab Data: n/a
CDC 'Split Type': MS12018
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4494AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1137AA IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3872CA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injected limb mobility decreased
SMQs:
Write-up: Patient states< "I received three shots on 10/10/12 about 11:00 a.m. The student put all three shots in my right arm. Later that day about 2:00 p.m. I could not use my arm. Went to doctor and was told to use warm compresses on my arm and that I should not have had three shots in one arm."

VAERS ID:470073 (history)  Vaccinated:2012-10-10
Age:52.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 7
Location:Virginia  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: I/D of axilla abscess done in the ED
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07549221A IMRA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Nodule, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pain in right arm, redness in right arm with a palpable nodule in the right axilla.

VAERS ID:470086 (history)  Vaccinated:2012-10-10
Age:66.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Male  Submitted:2012-10-17, Days after onset: 6
Location:Arizona  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Insomnia, Joint effusion, Mobility decreased, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Arm so sore could not sleep. Next morning upper arm completely swollen and red. By the afternoon fluid building up, by the elbow. Arm so sore could not use. Big pocket of fluid at the elbow size of tennis ball. Dr. put on medication okay now.

VAERS ID:470174 (history)  Vaccinated:2012-10-10
Age:20.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-11, Days after onset: 1
Location:Missouri  Entered:2012-10-17, 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':
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Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AD0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Erythema, Feeling hot, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Client tolerated procedure well. Did not state any concerns with vaccine. During waiting period became dizzy hot and rashy area appeared on opposite arm from flu shot and around neck. Face became reddened. Pt recovered with rest, cool compress and laying down x 30min. BP 128/76 WNL.

VAERS ID:470315 (history)  Vaccinated:2012-10-10
Age:13.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 6
Location:Kansas  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0101AE1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Dyspnoea, Injection site erythema
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)
Write-up: Pt. c/o feeling SOB in nasal passage et c/o red area over injection site.

VAERS ID:470321 (history)  Vaccinated:2012-10-10
Age:14.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 6
Location:California  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH2109 IN 
HPV4: HPV (GARDASIL)MERCK & CO. INC.1696AA UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR4032AA UNLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis
SMQs:
Write-up: (L) arm cellulitis 10/12/12. Tx with BACTRIM and KEFLEX and TYL #3.

VAERS ID:470334 (history)  Vaccinated:2012-10-10
Age:78.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 6
Location:Maine  Entered:2012-10-17
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':
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Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12072010IMLA
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Flu shot given 10/10/12. Pt returned 10/17/12 and reported she still had hives from the vaccine.

VAERS ID:470337 (history)  Vaccinated:2012-10-10
Age:68.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 7
Location:Massachusetts  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Pt called PCP - Told her she was probably sick before vaccine
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH847580UNRA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Pt states went home after receiving vaccine had headache, fever, muscle pain. Felt better after 1 hour.

VAERS ID:470339 (history)  Vaccinated:2012-10-10
Age:53.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Female  Submitted:2012-10-17, Days after onset: 5
Location:Washington  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207201 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1241AA IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B085BA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Rash on left arm with moderate swelling at injection site, BENADRYL relieved symptoms within 2 days.

VAERS ID:470342 (history)  Vaccinated:2012-10-10
Age:35.0  Onset:2012-10-13, Days after vaccination: 3
Gender:Female  Submitted:2012-10-17, Days after onset: 4
Location:California  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12062010IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.19477AA0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Injection site reaction, Muscular weakness, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Patient reports soreness and muscle weakness in PNEUMOVAX injected arm (left side). There was a bump that developed days later in shoulder area. Her doctor was notified and she will follow-up with an appointment.

VAERS ID:474723 (history)  Vaccinated:2012-10-10
Age:11.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 7
Location:Unknown  Entered:2012-10-17
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': WAES1210USA007031
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, Pain in extremity
SMQs:
Write-up: This spontaneous report as received from a consumer refers to a 11 year old female patient with no pertinent medical history, drug reactions or allergies. The patient was vaccinated with dose 1 and dose 2 of (oka/merck) VARIVAX (lot #, dose and route not reported) when she was younger on an unspecified date and was accidentally vaccinated with a third dose of (oka/merck) VARIVAX (lot #, dose and route not reported) on 10-OCT-2012. No other co-suspects were reported. Concomitant medications included MENACTRA (unspecified), tetanus toxoid (manufacturer unspecified). The patient''s mother reported that on 10-OCT-2012 her daughter''s arms hurt but other than that there were no other adverse reactions. The mother stated that the patient had two shots in her right arm and one shot in her left arm. The patient sought medical attention by calling the physician. The patient was given TYLENOL as treatment for the event and no lab diagnostic tests were performed. The outcome of arms hurt was reported as recovering. The relatedness for arms hurt was not provided for (Oka/Merck) VARIVAX. Additional information is not expected.

VAERS ID:470282 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 8
Location:New Hampshire  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The reporter stated that it was unknown if subject had concomitant medications or relevant medical history but the health care provider stated that the subject had "answered no to all questions asked on form to fill out." There had been no reactions experienced with previous flu shots.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0997350A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA735AA SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Anxiety, Crying, Feeling hot, Injection site erythema, Injection site pain, Injection site pruritus, Lacrimation increased, Mouth breathing
SMQs:, Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad), Lacrimal disorders (narrow)
Write-up: This case was reported by a healthcare professional (nurse) and described the occurrence of mouth open breathing in a female subject of unspecified age who was vaccinated with FLUARIX (GlaxoSmithKline). On 10 October 2012 the subject received a dose of FLUARIX (.5 ml, unknown route, right arm) and experienced mouth open breathing, injection site redness, injection site pruritus, injection site pain, hot all over, watery eyes, anxiety and crying. A discrepancy existed in the administration record and the incident report from the reporter as to the site of injection versus the site of the adverse events. "The vaccine was administered at a Flu clinic at a local business. Patient had itching and pain in her left upper arm with a large area of redness. She complained of feeling hot all over. She was breathing through her mouth, but there was no wheezing or shortness of breath. Her eyes were slightly watery. The patient was anxious and crying." Based on the report it was unclear which arm the events and injection occurred. The reporter indicated that the injection site was right arm and the adverse events at the injection site occurred in the "LUA" (left upper arm). The healthcare professional considered the events were clinically significant (or requiring intervention). The subject was treated with EPINEPHRINE and BENADRYL. The subject was encouraged by the flu clinic to "call her doctor or go to ER if symptoms persisted." The subject contacted her physician, but it was unknown if she visited the office. The "practice called the (subject) this morning (11 October 2012) and (the subject) report(ed) improvement but not 100 percent."

VAERS ID:470286 (history)  Vaccinated:2012-10-10
Age:59.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 7
Location:Washington  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Activities of daily living impaired, Asthenia, Blood pressure increased, Dissociation, Dizziness, Feeling abnormal, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Feeling very weak unable to do normal errands, lightheaded, felt a little spacey/ detached, pulse rate sometimes elevated to 110 just sitting in a chair. Blood pressure elevated. Took aspirin to thin my blood, and just rested. Symptoms gradually decreased over next 3 days to just occasional waves of weakness. Now I''m fine again - a week after the shot.

VAERS ID:470307 (history)  Vaccinated:2012-10-10
Age:54.0  Onset:2012-10-15, Days after vaccination: 5
Gender:Female  Submitted:2012-10-18, Days after onset: 3
Location:Illinois  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Crohns disease
Diagnostic Lab Data: aerobic culture status pending
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA712AB IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Chills, Culture, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Chills, fever and painful injection site.

VAERS ID:470355 (history)  Vaccinated:2012-10-10
Age:21.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 8
Location:Tennessee  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206501 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Hypoacusis, Pallor, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient received flu vaccination at approximately 10:50pm. At 11pm the patient returned complaining of dizziness and hard of hearing. After assessing patient appeared Pale and was placed in the seated position. Patient began shaking for about 5 seconds. Patient was placed on floor and feet elevated. Color regained and patient was coherent. Paramedics called and patient was taken to the hospital.

VAERS ID:470520 (history)  Vaccinated:2012-10-10
Age:65.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-17, Days after onset: 7
Location:Texas  Entered:2012-10-18, 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: Seizure disorder; CP; HTN
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1203901 IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Convulsion, Staring
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: Pt with multiple seizures post immunization (5) staring spells, witnessed pt with known controlled seizure disorder.

VAERS ID:470537 (history)  Vaccinated:2012-10-10
Age:49.0  Onset:2012-10-14, Days after vaccination: 4
Gender:Male  Submitted:2012-10-18, Days after onset: 4
Location:Michigan  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None; Physical
Preexisting Conditions: Aspirin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AD0IMRA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Tingling and numbness of the (L) arm and forearm and hand intermittent. Pain on the (L) side of neck. We are following the patient. No labs yet.

VAERS ID:471361 (history)  Vaccinated:2012-10-10
Age:23.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 7
Location:Kentucky  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA006750
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Joint range of motion decreased, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)
Write-up: This spontaneous report as received from a physician refers to a 23 years old female patient. The patient''s medical history and drug reactions/allergies were not reported. The patient was vaccinated intramuscularly with the first 0.5 ml dose of GARDASIL on 10-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. On 11-OCT-2012 the patient experienced numbness and muscle weakness in right arm, right hand, right shoulder, neck and it was no moving into her right hip and right upper thigh. The patient sought medical attention. At the time of reporting the patient had not recovered. Additional information has been requested.

VAERS ID:474887 (history)  Vaccinated:2012-10-10
Age:72.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-18
Location:Unknown  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007242
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Bursitis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: This spontaneous reports as received from a doctor of pharmacy refers to a 72 year old female patient. The patient was vaccinated with a 0.5 ml dose of PNEUMOVAX23 (Lot # reported as H01066, exp 02-FEB-2012, route not reported) on 10-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. In October 2012, the patient was evaluated in the emergency room and was diagnosed with severe bursitis and arthritis. The location on of bursitis and arthritis was unknown. No treatment information was reported. The outcome of the events was not reported. The relationship between the events and PNEUMOVAX23 was not reported. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:474906 (history)  Vaccinated:2012-10-10
Age:66.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 8
Location:Unknown  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: 10/10/2012, Body temperature, 100F, Fever
CDC 'Split Type': WAES1210USA007029
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMRA
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Inappropriate schedule of drug administration, Injection site swelling, Injection site warmth, Insomnia, Pain in extremity, 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: This spontaneous report as received from a registered pharmacist refers to a 66 years old female patient with sulfa drugs allergy. The patient was vaccinated with a 0.5 ml dose of PNEUMOVAX 23 IM into the right deltoid (Lot # not reported) on 10-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. On approximately 10-OCT-2012, "sometime on 10-OCT-2012 or early on 11-OCT-2012", the patient experienced swelling and heat at the injection site and pain in the lower extremity, fever of 100 F, some anxiety, and it was hard to sleep. The pharmacist stated that the patient called her doctor who asked why she got another dose of PNEUMOVAX 23 since she already had a dose in January 2012, so the patient had 2 doses of PNEUMOVAX 23 within 9 months time. No treatment was given for the events although the pharmacist stated comfort measure of compress was recommended. The reporter stated that the patient was feeling a little bit better on 11-OCT-2012. The relationship of the events with PNEUMOVAX 23 was not reported. Additional information has been requested.

VAERS ID:474923 (history)  Vaccinated:2012-10-10
Age:70.0  Onset:0000-00-00
Gender:Male  Submitted:2012-10-18
Location:Unknown  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007423
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0110490UNLA
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 70 years old male patient with no pertinent medical history and no drug reactions/allergies. The patient was vaccinated with ZOSTAVAX (lot number: H011049, expiration date: 05-SEP-2013) on 10-OCT-2012. There were no concomitant medications. The patient developed rash behind both knees and on the left shoulder following vaccination with ZOSTAVAX. The rashes were described as dime size on 15-OCT-2012. The patient did not remember exactly when the rash developed. The patient had contacted pharmacist for medical attention. No treatment or laboratory diagnostics studies were given. The outcome of rash was reported as not recovered/not resolved. Additional information is not expected.

VAERS ID:470563 (history)  Vaccinated:2012-10-10
Age:72.0  Onset:2012-10-15, Days after vaccination: 5
Gender:Male  Submitted:2012-10-19, Days after onset: 4
Location:Arizona  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.    
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)
Write-up: When first turned over in bed spinning head very dizzy last 1/2 hour.

VAERS ID:470584 (history)  Vaccinated:2012-10-10
Age:35.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 9
Location:Nebraska  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734   
Administered by: Private     Purchased by: Private
Symptoms: Hot flush, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: States began to feel flushed and hot, throat felt tight, symptoms progressivly worsened over 90 min, but then subsided and were gone by 2200.

VAERS ID:470605 (history)  Vaccinated:2012-10-10
Age:15.0  Onset:2012-10-17, Days after vaccination: 7
Gender:Female  Submitted:2012-10-19, Days after onset: 2
Location:Oregon  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Chronic ITP had recently seemed to resolve (normal platelet count for 1-2 months prior)
Diagnostic Lab Data: Platelet count 10/17/12 was 15,000 then down to 5,000 on 10/19/12.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AB IMRA
Administered by: Public     Purchased by: Other
Symptoms: Condition aggravated, Contusion, Idiopathic thrombocytopenic purpura, Petechiae, Platelet count decreased, Purpura, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Hypersensitivity (narrow)
Write-up: Relapse of ITP. Severe thrombocytopenia with symptoms of petechiae, mucosal purpura, bruising.

VAERS ID:470669 (history)  Vaccinated:2012-10-10
Age:48.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Female  Submitted:2012-10-19, Days after onset: 7
Location:Wyoming  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Chronic bronchitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ21581IN 
Administered by: Private     Purchased by: Public
Symptoms: Pulmonary oedema
SMQs:, Cardiac failure (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Evaluated in emergency dept on 10/15/2012 & 10/17/2012, and hospitalized on 10/17/2012 with pulmonary edema.

VAERS ID:470757 (history)  Vaccinated:2012-10-10
Age:22.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Female  Submitted:2012-10-19, Days after onset: 7
Location:New York  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: IBS
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0106490IMLA
Administered by: Private     Purchased by: Other
Symptoms: Contusion, Ecchymosis, Induration, Tenderness
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: "1 cm area of ecchymosis with induration tenderness from upper shoulder to forearm. Area bruised". (Patient went to Urgent Care).

