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Found 593491 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:436969 (history)  Vaccinated:2011-10-06
Age:2.0  Onset:0000-00-00
Gender:Male  Submitted:2011-10-06
Location:Texas  Entered:2011-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: AS OF THIS TIME, NO REACTION HAS BEEN REPORTED
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH460AA0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: No adverse event
SMQs:
Write-up: NO REACTION REPORTED YET

VAERS ID:437060 (history)  Vaccinated:2011-10-06
Age:0.59  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-06, Days after onset: 0
Location:California  Entered:2011-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3896AB3IDLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHE324753IMLL
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FB2064 PO 
Administered by: Private     Purchased by: Public
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Wrong vaccines given to patient. I went to room and asked mother of patient if patient was pt whom vaccines were ordered for, mom replied "Yes". Vaccines (Pentacel, Prevnar, Rotarix) were given. When vaccine record was given back to mom she said "No, she is not this patient (pointing to vaccine record)." I asked again this is not patient and mom responded no. I apologized and informed provider immediately.

VAERS ID:437071 (history)  Vaccinated:2011-10-06
Age:21.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-06, Days after onset: 0
Location:Oklahoma  Entered:2011-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Cerebral Palsy, scoliosis
Diagnostic Lab Data: NI
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDN571070IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Feeling hot, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Nausea, warm feeling, dizziness. Temp 97.9, pulse 75, BP 125/71, R 15

VAERS ID:437073 (history)  Vaccinated:2011-10-06
Age:59.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-06, Days after onset: 0
Location:California  Entered:2011-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None. Headache gone several hours after taking Advil.
CDC Split Type:
Vaccination
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Lot
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Headache
SMQs:
Write-up: Severe headache after having flu vaccine and tetanus shot at the same time.

VAERS ID:437077 (history)  Vaccinated:2011-10-06
Age:43.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-06, Days after onset: 0
Location:Hawaii  Entered:2011-10-06
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: allergy to latex
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH470AD IMLA
Administered by: Military     Purchased by: Private
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: pt states throat was tight, sent to ER

VAERS ID:437081 (history)  Vaccinated:2011-10-06
Age:19.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Kansas  Entered:2011-10-07
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 significantly abnormal.
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Chills, Flushing, Laboratory test normal, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Significant uncontrollable tremulousness/shaking, intermittent chills, intermittent flushing, Temp 100 deg F in ER

VAERS ID:437160 (history)  Vaccinated:2011-10-06
Age:39.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Iowa  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Asthenia, Confusional state, Dizziness, Eye irritation, Feeling abnormal, Feeling cold, Lip swelling, Nausea, Pyrexia, Sensation of foreign body, Sensation of heaviness
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: I got the shot at the end of my shift at work, came home and went to bed at 8a.m. At 10a.m. I woke up and felt like something was stuck in my throat, but could get no relief from coughing. I went back to bed and was freezing. At 12:15p.m. I awoke again with the same feeling in my throat and still freezing, now my bottom lip was swelled, I had a little nausea, felt weak, and my arms were really heavy. I called since they were the ones that gave the shot. The lady there said I should take some Benadryl and not be alone. I made my way to the bathroom and got some Benadryl, while in there feeling really dizzy like I was gonna pass out. I called my husband to come home. At 1:30p.m. I took 2 Benadryl. At 2:15 I was still freezing, but my eyes started burning, now I was running a fever of 100.7. At 3:30 I went to the Dr. now my temp was 101.4 and feeling really bad. The Dr. told me it was not a reaction, that a reaction takes 2-3 days to onset. On the handout I received with my shot it says the opposite. The Dr. gave me an antibiotic and sent me home. I am very confused NOT knowing what happened with me yesterday. I am going to miss 2 days of work with NO pay and disciplinary points on top of it. I believe it was a reaction, but how do I find out for sure?

VAERS ID:437165 (history)  Vaccinated:2011-10-06
Age:10.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Utah  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergic Rhinitis
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA677AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Mother noticed the patient''s injection site becoming red, swollen, and warm. Area of redness and swelling measures approximately 7 cm and is round.

VAERS ID:437275 (history)  Vaccinated:2011-10-06
Age:90.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-07, Days after onset: 0
Location:Iowa  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0813AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Local swelling, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 6cm reddened area, swelling, and increased warmth to area. No treatment needed, resident wasn''t even aware of reaction. No pain, discomfort or itch.

VAERS ID:437279 (history)  Vaccinated:2011-10-06
Age:26.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-07, Days after onset: 1
Location:Minnesota  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH4677AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Hypersensitivity, Lip swelling, Oedema mouth, Paraesthesia, Pharyngeal hypoaesthesia, Swelling face, Swollen tongue, Vaccination complication
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Allergic reaction to flu vaccine; pt presented with numbness in throat and tingling and swelling in mouth--lips and tongue; General puffiness in facial area, 10 minutes after receiving vaccination. Treatment: Benadryl IM. Fully recovered and released.

VAERS ID:437282 (history)  Vaccinated:2011-10-06
Age:37.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Texas  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA651AA0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Chest pain, Erythema, Feeling hot, Flushing, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient states as she was walking out of the office after receiving the vaccine she felt flush in her face, warmth in her chest and had chest pain. She continued back up to her work area and completed her shift indicating that the chest pain receded to a slight tingling in her chest and that the redness in her face went away but her ears remained red.

VAERS ID:437286 (history)  Vaccinated:2011-10-06
Age:11.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Colorado  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AB IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0692AA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM10054A0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Immediate post-injection reaction, Musculoskeletal stiffness, Opisthotonus, Seizure like phenomena, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dystonia (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Pt received Menveo, influenza and Gardasil vaccinations. Immediately after administration of last vaccine, Gardasil, pt began experiencing syncope, stiffening, arching back and demonstrated seizure-like movements. Episode lasted about 10-15 seconds. Pt. was seated during immunizations. Restrained pt in chair until alert. Pt stayed in chair, periodically putting head between knees, and observed for 30 min. Pt was alert upon leaving clinic.

VAERS ID:437299 (history)  Vaccinated:2011-10-06
Age:26.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-07, Days after onset: 0
Location:Michigan  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC528069FA5IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt c/o pain in (R) arm one day after injection - slight pinpoint rash - no redness or swelling noted. Saw Dr.

VAERS ID:437300 (history)  Vaccinated:2011-10-06
Age:69.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Male  Submitted:2011-10-07, Days after onset: 0
Location:Indiana  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH462AC1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Rash generalised
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Generalized rash - entire body, dizziness.

VAERS ID:437315 (history)  Vaccinated:2011-10-06
Age:10.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-07, Days after onset: 1
Location:Oklahoma  Entered:2011-10-07
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: ADHD; ODD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH469AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Decreased appetite, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Not hungry & vomited approximately 1 hr. after receiving flu vaccine. Vomited x 3+ on 10-6-11 and x1 today. Fever 7pm 10-6-11 99.8 this am 10:30 100.2. Feeling better at this time 12:52. Child reports another child was sick in his class at school. Mother & brother received vaccine same day no problems.

VAERS ID:437331 (history)  Vaccinated:2011-10-06
Age:52.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Male  Submitted:2011-10-07, Days after onset: 0
Location:Georgia  Entered:2011-10-07
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)SANOFI PASTEUR   RA
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Musculoskeletal stiffness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: numbness, tingling and stiffness to whole right upper extremity from shoulder to fingertips

VAERS ID:437335 (history)  Vaccinated:2011-10-06
Age:24.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-07, Days after onset: 1
Location:Pennsylvania  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: walnuts/pecans
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 RA
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Chills, Erythema, Immediate post-injection reaction, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Started burning/stinging right away, lasted for 3 1/2 hours. Woke up the next morning and the area was red and swollen about 2 inch diameter. Also had chills lasting all the next day.

VAERS ID:437340 (history)  Vaccinated:2011-10-06
Age:72.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Arizona  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: sulfa allergy, medical conditions at time of vaccination unknown
Diagnostic Lab Data: n/a
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH488AA0IMRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0662AA0SCLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling abnormal, Hyperhidrosis, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Patient felt sweaty and awful. At about 5:30 PM she said she felt funny and then just passed out.

VAERS ID:437344 (history)  Vaccinated:2011-10-06
Age:35.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Wisconsin  Entered:2011-10-07
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Sensitivity to Amoxicillin and Sulfa (GI illness and fever) Otherwise healthy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 6 RA
Administered by: Unknown     Purchased by: Other
Symptoms: Chest discomfort, Cough, Dyspnoea, Fear, Feeling abnormal, Flushing, Hyperhidrosis, Pruritus generalised, Speech disorder, Throat irritation, Tongue coated
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), 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), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Received Flu vaccine aroung 11:15 am, noted started to itch over most of body but was mild at this time. Continued through work, around 1:00 pm noted that was starting to feel short of breath with mild cough (tight feeling) and noted that tongue and throat starting to coated waxy feeling, cough started about this time. By 2:45 couldn''t speak more than a word, constant coughing and severe shortness of breath with flushing, sweating and feeling of fear. Was taken into ER and received treatment. Received 2 doses of Epi and other emergency meds to relieve symptoms and was effective.

VAERS ID:437392 (history)  Vaccinated:2011-10-06
Age:36.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Missouri  Entered:2011-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN allergy; mild pyelonephritis; hypoglycemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDN561060IMLA
Administered by: Private     Purchased by: Public
Symptoms: Hot flush, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: At 1730 she started having generalize and moderately intense "hot flashes". Denies SOA/CP, or edema of mouth, tongue, or lips. Around 1845 took 25mg BENADRYL. Hot flashed were coincidentally resolved by the time she took the po meds. While changing for bed at 2200 noticed bilat rashes on inner aspect of calves. No other S/S. The rashes was in same place as a "poison ivy" type reaction earlier in the summer, but long ago resolved. No other s/s overnight and resolved by morning.

VAERS ID:437348 (history)  Vaccinated:2011-10-06
Age:34.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-08, Days after onset: 1
Location:Illinois  Entered:2011-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Shellfish Allergy, asthma, rheumatoid arthritis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Abdominal discomfort, Dizziness, Headache, Influenza like illness, Pain
SMQs:, 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: Flu like symptoms, upset stomach, achy, headache and dizziness.

VAERS ID:437355 (history)  Vaccinated:2011-10-06
Age:10.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Male  Submitted:2011-10-08, Days after onset: 1
Location:Colorado  Entered:2011-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   RA
Administered by: Unknown     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Large and hot to the touch, red, circular raised area at the injection site. Measured 2 inches in diameter. He noticed it at lunch but didn''t tell mom until 5:00pm. No fever. Just the hot arm and sore to the touch. So far it has not gotten any worse or better. Was told by the nursing hotline to take him in Monday if it has not improved or to the urgent care if it gets any worse.

VAERS ID:437425 (history)  Vaccinated:2011-10-06
Age:75.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-08, Days after onset: 2
Location:Ohio  Entered:2011-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No allergies; Hypertension; Diabetes
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1101201 UNRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Arm red and hot to touch at the injection sight. Told the patient to ice his arm and take BENADRYL. If no improvement, I advised patient to seek medical attention.