VAERS ID:470769 (history)  Vaccinated:2012-10-10
Age:60.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Michigan  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: D.M.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AB IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Joint range of motion decreased, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Neck stiffness, started on (R) side 24 hours after injection went around neck. Dec. ROM of neck.

VAERS ID:470631 (history)  Vaccinated:2012-10-10
Age:74.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-21, Days after onset: 11
Location:California  Entered:2012-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Immediate post-injection reaction, Pain in extremity
SMQs:, Hypersensitivity (narrow)
Write-up: High dose influenza vaccine was administered to the upper right arm muscle. Arm was immediately sore and has gotten progressively more painful. Pain was treated with Tylenol Extra Strength Precise Pain Relieving Cream.

VAERS ID:470795 (history)  Vaccinated:2012-10-10
Age:60.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-22, Days after onset: 12
Location:Washington  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: Sensitivity to latex
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA726EA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Chills, Fatigue, Hyperhidrosis, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Nausea and extreme sudden fatgue. This passed over an hour. About 3:00 PM I developed a chill, at about 5:00 PM I broke into a sweat and again was extremely fatigued. According to co-workers I was pale and "looked like I was going to pass out." Thirty minutes later I laid down to sleep for an hour, after which I felt ok, just tired. I drove home and went to bed. The next morning I felt fine. A week later I had two days of generalized joint pain without other symptoms.

VAERS ID:471213 (history)  Vaccinated:2012-10-10
Age:47.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-24, Days after onset: 14
Location:Florida  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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH755AA0SYRRA
Administered by: Public     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site reaction, Musculoskeletal pain, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Immediate surge of tingling at injection site of right arm. Now have pain with range of motion to that arm and pain in shoulder after getting the flu shot.

VAERS ID:471673 (history)  Vaccinated:2012-10-10
Age:72.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Male  Submitted:2012-10-17, Days after onset: 6
Location:New York  Entered:2012-10-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pt said chicken allergy - but ok with eggs and had flu shot before no problem
Diagnostic Lab Data: He has had variable allergy test in past that sometimes show chix allergy
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59107 UNLA
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Headache, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Next day patient had fatigue and headache and then developed hives. Currently on hydroxyzine and ZANTAC.

VAERS ID:471674 (history)  Vaccinated:2012-10-10
Age:43.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 7
Location:New York  Entered:2012-10-25, 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: Penicillins (rash)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117800UNRA
Administered by: Other     Purchased by: Other
Symptoms: Axillary pain, Hyperaesthesia, Joint range of motion decreased, Pain in extremity
SMQs:, Arthritis (broad)
Write-up: Rt axilla pain skin sensitivity restricted ROM arm due to pain. No palpable masses.

VAERS ID:471775 (history)  Vaccinated:2012-10-10
Age:60.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-15, Days after onset: 4
Location:Michigan  Entered:2012-10-25, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0422AE0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness & swollen at injection site, given clindamycin large for first 4 days & 2 inch in diameter & hot to touch after 5 days.

VAERS ID:473003 (history)  Vaccinated:2012-10-10
Age:35.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Male  Submitted:2012-10-11, Days after onset: 0
Location:New York  Entered:2012-11-01, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Cat dander
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12252P0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Lacrimation increased, Rash erythematous, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Red spots on face, puffy face (L) eye, watery, headache. Pt''s 1st flu vaccine.

VAERS ID:473019 (history)  Vaccinated:2012-10-10
Age:4.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Oregon  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: None known but had rhinorrhea - mom thought allergies, dad thought URI
Preexisting Conditions: None
Diagnostic Lab Data: Exam only
CDC 'Split Type':
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DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4211AA3IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4545FA IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH13543SCLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHG131834IMRL
Administered by: Private     Purchased by: Private
Symptoms: Erythema multiforme, Rhinorrhoea
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Erythema multiforme 24 hours after 4 vaccines. Also had MOTRIN dose post vaccines, prior to E.M. I have seen 2 cases of E.M. this week in clinic. Questionable viral syndrome. The child has slight rhinorrhea - mom thought allergies, dad thought URI.

VAERS ID:473674 (history)  Vaccinated:2012-10-10
Age:78.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-11-08, Days after onset: 29
Location:Iowa  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Known
Preexisting Conditions: None Known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204901 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMRA
Administered by: Public     Purchased by: Private
Symptoms: Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain for nine days. Swelling in both hands.

VAERS ID:474603 (history)  Vaccinated:2012-10-10
Age:1.1  Onset:2012-10-11, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:North Carolina  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Tubes in ears 1 week before shots
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4481BA0UNRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF272903UNLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site rash, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Received 2 injections. Flu on (R) thigh on Wednesday afternoon. Thursday noticed rash on (R) leg. Fever Sat. Rash had spread to chest & abdomen on (R) side. ZITHROMAX for ears. PREVNAR on (L) thigh. ORAPRED 15mg/5mL 1/2 teaspoon qd x5.

VAERS ID:474833 (history)  Vaccinated:2012-10-10
Age:64.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Female  Submitted:2012-11-08, Days after onset: 27
Location:Kansas  Entered:2012-11-19, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06449211A UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain in extremity
SMQs:
Write-up: Sore arm for nearly one month, worst a couple days after vaccination, getting a little better, but still sore. No rash, itching or lump.

VAERS ID:474836 (history)  Vaccinated:2012-10-10
Age:45.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-15, Days after onset: 36
Location:Illinois  Entered:2012-11-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Migraines; Seizure History; Hypothyroidism; Allergic to penicillin, CEFZIL, Sulfa
Diagnostic Lab Data: WBC and ESR - neg results
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AD0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pain, Pain in extremity, Red blood cell sedimentation rate normal, Vomiting, White blood cell count normal
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pain and extreme swelling in (R) arm. Redness pain with mobility to ER 10/13/12 received IM ROCEPHIN and script for PO CLEOCIN. Started vomiting and took only a couple of antibiotics. Later put on BACTRIM.

VAERS ID:474853 (history)  Vaccinated:2012-10-10
Age:5.0  Onset:2012-10-29, Days after vaccination: 19
Gender:Male  Submitted:2012-11-19, Days after onset: 21
Location:Pennsylvania  Entered:2012-11-19
Life Threatening? Yes
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: Elevated sed rate; Spinal tap - CSF huge amt protein; MRI with coronal lighting up
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4483AA2IMRA
Administered by: Private     Purchased by: Public
Symptoms: Abasia, CSF protein increased, Culture throat, Gait disturbance, Incontinence, Nuclear magnetic resonance imaging brain abnormal, Pain, Pain in extremity, Red blood cell sedimentation rate increased, Upper respiratory tract infection, X-ray normal
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: URI 1-2 wks before this started. About October 29 started with leg pain, left first. Seen in ER 11-4-12 with leg pain & limping. Xrays normal -$g given MOTRIN. Seen in this office 11-5 and unable to walk at school. Xrays, throat culture obtained. Seen ER 11-9-12 with inability to move muscles without pain sent home. Seen here 11-12-12 - pt incontinent as too much pain to sit & urinate.

VAERS ID:475057 (history)  Vaccinated:2012-10-10
Age:49.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-11-06, Days after onset: 27
Location:Massachusetts  Entered:2012-11-20, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12067010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Activities of daily living impaired, Hypoaesthesia, Injection site anaesthesia, Injection site pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Arm pain/numbness at site of injection then down arm to hand/fingers. Arm pain has subsided but still having difficulty with left index finger pain. Could not work for 3-4 days due to arm pain.

VAERS ID:475161 (history)  Vaccinated:2012-10-10
Age:74.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 13
Location:Michigan  Entered:2012-11-20, Days after submission: 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: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AA SYRLA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site pain, Mobility decreased
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain at injection site increasing each day for 14 days after vaccine administration. Now too painful to move.

VAERS ID:475235 (history)  Vaccinated:2012-10-10
Age:47.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-10, Days after onset: 31
Location:Oregon  Entered:2012-11-20, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Penicillin; oxycodone; latex; High Blood pressure; Asthma
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMUN
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Feeling abnormal, Hypersensitivity, Lacrimation increased, Lip swelling, Pain, Rhinorrhoea, Skin warm, Swelling, Swelling face, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: 1-2 hrs later - wheezing - (inhaler not helping). 10-12-12 - Woke up arm sore to move - noticed red lump - hot to touch - size of silver dollar. 10-13-12 - Lump even larger - 7 inches wide & 5 inches down called Emergency Dr on call who advised me to take BENADRYL. Before started taking BENADRYL on late 10-13-12 my head & body started getting really hot also (like arm). The BENADRYL worked great. (Instantly was able to breathe) no more wheezing & redness & swollenness started to come down. On 10-15-12 stopped BENDARYL but wheezing came back & had to start it again. Had to take it on & off for about 2 weeks in order to breathe. 10-22-12 My lips & face (eyes) swelled up (but not tongue) & I started getting sick - nose - not able to breathe thru nose. Now 11-10-2012 I''m very sick w/ allergy symptoms, watery eyes, runny nose, etc. miserable. Haven''t gotten out of bed much in last month. And am afraid to continue taking BENADRYL constantly since it is the only thing that relieves allergic reactions, so don''t want to become immune to it so that it doesn''t work for me in future if I have a serious allergic reaction to something. I feel that they have injected me with straight poison. I want to dissolve it (get it out of me). I know I am hypersensitive to most medications. It''s like they injected me with some kind of toxin. And I''m still feeling the effects of it. Has it did this to other people? I feel they should at least compensate for all the BENADRYL I have had to buy.

VAERS ID:475157 (history)  Vaccinated:2012-10-10
Age:55.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-21, Days after onset: 42
Location:Connecticut  Entered:2012-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59808 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Headache, Injection site pain, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: 12 hours after receiving vaccine, c/o joint pain, ankle, knee and hip. C/O soreness at injection site; c/o N/V/headache for 24 hours.

VAERS ID:475269 (history)  Vaccinated:2012-10-10
Age:50.0  Onset:2012-10-16, Days after vaccination: 6
Gender:Female  Submitted:2012-11-26, Days after onset: 41
Location:Louisiana  Entered:2012-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: I had the flu shot on 10/16/2012 at 2 PM. (You did not administer it.) I wanted to go on record that it must have been a very strong lot. I was feeling sick by 4:30 PM and it got worse from there. By 5:30 PM, when I left work, I wasn''t sure to ask for a ride or go to the ER. I''ve never been so sick in 50 years. I felt if I gave in I''d pass out for sure. I drove home hugging the wheel. (Thinking I''d talk myself out of the feeling and a bit embarrassed over it.) By the time I arrived home I was p
Preexisting Conditions: No Contraindications per screening consent
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Dizziness, Malaise, Vertigo, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow)
Write-up: I had the flu shot on 10/16/2012 at 2 PM. (You did not administer it.) I wanted to go on record that it must have been a very strong lot. I was feeling sick by 4:30 PM and it got worse from there. By 5:30 PM, when I left work, I wasn''t sure to ask for a ride or go to the ER. I''ve never been so sick in 50 years. I felt if I gave in I''d pass out for sure. I drove home hugging the wheel. (Thinking I''d talk myself out of the feeling and a bit embarrassed over it.) By the time I arrived home I was projectile vomiting and diarrhea along with my head spinning. This went on till 3 AM Wednesday morning. I didn''t feel somewhat normal till 11:30 AM Wednesday.

VAERS ID:475270 (history)  Vaccinated:2012-10-10
Age:38.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-26, Days after onset: 47
Location:Louisiana  Entered:2012-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions:
Diagnostic Lab Data: NONE AT THIS TIME
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cough, Lacrimation increased, Ocular hyperaemia, Pyrexia, Respiratory tract congestion, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lacrimal disorders (narrow)
Write-up: HISTORY: EE presents to the EHO ALLERGIC TO COCONUTS, LOBSTER AND RUM.-swelling of throat --- carries an epi pen. Reaction 2012 OCT 10 to flu vaccine: red eyes, coughing, congestion and low grade fever (101.9). In 2011, temp was 101.2 with the same reaction. Treated with ibuprofen (800 mg X 1 dose) and Claritin (10mg q day) X 2 days. 10-11-12 Skin of the orbits of eyes are pinker than the surrounding facial tissue, eyes are watery in appearance and reddened. EE is fair skinned normally.

VAERS ID:475369 (history)  Vaccinated:2012-10-10
Age:29.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-27, Days after onset: 48
Location:Unknown  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2012US023202
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS123324 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pustule, Injection site swelling, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Case number PHEH2012US023202 is an initial spontaneous report received from a nurse on 20 Nov 2012. This case refers to a 29-year-old female patient. She was vaccinated with FLUVIRIN (batch number: 123324) on 10 Oct 2012. On the same day of vaccination she experienced pain in the arm and swollen area at the injection site that was full of pus. Saw her physician on 17 Oct 2012 due to these events. On 25 Oct 2012 she returned back to see her physician and all the symptoms had dissipated. The seriousness and causality was not reported.

VAERS ID:475538 (history)  Vaccinated:2012-10-10
Age:39.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Oregon  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12051210UNRA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Pain
SMQs:
Write-up: I got the flu shot on Oct 10, 2012. As of today 11/27/12, my right arm is still not able to move as normal like before. The arm will not able to lift very high or it will be painful when I try to lift high.

VAERS ID:478753 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 50
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA007631
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 10-OCT-2012 14:40, 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:475908 (history)  Vaccinated:2012-10-10
Age:39.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-11-30, Days after onset: 50
Location:Ohio  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: None noted
Diagnostic Lab Data: Had EKG, CXR, EMG started on Vimovo, Skelaxin.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Axillary pain, Back pain, Chest X-ray, Disorientation, Dizziness, Electrocardiogram, Electromyogram, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: 24 hours after injection developed pain in back that spread to L arm, under arm and down Left arm. Numbness in Left habd for 5 mins on 2 nites. Had dizziness and disorientation 2 days after injection. Still having pain in arm.