VAERS ID:437368 (history)  Vaccinated:2011-10-06
Age:53.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-09, Days after onset: 2
Location:Wisconsin  Entered:2011-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO - I "WAS" feeling great until hours after receiving what was basically forced upon us. Either the flu shot or possibly job loss. What a bunch of baloney, to make someone feel this lousy & then have to work feeling that way. If not required I would never recommend having a stinking flu shot.
Preexisting Conditions: allergic to penicillin, Biaxin, sulfa
Diagnostic Lab Data: Trying to work with a smile on my face & PRETEND I felt A-OK when I felt beyond lousy thanks to this half-baked idea that flu shots are a good thing, or even effective.
CDC Split Type:
Vaccination
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNLA
Administered by: Military     Purchased by: Other
Symptoms: Asthenia, Cold sweat, Dizziness, Dysphonia, Eye pain, Headache, Hyperhidrosis, Lacrimation increased, Malaise, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Nasty headache/back of neck/head. Major dizziness, nauseated, CLAMMY, SWEATY, hoarse, my eyes ached & watery, low energy + body aches, especially legs. The headache actually began only hours after the shot. I still have symptoms but they are gradually decreasing, except have YET been unable to kick the nasty headache caused by this stupid flu shot. Might as well have signed up for a kissing booth with an infected individual.

VAERS ID:437458 (history)  Vaccinated:2011-10-06
Age:16.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-06, Days after onset: 0
Location:New York  Entered:2011-10-09, 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: Shellfish
Diagnostic Lab Data:
CDC Split Type: NYC1100030
Vaccination
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Lot
Dose
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Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.YK20150IN 
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB441AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1177Z1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash pruritic, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient developed pruritic rash and throat itching shortly after vaccines administered. Given BENADRYL and observed in office with resolution of symptoms.

VAERS ID:437460 (history)  Vaccinated:2011-10-06
Age:74.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-09, Days after onset: 3
Location:Arizona  Entered:2011-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: No treatment was necessary.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH459AB IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient received HD Flu shot in left deltoid in afternoon on 10/6. She noticed some redness and swelling at the injection site and extending down her arm about an inch or two later that evening. On 10/9 she presented to the pharmacy with very little swelling or redness. She will discuss with her PCP at next visit.

VAERS ID:437481 (history)  Vaccinated:2011-10-06
Age:49.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-09, Days after onset: 3
Location:Mississippi  Entered:2011-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11004011UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.111Z UNRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt came in Sat 10-8-11 complaining about his right arm. The location where he received his pneumonia shot was very red and warm to the touch. The diameter of the redness was larger than the band-aid all the way around.

VAERS ID:437457 (history)  Vaccinated:2011-10-06
Age:24.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-08, Days after onset: 2
Location:Kansas  Entered:2011-10-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma; Latex allergy; Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDN55406 IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site reaction, Pruritus generalised, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately 20 min after administration of vaccine, patient developed large raised erythematous welt at injection site accompanied by wheezing, symptoms of wheezing relieved with albuterol inhaler. Generalized itching began about 20-24 hours after injection not completely relieved with antihistamines.

VAERS ID:437513 (history)  Vaccinated:2011-10-06
Age:30.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-10, Days after onset: 4
Location:Ohio  Entered:2011-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Allergy to the Flu shot
Diagnostic Lab Data:
CDC Split Type:
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DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 1IJLA
Administered by: Public     Purchased by: Private
Symptoms: Cognitive disorder, Disturbance in attention, Dizziness, Injected limb mobility decreased, Injection site induration, Injection site pain, Injection site swelling, Insomnia, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: The night the vaccine was given I had swelling and soreness in my L upper arm at the injection site. As the days progressed I could not extend my arm to shoulder height. There was dizziness, nausea and inability to sleep that occurred from date of administration to 10/10/11. On 10/10/11 I went back to facility to have verify there was a reaction. My L upper arm on the posterior side is swollen and hard around the muscle. Since the administration of the vaccine the site of injection could not be touched, laid on or rubbed. At night pain ranged from a 7-8 on a 10 scale. Cognitively I felt cloudy with an inability to focus and concentrate. I iced and applied Arnica topical gel to the injection site. Today, 10/10/11 my L arm still aches, sensitive to touch and pulls on the muscle when extended to the side body.

VAERS ID:437518 (history)  Vaccinated:2011-10-06
Age:68.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-10, Days after onset: 4
Location:Washington  Entered:2011-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Atrial Fibrillation
Diagnostic Lab Data: None
CDC Split Type:
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 3IJLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Injection site reaction, Injection site warmth, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Area around the injection formed a 2-2 1/2 inch red hot rash. The area ached and hurt until Monday morning 10/10/2011. I was told to go to the emergency romm if I became worse.

VAERS ID:437549 (history)  Vaccinated:2011-10-06
Age:21.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-10, Days after onset: 4
Location:Iowa  Entered:2011-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none stated
Preexisting Conditions: none stated
Diagnostic Lab Data: none
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11162 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen, red deltoid, tenderness at the injection site. Student ran temp from 99.0 to 100.2.

VAERS ID:437651 (history)  Vaccinated:2011-10-06
Age:71.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Female  Submitted:2011-10-10, Days after onset: 2
Location:Pennsylvania  Entered:2011-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11002010IMLA
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt. is developing hives. Started after shot at home - some have resolved but pt. stated hives are on her back now.

VAERS ID:437570 (history)  Vaccinated:2011-10-06
Age:80.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 5
Location:Michigan  Entered:2011-10-11
Life Threatening? No
Died? Yes
   Date died: 2011-10-07
   Days after onset: 1
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: MEDICATIONS: The patient is on the following medications at home. - Oxycodone one capsules orally p.r.n.. - Voltaren 75 mg orally twice a day. - Gabapentin 400 mg four times a day. - Digoxin 0.125 mg orally every other day. - Amlo
Current Illness: None noted
Preexisting Conditions: PAST MEDICAL HISTORY: Hypertension, neuropathy, atrial fibrillation. Chronic kidney disease stage 3. Depression, anxiety, chronic iron-deficiency anemia, COPD, stable, osteoarthritis and chronic pain syndrome, and history of recurrent falls.
Diagnostic Lab Data: 10/6/11: WBC 21.4, Scr-1.8, BUN-39, LA-7.9, ABG-7.16, troponin-0.01 10/7/11: Wbc-12.2, Neuts-71.1%, scr-2.2, BUN-47, LA-4.6, ABG-7.20, CRP-1.8, sed rate-10mm/hr
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH438AB IMLA
Administered by: Other     Purchased by: Private
Symptoms: Alanine aminotransferase increased, Antiphospholipid antibodies, Arrhythmia, Aspartate aminotransferase increased, Atelectasis, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bilirubin increased, Blood calcium increased, Blood chloride increased, Blood count abnormal, Blood creatinine increased, Blood gases, Blood glucose normal, Blood lactic acid normal, Blood magnesium increased, Blood pH decreased, Blood phosphorus normal, Blood potassium normal, Blood sodium increased, Blood urea increased, Bradycardia, Breath sounds abnormal, C-reactive protein, Carbon dioxide decreased, Cardiac arrest, Central venous catheterisation, Chest X-ray abnormal, Clostridium test negative, Compression fracture, Computerised tomogram abdomen abnormal, Computerised tomogram abnormal, Condition aggravated, Cyanosis, Death, Electrocardiogram P wave abnormal, Electrocardiogram abnormal, Endotracheal intubation, Eye movement disorder, Femoral pulse decreased, Gastrointestinal sounds abnormal, Haematocrit normal, Haemodilution, Haemoglobin normal, Heart rate decreased, Hypertension, Hypotension, International normalised ratio normal, Ischaemic hepatitis, Loss of consciousness, Mean cell volume normal, Mechanical ventilation, Mental status changes, Merycism, Neuropathy peripheral, Neutrophil percentage increased, Nodal rhythm, Occult blood positive, Ocular hyperaemia, Oliguria, Osteoporosis, PCO2 normal, PO2 increased, Peripheral coldness, Platelet count normal, Pneumothorax, Protein total decreased, Prothrombin time normal, Pulseless electrical activity, Radial pulse abnormal, Red blood cell sedimentation rate normal, Renal failure acute, Renal tubular necrosis, Resuscitation, Rhonchi, Rib fracture, Sepsis, Septic shock, Somnolence, Spinal compression fracture, Syncope, Troponin normal, Ultrasound Doppler, Ultrasound pelvis abnormal, Unresponsive to stimuli, Urinary sediment present, Urine analysis abnormal, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (narrow), Agranulocytosis (broad), Angioedema (broad), Haematopoietic cytopenias affecting more than one type of blood cell (broad), Lactic acidosis (broad), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Supraventricular tachyarrhythmias (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Osteoporosis/osteopenia (narrow), Renovascular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: DATE OF EXAM: 10/07/2011 at 08:20. SUBJECTIVE: The patient is an 80-year-old lady who was brought in to the Emergency Room last night unconscious. I reviewed the reviewed the history in the system as well as reviewed the history from the patient''s family at bedside. The patient''s daughter saw the patient during lunchtime and had lunch with her. She was in her usual state of health. She has not had any fever or chills. No productive cough, no chest pain, no abdominal pain and no diarrhea. She was in her usual state of health without any evidence of an infectious process. After lunch time, the patient was supposed to get her flu shot and was on her way to get her flu shot. The patient''s family believes that she has gotten her flu shot. They were not told otherwise. It is presumed that the patient has received her flu shot. We are at this time unsure of the route it was given if indeed she received it. At around 6:00 after work, the same daughter came to visit the patient to cook her dinner. She was noted to be unconscious, sitting up in her electrical wheelchair. The patient does have episodes of syncope and has had multiple episodes in the past. Normally this is associated with "bowel movement" vasovagal syncope). At this time, the patient was not on the toilet bowl. The patient''s daughter did not smell or see any evidence of bowel or bladder incontinence or any sign that she had tried to move her bowels. The patient''s daughter tried to pick her up, thinking that this was one of her usual episodes of syncope. She asked the nursing staff to help her wake the patient up, but when they could not wake up the patient, EMS was called. When EMS arrived, the patient was noted to have low blood pressure. The patient''s daughter believes that she had taken all of her morning medications since her medication dispenser for that day was empty. The only thing that they are not sure of is whether or not the patient took her "fibromyalgia pill". The patient was then brought to the emergency room. The patient remained unconscious and had to be intubated to protect her airway. She was given IV fluid boluses without good response and started on vasopressor initially with dopamine and subsequently changed to Levophed. While the patient was in the emergency room, the patient was noted to have a pulseless electrical activity. They were not sure how long the patient had pulseless electrical activity and so CPR was performed. The patient sustained some broken ribs as well as mild pneumothorax. I have counseled the patient''s family regarding this and they are aware. The patient remains unresponsive on the vent. Occasionally, she tried to move her upper extremities. She is noted to have some movements of the lower extremity, but is not necessarily consistent with stimulation and not necessary purposeful. Occasionally, she will bite down on her ET tube. She is also noted occasionally to be "ruminating". The patient has guaiac positive stools, but there is no evidence of active bleeding or GI bleed. Blood count remains stable despite aggressive IV fluid hydration. There is some decrease in blood count, but mainly secondary to hemodilution. OBJECTIVE: GENERAL: The patient is mainly unresponsive, intubated, on vent support and vasopressor support. VITAL SIGNS: Most recent vital signs showed blood pressure 114/90, heart rate of 98, respirations of 15-22, temperature 35.4 degrees centigrade. Temperature minimum was 34.7 degrees early this morning. HEENT: Normocephalic and atraumatic. ET and OGT noted. Pupils were 4-5 mm bilaterally and minimally reactive to 3-4 mm bilaterally. Doll''s eyes were equivocal. There is some eye movements, but not entirely consistent with doll''s eye movement. Pink conjunctivae, no icterus. I was unable to fully evaluate the patient''s oral mucosa. NECK: Supple. CHEST: Lungs are symmetrical with good chest expansion. Diminished breath sounds at the bases with occasional scattered rhonchi

VAERS ID:437598 (history)  Vaccinated:2011-10-06
Age:68.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Female  Submitted:2011-10-10, Days after onset: 2
Location:North Carolina  Entered:2011-10-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Complained of sinus/cold sx
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0745AA0SCRA
Administered by: Other     Purchased by: Private
Symptoms: Lip swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Administered 10-6-11, patient had swelling of lower lip early A.M. on 10-8-11. Then upper lip morning of 10-9-11. Began BENADRYL at onset of swelling & has continued since.