VAERS ID:478960 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 51
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': WAES1211USA011114
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Unknown     Purchased by: Unknown
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 10-OCT-2012 13:02, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperature below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478991 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 51
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': WAES1211USA011113
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 10-OCT-2012 11:20, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not provided. Two lot # were involved and the lot # were reported as: 0294AE, expiry date on 06-SEP-2014; and 0395AE, expiry date on 08-NOV-2014. It was unspecified which lot # the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:475916 (history)  Vaccinated:2012-10-10
Age:65.0  Onset:2012-10-14, Days after vaccination: 4
Gender:Male  Submitted:2012-12-01, Days after onset: 48
Location:Maryland  Entered:2012-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204201 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Persistent pain.

VAERS ID:475917 (history)  Vaccinated:2012-10-10
Age:58.0  Onset:2012-10-14, Days after vaccination: 4
Gender:Female  Submitted:2012-12-01, Days after onset: 48
Location:Maryland  Entered:2012-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS120420118IMRA
Administered by: Other     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Persistent pain.

VAERS ID:479281 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-12-02, Days after onset: 53
Location:Unknown  Entered:2012-12-02
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': WAES1211USA011115
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 10-OCT-2012 16:58, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot # were involved and the lot # were reported as; 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. IT was unspecified which lot # the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. this is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479325 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Unknown  Submitted:2012-12-02, Days after onset: 53
Location:Unknown  Entered:2012-12-02
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': WAES1211USA011116
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn patient of unknown age. On 10-OCT-2012 18:27, 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:479339 (history)  Vaccinated:2012-10-10
Age:  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-12-02, Days after onset: 53
Location:Unknown  Entered:2012-12-02
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': WAES1211USA011117
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 10-OCT-2012 19:59, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hours time period the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as:0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:476095 (history)  Vaccinated:2012-10-10
Age:27.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2012-12-03, Days after onset: 54
Location:Virginia  Entered:2012-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No concomitant vaccinations, medications or relevant medical history. No adverse events were reported with previous vaccinations. The subject has not previously received influenza vaccines.
Diagnostic Lab Data: Computerized tomogram, Oct2012, normal
CDC 'Split Type': A0998225A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA709AA0UNLA
Administered by: Other     Purchased by: Public
Symptoms: Aphasia, Computerised tomogram normal, Dysphemia, Dystonia, Headache, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Dystonia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: This case was reported by a physician and described the occurrence of inability to speak in a 27-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). On 10 October 2012 the subject received 1st dose of FLUARIX (.5 ml, unknown, left arm). On 10 October 2012, within hours of vaccination with FLUARIX, the subject experienced headache and arm pain. On 15 October 2012, five days after vaccination with FLUARIX, the subject experienced inability to speak, stuttering speech and numbness in arms and legs. On 16 October 2012, six days after vaccination with FLUARIX, the subject experienced worsening inability to speak and went to the emergency department where a dystonic reaction was suspected. At the time of the report, the subject was currently in the ED because of worsening ability to speak. A computed tomography scan was performed and normal. The mother of the subject reported to the primary care physician, that the ED was "saying it may be a dystonic reaction caused by flu vaccine"; the subject never had a flu vaccine before. At the time of reporting the inability to speak was worse; stuttering speech and headache were unresolved. The dystonic reaction, numbness in arm and leg and arm pain were not specified. The physician considered the numbness in the arms and legs as unrelated to vaccination with FLUARIX. Follow-up information was received on 26 November 2012 via healthcare professional who reported the events occurred on 15 October 2012 resolved on an unspecified date. The healthcare professional considered the event serious and the subject required hospitalization.

VAERS ID:476311 (history)  Vaccinated:2012-10-10
Age:56.0  Onset:2012-10-14, Days after vaccination: 4
Gender:Female  Submitted:2012-12-04, Days after onset: 51
Location:Michigan  Entered:2012-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Skin allergies were in the process of being evaluated
Diagnostic Lab Data: Patient called her physician to discuss and was told to use hydrocortisone cream. Also was told to try Benadryl to help control the itching. It resolved in about a week.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH756AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash, Injection site reaction, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Itchy red rash on area where injection was administered. Other arm also had slight rash, but left deltoid rash was much more prominent.

VAERS ID:476339 (history)  Vaccinated:2012-10-10
Age:32.0  Onset:0000-00-00
Gender:Female  Submitted:2012-12-04
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: The subject''s medical history included four full-term previous pregnancies; history of the births was not known.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0998075A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA733AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Maternal exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This prospective pregnancy case was reported by a healthcare professional and described the occurrence of vaccine exposure during pregnancy in a 32-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). The subject''s medical history included four full-term previous pregnancies; history of the births was not known. On 10 October 2012 the subject received unspecified dose of FLUARIX (unknown). Her last menstrual period was on an unspecified date and estimated date of delivery in February 2013. The subject was exposed to FLUARIX during unknown trimester. On 10 October 2012, at the time of vaccination with FLUARIX, the subject experienced vaccine exposure during pregnancy. The outcome of the pregnancy was unknown. Follow up information was received on 26 November 2012 via healthcare professional. The subject''s last menstrual period was on 27 July 2012 and estimated date of delivery was 16 April 2013. The pregnancy was by normal conception and consisted of one fetus. The subject was exposed to FLUARIX at 10 weeks gestation during the first trimester. The reporting healthcare professional considered the event of vaccine exposure during pregnancy to be serious [clinically significant] due to the potential risk of congenital anomaly. At the time of the report, the congenital anomaly was not confirmed by diagnostic/ prenatal testing or relevant medical history; no details were provided. The outcome of the pregnancy was ongoing.

VAERS ID:476376 (history)  Vaccinated:2012-10-10
Age:81.0  Onset:2012-10-22, Days after vaccination: 12
Gender:Female  Submitted:2012-12-04, Days after onset: 43
Location:Iowa  Entered:2012-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: NKA, Osteopenia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH753AB IMLA
Administered by: Public     Purchased by: Public
Symptoms: Blood pressure increased, Gait disturbance, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypertension (narrow)
Write-up: Noticed tingling in feet which then progressed over the next several days to difficulty walking. She was seen in the ER on 10/31/12 due to difficulty walking and also found to have elevated BP. Started on Metoprolol. Went away for the winter and was seen at clinic where Dr. said possible Guillain Barre. Saw family Dr. yesterday who told her to report as possible reaction to flu vaccine. Will have EMG and further testing next week.

VAERS ID:479296 (history)  Vaccinated:2012-10-10
Age:60.0  Onset:2012-10-12, Days after vaccination: 2
Gender:Male  Submitted:2012-12-26, Days after onset: 75
Location:South Carolina  Entered:2012-12-26
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 DIAGNOSTICS12071011SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site vesicles
SMQs:
Write-up: Blisters at the injection site. Triamcinolone.

VAERS ID:479429 (history)  Vaccinated:2012-10-10
Age:51.0  Onset:2012-11-23, Days after vaccination: 44
Gender:Female  Submitted:2012-12-20, Days after onset: 27
Location:Kentucky  Entered:2012-12-27, 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:
Preexisting Conditions: Not reported
Diagnostic Lab Data: Not reported
CDC 'Split Type': 201212031
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Cough, Influenza, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Initial report was received from a consumer, who was also the patient, on 13 December 2012. A 51-year-old female patient had received an injection of INFLUENZA VACCINE (manufacturer, lot number, route and site not reported) on 10 October 2012 and on 23 November 2012 experienced the flu which lasted until 27 November 2012. She experienced chills, fever and cough. Outcome was recovered. Documents held by sender: None.

VAERS ID:481226 (history)  Vaccinated:2012-10-10
Age:0.3  Onset:2012-10-11, Days after vaccination: 1
Gender:Male  Submitted:2013-01-07, Days after onset: 88
Location:Indiana  Entered:2013-01-14, 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: Candidal derm diaper rash
Preexisting Conditions: Reflux (GERD)
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B357BB1IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.H0125701IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG107841IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FB305A1PO 
Administered by: Private     Purchased by: Private
Symptoms: Abnormal behaviour, Eczema, Irritability, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: Fever began the evening of immunizations. Baby was seen and examined the following day since he had URI sxs preceding immunizations. There was no evidence OM. He continued to be extremely fussy & irritable & febrile. Seen again 10/17 - no bacterial infection, no meds. Baby did develop facial eczematous rash on 10/15 - resolved with tx for eczema & BENADRYL. Took 2 weeks before happy baby again. MARKED BEHAVIORAL DIFFERENCE.

VAERS ID:481524 (history)  Vaccinated:2012-10-10
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2013-01-03
Location:New York  Entered:2013-01-16, 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: Unknown
Preexisting Conditions: The subject had no previous pregnancies. The subject was not using contraception. The conception was by normal method.
Diagnostic Lab Data: UNK
CDC 'Split Type': A1002927A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, Musculoskeletal discomfort, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This prospective pregnancy case was reported by a consumer (subject''s father) and described the occurrence of fever in a 17-year-old female subject who was vaccinated with Hepatitis B vaccine (manufacturer unspecified), seasonal influenza vaccine (non-gsk), MMR vaccine (non-gsk), meningitis vaccine and strain not specified (Meningococcal vaccine) for prophylaxis during pregnancy. A physician or other health care professional has not verified this report. The subject had no previous pregnancies. The subject was not using contraception. The conception was by normal method. On 10 October 2012 the subject received 2nd dose of Hepatitis B vaccine (unknown details) during approximately the 2nd trimester of pregnancy. In June 2012 the subject received the first dose of Hepatitis B vaccine (unknown details), a dose of Meningococcal vaccine (unknown details) and experienced vaccine exposure during approximately the first trimester of pregnancy. The gestational age at the times of vaccination exposures were not reported. The date of the last menstrual period was reported as May 2012. The estimated date of delivery was reported as February or March of 2013. The reporter stated that he "did not know the brand of the vaccines the patient received." The reporter stated that "he received [GSK''s] number from a leaflet that he received at the clinic. [GSK''s] number was listed along with other numbers and he did not know where to call to ask questions about receiving vaccines while being pregnant." In 2012, less than one year after vaccination with Hepatitis B vaccine, MMR vaccine (Non-GSK), Meningococcal vaccine and Seasonal influenza vaccine (Non-GSK), the subject experienced fever and muscle discomfort. In 2012, the events of fever and muscle soreness were resolved. At the time of reporting, the pregnancy was ongoing.

VAERS ID:483385 (history)  Vaccinated:2012-10-10
Age:73.0  Onset:2012-11-10, Days after vaccination: 31
Gender:Female  Submitted:2013-02-01, Days after onset: 83
Location:Unknown  Entered:2013-02-01
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': WAES1301USA012896
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0172AE SCUN
Administered by: Other     Purchased by: Other
Symptoms: Oral herpes
SMQs:, Oropharyngeal infections (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 73 years old female patient with no known relevant medical history or drug allergies. The patient was vaccinated with lot # (0172AE, Exp. 18-APR-2013), 0.65 ml live ZOSTAVAX subcutaneously on 10-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. On 10-NOV-2012 ("a month later") the patient developed cold sore, which has reoccurred at least once a month on unspecified dates since receiving ZOSTAVAX vaccination. The pharmacist noted that the patient showed her the location of the healed cold sores and that there was an indentation where the cold sore had healed. No treatment was given for the event. The patient contacted pharmacist for medical attention. No lab test was performed. Final outcome of patient''s cold sores is unknown. The relatedness for cold sores is unknown for live ZOSTAVAX. Additional information is not expected.

VAERS ID:483395 (history)  Vaccinated:2012-10-10
Age:72.0  Onset:2012-11-12, Days after vaccination: 33
Gender:Female  Submitted:2013-02-04, Days after onset: 84
Location:Maine  Entered:2013-02-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known to me
Current Illness: None known
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0172AE0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Oral herpes
SMQs:, Oropharyngeal infections (narrow)
Write-up: One month after vaccination patient has been experiencing cold sores on a monthly basis.

VAERS ID:484077 (history)  Vaccinated:2012-10-10
Age:37.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2013-01-24, Days after onset: 106
Location:Michigan  Entered:2013-02-11, Days after submission: 18
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: There were no provided details as to other vaccinations on the same date. There were no provided details for concomitant medications or relevant medical history. The subject had received previous flu shots but there was no provided documentation regarding adverse reaction to the previous flu shots. There was no provided adverse reactions to previous vaccinations at the time of reporting.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0998245A
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA731AA SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: This case was reported by a physician and described the occurrence of itching in a 37-year-old male subject who was vaccinated with FLULAVAL (GlaxoSmithKline). On 10 October 2012 at 17:50 the subject received a dose of FLULAVAL (.5 ml, unknown route, right arm). On 10 October 2012, at 23:00, approximately 5 hours after vaccination with FLULAVAL, the subject experienced itching. The physician stated that the subject "continues itching all over the past 9 days since receiving a FLULAVAL shot" on 10 October 2012. The subject "waited seven days, and treated /relieved the itching with over-the-counter BENADRYL on 17 October 2012." He then reported the experience to the physician on 18 October 2012. At the time of reporting the event was unresolved. The physician stated that the itching continued to persist at the time of the report. The physician reported concern over the length of time that the itching had persisted and will continue monitoring. The physician considered the event was possibly related to vaccination with FLULAVAL. Follow-up information was received on 14 November 2012 via physician who reported the subject''s event of itching started on 10 October 2012 and resolved on 24 October 2012. No other information was provided.

VAERS ID:484260 (history)  Vaccinated:2012-10-10
Age:27.0  Onset:2012-10-10, Days after vaccination: 0
Gender:Female  Submitted:2013-02-12, Days after onset: 125
Location:Washington  Entered:2013-02-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA735BA1IMLA
Administered by: Other     Purchased by: Public
Symptoms: Blood pressure abnormal, Dizziness, Tunnel vision
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (broad), Optic nerve disorders (broad), Retinal disorders (narrow), Vestibular disorders (broad)
Write-up: Patient had dizziness and tunnel vision-felt faint. 911 was called. EMT checked vitals, decided she was stable and left. PT stayed with nurse until BP returned to normal and nurse advised taking the rest of the day off and calling 911 if she experiences any other issues. PT indicated she hasn''t had a flu shot since she was 8 yrs old and does often feel faint when having blood drawn or receiving shots.