VAERS ID:437599 (history)  Vaccinated:2011-10-06
Age:45.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-07, Days after onset: 1
Location:Minnesota  Entered:2011-10-11, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT4163AA IDLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Rash erythematous, Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Itchy, red bump on injection site & red spots all over body.

VAERS ID:437688 (history)  Vaccinated:2011-10-06
Age:53.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 5
Location:North Carolina  Entered:2011-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH477AD IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Oedema peripheral, Pain in extremity, Tendonitis, X-ray limb normal
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (narrow)
Write-up: 10-6-11 Patient received FLUZONE 0.5 ml IM in LD. Early pm pain began in (L) hand (later pain level 7). 10-7-11 Next day noted swelling in (L) hand and was unable to close fist due to swelling. Seen in clinic. Sent to ED - X-ray (L) hand. Normal 3 views (L) hand. Was told in ED prob. tendonitis. States 10-11-11 (L) hand still has pain level about 2-3.

VAERS ID:437689 (history)  Vaccinated:2011-10-06
Age:48.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-06, Days after onset: 0
Location:Michigan  Entered:2011-10-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH469AB UNUN
Administered by: Public     Purchased by: Other
Symptoms: Sensation of foreign body, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: 9:50 had shot - scratchy throat by 11:00 - at lunch throat feels like lump - called 911 - they did not give EPI -$g she was driven to urgent care - has had flu shot before - resolved.

VAERS ID:437713 (history)  Vaccinated:2011-10-06
Age:63.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Ohio  Entered:2011-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Gastroenteritis; Syncope
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AA0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Redness, rash & itching surrounding injection site.

VAERS ID:437719 (history)  Vaccinated:2011-10-06
Age:46.0  Onset:0000-00-00
Gender:Female  Submitted:2011-10-10
Location:Montana  Entered:2011-10-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR6036 UNUN
Administered by: Private     Purchased by: Unknown
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: Swelling, pain, redness to site of vaccine. Pink, increased warmth.

VAERS ID:437722 (history)  Vaccinated:2011-10-06
Age:  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 5
Location:Montana  Entered:2011-10-11
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR6036 UNUN
Administered by: Public     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:437747 (history)  Vaccinated:2011-10-06
Age:36.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Male  Submitted:2011-10-11, Days after onset: 3
Location:Virginia  Entered:2011-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 1IN 
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Diarrhoea, Headache, Lethargy, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)
Write-up: Extreme abdominal pains cyclic and consistent; diarrhea; headaches; nausea; body aches; lethargic; small amount of vomiting over the duration of 4 days and continuing.

VAERS ID:437748 (history)  Vaccinated:2011-10-06
Age:63.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-11, Days after onset: 5
Location:California  Entered:2011-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Hytrin, Atarax
Current Illness: None
Preexisting Conditions: Radiation proctitis, prostate cancer survivor
Diagnostic Lab Data: Numerous EKGs, numerous blood tests, chest x-ray, treadmill heart stress test. Saline IV and oxygen feed for 2 days. Heart enzyme level decreased as temperature decreased.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Abdominal discomfort, Atrial fibrillation, Blood test, Cardiac enzymes increased, Cardiac stress test, Chest X-ray, Chills, Dyspnoea, Electrocardiogram, Exercise electrocardiogram, Myocardial infarction, Pain, Pyrexia, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Embolic and thrombotic events, arterial (narrow), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Chills, fever of 102, upset stomach, shaking, shortness of breath, body aches, increase of heart enzyme indicating a heart attack, atrial fibrillation.

VAERS ID:437768 (history)  Vaccinated:2011-10-06
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2011-10-07
Location:Texas  Entered:2011-10-11, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1100701 IMAR
Administered by: Unknown     Purchased by: Unknown
Symptoms: Vaccination complication
SMQs:
Write-up: The patient did not report any problem and there was none observed after the shot was given. He said he has had a flu shot last year. The next day however, the patient''s mother called an informed us that her son had a reaction to the vaccine late in the night and later on was taken into the hospital. At the time of this report I do not have any additional information.

VAERS ID:437776 (history)  Vaccinated:2011-10-06
Age:62.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Male  Submitted:2011-10-11, Days after onset: 4
Location:Arizona  Entered:2011-10-11
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: Insulin dependent diabetic; DEMEROL allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUF478AC IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain in biceps/triceps muscle. 2 inch wide band of redness and edema wrapping from just below injection site to the inside of elbow. Warm to the touch, painful. Symptoms resolved 10/11/11 - patient has had previous influenza vaccines with no adverse reactions other then malaise/soreness at injection site.

VAERS ID:437753 (history)  Vaccinated:2011-10-06
Age:49.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-12, Days after onset: 6
Location:Georgia  Entered:2011-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~0.00~Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: DIABETIC- CONTROLLED hbA1C = 4.5
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Disorientation, Dizziness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: DIZZINESS, DISORIENTED THREE TIMES DURING THE DAY, AND TWICE AGAIN ON 10/11/2011

VAERS ID:437760 (history)  Vaccinated:2011-10-06
Age:68.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-08, Days after onset: 2
Location:Delaware  Entered:2011-10-12, 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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH469AB IMRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Arm is painful, swollen, & has redness around the injection site that looks like a set of eye glasses with a red circle around the site a small red bridge then another big red area.

VAERS ID:437811 (history)  Vaccinated:2011-10-06
Age:40.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-12, Days after onset: 6
Location:Illinois  Entered:2011-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Allergic to Sulfa
Diagnostic Lab Data: No testing done Did not seek medical attention
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11009011IMLA
Administered by: Public     Purchased by: Other
Symptoms: Breast swelling, Burning sensation, Immediate post-injection reaction, Muscle spasms, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Injection received at 10:45 AM on 10-6-11 in Left deltoid. Immediately started burning and burning sensation ran up arm and down her back. On Friday 10-7-11 had swelling of left axillary area and left side of chest including breast. Swelling of breast has subsided but still having some swelling of axillary region. Had some muscle spasms under left arm for about 3 days.

VAERS ID:437817 (history)  Vaccinated:2011-10-06
Age:48.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-12, Days after onset: 6
Location:Texas  Entered:2011-10-12
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: known allergy to antibiotic - cephradine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Eye irritation, Influenza, Oropharyngeal pain, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Eye irritation, swollen and sore throat. Took Benadryl. Swollen throat and flu symptoms for 24 hrs. Continued Benadryl. Visited doctor next day and he confirmed was reaction to flu shot.

VAERS ID:437965 (history)  Vaccinated:2011-10-06
Age:40.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-10, Days after onset: 3
Location:North Carolina  Entered:2011-10-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diazepam; Fish oil; Meclizine; SUDAFED; PROVENTIL; NEXIUM
Current Illness: Paronychia; hypothyroidism; anemia; vertigo
Preexisting Conditions: (Allergic PCN, sulfa, e-mycin, LEVAQUIN); PSVT; hypothyroidism
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH477AC2IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1011AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Injected limb mobility decreased, Injection site erythema, Malaise, Nausea, Respiratory tract congestion
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 10-5-11 received flu vaccine Lt deltoid & Rt pneumonia vaccine. 10-6-11 came by clinic Rt upper arm, area red & pt states cannot raise her arm. Feels sick, dizzy & stopped up. Dr informed, instructed to apply ice & take IBU, can call back tomorrow. AM 10/7/11 called & checked on pt. Arm better, still stopped up. Dizziness no better. Nausea. Asked pt if she needed to be seen, felt like she would be OK. 10/7/11 (pm) husband called requested something for nausea. PHENERGAN called in & to take TYLENOL q 4-6 hours.

VAERS ID:438217 (history)  Vaccinated:2011-10-06
Age:27.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Female  Submitted:2011-10-13, Days after onset: 5
Location:North Carolina  Entered:2011-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Sulfa allergy; Mepivacaine allergy; GERD; Chronic headaches
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDN573070IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Pain, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Starting 36 hrs after vaccine administration, patient felt aches/pains in ankles, which gradually progressed as general moderate intensity (7/10) pain/aches from feet to hips over the next 24 hours. The lower body aches lasted about two days, and was marginally responsive to APAP (cannot take NSAIDs). By 1 week after vaccine, patient''s aches had resolved.

VAERS ID:438522 (history)  Vaccinated:2011-10-06
Age:32.0  Onset:0000-00-00
Gender:Female  Submitted:2011-10-14
Location:California  Entered:2011-10-15, 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) (FLUZONE)SANOFI PASTEURUH469AA0IMUN
Administered by: Other     Purchased by: Private
Symptoms: No adverse event, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: N/A. No adverse event. Would like to report and document administration of FLUZONE MDI (w/ preservative) when patient requested FLUZONE preservative-free formulation. Pt. has been contacted.

VAERS ID:439238 (history)  Vaccinated:2011-10-06
Age:76.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-08, Days after onset: 2
Location:Nebraska  Entered:2011-10-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH476AA10IMAR
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Asthenia, Chills, Fatigue, Nervousness, Pain
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Hypoglycaemia (broad)
Write-up: Had flu shot at 10:18. By evening meal he was to tired and weak to eat, so wife feed him. Had chills and body aches and weakness and shaky. Started feeling better the next day.

VAERS ID:439257 (history)  Vaccinated:2011-10-06
Age:80.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-08, Days after onset: 1
Location:Ohio  Entered:2011-10-19, 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:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH458AB IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Large rash on arm flu shot was administered - still there several days later.

VAERS ID:439258 (history)  Vaccinated:2011-10-06
Age:18.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-06, Days after onset: 0
Location:Missouri  Entered:2011-10-19, Days after submission: 13
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 DIAGNOSTICS1100101 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling hot, Loss of consciousness, Nausea, Seizure like phenomena, Tremor, Unresponsive to stimuli, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: 5-10 min after administration pt. passed out in waiting room, became unresponsive, then began shaking (almost seizure like) by time I got to him he began to regain consciousness and was talking to us. His BP was 138/78 and P 72. 911 was called. He was complaining about being hot and nauseated. He vomited while EMT was here. Pt. transported to hospital.

VAERS ID:439291 (history)  Vaccinated:2011-10-06
Age:30.0  Onset:2011-10-10, Days after vaccination: 4
Gender:Female  Submitted:2011-10-19, Days after onset: 9
Location:Montana  Entered:2011-10-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR60360IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Hyperaesthesia, Hypoaesthesia, Pain, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Within a few hours of the injection, (L) deltoid area became very sore, even with light tough. This soreness continued for 3-4 days. Still unable to sleep on (L) side due to pain and numbness from pressure. Prolonged weight bearing on (L) arm also causes these symptoms.

VAERS ID:439488 (history)  Vaccinated:2011-10-06
Age:62.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Male  Submitted:2011-10-21, Days after onset: 13
Location:Ohio  Entered:2011-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No acute illnesses
Preexisting Conditions: NKDA Perpheral vascular disease, Atrial fibrillation, Tobacco use disorder, Hypertension, hx of oral SCC in situ, hx of erosive gastritis
Diagnostic Lab Data: none available
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT441AA IMRA
Administered by: Military     Purchased by: Public
Symptoms: Cough, Diarrhoea, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 days following the administration of the flu shot this pt developed nausea, vomiting, diarrhea, body-aches, fever, and cough. All resolved in about 1 week except the cough which has been residual for the last 2-3 wks. Wife also developed similar symptoms a few days after the onset of the patient''s symptoms began. The patients sx were not reported to this physician until the day of this report.

VAERS ID:439831 (history)  Vaccinated:2011-10-06
Age:66.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-25, Days after onset: 19
Location:New Jersey  Entered:2011-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0843AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:439919 (history)  Vaccinated:2011-10-06
Age:48.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-25, Days after onset: 18
Location:South Carolina  Entered:2011-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED11054P1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: Very Painful Shoulder/Arm, Left

VAERS ID:439937 (history)  Vaccinated:2011-10-06
Age:65.0  Onset:0000-00-00
Gender:Male  Submitted:2011-10-25
Location:Pennsylvania  Entered:2011-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No acute illnesses
Preexisting Conditions: NKA at time of vaccine Medical Conditions:Hearing loss, back pain, chronic prostatitis, GERD, allergic rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA618BA3IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0843AA IJRA
Administered by: Unknown     Purchased by: Other
Symptoms: Chills, Erythema, Local swelling, Malaise, Pyrexia
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Local Redness, swelling, fever, malaise, chills. Patient received vaccines and e-mailed clinician 5 days later saying that aforementioned s/sx occurred and were resolving.

VAERS ID:440006 (history)  Vaccinated:2011-10-06
Age:55.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-25, Days after onset: 19
Location:Illinois  Entered:2011-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Cancer in 1982 clear now.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1100901 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left arm where he got his injection is still sore and hurts "like I got a shot". No redness, warmth or knot.

VAERS ID:440069 (history)  Vaccinated:2011-10-06
Age:40.0  Onset:2011-10-12, Days after vaccination: 6
Gender:Female  Submitted:2011-10-21, Days after onset: 9
Location:Virginia  Entered:2011-10-26, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Temporal headache, ringing in ears, facial paraesthesia, tingling lips~Influenza (Seasonal) (no brand name)~UN~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: The patient had a history of left temporal pain, tinnitus and facial tingling paraesthesia after receiving an influenza vaccination in 2010.
Diagnostic Lab Data: Not reported
CDC Split Type: 201109964
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT447AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye pruritus, Headache, Influenza like illness, Paraesthesia, Paraesthesia oral, Rhinorrhoea, Similar reaction on previous exposure to drug, Tinnitus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hearing impairment (narrow)
Write-up: Initial report was received 13 October 2011 from a health care professional. A 40-year-old female patient who had a history of left temporal pain, tinnitus, and facial tingling and paraesthesia in 2010 following an Influenza vaccination, had received an intramuscular left deltoid injection of FLUZONE No Preservative 2011-2012, lot number UT447AA on 06 October 2011 and one day later, she developed a runny nose, itchy eyes, and flu-like symptoms. On 12 October 2011, six days after vaccination, she developed left temporal pain, increased ringing in her ears, and tingling and paraesthesia of the face and lower lip. The event required a doctor''s visit; it was not reported if treatment was required. The patient had been taking TOPRAMAX concomitantly. According to the reporter, the patient''s neurologist approved vaccination. Outcome was unknown. Documents held by sender: None.

VAERS ID:440097 (history)  Vaccinated:2011-10-06
Age:80.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-17, Days after onset: 11
Location:Florida  Entered:2011-10-26, 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: No
Preexisting Conditions: Breast cancer
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH468AC0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oropharyngeal pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Night of vaccination pt had fever starting at 101 then progressed to 103. She also experienced body aches and sore throat. Symptoms lasted until AM.

VAERS ID:440149 (history)  Vaccinated:2011-10-06
Age:58.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-26, Days after onset: 20
Location:New York  Entered:2011-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Anaemia, Back pain, Chills, Headache, Influenza like illness, Pain, Platelet count increased, Pyrexia, Tremor
SMQs:, Haematopoietic erythropenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Started with severe backache, in 3 days progressed to severe headaches, and major flu like symtoms, high fever, severe chills and tremors,and body aches. High white platelets jumped to 638,000, then to 900,000, and became amemic. Have been sent to hematologist on 22nd. Waiting for results-appt on Nov 1st.

VAERS ID:440426 (history)  Vaccinated:2011-10-06
Age:0.19  Onset:0000-00-00
Gender:Female  Submitted:2011-10-27
Location:New Jersey  Entered:2011-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
RVX: ROTAVIRUS (NO BRAND NAME)UNKNOWN MANUFACTURER    
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever for 3 days of about 100, vomiting and diarrhea for two weeks. Vomiting continued for 18 days.

VAERS ID:440586 (history)  Vaccinated:2011-10-06
Age:49.0  Onset:2011-10-09, Days after vaccination: 3
Gender:Female  Submitted:2011-10-29, Days after onset: 20
Location:Florida  Entered:2011-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No, but was have a high ANA titer and am will have testing in November for Lupus.
Preexisting Conditions: Pcn, Sulfa, Benzoin,
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Erythema, Joint swelling, Skin warm
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pain and swelling to joints specifically the sides of both knees, hands, and feet. Redness and warm to the touch on the sides of both knees.

VAERS ID:440626 (history)  Vaccinated:2011-10-06
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2011-10-29
Location:New Jersey  Entered:2011-10-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT473AA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Her arm is extremely sore.

VAERS ID:440700 (history)  Vaccinated:2011-10-06
Age:70.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-22, Days after onset: 16
Location:North Carolina  Entered:2011-10-31, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Oxygen; blood work; stress test; MRI
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR  UNUN
Administered by: Public     Purchased by: Public
Symptoms: Blood test, Cardiac stress test, Chills, Faecal incontinence, Loss of consciousness, Nuclear magnetic resonance imaging, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (broad), Hypoglycaemia (broad)
Write-up: About 7:25 chills, shakes. About 7:30 passed out (about 10 seconds) pavement, about 5 mins. vomit and bowel movement - family called 911.

VAERS ID:440829 (history)  Vaccinated:2011-10-06
Age:58.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-31, Days after onset: 25
Location:New Mexico  Entered:2011-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None specified
Preexisting Conditions: Penicillin, oyster, clam allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1102101 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient developed a maculopapular rash (painless) on arms, chest, and back shortly after receiving the flu shot.

VAERS ID:440844 (history)  Vaccinated:2011-10-06
Age:66.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:North Carolina  Entered:2011-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Joint swelling, Mobility decreased, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Dementia (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: My arm & shoulder swelled, very sore, could not move arm well, had to have help getting clothes on. Doctor gave Prednisone 5 mg 6 day pak plus refill.

VAERS ID:440895 (history)  Vaccinated:2011-10-06
Age:83.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-01, Days after onset: 26
Location:Florida  Entered:2011-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBPV: HIB POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Bacterial infection, Cellulitis, Erythema, Feeling hot, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pain, hot, swollen, red, doctor visit cellulitis, bacterial infection, prednisone, cephalexin, ciprofloxin, Vicodin.

VAERS ID:440931 (history)  Vaccinated:2011-10-06
Age:72.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-10-28, Days after onset: 22
Location:Arizona  Entered:2011-11-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Not reported
CDC Split Type: 201110288
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH436AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)
Write-up: Initial report received on 21 October 2011 from a Nurse Practitioner. A male patient (date of birth unknown) with unknown medical history had received a dose of FLUZONE HIGH-DOSE (lot number unknown) on an unknown date and 4 hours post-vaccination experienced an MI (myocardial infarction) requiring hospitalization. Patient''s recovery status was reported as unknown. No further information was provided. Documents held by sender: None.

VAERS ID:441046 (history)  Vaccinated:2011-10-06
Age:37.0  Onset:2011-10-22, Days after vaccination: 16
Gender:Male  Submitted:2011-11-01, Days after onset: 10
Location:Pennsylvania  Entered:2011-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Spinal tap; MRI head and neck; CT scan; Blood work
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1100401 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blood test, Chest discomfort, Chest pain, Computerised tomogram, Fatigue, Lumbar puncture, Mobility decreased, Motor dysfunction, Muscle spasms, Muscle tightness, Muscular weakness, Myalgia, Neck pain, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: 10/22/11 - Bilateral muscle weakness hands & forearms. During day progressed to include bilateral muscle spasms of calves with pain & weakness. By evening symptoms migrated to hamstrings. 10/23/11 symptoms cont to migrate to upper and lower extremities and started to lose dexterity in fingers. 10/23/11 night - very achy, tired, movement was very difficult, experienced tightness with movement. 10/24/11 at 4AM - woke up due to pain and tightness of thorax and neck. Seen at 8:15AM at PHCP office and sent directly to ER.

VAERS ID:441114 (history)  Vaccinated:2011-10-06
Age:63.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-02, Days after onset: 27
Location:Michigan  Entered:2011-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: joints ached, Nausea/vomiting~Tetanus Diphtheria (no brand name)~UN~38.00~Patient
Other Medications:
Current Illness: No
Preexisting Conditions: Penicillin and wasp stings
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3353AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Injection site pain, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient stated on 10/6/2011 she developed aching joints and muscles, nausea & vomiting and soreness at the injection site. Nausea/vomiting subsided in 2 days. Still experiencing joint pain today 11/2/2011. Had similar reaction to tetanus vaccine about 25 years ago.