VAERS ID:484683 (history)  Vaccinated:2012-10-10
Age:13.0  Onset:2012-11-19, Days after vaccination: 40
Gender:Female  Submitted:2013-02-15, Days after onset: 88
Location:Connecticut  Entered:2013-02-15
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Type 1 diabetes - insulin resistent
CDC 'Split Type':
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0131AE1UNUN
Administered by: Private     Purchased by: Other
Symptoms: Insulin resistance test, Insulin resistant diabetes, Type 1 diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)
Write-up: Patient was diagnosed with type 1 diabetes.

VAERS ID:485230 (history)  Vaccinated:2012-10-10
Age:0.8  Onset:2012-10-10, Days after vaccination: 0
Gender:Male  Submitted:2012-10-29, Days after onset: 19
Location:Arizona  Entered:2013-02-20, Days after submission: 114
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2012SE82887
Vaccination
Manufacturer
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2106 IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: A report has been received from a Health Professional concerning a 9 month old, Male subject, who had been receiving Nasal FLUMIST. FLUMIST was started on an unknown date. The patient experienced inadvertently gave FLUMIST to a 9 month old which started on 10-Oct-2012. Pediatric office inadvertently gave FLUMIST to a nine month old patient on 10-Oct-2012. Patient experienced no symptoms at the time of administration, and no symptoms were reported at the time of reporting either. The patient recovered from the event of inadvertently gave FLUMIST to a 9 month old on an unspecified date. The report was considered to be non-serious.

VAERS ID:489187 (history)  Vaccinated:2012-10-10
Age:0.1  Onset:0000-00-00
Gender:Male  Submitted:2013-04-12
Location:Texas  Entered:2013-04-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B300CA IMLA
HIBV: HIB (ACTHIB)SANOFI PASTEURUH608AB IMLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF70996 IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0060AE PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: Patient was given his 2 mo, vaccines at 3wk 5d old. No adverse event occurred.

VAERS ID:507493 (history)  Vaccinated:2012-10-10
Age:69.0  Onset:2012-10-20, Days after vaccination: 10
Gender:Male  Submitted:2012-12-28, Days after onset: 69
Location:Unknown  Entered:2013-10-17, Days after submission: 292
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Since event have some short memory loss; bypass surgery in 1990 and 2003; carotid artery cleaned left side 2010; nuclear stress compared to 2008 test with minimal changes; nonsmoker and no alcohol use; no allergies
Diagnostic Lab Data: Revived by CPR, in hospital 10 days, ICD implanted; nuclear stress test; cardioversion medication change
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4499AA2UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117801UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amnesia, Atrial flutter, Cardiac arrest, Cardiac stress test, Cardioversion, Implantable defibrillator insertion, Resuscitation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad)
Write-up: Received a flu and a pneumonia shot at the same time from local doctor after a brief checkup, shots given on 10/20/2012. Shortly thereafter went into cardiac arrest and was revived and a ICD has been planted. I now have atrial flutter that will not subside. I was and am in good physical health for my age, had no indications that there was an imminent heart problem.

VAERS ID:469147 (history)  Vaccinated:2012-10-11
Age:33.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:South Carolina  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Injection site pain, Nausea, Neck pain
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Serious pain from injection site shooting up through shoulder and up neck toward ear. Strong pain - I get the flu shot each year and have never had this before. Some nausea and weakness. Had to lie down for a while to get control over pain. Still hurts on neck area bad.

VAERS ID:469153 (history)  Vaccinated:2012-10-11
Age:25.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Illinois  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Fibromyalgia; Iron Deficient Anemia; Obesity; Allergic to Tetnus Toxoid Vaccine; Gastritis/GERD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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HPV4: HPV (GARDASIL)MERCK & CO. INC. 0SYRLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dizziness, Feeling abnormal, Feeling hot, Hyperhidrosis, Pallor, Panic reaction, Vision blurred, Visual impairment
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: I received my first Gardasil vaccine today. Within a few minutes, I felt a "rush" in my head, as though all the blood was draining from it. Everything started to become blurry, then black dots, then just black when I became dizzy. I felt like I was going to faint. It was a very scary situation that caused me to panic. I became very hot and sweaty following the injection. I was told I was "pale as a ghost". The nurse got me a glass of water and put a cold compress behind my neck. I put my head down and tried deep-breathing techniques. I laid down on an examination table for a few minutes. I felt recovered within 15 minutes, but feel very traumatized over what happened. I do not at all look forward to my next vaccine of Gardasil. I was not told about the possibility of fainting or feeling as though I would faint before the vaccine was administered.

VAERS ID:469154 (history)  Vaccinated:2012-10-11
Age:17.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Alaska  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: Pregnancy, approx 32 weeks
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AB IMRA
Administered by: Other     Purchased by: Other
Symptoms: Grip strength decreased, Mobility decreased, Sensory loss
SMQs:, Peripheral neuropathy (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: Described loss of sensation in her lower arm and inability to move her fingers or grasp her right hand.

VAERS ID:469278 (history)  Vaccinated:2012-10-11
Age:71.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-11, Days after onset: 0
Location:Ohio  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomited one time about 1 1/2 hrs. after receiving flu vaccine. Pt stated he felt better after vomiting. Followed up with pt and he says he''s fine.

VAERS ID:469281 (history)  Vaccinated:2012-10-11
Age:61.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Michigan  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Induration, Nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Immediately after vaccination, patient developed a hard nodule about 1" in diameter. She said it did not hurt and she had previous vaccinations without issue.

VAERS ID:469157 (history)  Vaccinated:2012-10-11
Age:55.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:California  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Joint pain from rheumatoid arthritis
Preexisting Conditions: Allergy to tetracyclines - reaction is vomiting
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Other
Symptoms: Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Noted swelling on L deltoid and severe 10/10 pain approximately 5 hrs after vaccinated with Pneumococcal vaccine. Reported to PCP who prescribed Vicodin. The patient took 2 tablets of Vicodin with pain relief. However, noticed that swelling was spreading and thus, presented to ED for further evaluation. Of note, R deltoid where flu vaccine was administered was normal.

VAERS ID:469229 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-12, Days after onset: 1
Location:Nevada  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: It is now 15 hours after the injection. The pain and limited mobility is worse now.
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The arm where injection was given is very painful from the shoulder to the elbow. It is difficult to move, regardless of pain.

VAERS ID:469238 (history)  Vaccinated:2012-10-11
Age:41.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 0
Location:New York  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None. Had annual physical at time of vaccine and was extremely healthy.
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal discomfort, Headache, Malaise, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Bad headache, nausea, fever, body aches, gastrointestinal discomfort, general malaise. Went from perfectly healthy to wanting to curl up in a corner and cry.

VAERS ID:469309 (history)  Vaccinated:2012-10-11
Age:35.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 0
Location:Massachusetts  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: MS
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Upper respiratory tract infection
SMQs:
Write-up: Upper respiratory infection.

VAERS ID:469310 (history)  Vaccinated:2012-10-11
Age:35.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 0
Location:Massachusetts  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 14IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever of 102, chills, body aches, headache.

VAERS ID:469386 (history)  Vaccinated:2012-10-11
Age:47.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 0
Location:Virginia  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Pruritus generalised, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Red rash on face, itching all over body.

VAERS ID:469390 (history)  Vaccinated:2012-10-11
Age:37.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:New Jersey  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Gastroparesis, GERD, IBS-C, Vaso-vagal syncope, hx Lyme''s Disease
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Decreased appetite, Dysgeusia, Fatigue, Immediate post-injection reaction, Nausea, Neck pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: My arms was very sore immediately after the shot and the pain traveled up my neck within 10 minutes. I also got an odd semi-metallic taste in my mouth within a few minutes after vaccine. I went to bed with the pain in my arm and neck and woke up around 7:30am extremely nauseated. I have been nauseous all day and have no appetite to eat or drink. I also have a low-grade fever 99.5F, and am very tired. I have taken Zofran, so that I do not vomit and Tylenol for the pain and fever.

VAERS ID:469399 (history)  Vaccinated:2012-10-11
Age:34.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-12, Days after onset: 1
Location:Indiana  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3081IMRA
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURU3788AA0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURG154131IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH346AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Headache, Hypoaesthesia, Injection site anaesthesia, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Sore imm site. Numbness radiating from inj site to right jaw and down to lower back. Headache, nausea, dizziness.

VAERS ID:469400 (history)  Vaccinated:2012-10-11
Age:62.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:Hawaii  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: ER visit: Epinephrine 0.3 mg IM, Dexamethasone inj 10mg IV push, Famotidine 20mg IV push, Diphenhydramine inj 25 mg IV, NaCl IV 1000ml Bolus, EKG
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH751AB0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dyspnoea, Eye irritation, Eye pruritus, Heart rate increased, Lacrimation increased, Lip swelling, Pharyngeal oedema, Speech disorder, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Corneal disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Swollen lips, tongue, throat, eyes burning/itching/tearing, difficulty with speech, increased heart rate, shortness of breath.

VAERS ID:469515 (history)  Vaccinated:2012-10-11
Age:1.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-12, Days after onset: 1
Location:Texas  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4488EA0IMLL
HEPA: HEP A (VAQTA)MERCK & CO. INC.1647AA0IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1898AA0SCLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF533703IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0098270SCRL
Administered by: Private     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: 12 hours (approx.) after INFLUENZA 0.25 was given to patient in left thigh, he presented with a bright red dime sized swelling at the injection site. No other reaction reported.

VAERS ID:469404 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-13, Days after onset: 2
Location:Ohio  Entered:2012-10-13
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: nonoon
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4470AA IDLA
Administered by: Private     Purchased by: Private
Symptoms: Eye swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hive on the neck and face, swelling around the eyes.

VAERS ID:469414 (history)  Vaccinated:2012-10-11
Age:0.5  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-13, Days after onset: 2
Location:D.C.  Entered:2012-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Vomiting x 2 days
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4230AA2IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF724932IMLL
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: None.

VAERS ID:469424 (history)  Vaccinated:2012-10-11
Age:49.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-13, Days after onset: 2
Location:Georga  Entered:2012-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Reactive Airway Disease
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AB IM 
Administered by: Public     Purchased by: Unknown
Symptoms: Flushing, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Approximately 90 minutes after vaccine was given, patient states that she began itching all over and by 4 1/2 hours after the vaccine was administered the itching became unbearable. Her face also became flushed.

VAERS ID:469660 (history)  Vaccinated:2012-10-11
Age:89.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-13, Days after onset: 2
Location:Michigan  Entered:2012-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No known illness
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4489AA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt said she had collapsed after getting out of her car when she returned home from getting a FLUZONE HD. She stated she felt weak, dizzy and lightheaded for the rest of the evening.

VAERS ID:469654 (history)  Vaccinated:2012-10-11
Age:50.0  Onset:2012-10-14, Days after vaccination: 3
Gender:Female  Submitted:2012-10-14, Days after onset: 0
Location:Maryland  Entered:2012-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Elevated BP
Preexisting Conditions: Sulfa; LIPITOR; Amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07549221A UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H012650 UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Pruritus, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Cellulitis localized to left upper extremity, itching, redness, increased warmth, tenderness.

VAERS ID:469455 (history)  Vaccinated:2012-10-11
Age:1.4  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-15, Days after onset: 4
Location:Unknown  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS 0  
Administered by: Private     Purchased by: Private
Symptoms: Irritability, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)
Write-up: Pt received 1st dose of DTaP at 16 mo due to parent apprehension that father had reaction to DTP vaccine as a child. Patient has had Hib and Prevnar in the past without incident. On the day of vaccine, pt developed extreme fussiness and irritability along with fever. Pt did not have any other vaccine except DTaP. His exam was normal with no source for his fever. He also had emesis x 3.

VAERS ID:469608 (history)  Vaccinated:2012-10-11
Age:46.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 4
Location:Massachusetts  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
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, Drug administered at inappropriate site, Injected limb mobility decreased, Injection site nerve damage, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Nursing student administered flu shot at flu shot clinic. I noticed immediately that she placed shot too high. Once vaccine was injected, there was much pain, like she hit a nerve. One hour later, I was unable to move my arm and unable to lift arms ove head to get dressed. Today 10/15/12, I have continued pain and tingling down my arm and hands.

VAERS ID:469612 (history)  Vaccinated:2012-10-11
Age:38.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 4
Location:Ohio  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Food allergies - oranges, celery, potato, lima beans, mango, spinach; seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SCLA
Administered by: Other     Purchased by: Other
Symptoms: Blood pressure increased, Dysphagia, Dyspnoea, Heart rate increased, Ocular hyperaemia, Oedema mouth, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Facial swelling, mouth swelling, eyes bloodshot, trouble breathing, racing pulse, increased blood pressure, difficulty swallowing, difficulty breathing.

VAERS ID:469623 (history)  Vaccinated:2012-10-11
Age:40.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Male  Submitted:2012-10-15, Days after onset: 3
Location:Washington  Entered:2012-10-15
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: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205121 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B097BA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Asthenia, Hallucination, Hyperhidrosis, Injection site erythema, Injection site urticaria, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Minor muscle pain and low fever in AM switched to joint pain, muscle pain, weakness, sweats and high fever (hallucinations) in PM. Hives and redness at injection sites occurred 10/14 (still exists).

VAERS ID:469667 (history)  Vaccinated:2012-10-11
Age:65.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-15, Days after onset: 4
Location:Maryland  Entered:2012-10-15
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: Type 2 Diabetes
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4491AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Pyrexia, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Shivering, shaking chills, vomiting, fever.

VAERS ID:469686 (history)  Vaccinated:2012-10-11
Age:24.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 4
Location:Minnesota  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AB0IMLA
Administered by: Military     Purchased by: Private
Symptoms: Blood pressure increased, Nausea, Swelling, Swelling face, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: Reports nausea, vomiting, facial swelling, chest swelling, increased blood preasure, temp. Went to ETC for these symptoms, was d/c home later that evening.