VAERS ID:441166 (history)  Vaccinated:2011-10-06
Age:32.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:2011-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11064P0IMAR
Administered by: Public     Purchased by: Unknown
Symptoms: Eye pain, Headache, Migraine with aura, Optic neuritis, Photopsia
SMQs:, Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Retinal disorders (narrow), Ocular infections (broad)
Write-up: Received vaccine 10/6/11 approx 6 hr late had very bad headache next morning noticed flashing light out of corner of (R) eye. Headache and flashes continued so I called eye dr after 3 eye appt in 3 day determined optic nerve was inflamed and optic migraines prescribed NSAID follow up 6 mth. Headache 15 day still have eye pain.

VAERS ID:441228 (history)  Vaccinated:2011-10-06
Age:48.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2011-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH467AB0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Headache, Hypoaesthesia, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: (L) arm swelling, pain and redness with numb spots. Pt also c/o headache x 4 days. Several inches in length and width.

VAERS ID:441229 (history)  Vaccinated:2011-10-06
Age:35.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2011-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cold; Low grade fever 99.2
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH467AB0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt reported red, swollen, extremely painful arm x3 day. Pts states "arm swelled up twice the size of normal". BENADRYL and compresses given.

VAERS ID:441301 (history)  Vaccinated:2011-10-06
Age:65.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-03, Days after onset: 28
Location:Oregon  Entered:2011-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: EMPHYSEMA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT480AA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: PERSISTENT SORENESS AT SITE, SHOOTING PAIN DOWN ARM (right) TO MIDDLE FINGER AREA.

VAERS ID:441355 (history)  Vaccinated:2011-10-06
Age:38.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-04, Days after onset: 29
Location:Unknown  Entered:2011-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA652AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bursitis, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Developed sore arm which became progressed. Reported to clinic 10/17/11. Dx bursitis and started on physical therapy.

VAERS ID:441501 (history)  Vaccinated:2011-10-06
Age:54.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-04, Days after onset: 29
Location:Florida  Entered:2011-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA691AA IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Discomfort, Neck pain, Pain in extremity
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient could not sleep due to pain that radiated up neck and down arm. Pain improved but still uncomfortable for at least 5 days. Patient left for another country for 2 week. Pain was tolerable during this period. Radiating pain returned upon return.

VAERS ID:441906 (history)  Vaccinated:2011-10-06
Age:78.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-10, Days after onset: 4
Location:North Carolina  Entered:2011-11-09, Days after submission: 30
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 noted
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDN55406 IMAR
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Unable to follow up with customer - phone disc. Per conversation of operation manager with the patient. Following the shot, she began to have soreness in her arm, soreness did not go away and she visited her primary care physician to receive a cortisone shot. The shot was not effective. She returned the next week for another cortisone shot. As of 10/19 she is staring to feel better.

VAERS ID:441999 (history)  Vaccinated:2011-10-06
Age:79.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-10-25, Days after onset: 18
Location:Wisconsin  Entered:2011-11-09, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA674AA2UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0595AA0UNRA
Administered by: Private     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:442167 (history)  Vaccinated:2011-10-06
Age:52.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-11-11, Days after onset: 35
Location:California  Entered:2011-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin 10 mg OTC allergy medication
Current Illness: none
Preexisting Conditions: Allergies to trees and dust; occasional asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Private     Purchased by: Other
Symptoms: Bone pain, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (broad)
Write-up: Left upper arm pain that has persisted for over a month. Pain is not bruising, there is no swelling or sign of inflammation. The pain feels like it is in the bone and can be quite severe with certain arm movements like pulling clothing over head or reaching behind. The pain has not improved at all over time - it feels the same as day one. Patient called this in to facility and was told to apply heat and take pain medication. This has not helped.

VAERS ID:442209 (history)  Vaccinated:2011-10-06
Age:68.0  Onset:2011-10-09, Days after vaccination: 3
Gender:Male  Submitted:2011-11-13, Days after onset: 35
Location:South Carolina  Entered:2011-11-13
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: no
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH460AC IMRA
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Patient states that both his hands got stiff for about 3 days.

VAERS ID:442974 (history)  Vaccinated:2011-10-06
Age:63.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-11, Days after onset: 36
Location:Arizona  Entered:2011-11-14, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to CIPRO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11010010IMAR
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Periarthritis
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (narrow)
Write-up: Pt states she experienced increasing pain in shoulder where vaccine was administered. Severe pain & "frozen shoulder" still & is seeing an orthopedist for tx.

VAERS ID:442538 (history)  Vaccinated:2011-10-06
Age:41.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-15, Days after onset: 40
Location:Michigan  Entered:2011-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy: penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT473AB IMLA
Administered by: Private     Purchased by: Private
Symptoms: Bronchospasm, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (narrow), Oropharyngeal allergic conditions (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Throat swelling, severe bronchospasm.

VAERS ID:442934 (history)  Vaccinated:2011-10-06
Age:1.77  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-11-17, Days after onset: 42
Location:Tennessee  Entered:2011-11-17
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
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B099BA3IMLL
HEPA: HEP A (VAQTA)MERCK & CO. INC.1068AA1IMLL
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Skin warm, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Dad brings child to clinic 11/7/11 , one month after immunizations were given. Describes whelps ? redness, warmth, swelling on child trunk and extremities after 10/6/11 immunizations were given. Treated child with OTC TYLENOL, was much improved the next morning.

VAERS ID:443115 (history)  Vaccinated:2011-10-06
Age:11.0  Onset:2011-10-28, Days after vaccination: 22
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:2011-11-21
Life Threatening? Yes
Died? Yes
   Date died: 2011-11-02
   Days after onset: 5
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: DEPAKOTE
Current Illness: None
Preexisting Conditions: Trisomy 21; epilepsy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0675AA1UNRA
Administered by: Public     Purchased by: Public
Symptoms: Death, Diarrhoea, Escherichia infection
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrheal illness on 10/28/11 - transferred to hospital on 10/31/11. Died on 11/2/11 - dx with E-coli 0157 Huhs. She was Trisomy 21 (Downs) & epilepsy, well controlled with med.

VAERS ID:443136 (history)  Vaccinated:2011-10-06
Age:42.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-11, Days after onset: 36
Location:California  Entered:2011-11-21, 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: The patient''s medical history was not reported.
Diagnostic Lab Data: Not reported
CDC Split Type: 201110937
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4163BA IDLA
Administered by: Private     Purchased by: Unknown
Symptoms: Hypersensitivity, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial report received from a health care professional on 09 November 2011. A female patient received an intradermal injection (site not reported) of FLUZONE Intradermal, sanofi pasteur lot number not reported, on an unknown date. The patient''s medical history was not reported. On an unknown date, the patient had a severe allergic reaction with severe wheezing to the FLUZONE intradermal. The patient required treatment with epinephrine and steroids. The outcome was not reported. Documents held by sender: None.

VAERS ID:445154 (history)  Vaccinated:2011-10-06
Age:47.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-10, Days after onset: 4
Location:Indiana  Entered:2011-12-12, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma; Migraines
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA691AA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Chills, Dizziness, Headache, Heart rate increased, Hyperhidrosis, Injection site erythema, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 6-8 hrs after injection. Aches, pains, fever (102), chills, sweating, headache, dizziness, elevated heart rate (110), swelling at site (goose egg size). Redness at site.

VAERS ID:447129 (history)  Vaccinated:2011-10-06
Age:74.0  Onset:2011-10-19, Days after vaccination: 13
Gender:Male  Submitted:2012-01-10, Days after onset: 83
Location:California  Entered:2012-01-10
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril; Simvastatin; Fenofibrate; Metformin hydrochloride
Current Illness: Diabetes; Hypertension
Preexisting Conditions: The subject had previous flu shots every year since 2002 with no documented adverse event. The subject has had not adverse events following other previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0960431A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA682AA UNLA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Guillain-Barre syndrome, Pain
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: This case was reported by a physician and described the occurrence of Guillain-Barre syndrome in a 74-year-old male subject who was vaccinated with FLULAVAL (GlaxoSmithKline). Concurrent medical conditions included diabetes and hypertension. Concurrent medications included LISINOPRIL, SIMVASTATIN, LOFIBRA and METFORMIN. On 6 October 2011 the subject received a dose of FLULAVAL (.5 ml, unknown route, left arm). On 19 October 2011, 13 days after vaccination with FLULAVAL, the subject experienced body pain and chills. On 4 November 2011 the subject experienced Guillain Barre syndrome, went to the emergency room and was admitted to the hospital. On 11 November 2011, he was transferred to a rehabilitation center. On 23 December 2011, he was discharged with home care. The subject was hospitalised and the physician considered the events were disabling and clinically significant (or requiring intervention). At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with FLULAVAL.

VAERS ID:447361 (history)  Vaccinated:2011-10-06
Age:43.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2012-01-13, Days after onset: 98
Location:California  Entered:2012-01-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Bone pain, Chills, Musculoskeletal stiffness, Pain in extremity, Pyrexia, Rash, Rash erythematous, Skin hypertrophy
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, bone aches, stiff painful arm, chills- Motrin for two days I took Motrin and stayed in bed and slept. Facial red rash started 6 days after vaccine and I began to develop red bumps and thickening of the facial skin.

VAERS ID:447688 (history)  Vaccinated:2011-10-06
Age:57.0  Onset:2011-11-09, Days after vaccination: 34
Gender:Female  Submitted:2011-11-10, Days after onset: 1
Location:Connecticut  Entered:2012-01-20, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.017AA0SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site haematoma, Malaise
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient described redness of arm appearing off and on red ring where vaccine given, feeling sick off and on - on inspection 1 large bruise just above her elbow and diffuse redness. No red ring. Called drug co to report & risk management.

VAERS ID:447825 (history)  Vaccinated:2011-10-06
Age:61.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-12-03, Days after onset: 58
Location:California  Entered:2012-01-23, Days after submission: 51
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: Interstitial cystitis
Diagnostic Lab Data: Physical therapy/MRI to be done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA636BA1IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Injection site pain, Mobility decreased, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Immediate pain on injection. Deltoid soreness advanced to severe pain and limited movement due to pain at left upper arm. Profuse muscle pains for 3 days post vaccine. On going intermittent muscle weakness with mod-severe pain to left upper arm - injection site as well.

VAERS ID:448241 (history)  Vaccinated:2011-10-06
Age:70.0  Onset:2011-10-09, Days after vaccination: 3
Gender:Female  Submitted:2012-01-27, Days after onset: 110
Location:California  Entered:2012-01-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: HRT; Valaciclovir hydrochlorid
Current Illness: Unknown
Preexisting Conditions: The subject did not experience adverse reactions with previous vaccinations, including flu shots. The subject reported that she had received flu shots yearly for the past 15 years.
Diagnostic Lab Data: UNK
CDC Split Type: A0962737A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA694AA UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0453AA UNUN
Administered by: Private     Purchased by: Private
Symptoms: Abdominal distension, Atrial fibrillation, Cardiac pacemaker insertion, Cardiovascular disorder, Chest discomfort, Chest pain, Chills, Diarrhoea, Dyspnoea, Hepatic enzyme abnormal, Muscle spasms, Pain, Pain in extremity, Pleural effusion, Pyrexia, Vomiting
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a consumer (also the subject) and described the occurrence of pleural effusion in a 70-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). A physician or other health care professional has not verified this report. Concurrent vaccinations included pneumonia vaccine (non-gsk); manufacturer unspecified; unknown; unknown given on 6 October 2011. Concomitant medications included Hormone replacement therapy and VALTREX. On 6 October 2011 at 12:00 the subject received a dose of FLULAVAL (unknown, left arm). On 9 October 2011, 3 days after vaccination with FLULAVAL, the subject experienced pain in arm and chest, fever, chills and body pain. On an unspecified dates in October 2011, the subject experienced pleural effusion, atrial fibrillation, liver enzymes "out of whack", shortness of breath, acute muscle spasm, chest tightness, vomiting, diarrhea and "bloating in stomach and intestine". She reported she had a pacemaker placed as a result of the "cardiovascular side effects". The subject reported she was hospitalized twice due to the side effects. The first hospitalization was from 22 October 2011 to 25 October 2011. The second hospitalization was on 1 November 2011 and she was discharged 3 weeks later. At the time of the report, the subject was taking prednisone. At the time of reporting the outcomes of the events were unspecified.