VAERS ID:469775 (history)  Vaccinated:2012-10-11
Age:71.0  Onset:2012-10-14, Days after vaccination: 3
Gender:Male  Submitted:2012-10-15, Days after onset: 1
Location:Delaware  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Patient received shot on 10/11/12. Called Monday, 10/15/12, stating his arm was still sore & that it started to tingle "like when I got the shingles shot." Told pt if persist or gets worse call doctor.

VAERS ID:469814 (history)  Vaccinated:2012-10-11
Age:57.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-15, Days after onset: 3
Location:Maine  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Evening of 10-12-2012
Preexisting Conditions: Hyperlipidemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH729BA5UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Headache, Nausea, Pruritus, Pyrexia, Swelling
SMQs:, 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), Hypersensitivity (broad)
Write-up: 10-12-12 low grade fever, HA, nausea 10-13-12 redness and swelling, itching has improved a lot.

VAERS ID:469938 (history)  Vaccinated:2012-10-11
Age:60.0  Onset:2012-10-15, Days after vaccination: 4
Gender:Female  Submitted:2012-10-15, Days after onset: 0
Location:Tennessee  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS123121 UNLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0567AC0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red spot at injection site.

VAERS ID:469790 (history)  Vaccinated:2012-10-11
Age:55.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Female  Submitted:2012-10-16, Days after onset: 3
Location:Iowa  Entered:2012-10-16
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: codeine allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204521 SCLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Induration (palm sized) and heat at site (back of left arm). Swelling, pain and chills radiating to shoulder.

VAERS ID:469953 (history)  Vaccinated:2012-10-11
Age:76.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Male  Submitted:2012-10-16, Days after onset: 4
Location:Florida  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Rheum. arthritis
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURY4525AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA IMRA
Administered by: Other     Purchased by: Military
Symptoms: Drug administered at inappropriate site, Hypotonia, Monoplegia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt received flu shot in left arm. Pneumonia in Rt. At 5am morning after injections the pt experienced a paralyzed arm. Could move fingers but arms limp & really sore. Did not go to hospital because symptoms did not get worse. Daughter advised him. Symptoms resolved within following 2 days. He remarked that the shot was administered very high on the arm.

VAERS ID:469956 (history)  Vaccinated:2012-10-11
Age:4.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-16, Days after onset: 4
Location:Colorado  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALS 4IM 
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 4IM 
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC. 0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Discomfort, Injection site discolouration, Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Livedo reticularis, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: My daughter was given Kinrix, Flu, and ProQuad. ProQuad was given subcutaneous on her right arm. At the injection site her arm became swollen and turned reddish/purple and mottled the next day 10/12/12. She complained that her arm hurt and wouldn''t let anyone touch it. On 10/14/12 on her left arm in the bend of her elbow she developed a petechial type rash, some spots darker than others. The right arm remained swollen and mottled for 5 days and the petechial rash started to go away on 10/16/12 (2 days). She had no other symptoms, no fever, or nausea, or loss of appetite. The majority of her discomfort was over the weekend and it didn''t seem like an emergency because there were no other symptoms. She didn''t take any medication. I called the physician''s office on Tuesday 10/16/12.

VAERS ID:469963 (history)  Vaccinated:2012-10-11
Age:81.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 5
Location:Washington  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: The patients illnesses at time of vaccination are unknown.
Preexisting Conditions: The patients medical history is unkknown.
Diagnostic Lab Data: Any laboratory test done are unknown.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU449BA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Chills, Diarrhoea, Poor quality sleep, Productive cough, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Noninfectious diarrhoea (narrow)
Write-up: This currently 81 year old female patient, with no known medical history, and no known medical conditions reports adverse events with Fluzone HD 2012-13 prefilled syringe. The patient had no other vaccines 4 weeks prior to Fluzone. The patient received the Fluzone HD 2012-13 on 11Oct2012 at 12:40 pm to prevent flu. The patient called the pharmacy on 14Oct2012 in the am to report adverse events with the flu shot. The patient stated on 11Oct2012 in the PM she was sleepy, had no energy for the rest of the day after getting the flu shot. The patient also reports that the night on 11Oct2012 she had chills and restless sleep. On 12Oct2012 the patient reports no measurable fever and the patient developed a cough with sputum. The patient described the sputum as having little or no color. On 13Oct2012 the patient reported having diarrhea. As of 14Oct2012, the patient has not seen her primary care provider for her described events. As of 16Oct2012, the outcome of all the patient described events are unknown.

VAERS ID:470111 (history)  Vaccinated:2012-10-11
Age:58.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:New York  Entered:2012-10-16, 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: Leg pain
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Chills, Headache, Lip swelling, Nausea, Ocular hyperaemia, Pharyngeal oedema
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (narrow), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Throat swelled, lips swelled, asthma attack, severe chills, nausea, eyes red, headache.

VAERS ID:470114 (history)  Vaccinated:2012-10-11
Age:77.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Wisconsin  Entered:2012-10-16, 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 known
Preexisting Conditions: All: PCN, KEFLEX, Clindamycin, Streptomycin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12057010IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0098260IMLA
Administered by: Other     Purchased by: Public
Symptoms: Blood pressure increased, Fall, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hypertension (narrow)
Write-up: A few minutes after receiving FLUVIRIN and PNEUMOVAX 23, pt had needle-like pain in back and hips so severe she had to fall to the floor. She felt better after another few minutes, but her BP was elevated (191/86), so I referred her to her primary physician who saw her that day.

VAERS ID:470176 (history)  Vaccinated:2012-10-11
Age:41.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Rhode Island  Entered:2012-10-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Seasonal allergies
Preexisting Conditions: Anxiety; ADHD; Chronic migraines
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLL726AB IMRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Oropharyngeal pain, Pruritus, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Pt received IM flu vaccine (R) arm approximately 5-10 min pt c/o itchiness (R) arm, then began w/ itch back/head, legs mild redness (R) arm 50 mg BENADRYL 1910 - pt felt less itchiness c/o tongue swollen and throat sore/tight pt observed 20 min swelling decreased - cont w/ itchiness.

VAERS ID:470268 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Female  Submitted:2012-10-16, Days after onset: 3
Location:North Carolina  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: HBP; Allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12243P IMLA
Administered by: Other     Purchased by: Private
Symptoms: Back pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: Pt. received flu vaccine 10/11/12, said arm started hurting 10/13/12, came in 10/16/12 to see if sore arm, radiating into back was normal.

VAERS ID:473554 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-16, Days after onset: 5
Location:Michigan  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA006624
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1418X SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse refers to an unspecified patient. The patient was vaccinated subcutaneously with a dose of 0.65 ml ZOSTAVAX (lot # 663197/1418X, expiration date 04-APR-2010) on 11-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effect reported. It was unspecified if the patient had sought medical attention. Additional information has been requested.

VAERS ID:470068 (history)  Vaccinated:2012-10-11
Age:76.0  Onset:2012-10-16, Days after vaccination: 5
Gender:Male  Submitted:2012-10-17, Days after onset: 1
Location:Indiana  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none known
Preexisting Conditions: good health
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: Other
Symptoms: Chills, Herpes zoster, Influenza, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Three days after Flu Hd vacination I developed flu symptoms including sneezing chills and running nose then on the above date I came down with the Shingles, on Oct 16 I saw my Dr, he confirmed the shingles and started me on a treatment.

VAERS ID:470105 (history)  Vaccinated:2012-10-11
Age:24.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 6
Location:Washington  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No concomitant vaccinations. Concomitant medications and relevant medical history were unknown. The subject had previously received influenza vaccinations and to the reporters knowledge no adverse events were reported. To the reporters knowledge no adverse events were reported with previous immunizations.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0997590A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA712AB0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure increased, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of itching in a 24-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). On 11 October 2012 at 15:15 the subject received 1st dose of FLUARIX (unknown, left arm). On 11 October 2012, within hours of vaccination with FLUARIX, the subject experienced itching, elevated blood pressure and hive. The healthcare professional reported that the subject is a staff member in the office. The subject experienced itching, hives and elevated blood pressure. At the time of the call the subject was still in the office being treated; BENADRYL was given as treatment to prevent hospitalization. The healthcare professional considered the events were clinically significant (or requiring intervention). At the time of reporting the outcome of the itching, elevated blood pressure and hive was unspecified. The healthcare professional considered the events were probably related to vaccination with FLUARIX. The healthcare professional reported another case, see also A0997591A.

VAERS ID:470107 (history)  Vaccinated:2012-10-11
Age:34.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 6
Location:Washington  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No concomitant vaccinations. Concomitant medications and relevant medical history were unknown. The subject had previously received influenza vaccinations and to the reporters knowledge no adverse events were reported. To the reporters knowledge no adverse events were reported with previous immunizations.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0997591A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA712AB0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure increased, Dizziness, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of itching in a 34-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). On 11 October 2012 at 15:15 the subject received 1st dose of FLUARIX (unknown, right arm). On 11 October 2012, within hours of vaccination with FLUARIX, the subject experienced itching, elevated blood pressure and dizziness. The healthcare professional reported that the subject is a staff member in the office. The subject experienced itching, hives and elevated blood pressure. At the time of the call the subject was still in the office being treated; BENADRYL was given as treatment to prevent hospitalization. The healthcare professional considered the events were clinically significant (or requiring intervention). At the time of reporting the outcome of the itching, elevated blood pressure and dizziness was unspecified. The healthcare professional considered the events were probably related to vaccination with FLUARIX. The healthcare professional reported another case, see also A0997590A.

VAERS ID:470127 (history)  Vaccinated:2012-10-11
Age:4.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-17, Days after onset: 6
Location:Mississippi  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Bad Allergies. Family says he takes Singulair & Zyrtec from allergist.
Diagnostic Lab Data: n/a
CDC 'Split Type': MS12019
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B204AA IMRA
HIBV: HIB (ACTHIB)SANOFI PASTEURUH265AA3IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0258AE1SCLA
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF709960IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0096351SCRA
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Received immunizatios @ 1:20 p.m. Returned to clinc @ 1:45 p.m with rash on face and both sides of neck. Nurse adminstered Benadryl 6.25 mg (1/2 tsp) P O for mild reaction per standing orders. After 25 minutes rash seemed to be fading with no spreading; No shortness of breath or swallowing difficulty. Parent left with child with instructions to go to ER if any other problems occur.

VAERS ID:470159 (history)  Vaccinated:2012-10-11
Age:7.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 5
Location:California  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
Administered by: Public     Purchased by: Public
Symptoms: Nausea, Pyrexia, Rash, Skin discolouration, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Given Hep A vaccine and 2nd Dose of Chicken Pox vaccine on same clinic visit. High fever at 101F, small skin colored bumps covering much of her back, nausea and vomiting.

VAERS ID:473570 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-17, Days after onset: 6
Location:Unknown  Entered:2012-10-17
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': WAES1210USA006597
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 registered nurse refers to a patient of unknown age. The patient was intended to receive vaccinated ZOSTAVAX was inadvertently administered with 0.5 ml of VARIVAX (merck) (Lot# unspecified) on 11-OCT-2012. No adverse effects reported. The outcome was unknown unknown. Additional information is not expected.

VAERS ID:474717 (history)  Vaccinated:2012-10-11
Age:61.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 6
Location:Pennsylvania  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007365
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect route of drug administration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report was received from a 61 years old female patient with unspecified allergies. The patient was vaccinated with one shot 0.65 ml ZOSTAVAX on 11-OCT-2012. Lot# was unspecified. Concomitant medications included: AMITIZA. The patient reported that, on 11-OCT-2012, the ZOSTAVAX was given to her in her muscle, not subcutaneously. She had been back to the office 3 times and each time the office had repeatedly told her that the vaccine was given in her muscle. Her arm at the injection site on the right arm was sore from Thursday (11-OCT-2012) to Saturday (13-OCT-2012) and currently it was just sore when touched. No treatment was given for the event. No lab diagnostic study performed. The patient was not recovered. The patient was seen at the office to seek medical attention. Additional information has been requested.

VAERS ID:474718 (history)  Vaccinated:2012-10-11
Age:73.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 6
Location:Unknown  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions: SULFA drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007345
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0100427 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a pharmacist refers to a 73 years old female patient with allergic to sulfa. The patient has no pertinent medical history. The patient was vaccinated with, 1 vial ZOSTAVAX (lot number reported as H0100427; Expired date 12-SEP-2013) subcutaneously on 11-OCT-2012 on unknown injection site. No other co-suspects were reported. No concomitant medications were reported. On 11-OCT-2012 the patient developed "a red ring" and soreness at the site of injection after receiving ZOSTAVAX. There was no treatment given for adverse events and no laboratory diagnostics study performed. The patient was not recovered at the time of report. The patient had called the pharmacist for medical attention. Additional information is not expected.

VAERS ID:470373 (history)  Vaccinated:2012-10-11
Age:28.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 7
Location:Washington  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: None
Diagnostic Lab Data: Metabolic Panel, EKG and Thyroid tests done. All tests normal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA738AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Electrocardiogram normal, Metabolic function test normal, Panic attack, Paraesthesia, Swelling face, Tachycardia, Thyroid function test normal
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Onset on 10/11/12 difficulty breathing, facial swelling, bilateral arm tingling sensation and tachycardia. Seen in ER tx with Lorazepam & Diphenhydramine. F/u with PCP on 10/12 - Tx with 1000 ml Normals Saline, 25 mg Hydroxyzine and Prednisone. F/u on 10/16 (Tachycardia and Panic Attack) tx with Lorazepam - over 6 week period. Pt doing well.

VAERS ID:470524 (history)  Vaccinated:2012-10-11
Age:39.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Male  Submitted:2012-10-17, Days after onset: 5
Location:Texas  Entered:2012-10-18, 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: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B087CB UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1792AA0SCAR
Administered by: Public     Purchased by: Public
Symptoms: Injection site pruritus, Injection site reaction, Injection site swelling, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: (1) Swelling; Itching a sight 10-12-12. (2) Circle the size of Lemon at site of injection today 10-17-12. (3) Pins/needles to touch - 10-12-12 at site.

VAERS ID:471363 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 7
Location:Unknown  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA006705
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 nurse practitioner refers to a female patient of unknown age. The patient was vaccinated with the first dose of GARDASIL in February 2010, with the second dose in April or May 2010 and the third dose would be administered in the vaccination schedule on 11-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effect reported. Additional information has been requested.

VAERS ID:474879 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-18, Days after onset: 7
Location:Unknown  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA006726
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Syringe issue, Underdose
SMQs:
Write-up: This spontaneous report as received from a certified nurse practitioner refers to a patient of unknown age and gender. The patient was vaccinated with first dose of PNEUMOVAX23, intramuscularly, on 11-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. Nurse reported that patient was being administered PNEUMOVAX23 when some of the dose came out of the barrel of the syringe while the needle was in the arm of the patient. No adverse effect reported. Additional information has been requested.

VAERS ID:474903 (history)  Vaccinated:2012-10-11
Age:78.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Female  Submitted:2012-10-18, Days after onset: 5
Location:Unknown  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007300
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a 78 years old female consumer reporting on herself who on 11-OCT-2012, was vaccinated subcutaneously with a dose ZOSTAVAX (dose and lot number not reported). No other co-suspects were reported. Concomitant medications included estradiol, citalopram and lovastatin (manufacturer unknown). The consumer reported that on 13-OCT-2012, she developed a rash on her left arm and swelling developed at the injection point where ZOSTAVAX was administered. On 14-OCT-2012, the consumer developed a rash on her face. No treatment was given for the experience. At the time of the report, the patient''s outcome was unknown. The patient did not seek medical attention. The relatedness for patient developed a rash on her left arm, rash on her face and patient developed swelling at the injection point was unknown for ZOSTAVAX. Additional information has been requested.

VAERS ID:474905 (history)  Vaccinated:2012-10-11
Age:81.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 6
Location:Colorado  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions: Sulfa allergy; Penicillin drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007292
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a physician refers to a 81 years old female patient with allergy to penicillin and sulfa who on 11-OCT-2012, was vaccinated subcutaneously on her left arm with a 0.65 ml dose of ZOSTAVAX (lot number H01436). No other co-suspects were reported. Concomitant medications included several medications but physician would not specify which ones. The physician reported that on 12-OCT-2012, the patient developed itching on the right side of her chest which then developed into red bumps and a rash. No treatment information was reported. At the time of the report, the patient had not recovered. The physician thought the expiration date of the vaccine was November 6th but she did not know the year because she could not get her computer to bring up the information. The relatedness for patient developed itching on the right side of her chest, red bumps and a rash was unknown for ZOSTAVAX. Additional information has been requested.

VAERS ID:470465 (history)  Vaccinated:2012-10-11
Age:55.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 8
Location:Indiana  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AC IM 
Administered by: Private     Purchased by: Private
Symptoms: Joint range of motion decreased, Musculoskeletal pain, Periarthritis
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (narrow)
Write-up: Shoulder pain, capsulitis, limited ROM. Sx currently lasting 8 days.

VAERS ID:470551 (history)  Vaccinated:2012-10-11
Age:49.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 7
Location:Nevada  Entered:2012-10-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50008 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Back pain, Blister, Constipation, Joint stiffness, Pain in extremity, Pelvic pain, Pubic pain
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Left side of pelvis, pubic area, thigh hip, back of hip and small of back all ached; also constipated; abdominal cramps on left side; joint stiffness on left side and both hips; some blisters in these areas.

VAERS ID:470573 (history)  Vaccinated:2012-10-11
Age:28.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 7
Location:Wisconsin  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Acute Sinusitis
Preexisting Conditions: Gardasil vaccine, molds, dust mite
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Erythema and swelling around injection site emerged less than 24 hours after injection. Erythema continued to increase, so patient presented to ED on 10/12/12. Returned to ED on 10/13/12 when she developed a fever to 102 F in addition to worsening erythema. Was admitted to hospital for presumed cellulitis and treated with antibiotics.

VAERS ID:470578 (history)  Vaccinated:2012-10-11
Age:48.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Female  Submitted:2012-10-19, Days after onset: 6
Location:Connecticut  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Did not report illness at time of vaccination.
Preexisting Conditions: History of pneumonia.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138470SCRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Erythema, Injection site erythema, Oedema peripheral, Pain in extremity, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Approximately 30 hours after vaccination developed fever of 102, chills and right arm became red, hot, painful and swollen. Redness extended from axilla to elbow. MD started patient on Augmentin 875mg po x 10 days. Patient reported event on 10/18/12. "Doing fine" at present. Denies any respiratory signs or symptoms. Not sure if latex allergy. "Heard something about it years ago." Reports can wear latex gloves and no allergy to kiwi or bananas.

VAERS ID:470579 (history)  Vaccinated:2012-10-11
Age:74.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 8
Location:New York  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions: None.
Diagnostic Lab Data: Note: I was given the extra-strength flu vaccine.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4490AA SYRUN
Administered by: Other     Purchased by: Public
Symptoms: Cold sweat, Cough, Dysphagia, Dysphonia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Body broke out in cold sweat, followed by extreme hoarseness, difficulty swallowing, constant coughing, runny nose. Symptoms increased in intensity for 4 days, and then began to subside by day 5. Symptoms almost gone today but still lingering mildly.

VAERS ID:470585 (history)  Vaccinated:2012-10-11
Age:20.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Male  Submitted:2012-10-19, Days after onset: 7
Location:Hawaii  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Started on course of Zantac in AM, Benadryl at night. Slight improvement of lesions on f/u exam 10/19/12. Started on oral corticosteroid taper on 10/19/12 for six days. Will f/u with medical on 10/29/12.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP597080IMLA
JEV1: JAPANESE ENCEPHALITIS (IXIARO)INTERCELL AGUNKNOWN0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Rash, Rash pruritic, Skin lesion
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Skin rash on arms, legs, chest and back that was itchy. Progressively became worse over the weekend and was seen by medical on Mon 10/15/12.

VAERS ID:470595 (history)  Vaccinated:2012-10-11
Age:75.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 7
Location:Kentucky  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDPS9407A1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad)
Write-up: Patient said that her arm began to hurt by the next morning and that is has gotten worse each day and that she can hardly raise her arm.

VAERS ID:470771 (history)  Vaccinated:2012-10-11
Age:68.0  Onset:2012-10-14, Days after vaccination: 3
Gender:Male  Submitted:2012-10-18, Days after onset: 4
Location:West Virginia  Entered:2012-10-19, 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 acute illness
Preexisting Conditions: Allergic: Shrimp
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: New onset forehead pruritus 2 evenings after immunization, followed by/progressed to forehead rash next AM. Spread to post. neck and (R) scapula over next 3 days.

VAERS ID:470908 (history)  Vaccinated:2012-10-11
Age:48.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-19, Days after onset: 8
Location:Massachusetts  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Routine F/U
Preexisting Conditions: NKDA
Diagnostic Lab Data: EKG; Troponin; CXR
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AA2IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest X-ray normal, Chest discomfort, Electrocardiogram normal, Non-cardiac chest pain, Troponin normal
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Per ER note 10/11/12 3:36PM "had office visit and got a flu shot, felt OK until going to bed at 8 or 9PM, at which time he felt discomfort in the anterior chest". Workup unremarkable, inc CXR (-), neg troponin, EKG (-). D/C Dx: Non-cardiac chest pain.

VAERS ID:475531 (history)  Vaccinated:2012-10-11
Age:71.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 8
Location:Unknown  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions: 2002, Breast cancer; Penicillin, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007617
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011427 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site discolouration, Injection site haemorrhage, Injection site induration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a Doctor of pharmacy refers to a 71 years old female patient with penicillin allergy. The patient''s medical history included breast cancer in 2002. The patient was vaccinated with a dose of ZOSTAVAX (Lot # H011427, expiration date 12-SEP-2013) SQ in the left arm on 11-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. The pharmacist reported that on 11-OCT-2012, immediately after withdrawing the needle, the patient developed a hardened bubble at the injection site. The bubble enlarged but subsequently stabilized. The injection site bled for a short time then resolved. On 12-OCT-2012, the pharmacist called the patient, the bubble had resolved and there was a quarter sized blue area at the injection site and the patient was recovering. The patient did not receive treatment for the adverse events. There were no lab diagnosis or studies performed. Additional information has been requested.

VAERS ID:475957 (history)  Vaccinated:2012-10-11
Age:62.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-21, Days after onset: 9
Location:Unknown  Entered:2012-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007383
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H013017 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, 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 pharmacist refers to a 62 years old female patient. The patient had no pertinent medical history and drug reactions. The patient was vaccinated with ZOSTAVAX (lot number reported as H013017, expiration date 09-OCT-2013) subcutaneously on 11-OCT-2012. No other co-suspects were reported. There were no concomitant medications. On 12-OCT-2012 the patient experienced "a red rash one to one-and-a-half inches in diameter around the injection site which was also warm and had some hardness associated with it". No treatment was given for adverse event. No laboratory diagnostics studies were performed. The outcome of adverse event was reported as not recovered. The patient stopped into the pharmacy for seek medical attention. Additional information is not expected.

VAERS ID:470767 (history)  Vaccinated:2012-10-11
Age:84.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-22, Days after onset: 11
Location:Wyoming  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: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4494AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Feeling cold
SMQs:
Write-up: Ct left flu clinic heading for physical therapy. 10 min prior to arrival ct became cold, teeth were shattering uncontrollably, physical therapists assessed ct pulse to be $g 100/min. After a warm blanket was placed over client, she warmed up and was fine. No problems afterwards.

VAERS ID:471022 (history)  Vaccinated:2012-10-11
Age:53.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-13, Days after onset: 2
Location:Michigan  Entered:2012-10-22, 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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS120671 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0653AE1IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Initially patient felt pain upon immunization. After two hours patient had a very painful right arm and could not move it. Required ER visit, right arm.

VAERS ID:471024 (history)  Vaccinated:2012-10-11
Age:4.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Male  Submitted:2012-10-15, Days after onset: 3
Location:Michigan  Entered:2012-10-22, 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:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B138AA4UNLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH122313UNRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1897AA1UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0569AE1UNLL
Administered by: Private     Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever 102 degrees.

VAERS ID:475993 (history)  Vaccinated:2012-10-11
Age:62.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 11
Location:South Carolina  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Anxiety; Hypertension; Hypercholesterolaemia; Diabetes mellitus
CDC 'Split Type': WAES1210USA008069
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0170AE SCLA
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a 62 years old female patient with diabetes, hypercholesterolemia, hypertension and anxiety. The patient was vaccinated with ZOSTAVAX (lot number 671780/0170AE; expired date as reported 06-MAR-2013 (0.65 ml, once, subcutaneously, left arm) on 11-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. On 11-OCT-2012 the patient had been experiencing a headache since she received ZOSTAVAX. At the time of this report, the patient was still experiencing a headache, and she has not reported her experience to her physician. The reporter stated that the patient was "nervous about receiving ZOSTAVAX." Treatment TYLENOL was given for the adverse event. The patient was not recovered at the time of report. No laboratory diagnostics study performed. The patient had consulted pharmacist for medical attention. Additional information is not expected.

VAERS ID:475998 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-15, Days after vaccination: 4
Gender:Female  Submitted:2012-10-22, Days after onset: 7
Location:California  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008068
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Headache, Influenza like illness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: This spontaneous report as received from a female patient of unknown age refers to herself. The patient was vaccinated with ZOSTAVAX (lot number, dose, route and injection site were not reported) on 11-OCT-2012 for prevention of shingles. No other co-suspects were reported. NO concomitant medications were reported. On 15-OCT-2012 the patient started flu-like symptoms. She had pain in her muscles in her back, a headache and some blurred vision (for distance only). There was no treatment given for adverse events and no laboratory diagnostics study performed. The outcome was unknown at the time of report. The patient had seen the health professional on 15-OCT-2012 for medical attention. Additional information is not expected.

VAERS ID:470856 (history)  Vaccinated:2012-10-11
Age:83.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Female  Submitted:2012-10-23, Days after onset: 10
Location:Florida  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: No
Preexisting Conditions: Hypertension, hypothyroidism, high cholesterol
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0130140SCRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site reaction: red, raised circle about 4 to 5 inches in diameter around injection.

VAERS ID:471332 (history)  Vaccinated:2012-10-11
Age:65.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Texas  Entered:2012-10-23, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to Bee Stings
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06349211A IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Erythema, Oedema peripheral, Pruritus, Swelling face, Tachycardia, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Face and hands, feet swelling, redness, hives, itching, SOB, tachycardia PR - 110, BP - 148/98.

VAERS ID:471356 (history)  Vaccinated:2012-10-11
Age:52.0  Onset:2012-10-14, Days after vaccination: 3
Gender:Male  Submitted:2012-10-22, Days after onset: 8
Location:California  Entered:2012-10-23, 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: Laceration
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4137AA0UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Injection site pain, Pain in extremity, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, swelling and severe pain all upper arm, feeling feverish.

VAERS ID:471365 (history)  Vaccinated:2012-10-11
Age:51.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 12
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: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH755AB SYRLA
Administered by: Public     Purchased by: Other
Symptoms: Movement disorder, Pain in extremity
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad)
Write-up: Pain in rt arm, can''t lift or put behind back.

VAERS ID:471382 (history)  Vaccinated:2012-10-11
Age:61.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 7
Location:Washington  Entered:2012-10-23, 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: Taking treatment for cancer
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0113310SCLA
Administered by: Other     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed rash on the right side of the body after one hour of ZOSTAVAX injection. Injection was given on 10/11/12 patient notified us on 10/15/12. Patient is on HEPCEPTIN. She was cleared to get ZOSTAVAX by her oncologist.

VAERS ID:471393 (history)  Vaccinated:2012-10-11
Age:64.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Male  Submitted:2012-10-23, Days after onset: 10
Location:Maine  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: Back pain; sinus pressure/congestion
Preexisting Conditions: Type 1 DM; A fib; chronic bronchitis; depression; Diabetic peripheral neuropathy; hypertension; hypogonadism; insomnia; muscle weakness; post polio syndrome; osteoporosis; neuralgia; nicotine depend.; sciatica
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH759AB2IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0074AE0IMRA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Erythema, Hypersensitivity, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 10/11/12 PNEUMOVAX and Flu vacc. admin. right bicep. 10/13/12 pt presented at Express Care with redness, swelling and pain right arm. Diagnosis: Allergic Reaction, cellulitis of the arm. Treatment: Cephalexin 500mg 1 tablet TID, BENADRYL.