VAERS ID:448596 (history)  Vaccinated:2011-10-06
Age:0.55  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2012-01-27, Days after onset: 113
Location:Maryland  Entered:2012-02-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Culture sent out 1/27/12
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B285GB2UNRL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4149DB0UNRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH401AA2UNLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH9169752UNLL
Administered by: Private     Purchased by: Private
Symptoms: Culture, Immediate post-injection reaction, Injection site mass, Purulence
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Mom reports that child got a lump on right thigh immediately after shot was given and has persisted & enlarged over last couple of months. Now has come to a head & copious amounts of purulent drainage was expressed. Cultures sent & placed on antibiotics.

VAERS ID:448928 (history)  Vaccinated:2011-10-06
Age:30.0  Onset:2012-02-03, Days after vaccination: 120
Gender:Female  Submitted:2012-02-06, Days after onset: 3
Location:California  Entered:2012-02-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11064P IMLA
Administered by: Public     Purchased by: Other
Symptoms: Facial paresis, VIIth nerve paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: Awoke 2/3/11 with sudden-onset Left-sided facial weakness/paralysis. Diagnosed by her personal physician on 2/3/11 with Bell''s Palsy; treated by her PMD with Prednisone 20mg PO BID x6 days. Individual is on day 4 of treatment, and is still currently having symptoms.

VAERS ID:450575 (history)  Vaccinated:2011-10-06
Age:  Onset:0000-00-00
Gender:Female  Submitted:2011-10-13
Location:Maryland  Entered:2012-02-23, Days after submission: 133
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: MEDI0013755
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: A non-serious spontaneous report of sore throat has been received from a consumer concerning an adult female herself, subsequent to FLUMIST. Neither relevant past medical history nor concomitant medications had been reported for this patient. On 06-Oct-2011, the patient''s received FLUMIST. After receiving FLUMIST, the patient had sore throat which lasted for four days. The patient also had a son, who too received FLUMIST on the same day. He had a non-productive cough in his chest for four days. The outcome of the event sore throat was recovered.

VAERS ID:450594 (history)  Vaccinated:2011-10-06
Age:  Onset:0000-00-00
Gender:Male  Submitted:2011-10-13
Location:Maryland  Entered:2012-02-23, Days after submission: 133
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: MEDI0013756
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Cough
SMQs:, Anaphylactic reaction (broad)
Write-up: A non-serious spontaneous report of non-productive cough has been received from a consumer concerning her son, subsequent to FLUMIST. Neither relevant past medical history nor concomitant medications had been reported for this patient. On 06-Oct-2011, the patient received FLUMIST. After receiving FLUMIST, the patient had non-productive cough for four days. The outcome of the event non-productive cough was recovered.

VAERS ID:450275 (history)  Vaccinated:2011-10-06
Age:47.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Male  Submitted:2011-10-08, Days after onset: 0
Location:Texas  Entered:2012-02-24, Days after submission: 139
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 DIAGNOSTICSAFLUA616AA0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt c/o rash, shingles.

VAERS ID:450868 (history)  Vaccinated:2011-10-06
Age:49.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Male  Submitted:2012-02-27, Days after onset: 142
Location:New York  Entered:2012-03-01, 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: Lisinopril
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Frozen shoulder 1-23-2012
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Joint swelling, Periarthritis
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Shoulder was swollen and red mark present for 2 days after flu shot. Made an appointment to see orthopedic on 1-23-12. Doc gave me cortisone said I had frozen shoulder.

VAERS ID:452630 (history)  Vaccinated:2011-10-06
Age:51.0  Onset:2011-10-18, Days after vaccination: 12
Gender:Female  Submitted:2011-12-20, Days after onset: 63
Location:Arizona  Entered:2012-03-29, Days after submission: 99
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin; Nortriptyline; Acetate cream; "Citalopram"
Current Illness:
Preexisting Conditions: Illness at the time of vaccination was reported as none. Medical history included allergy to penicillin. Concomitant medication included multivitamin, nortriptyline, and acetate cream. Follow-up information received on 16 March 2012 reported patient had a negative "C-Scope" with plan to re-scope in five years. The patient had no sex drive and decreased libido. She took concomitant medication "citalopram 10/day" and was doing "great". The patient denied use of tobacco or alcohol. The patient had a two step purified protein derivative (PPD) on (date not reported) that was questionably positive. She had no history of PPD exposure and had a one and a half centimeter (cm) red area (prior to PPD). The doctor requested copy of PPD test results. Th
Diagnostic Lab Data: Follow-up information on 06 October 2011, noted that the patient had a two step purified protein derivative (PPD) on (date not reported) that was questionably positive. She had no history of PPD exposure and had a one and a half centimeter (cm) red area (prior to PPD). The doctor requested copy of PPD test results.
CDC Split Type: 201110457
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC39680IMRA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Erythema, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Local reaction, Oedema peripheral, Pain, Pain in extremity, Tuberculin test positive, Type IV hypersensitivity reaction
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial report was received on 27 October 2011 from a health care professional, at which time this case was assessed as non-serious, listed. Based upon follow-up information received on 16 March 2012 from a health care professional, it was determined this case now meets seriousness criteria (OTHER-MEDICALLY SIGNIFICANT) and this case has been upgraded from non-serious to serious. This narrative includes information reported on both dates. The reporter for this case is the same as case number 2011-10458. A 51-year-old female patient received dose one of a right arm intramuscular injection of ADACEL, sanofi pasteur Ltd., lot number C3968 (sanofi pasteur Inc. lot number U4088CA) on 06 October 2011. On 16 October 2011, ten days after vaccination, the patient developed "acute local delayed local reaction" swelling, pain and redness in right arm. She applied ice to site on 17 October 2011 and swelling was decreasing. The patient sought treatment with doctor on 18 October 2011. Vital signs were noted as temperature 97.1 degrees Fahrenheit, pulse 64 beats per minute, blood pressure 124/74, and weight 150 pounds. The patient denied shortness of breath, denied any injury or hitting arm, and denied fever. The patient had right arm pain with abduction and her right upper arm had swelling, was warm and tender, and had redness two and a half centimeters (cm). The patient''s energy was noted to be okay (OK), and the rest of the exam was noted to be negative. The patient was diagnosed with Cellulitis and delayed hypersensitivity local reaction, questionably an adverse reaction to ADACEL (Tdap). Treatment included BACTRIM DS twice a day for seven days "BID X 7 d." for right upper arm. The patient was instructed to call if worsens and follow-up in office in one week. The patient''s medical history included an allergy to Penicillin and the patient''s concomitant medications included multivitamin, nortriptyline, and acetate cream. It was noted that the patient had a negative "C-Scope" with plan to re-scope in five years. The patient had no sex drive and decreased libido. She also took concomitant medication "citalopram 10/day" and was doing "great" and the plan was to "try drug holiday". The patient denied use of tobacco or alcohol. The patient had a two step purified protein derivative (PPD) on (date not reported) that was questionably positive. She had no history of PPD exposure and had a one and a half centimeter (cm) red area (prior to PPD). The doctor requested copy of PPD test results. The patient refused "F.S.". She had elevated low-density lipoprotein (LDL) and elevated high-density lipoprotein (HDL) and was doing great with diet and exercise. Vital Signs on 06 October 2011: temperature 97.0 degrees Fahrenheit, Pulse 60 beats per minute, blood pressure 124/84 mmHg, weight 149 pounds. The patient''s outcome was reported as unknown. Documents held by sender: Medical record.

VAERS ID:454509 (history)  Vaccinated:2011-10-06
Age:  Onset:0000-00-00
Gender:Female  Submitted:2012-04-25
Location:Minnesota  Entered:2012-04-27, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Illness at the time of vaccination was not reported. At time of vaccination, patient was approximately four to five weeks pregnant with last menstrual period noted as 04 September 2011.
Diagnostic Lab Data: Not reported
CDC Split Type: 201109760
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR  SYRUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abortion induced, Maternal exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Initial report was received from a health care professional on 07 October 2011. A 4 to 5 weeks pregnant female (age not reported) had received an ADACEL injection (lot number and site of administration not reported). The patient Medical History and Estimated Date of Delivery were not reported. Last Menstrual Period was reposted as 09 April 2011. The patient did not experience an adverse event. The outcome was not reported. Follow-up information was received from a healthcare professional on 16 April 2012. Based upon the new information provided, this case has been upgraded to serious. The reporter corrected the patient''s first initial of her first name. The patient''s Date of Last Menstrual Period was 04 September 2011 (previously reported as 09 April 2011). The reporter stated the patient terminated pregnancy. The patient''s outcome was unknown. Documents held by sender: None.

VAERS ID:454895 (history)  Vaccinated:2011-10-06
Age:0.54  Onset:2012-03-17, Days after vaccination: 163
Gender:Female  Submitted:2012-05-01, Days after onset: 45
Location:Wisconsin  Entered:2012-05-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The subject''s medical history was not reported. The subject''s vaccine history included 2 doses of PENTACEL; lot number C3800AA received on 27 May 2011 and lot number C3871AA received on 24 August 2011.
Diagnostic Lab Data:
CDC Split Type: 201204394
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3912AA2UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Apnoea, Chest X-ray normal, Cough, Pertussis, Polymerase chain reaction, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (narrow), Respiratory failure (narrow)
Write-up: Initial report received on 20 April 2012 from the Investigator participating in post-marketing study under the reference number M5A16. A case of pertussis in a 12-month-old female subject was identified by the investigator based on review of data from the Electronic Disease Surveillance (EDSS) electronic database. The subject had received 3 doses of PENTACEL; lot number C3800AA received on 27 May 2011, lot number C3871AA received on 24 August 2011 and lot number C3912AA received on 06 October 2011 (routes and sites of administration not reported). The subject developed a paroxysmal cough with whoop on 27 March 2012, approximately five months after the last dose. The subject also experienced sleep disturbance and apnea. Laboratory testing included positive PCR on 27 March 2012. Chest x-ray findings were negative for pneumonia. Corrective treatments consisted of azithromycin starting on 28 March 2012 for five days. The subject was not hospitalized. At the time of final contact on 18 April 2012, the subject''s cough was still persisting. The duration of the cough was reported at that time as 22 days. Investigator causality assessment is not required as per protocol. Documents held by sender: None.