VAERS ID:471416 (history)  Vaccinated:2012-10-11
Age:79.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-13
Location:California  Entered:2012-10-23, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Haemarthrosis, Mobility decreased, Neck pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Parkinson-like events (broad), Arthritis (broad)
Write-up: Radiating pain in the neck. Can''t move her arm - shoulder joint. Hematoma.

VAERS ID:472145 (history)  Vaccinated:2012-10-11
Age:50.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 12
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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA006186
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)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 pharmacist refers to a 50''s plus years old female patient. The patient was vaccinated with PROQUAD (lot #, dose and route were unknown) instead of ZOSTAVAX today (on 11-OCT-2012). No other co-suspects were reported. No concomitant medications were reported. Pharmacist states error only, when occurred at the local clinic. No adverse effects reported. At the report time the outcome of event was unknown. It was unknown if the patient sought medical attention. Additional information is not expected.

VAERS ID:472151 (history)  Vaccinated:2012-10-11
Age:41.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 12
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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007517
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0565Z IMUN
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 41 years old female patient. On 11-OCT-2012 the patient was inadvertently administered intramuscularly an expired dose of GARDASIL (lot # 666162/0565Z, expiration date 15-SEP-2012). It was not known which dose in the GARDASIL vaccination schedule this was. No adverse event was reported. It was unspecified whether the patient sought for medical attention. The outcome was unknown. Additional information has been requested.

VAERS ID:471174 (history)  Vaccinated:2012-10-11
Age:11.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-15, Days after onset: 4
Location:Florida  Entered:2012-10-24, 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 known
Preexisting Conditions:
Diagnostic Lab Data: EKG; chest x-ray; CBC; Chem; UA; - all normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AB5IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.40097460UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4289AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4009AA0UNLA
Administered by: Private     Purchased by: Public
Symptoms: Chest X-ray normal, Dehydration, Dizziness, Electrocardiogram normal, Eye swelling, Full blood count normal, Headache, Influenza virus test negative, Laboratory test normal, Myalgia, Pain, Pallor, Streptococcus test negative, Syncope, Tachycardia, Tremor, Urine analysis normal
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: 10/11/12- 4 vaccines given. 30 minutes later syncopal episode, tachycardia. BENADRYL given. Revived 30 minutes later, collapsing w/severe tremor, pallor, tachycardia. EMS called, transported to hospital. EKG, CBC, Chem, U/A. Friday, 10/12/12 - office visit at doctor. Eyes swollen, headache, muscle pain, pallor, body ache. Flu and Strep tests negative. Friday evening - Headache worsened, very severe; sent back to ER, admitted by Dr. Saturday, 10/13/2012 - discharged to home from hospital. Sunday, 10/14/2012 went to hospital. Treated for dehydration. Had dizziness, headache, body pain. Monday, 10/15/2012 seen at Dr. office. Headache now gone, hydrated and happy.

VAERS ID:471278 (history)  Vaccinated:2012-10-11
Age:64.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 12
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: None
Preexisting Conditions: Hx Thyroid Cancer
Diagnostic Lab Data: None. Doctor was going to send me for PT if neck didn''t improve. Didn''t realize at the time it was R/T Flu shot.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Burning sensation, Headache, Musculoskeletal stiffness
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Stiff neck, burning pain in shoulders, headache. Stiff neck was opposite side of injection site.

VAERS ID:471457 (history)  Vaccinated:2012-10-11
Age:68.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-10-20, Days after onset: 8
Location:Maryland  Entered:2012-10-24, 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: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0567AE1UNLA
Administered by: Unknown     Purchased by: Private
Symptoms: Chills, Fatigue, Injection site erythema, Injection site mass, Injection site pruritus, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Chills, fever, exhaustion, itching, golf-ball size lump at injection, arm red & itchy the circumference, down to the elbow. R. Alcohol & Cortisone cream, ADVIL.

VAERS ID:471544 (history)  Vaccinated:2012-10-11
Age:47.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Female  Submitted:2012-10-23, Days after onset: 10
Location:Unknown  Entered:2012-10-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain, Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Urticaria, pruritus & pain, swelling.

VAERS ID:471548 (history)  Vaccinated:2012-10-11
Age:72.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:Illinois  Entered:2012-10-24, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12067010IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0095230IMRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt called complaining of slight fever, red arm and raised bump. Pt came into store following morning and arm was barely red and no swelling. Pt went to MD and they gave her antibiotics.

VAERS ID:471559 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Male  Submitted:2012-10-20, Days after onset: 7
Location:Pennsylvania  Entered:2012-10-24, Days after submission: 4
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: Back problems
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: On 2nd day after shot I got hives in evening next day gone then came back in that evening goes away at daylight and came back the next 6 days.

VAERS ID:471571 (history)  Vaccinated:2012-10-11
Age:34.0  Onset:2012-10-20, Days after vaccination: 9
Gender:Male  Submitted:2012-10-24, Days after onset: 4
Location:Ohio  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: Herpes Simplex virus
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A IDUN
Administered by: Other     Purchased by: Unknown
Symptoms: Fatigue, Lymphadenopathy, Myalgia, Skin lesion
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Employee developed fatigue, muscle pain and lymphadenopathy 9 days after vaccination. 2 lesions - chin, (L) great toe pustular.

VAERS ID:471407 (history)  Vaccinated:2012-10-11
Age:34.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 14
Location:Indiana  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: Allergic to PCN, Sulfa, Mushrooms, Pollens, Bee Stings, Molds Topical Neosporin causes blisters
Diagnostic Lab Data: Solumedrol 125mg IM given by MD in Office
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0184AE SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Facial swelling and Rash on neck and chest. MMR given in MD office under direct care of MD due to her Topical Neosporin allergies.

VAERS ID:471785 (history)  Vaccinated:2012-10-11
Age:65.0  Onset:0000-00-00
Gender:Female  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: Prophylaxis; 10/11/2012, Hospitalisation; Drug hypersensitivity; Cardiac disorder; Diabetes mellitus
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA009598
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site cellulitis, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a hospital registered nurse, concerning a 65 year old female patient with diabetes, unspecified cardiac issues (for which patient has been hospitalized on 11-OCT-2012), and penicillin allergy. On 11-OCT-2012, the patient was vaccinated with a 0.5 ml PNEUMOVAX23 in the left arm (route and frequency were not reported) (Lot # and expiration date were not reported). On the same date, the patient was vaccinated concomitantly with a dose of unspecified Influenza Virus Vaccine (manufacturer unknown) in the right arm. In October 2012, the patient developed sore of the left arm, cellulitis, swollen and tender where the PNEUMOVAX23 was administered. The nurse stated that she was not sure if the PNEUMOVAX23 was administered below the deltoid site or not. She stated that client was chubby and had odd shaped arms and it was hard to define where the deltoid area was. Nurse stated that the patient also developed reaction of the right arm (MARRS #: 1210USA010519). Nurse stated that she believed the patient''s hospitalization may have been prolonged because of the adverse reaction to the PNEUMOVAX23 and flu vaccine (manufacturer unknown). Unspecified antibiotics were given as treatment for the events. On 15-OCT-2012, the patient was released from hospital. At the time of the report, the outcome of the patient was unknown. The relatedness for sore, cellulitis, tender and swollen of the left arm where the PNEUMOVAX23 was administered was unknown for PNEUMOVAX23. This is one of two reports from the same source. Additional information has been requested.

VAERS ID:471910 (history)  Vaccinated:2012-10-11
Age:72.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 0
Location:Michigan  Entered:2012-10-26, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 IMUN
Administered by: Other     Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Injection site haematoma, Injection site induration, Injection site mass
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Immediately after injection, pt experienced bruising and small, firm lump at the site.

VAERS ID:471747 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-15, Days after vaccination: 4
Gender:Female  Submitted:2012-10-28, Days after onset: 13
Location:California  Entered:2012-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH730AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Anxiety, Dizziness, Dry mouth, Headache, Hypertension, Nausea
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), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Anxiety; dry mouth; headache; light-headed; nausea; elevated blood pressure. Doctor visit, Atavan prescribed.

VAERS ID:472030 (history)  Vaccinated:2012-10-11
Age:75.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-28, Days after onset: 17
Location:Florida  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:
Preexisting Conditions: Diabetes Mellitus; High Blood Pressure
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4524AA0IMUN
Administered by: Other     Purchased by: Public
Symptoms: Balance disorder, Chills, Feeling drunk, Gait disturbance, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Patient got home. Started to experience chills. The chills worsened to shuddering & felt like extremities drew in to body. Then felt nauseous. It subsided - so patient fell asleep and woke feeling like "drunk" - staggering & off balance. All symptoms subsided 24 hrs after vaccine. Physician seen day after vaccine 9:30am 10/12/12.

VAERS ID:472168 (history)  Vaccinated:2012-10-11
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-24
Location:Missouri  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
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHABVC861BB3UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Incorrect dose administered
SMQs:
Write-up: Clerical did not pull chart (that showed Hep B x 3) Thought client knew and she stated she needed Hep B #3. Gave Hep B 10-11-12.

VAERS ID:472137 (history)  Vaccinated:2012-10-11
Age:3.0  Onset:2012-10-19, Days after vaccination: 8
Gender:Female  Submitted:2012-10-26, Days after onset: 7
Location:Rhode Island  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: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH751AA2UNLA
Administered by: Private     Purchased by: Public
Symptoms: Contusion, Idiopathic thrombocytopenic purpura, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow)
Write-up: On 10/19 patient seen for petechiae, unexplained bruising and diagnosed w/ ITP.

VAERS ID:472204 (history)  Vaccinated:2012-10-11
Age:2.0  Onset:2012-10-24, Days after vaccination: 13
Gender:Female  Submitted:2012-10-30, Days after onset: 6
Location:North Carolina  Entered:2012-10-30
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
DTAP: DTAP (TRIPEDIA)SANOFI PASTEUR   LG
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR   LG
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.   LG
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER   LG
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER   LG
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0 LG
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH   LG
Administered by: Public     Purchased by: Other
Symptoms: Cough, Crying, Discomfort, Malaise, Pallor, Pyrexia, Rash, Rash erythematous, Rash morbilliform, Rhinorrhoea
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: BLANCHING RED RASH ALL OVER HER BODY, w/ Cough, runny eyes, runny nose, fever, malaise, discomfort, crying, spots in mouth, treating currently at home and still observing symptoms and treatment. Symptoms have continued over a course of less than a week. Symptoms Presenting like classic Measles.

VAERS ID:476826 (history)  Vaccinated:2012-10-11
Age:66.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 19
Location:Oregon  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; Drug hypersensitivity; Drug hypersensitivity; Drug hypersensitivity; Gastrooesophageal reflux disease; Asthma; Hypothyroidism
Preexisting Conditions: INAPSINE, Hypersensitivity; SULFA, Hypersensitivity; erythromycin, Hypersensitivity; penicillin (unspecified), Hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA010175
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1098533N UNUN
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Injection site reaction, Rash erythematous, Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a Registered Nurse refers to herself a 66 years old female patient with hypothyroidism, asthma and GERD and a medical history of drug allergies to: Penicillin, Erythromycin, SULFA, INAPSINE. On 11-OCT-2012, the patient was vaccinated with ZOSTAVAX (lot 1098533N exp not reported) (dose, and route not reported). Concomitant medications included SYNTHROID, ascorbic acid, multivitamins (unspecified), probiotics, chondroitin sulfate sodium, glucosamine sulfate, PRILOSEC, PRAVACHOL, gemfibrozil, calcium (unspecified) and magnesium (unspecified). The retired nurse reported that on 11-OCT-2012, she developed a red raised rash around the injection site as well as all over her body, she also mentioned the rash itches and burns. The patient was put on treatment with BENADRYL and CLARITIN. The nurse stated that VZV packed was offered and declined. At the time of the report the patient''s outcome for adverse events was reported as not recovered/not resolved. The relatedness for adverse events was unknown for ZOSTAVAX. Additional information has been requested.

VAERS ID:472279 (history)  Vaccinated:2012-10-11
Age:62.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Male  Submitted:2012-10-26, Days after onset: 13
Location:New Hampshire  Entered:2012-10-31, Days after submission: 5
Life Threatening? No
Died? Yes
   Date died: 2012-10-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Recent massive heart attack; Narcolepsy
Diagnostic Lab Data:
CDC 'Split Type': 2012033702
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP58306 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Death
SMQs:
Write-up: This medically confirmed spontaneous report (initial receipt: 18-Oct-2012) concerns a 62-year-old male patient, who had a medical history of recent massive heart attack and narcolepsy. He had no known drug allergy. He was taking ''a lot of medications'' (type unspecified). On 11-Oct-2012 the patient received AFLURIA (batch number: P58306) injection at a dose of 0.5 mL intramuscularly. On the day of vaccination, the patient did not complain of any symptoms and went home without any adverse events. On 13-Oct-2012 the patient was found dead. The cause of death was still being investigated. According to the pharmacist (reporter), the patient had many health problems including a recent massive heart attack (date unspecified).

VAERS ID:472339 (history)  Vaccinated:2012-10-11
Age:31.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 20
Location:Oregon  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: 7 MONTHS PREGNANT
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on arms, wrists, armpits, feet, ankles, abdomen, low back, buttocks, legs. Re-occurring daily in evenings, ongoing still. Taking Benadryl in evenings.

VAERS ID:472414 (history)  Vaccinated:2012-10-11
Age:40.0  Onset:2012-10-28, Days after vaccination: 17
Gender:Male  Submitted:2012-10-31, Days after onset: 3
Location:Florida  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: Unknown
Preexisting Conditions: HTN
Diagnostic Lab Data: MD notes above. Emp had previous Emergency visits unrelated to flu vaccine also on 10/4/12 and 10/15/12. Did not c/o pain or swelling at the vaccine site in the ED at the 10/15/12 visit.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4483AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cellulitis, Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Seen in ED- Physician note "cellulitis". "Pt with swelling/erythema post-injection. Possible reaction from injection but more likely cellulitis based on duration of symptoms and timing of injection.