VAERS ID:455322 (history)  Vaccinated:2011-10-06
Age:32.0  Onset:0000-00-00
Gender:Female  Submitted:2012-05-02
Location:Washington  Entered:2012-05-10, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.501088P IN 
Administered by: Public     Purchased by: Unknown
Symptoms: Conjunctivitis, Influenza, Keratitis, Lymph gland infection, Sinusitis
SMQs:, Severe cutaneous adverse reactions (broad), Corneal disorders (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: 1. Flu. 2. Sinus infection. 3. Conjunctivitis. 4. Sinus infection. 5. Keratitis (ongoing). 6. Lymph node infection (ongoing) 7 rounds of antibiotics since Oct 2012 when vacc was rec.

VAERS ID:459374 (history)  Vaccinated:2011-10-06
Age:0.75  Onset:2011-10-07, Days after vaccination: 1
Gender:Male  Submitted:2012-07-16, Days after onset: 283
Location:Massachusetts  Entered:2012-07-16
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: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 2IMRL
Administered by: Unknown     Purchased by: Other
Symptoms: Agitation, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Patient developed swelling at site of injection, developed a fever and remained agitated and febrile for several days. 104.2 F rectal temperature noted on 01/07/2011. Parents administered ibuprofen to lower temperature. High temperatures abated but fever continued for several days.

VAERS ID:465336 (history)  Vaccinated:2011-10-06
Age:60.0  Onset:0000-00-00
Gender:Female  Submitted:2012-09-17
Location:Ohio  Entered:2012-09-17
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1101901 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Contusion, Cyanosis, Erythema, Oedema peripheral, Skin discolouration, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Acute central respiratory depression (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling on right arm, black, blue and red. 6 x 6 cm bruising. No fever, some tenderness.

VAERS ID:473342 (history)  Vaccinated:2011-10-06
Age:61.0  Onset:2011-10-20, Days after vaccination: 14
Gender:Female  Submitted:2012-10-12, Days after onset: 358
Location:Georgia  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Ophthalmological examination, See below, Patient developed an episcleritis in her right eye which continued into spring 2012.
CDC Split Type: WAES1110USA01025
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Episcleritis, Gastrointestinal viral infection, Incorrect route of drug administration, Ophthalmological examination abnormal, Respiratory tract infection viral
SMQs:, Optic nerve disorders (broad), Corneal disorders (broad), Scleral disorders (narrow), Medication errors (narrow)
Write-up: Information has been received from a female patient (an epidemiologist from the CDC) who reported that she received a dose of ZOSTAVAX (Merck) intramuscularly rather than subcutaneously on the morning of 06-OCT-2011. No adverse event reported. The patient sought no medical attention. Follow up information has been received from the HCP (Ph.D.) who reported on herself received the second dose of ZOSTAVAX (Merck) on an unspecified date (lot # and route not reported). The patient developed respiratory and gastrointestinal (GI) viral infection 1 weeks after receiving ZOSTAVAX (Merck) IM and both events were resolved, and then developed episcleritis 1 weeks after that (so 2 weeks after receiving ZOSTAVAX (Merck)). The patient was trying to resolve episcleritis as of now and was being seen by an ophthalmologist. Follow-up information was received via Vaccine Adverse Event Reporting System (VAERS) form from 61 year old female epidemiologist reporting on herself. Patient was vaccinated at a private doctor''s office/hospital. The patient received a flu shot (manufacturer unknown) on her left arm on 04-OCT-2011. On 06-OCT-2011 the patient received first dose of ZOSTAVAX in her left arm muscle in the morning. Lot number of ZOSTAVAX not reported. Patient was well at the time of flu and shingles shots. Vaccine was administered in a private doctor''s office/hospital. Patient also stated that an adverse event should be filed as she had a severe episcleritis in her right eye for half a year after her shingles shot. The event had resolved on approximately May 2012 (late spring of 2012). Additional information is not expected.

VAERS ID:472061 (history)  Vaccinated:2011-10-06
Age:62.0  Onset:2011-10-15, Days after vaccination: 9
Gender:Female  Submitted:2012-10-30, Days after onset: 381
Location:Texas  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NIFEDIAC; Triamterene; Pravastatin
Current Illness: None
Preexisting Conditions: Taking medicine for blood pressure
Diagnostic Lab Data: EMG abnormal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH477AB IMLA
Administered by: Other     Purchased by: Private
Symptoms: Abasia, Activities of daily living impaired, Balance disorder, Blood test, Carpal tunnel decompression, Decreased activity, Dysstasia, Electromyogram abnormal, Fall, Guillain-Barre syndrome, Hypoaesthesia, Mobility decreased, Nuclear magnetic resonance imaging abnormal, Pain in extremity, Paraesthesia, Stomach mass, Surgery, Walking aid user
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Demyelination (narrow), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: Before Oct 6, 2011, I was an active person. I took care of 160 acres of land, 50 head of cattle and 20 goats. My husband worked for 14 days and then home 14 days. On Oct. 6 I had the shot and felt the first effects on Oct. 15. Was sitting on a bale of hay and could not get up. My husband had to help. Later that evening my legs started to ache. I had started taking a cholesterol pill in Sept and I figured from what I had heard and read that this was causing it. This continued through November when I fell and the numbness & tingling started. Even into December, this kept up, but by January 2012 my balance went. This is when I went to dr, my family doctor. He did blood work and sent me to another dr who ordered MRI''s and did part of an EMG on my right side. The MRI showed a mass in my stomach, so I was sent to a dr & had surgery on Feb. 14, 2012, no cancer was found. She referred me to dr (neurologist) who saw me in the hospital the next day Feb. 15. He examined me and told me I had GBS. No one ever mentioned flu shot until April 4 when I had CTS surgery with dr. The nurse with me and some of her friend had gotten it about 10 years before right after flu shots. That is when my time line all fell into place. No one would comment on it, so we started checking on our own. Dr had told me after the EMG that what I had was permanent. There was nothing that could be done for me. I now am walking with a cane or walker, can''t step up without help, and live with the numbness, tingling and pain. I can no longer take care of the land and cattle and we had to sell my goats. The worst part is telling my little 2 1/2 year old grandson I can''t sit on the floor and play, run or walk with him. I now sit back and watch others have fun. So much for the golden years.

VAERS ID:474190 (history)  Vaccinated:2011-10-06
Age:  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-16, Days after onset: 41
Location:Texas  Entered:2012-11-09, Days after submission: 359
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: Not reported
Diagnostic Lab Data: Not reported
CDC Split Type: 201109900
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4163AA IDUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Injection site erythema, Injection site pain, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Initial report received from a health care professional on 06 October 2011. This case is a cluster of 2 unidentified patients who experienced similar adverse events following vaccination with FLUZONE Intradermal. This reporter also reported another adverse event, which was captured in case number 2011-09901 and case 2011-09902. A group of 2 unidentified patients received an intradermal injection of FLUZONE Intradermal, sanofi pasteur Inc. lot number UT4163AA, on 06 October 2011. On 06 October 2011, both patients developed nausea and dizziness on the way home after vaccination. The nausea and dizziness continued the next day. The patients had swelling, redness and pain at the injection site. The outcome was reported as recovered for both patients. Documents held by sender: None.

VAERS ID:475766 (history)  Vaccinated:2011-10-06
Age:  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-12-08, Days after onset: 63
Location:New York  Entered:2012-11-09, Days after submission: 337
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: No illness at the time of vaccination per reporter. Medical history included gluten intolerance.
Diagnostic Lab Data: None
CDC Split Type: 201111171
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT425AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Injected limb mobility decreased, Injection site pain, Nausea, Neck pain, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Initial report was received from a healthcare professional on 15 November 2011. A female patient had received an intramuscular FLUZONE; lot number UT425AA in right deltoid on 06 October 2011. On the same day of the injection in the evening, the patient developed chills, body aches and neck ache. On 07 October 2011 in the am, the patient experienced nausea, arm swelling, pain at right deltoid and difficulty using her arm. The symptoms progressed and she was seen in the emergency room (ER) prior to office visit. No further information was available at the time of the report. The patient outcome was not recovered/not resolved. Documents held by sender: none.

VAERS ID:439315 (history)  Vaccinated:2011-10-06
Age:36.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-10-20, Days after onset: 14
Location:Foreign  Entered:2011-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: B0756876A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSAHPVA135BE0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal distension, Genital swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a physician via a sales representative and described the occurrence of abdominal swelling in a 36-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 6 October 2011 the subject received 1st dose of CERVARIX (unknown route of administration, unknown site of injection). On 6 October 2011, less than one day after vaccination with CERVARIX, the subject experienced abdominal swelling that spread to pubic area. On 12 October 2011, the physician prescribed an antihistamine and following its administration, swelling spread to face. The physician considered the events were clinically significant (or requiring intervention). At the time of reporting, the events were worse.

VAERS ID:441152 (history)  Vaccinated:2011-10-06
Age:12.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-02, Days after onset: 27
Location:Foreign  Entered:2011-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No medical conditions, allergies or health problems. No history of epilepsy.
Diagnostic Lab Data: UNK
CDC Split Type: B0757546A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSAHPVA07DA0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Convulsion, Head injury, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: This case was reported by a regulatory authority (# GB-MHRA-ADR 21303181) and described the occurrence of blacked out in a 12-year-old female subject who was vaccinated with CERVARIX. On 6 October 2011 the subject received her 1st dose of CERVARIX (0.5 ml). On 6 October 2011, approximately 10 to 15 minutes after vaccination with CERVARIX, on standing up the subject blacked out and banged her head. It was reported that the subject also had a minor seizure which lasted around 10 to 15 seconds. The regulatory authority reported that the events were clinically significant (or requiring intervention). The subject was taken to hospital for observation and discharged later in the day with no lasting effects. She was back in school the same day, 6 October 2011. Patient blacked out, no dizziness very unexpected, 15 minutes following 1st vaccination, banged head, minor seizure, no history of epilepsy, lasted around 10-15 seconds. Reaction happened 10-15 minutes following vaccine, on standing up. No further treatment, ambulance called, taken to hospital for observation, discharged later in the day, no lasting effects, was back in school the same day.

VAERS ID:441685 (history)  Vaccinated:2011-10-06
Age:12.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-04, Days after onset: 29
Location:Foreign  Entered:2011-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Young lady didn''t have any medical history. Hadn''t had any childhood immunisation. No allergies known at time.
Diagnostic Lab Data: Blood pressure, Satisfactory; Pulse rate, Satisfactory
CDC Split Type: B0758455A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSAHPVA082AI IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dreamy state, Dyskinesia, Excoriation, Fall, Head injury, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a regulatory authority (# GB-MHRA-ADR 21307683) and described the occurrence of loss of consciousness in a 12-year-old female subject who was vaccinated with CERVARIX. On 6 October 2011 the subject received a dose of CERVARIX (0.5 ml, intramuscular). On 6 October 2011, at an unspecified time after vaccination with CERVARIX, the subject suddenly fell to the left side of the chair then fell off her seat in a jerking motion but was gently guided to the floor by staff. Banged her forehead, small graze. Was out for 30-60 seconds. Pulse and blood pressure taken three times and satisfactory. Subject thought she was in a dream state. The regulatory authority reported that the events were clinically significant (or requiring intervention). On 6 October 2011, the events were resolved. Verbatim Text: Young lady suddenly fell to the left side of the chair then fell off her seat in a jerking motion but was gently guided to the floor by staff. Banged her forehead, small graze. Was out for 30-60 seconds. Pulse and blood pressure taken three times and satisfactory. Patient thought she was in a dream state. Mum informed and ambulance took her to A&E department for observation.