VAERS ID:472746 (history)  Vaccinated:2012-10-11
Age:51.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 20
Location:North Carolina  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: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206501 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Received injection around 9:30 AM on 10-11-12. Itching started that night around 7:00 pm. Hives started a couple of days later. Saw PCP on 10-24-12 given cortisone injection and oral medication.

VAERS ID:472963 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 11
Location:Arizona  Entered:2012-10-31, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Tension headaches
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0106610IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling at injection site from shoulder to elbow - no fever or chills. Lasted until 10/14/12.

VAERS ID:472572 (history)  Vaccinated:2012-10-11
Age:49.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-11-01, Days after onset: 21
Location:New Mexico  Entered:2012-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH759AB0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chest discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Employee stated that two hours after receiving vaccine she felt tightness in her chest and felt that her throat was constricting. Employee stated that this feeling never subsided until she fell asleep that night, approximately 12 hours after receiving vaccine. No treatment was given. Employee did state she is very sensitive to any medication.

VAERS ID:473021 (history)  Vaccinated:2012-10-11
Age:66.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:Wisconsin  Entered:2012-11-01, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205501 IMUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H009826 IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient reported - feeling feverish, hardness, pain and redness, at site of injection on right arm where patient had received pneumonia vaccination on 10/11/12. Patient''s PCP confirmed that it was cellulitis. Patient was prescribed antibiotic Clindamycin on 10/12/12. On 10/12/12 patient reported no improvement.

VAERS ID:477069 (history)  Vaccinated:2012-10-11
Age:1.3  Onset:2012-10-22, Days after vaccination: 11
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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA010216
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H009639 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a registered nurse concerning a 16 months old male patient. On 11-OCT-2012, the patient was vaccinated with a dose of VARIVAX (Merck) (dose and route were not reported) (Lot #: H009639; Expiration date not reported). Concomitant medications included PEDIARIX, Hib conj vaccine (unspecified carrier) MMR II, hepatitis A virus vaccine (unspecified) and PREVNAR. On 22-OCT-2012 the patient developed a chickenpox rash, on the thigh where the shot was given after receiving VARIVAX (Merck). The patient sought unspecified medical attention. No treatment was given for the event. At the time of the report, the patient''s outcome for chickenpox rash was reported as recovered/resolved. The relatedness for chickenpox rash was unknown for VARIVAX (Merck). Additional information has been requested.

VAERS ID:472710 (history)  Vaccinated:2012-10-11
Age:49.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-11-02, Days after onset: 22
Location:Pennsylvania  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: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207101 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect route of drug administration, Injected limb mobility decreased, Injection site pain, Sleep disorder
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The nurse administering the shot gave the shot at the top of my shoulder and it was painful when she put the needle in and then when she pushed the meds in also. Never have I had a shot given in that location before and never did I have pain like this during a flu shot. My arm was sore all day and thought it was going to go away in time. I has been getting worse and not better. This is keeping me up at night and I have loss of function and mobility along with pain. I reported this to my HR manager and found out that there were others with the same issue. Was contacted by a nurse who asked me to explain what happened that day. She suggested we see our PCP, which was my next move, and then gave us contact info and fax number where we can send any and all receipts for treatment related to the pain of this shot. I have an appointment with my PCP 11/7/12.

VAERS ID:472770 (history)  Vaccinated:2012-10-11
Age:43.0  Onset:2012-10-14, Days after vaccination: 3
Gender:Male  Submitted:2012-11-02, Days after onset: 19
Location:Pennsylvania  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: None
Preexisting Conditions: Diabetes, high Blood Pressure
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Hypoaesthesia, Injected limb mobility decreased, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Sore muscle and joint in left arm. Has ranged from limited mobility in shoulder joint to numbness to elbow. As of 10/31/2012, there is pain in the left elbow joint.

VAERS ID:473221 (history)  Vaccinated:2012-10-11
Age:67.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-28, Days after onset: 17
Location:Washington  Entered:2012-11-02, 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) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA UNAR
Administered by: Other     Purchased by: Public
Symptoms: Chills, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever, headache, chills, body aches 4 hour duration, then fine.

VAERS ID:472839 (history)  Vaccinated:2012-10-11
Age:31.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-11-04, Days after onset: 24
Location:Nevada  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Private     Purchased by: Private
Symptoms: Bronchitis, Chest discomfort, Cough, Dysphonia, Respiratory disorder
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Acute central respiratory depression (broad)
Write-up: Sudden onset of what felt like a deep respiratory illness similar to bronchitis. Included coughing, hoarseness, and a feeling of tightness in my chest when I breath. I did not take any treatment or seek medical attention. I drank a lot of water and went to bed and it was gone by morning. I didn''t connect it to the flu shot until now but it was very strange to have an illness come on so strong and so quickly and then to be gone just as fast. I had the DTAP vaccine at the same time as the flu shot earlier that afternoon.

VAERS ID:472908 (history)  Vaccinated:2012-10-11
Age:28.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-11-05, Days after onset: 25
Location:Pennsylvania  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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12071012UNLA
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Drug administered at inappropriate site, Injection site pain, Mobility decreased, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Shot was incorrectly given in the shoulder joint instead of the muscle further down on the arm right beneath the joint. Since receiving the injection I have been experiencing burning sensations in my arm and decreased arm mobility. I frequently wake up throughout the night in pain at the location of the injection. Arm hurts all day long.

VAERS ID:473712 (history)  Vaccinated:2012-10-11
Age:92.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-30, Days after onset: 19
Location:Pennsylvania  Entered:2012-11-05, 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: Prostate cancer
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AC UNRA
Administered by: Other     Purchased by: Public
Symptoms: Chills, Pain in extremity, Urinary incontinence, Weight bearing difficulty
SMQs:
Write-up: That evening, he states he had chills. Then 3 episodes of loss of bladder control. Then on 10/12/12 he had pain in his left leg and couldn''t put weight on it. Two days later he was fine.

VAERS ID:473163 (history)  Vaccinated:2012-10-11
Age:67.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-11-06, Days after onset: 26
Location:Florida  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:
Preexisting Conditions: High blood pressure, regulated, prostate cancer, radiation seeds 9yrs ago
Diagnostic Lab Data: WENT TO clinic 11 5 2012 on another Apppointment, WAS ADVISED IF THE SYMPTOMS DO NOT GET BETTER IN A FEW MORE DAYS TO MAKE ANOTHER APPOINMTMENT WITH MY REGULaR DOCTOR.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Chills, Cough, Grip strength decreased, Pain, Pain in extremity, Rhinorrhoea, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: WENT TO BED AND AT 9.30 PM LEGS STARTED HURTING TERRIBLE, REST OF BODY WAS ACHING, GOT UP TO US BATHROOM, AFTER THIS WENT TO GET A DRINK OUT OF THE FRIGE, WHEN WENT TO TAKE HOLD OF BOTTLE OF CRANBERRY WAS UNABLE TO HOLD DUE TO VIOLENT SHAKING, SOMEHOW MADE IT BACK TO BED AND BY WRAPPING UP GOOD FINALLY GOT RID OF CHILLS. BUT STILL ACHED ALL NIGHT LONG, AS OF TODAY, I STILL HAVE ACHES, RUNNING NOSE, STOPPED UP, COUGHING.

VAERS ID:473172 (history)  Vaccinated:2012-10-11
Age:84.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-10-31, Days after onset: 20
Location:Texas  Entered:2012-11-06, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA0IMUN
Administered by: Public     Purchased by: Private
Symptoms: Bronchospasm, Laryngeal oedema, Lip swelling, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Laryngeal edema, facial & lip swelling and bronchospasm.

VAERS ID:473309 (history)  Vaccinated:2012-10-11
Age:45.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 27
Location:New Jersey  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: Lotions/Sunscreen
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AB IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Injection site discomfort
SMQs:
Write-up: Person noted at time of injection, felt discomfort at site. Localized discomfort continued since and now has increased to where she has discomfort when trying to raise left arm above shoulder height.

VAERS ID:474475 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-10-31, Days after onset: 20
Location:Minnesota  Entered:2012-11-07, 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:
Current Illness: None
Preexisting Conditions: Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205001 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt reported pain in upper arm from time of administration that lasted ~20 days. Pt follow up with clinic and reported that MD felt that the injection was delivered too high. No redness or swelling at inj site at any time.

VAERS ID:474607 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-18, Days after vaccination: 7
Gender:Female  Submitted:2012-11-05, Days after onset: 18
Location:Ohio  Entered:2012-11-08, Days after submission: 3
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: DES exposure during mother''s pregnancy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204201 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: Pt received flu vaccine on 10/11/12. One week after started noticing red raised dots on arms. On 10/23/12 had raised red prickly rash all over arms, groin, thighs, face, forehead with burning. Reported to occupational health & was started on MEDROL DOSE PAK.

VAERS ID:474328 (history)  Vaccinated:2012-10-11
Age:56.0  Onset:2012-10-14, Days after vaccination: 3
Gender:Male  Submitted:2012-11-09, Days after onset: 26
Location:Pennsylvania  Entered:2012-11-14, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH752AB0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Herpes zoster, Influenza
SMQs:
Write-up: Developed flu 5 days of shot. Developed shingles 2-3 weeks of shot.

VAERS ID:474444 (history)  Vaccinated:2012-10-11
Age:86.0  Onset:2012-10-24, Days after vaccination: 13
Gender:Female  Submitted:2012-11-09, Days after onset: 16
Location:Michigan  Entered:2012-11-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA IMRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Extreme pain at injection site for prolonged time 1 month sharp stabbing pain an undulation at site as well.

VAERS ID:474619 (history)  Vaccinated:2012-10-11
Age:14.0  Onset:2012-10-16, Days after vaccination: 5
Gender:Male  Submitted:2012-11-16, Days after onset: 31
Location:Georga  Entered:2012-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergies to shellfish; allergic rhinitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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HPV4: HPV (GARDASIL)MERCK & CO. INC.H0106490IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Haemorrhoids, Idiopathic urticaria
SMQs:, Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria daily for more than 3 weeks. Required antihistamines and steroids and allergist referral. Diagnosis there was idiopathic urticaria but still in process of workup. Also developed hemorrhoids. Unclear whether any of the above related to HPV vaccine.

VAERS ID:475325 (history)  Vaccinated:2012-10-11
Age:61.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-11-07, Days after onset: 26
Location:Washington  Entered:2012-11-20, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Uncertain says pt - see (7)
Preexisting Conditions:
Diagnostic Lab Data: URI treated w/ amoxicillin
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS123123 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Oropharyngeal pain, Respiratory tract congestion, Upper respiratory tract infection
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Day prior to shot felt achy but not that sick. Day of shot felt ok. Day after shot pt woke up with sore throat that lasted a couple days, then on day 4 had head & chest congestion for "awhile". Pt went to urgent care for antibiotic on day 9. Symptoms slowly resolving even today.

VAERS ID:474998 (history)  Vaccinated:2012-10-11
Age:29.0  Onset:2012-10-16, Days after vaccination: 5
Gender:Male  Submitted:2012-11-20, Days after onset: 35
Location:Georga  Entered:2012-11-21, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: Bloodwork, MRI, reflex tests
CDC 'Split Type':
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TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Blood test, Facial paresis, Hypoaesthesia, Muscular weakness, Myalgia, Nuclear magnetic resonance imaging, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad)
Write-up: Symptoms started with tingling and numbness in hands and feet. This progressed in intensity and spread to the trunk of the body as well as the face. Approximately a week after initial symptoms I began experiencing weakness in the legs as well as muscle soreness and dull pain associated with certain movements. Had trouble controlling some facial muscles. Symptoms increased in intensity for about 2 weeks, leveled off for about 2 weeks, and since have been slowly diminishing but are still present to this day.

VAERS ID:475598 (history)  Vaccinated:2012-10-11
Age:77.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-11-26, Days after onset: 45
Location:Oregon  Entered:2012-11-28, 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: Abdominal cramping; DJD
Preexisting Conditions: DJD; Chronic cough; (H/O BOOP); HTN; Mitral aortic regurg
Diagnostic Lab Data: CRP, 5.8; (R) wrist x-ray severe DJD
CDC 'Split Type':
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4494AA IMRA
Administered by: Private     Purchased by: Other
Symptoms: C-reactive protein increased, Inflammatory pain, X-ray limb abnormal
SMQs:, Osteonecrosis (broad)
Write-up: Painful inflamed wrist, hands, neck and top of feet. Elevate C-reactive protein.

VAERS ID:478984 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 50
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': WAES1211USA011061
Vaccination
Manufacturer
Lot
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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 11-OCT-2012 11:37, 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:479163 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 50
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': WAES1211USA011062
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 11-OCT-2012 18:23, 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:479164 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 50
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': WAES1211USA011060
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 11-OCT-2012 11:34, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:475920 (history)  Vaccinated:2012-10-11
Age:62.0  Onset:2012-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-12-01, Days after onset: 50
Location:Mississippi  Entered:2012-12-01
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: Still under doctor care. Possible physical therapy to be scheduled.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site reaction, Rotator cuff syndrome
SMQs:
Write-up: L shoulder impingement.

VAERS ID:476050 (history)  Vaccinated:2012-10-11
Age:68.0  Onset:2012-10-13, Days after vaccination: 2
Gender:Female  Submitted:2012-12-02, Days after onset: 50
Location:Louisiana  Entered:2012-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1071AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Discomfort, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left deltoid injection site was sore 2 days afterward. When patient puts weight on left arm, she doesn''t feel it at first, then it hurts. Discomfort experienced when putting arm back. No external sign of problem.

VAERS ID:479278 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-12-02, Days after onset: 52
Location:Unknown  Entered:2012-12-02
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': WAES1211USA011118
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 11-OCT-2012 09:21, 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:479282 (history)  Vaccinated:2012-10-11
Age:  Onset:2012-10-11, Days after vaccination: 0
Gender:Male  Submitted:2012-12-02, Days after onset: 52
Location:Unknown  Entered:2012-12-02
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': WAES1211USA011121
Vaccination
Manufa