VAERS ID:441956 (history)  Vaccinated:2011-10-06
Age:  Onset:2011-10-07, Days after vaccination: 1
Gender:Female  Submitted:2011-11-09, Days after onset: 33
Location:Foreign  Entered:2011-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Penicillin allergy; Otherwise fit and well.
Diagnostic Lab Data: Blood electrolytes, Normal; Blood urea, Normal; C-reactive protein, <2; Haemoglobin, Normal; White blood cell count, Normal
CDC Split Type: B0759338A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSAHPVA083ED IMUN
Administered by: Other     Purchased by: Other
Symptoms: Blood electrolytes normal, Blood urea normal, C-reactive protein increased, Chills, Haemoglobin normal, Injection site pain, Pain, Pyrexia, White blood cell count normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a regulatory authority (# GB-MHRA-ADR 21312218) and described the occurrence of pain in a female subject of unspecified age who was vaccinated with CERVARIX (GlaxoSmithKline). The subject''s medical history included penicillin allergy. Historic vaccines included CERVARIX. On 6 October 2011 the subject received unspecified dose of CERVARIX (intramuscular). On 7 October 2011, 1 day vaccination with CERVARIX, the subject experienced pain, fever, rigors and injection site pain. The subject was hospitalised. On 7 October 2011, the events were resolved. Aches and pains, fever, rigors. Improved with paracetamol. Arm pain at site of injection.

VAERS ID:443139 (history)  Vaccinated:2011-10-06
Age:  Onset:0000-00-00
Gender:Female  Submitted:2011-11-18
Location:Foreign  Entered:2011-11-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: 2011279184
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Vaccination site cellulitis
SMQs:
Write-up: This is a spontaneous report from a contactable physician communicated to a Pfizer company representative. A female patient (age unknown) received a dose of PREVENAR 13 intramuscularly on 06Oct2011. Relevant medical history, concomitant medications and past product history were not provided. On an unknown date, following administration of the vaccination, the patient developed vaccination site cellulitis. Hospitalization was required. Therapeutic measures taken as a result of the event included initiation of antibiotic therapy with ampicillin and sulbactam. Subsequently, on an unspecified date, the patient recovered from the vaccination site cellulitis and was discharged from the hospital.

VAERS ID:443337 (history)  Vaccinated:2011-10-06
Age:0.3  Onset:0000-00-00
Gender:Male  Submitted:2011-11-18
Location:Foreign  Entered:2011-11-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1111USA01536
Vaccination
Manufacturer
Lot
Dose
Route
Site
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALS 1IMUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH 1IMUN
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC. 1PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cold sweat, Diarrhoea, Faeces discoloured, Hypotonia, Pyrexia, Skin warm, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Information was obtained on request by the company from the agency via a public case details form (local ref # AUS/11/1623), concerning a 19 week old male child who on 06-OCT-2011 was vaccinated with the second dose of ROTATEQ (lot # not reported) orally, the second dose of INFANRIX HEXA intramuscularly and the second dose of PREVNAR 13 intramuscularly. Twelve hours post vaccinations patient developed an instant of water, green diarrhoea; vomiting commenced the next morning with all feeds, fever, hot to touch, clammy and floppy. The patient was admitted to hospital paediatric ward for nasogastric NG rehydration. At the time of reporting the patient had recovered from the events. The agency considered that the events of watery, green diarrhoea, vomiting, fever, clammy and floppy were possibly related to ROTATEQ, INFANRIX HEXA intramuscularly and PREVNAR. The original reporting source was not provided. Additional information is not expected.

VAERS ID:443251 (history)  Vaccinated:2011-10-06
Age:1.1  Onset:2011-10-06, Days after vaccination: 0
Gender:Male  Submitted:2011-11-21, Days after onset: 46
Location:Foreign  Entered:2011-11-22, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cough for several days prior to vaccination; Upper respiratory tract infection for several days prior to vaccination; Rhinitis NOS for several days prior to vaccination
Diagnostic Lab Data: Thermometry, 39.1 Centigrade; Urine examination (UNKNOWN): normal; Bacteria stool test (UNKNOWN): negative; Parasite stool test (UNKNOWN): negative; Virus stool test (UNKNOWN): negative; Physical examination (06Oct2011): 1-year and 1 month old male patient, slightly reduced general condition. Skin inconspicuous, normal turgor. Pharynx reddened, phlegmy, TF both sided cerumen relocated, Heart actions rhythmic, no heart noises, Pulmo so far inconspicuous at crying child, smooth abdomen, palpatory without any pathological findings, normal peristalsy, male genitals, slight diaper rash, no meningism, temperature 39.1 degrees C (ear); Blood gas analysis (Oct2011) pH 7.41, base excess -3.7, otherwise balanced
CDC Split Type: 2011279207
Vaccination
Manufacturer
Lot
Dose
Route
Site
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALSA21CB009C UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF32047 UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bacterial test, Base excess decreased, Blood pH normal, Dehydration, Dermatitis diaper, Diarrhoea, Febrile convulsion, Gastroenteritis, General physical health deterioration, Increased upper airway secretion, Musculoskeletal stiffness, Myoclonus, Parasite stool test negative, Pharyngeal erythema, Pyrexia, Screaming, Upper respiratory tract infection, Urine analysis normal, Viral test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This is a spontaneous report from a physician downloaded from the web portal of Regulatory Authority under Regulatory authority report number DE-PEI-PEI2011035302. A 13-month-old male patient received a dose of PREVENAR 13 (lot # F32047) and a dose of INFANRIX HEXA (lot # A21CB009C) on 06Oct2011. Relevant medical history included upper respiratory infection with cough and rhinitis for several days prior to vaccination. Concomitant medications were none and no past product history was reported. On 06Oct2011, in the afternoon, the patient developed fever and three suspected events of febrile seizures with myoclonus and vomiting. The patient was hospitalized and treated with infusions and antipyretics. Vomiting recurred, moreover the patient developed diarrhoea. There were no further events of seizures. Relevant lab tests included Body temperature of 39.1 C; Urine examination normal; Bacteria stool test: negative; Parasite stool test: negative and Virus stool test; negative. In addition, EEG was recommended but refused by the parents. The patient was discharged from hospital against medical advice on 08Oct2011. Clinical course from the hospital medical records was as follows: On the morning of 06Oct2011 the patient received 6-fold vaccination. During course of the afternoon the patient developed fever and the patient''s mother described in this context three seizure suspected events. Two times she recognized myoclonia, especially in the area of upper extremities for a few seconds. Once the patient tonically seized out of sleeping and the patient''s body was stiff and the hands were agglomerated to fists at that time. Afterwards the patient impressed as he was frightened and began to scream. No eye rolling, no increased salivation, no bedwetting occurred. In addition the patient vomited three times in the afternoon. The patient had tolerated previous vaccinations well and did suffer from rhinitis and cough in the last days and did not suffer from any pre-existing diseases. At that time the patient did not receive any medication. The patient was hospitalized on 06Oct2011 due to suspicion of febrile seizure in the case of status post 6-fold vaccination on the same day and existing infection of upper respiratory tract since a few days. At first a fluid substitution with glucose/electrolyte fluid was done in the case of mild dehydration. In addition an antipyresis was done due to continuing fever. During further course the patient showed increasing thin malodorous and decolorized diarrhea and vomited several times. Fever was well regredient and stool normalized in consistency and colour. On 08Oct2011 the patient''s parents wished the advanced discharge against doctor''s orders. An EEG in fever-free condition (necessary from the point of view of clinicians) was refused. The patient''s parents were extensively told that at that time no sure recovering of seizure symptomatology can happen "with the till that point done diagnostic". As a precaution diazepam rectioles (5mg) were prescribed and the patient''s parents were told what to do when the patient develops seizure again. The patient was discharged on 08Oct2011 in a stable general condition. Mentioned primary diagnosis in medical discharge record was gastroenteritis and further diagnoses were infection of upper respiratory tract and fever seizure. Follow-up activities not applicable. Follow-up provided automatically by regulatory authority.

VAERS ID:444102 (history)  Vaccinated:2011-10-06
Age:53.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-30, Days after onset: 55
Location:Foreign  Entered:2011-12-01, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic pneumonia
Diagnostic Lab Data: ??-Oct-2011, C-reactive protein, 198 mg/l; ??-Oct-2011, C-reactive protein, 160 mg/l
CDC Split Type: 2011030391
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: C-reactive protein increased, Diarrhoea, Influenza like illness, Injection site erythema, Injection site pain, Injection site warmth, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: This health authority report (initial receipt 21-Oct-2011) concerns a 53-year-old female patient, who had a medical history of chronic pneumonia. On 06-Oct-2011 the patient received an injection of influenza vaccine and concomitantly an injection of pneumococcal vaccine for vaccination. Symptoms started the same day with body pain, later described as influenza-like symptoms. On 07-Oct-2011 the patient also had diarrhoea and vomiting. On 09-Oct-2011 she was admitted to hospital. CRP (C-reactive protein) was measured to 198 mg/L, decreasing to 160 mg/L. There was also injection site reactions, as redness, warmth and tenderness, in left arm (where the pneum. vaccine was injected). Treatment included IV (intravenous penicillin and amoxycillin tablet for 10 days. The event outcome was recovering on 10-Oct-2011.

VAERS ID:444480 (history)  Vaccinated:2011-10-06
Age:53.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-12-02, Days after onset: 57
Location:Foreign  Entered:2011-12-05, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Pneumonia
Preexisting Conditions:
Diagnostic Lab Data: Serum C-reactive protein, ??Oct11, 198 mg/l; serum C-reactive protein, ??Oct11,160 mg/l
CDC Split Type: WAES1110USA04507
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  SYRUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  SYRLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: C-reactive protein increased, Diarrhoea, Influenza like illness, Injection site erythema, Injection site pain, Injection site warmth, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Case received from a physician via the Health Authorities on 21-OCT-2011 under the reference number NO-NOMAADVRE-FHI-2011-13049, NIPH 11/1981. Case medically confirmed. A 53-year-old female patient had received an injection of PNEUMOVAX 23 (manufacturer and batch number not reported, 1 dosage form parenteral) and concomitantly an injection of AFLURIA (manufacturer and batch number not reported, 1 dosage form parenteral) on 06-OCT-2011 and later on she developed body pain, some hours post vaccination on (06-OCT-2011) and on 07-OCT-2011, diarrhoea and vomiting. The patient was admitted to hospital on 09-OCT-2011. On the 10-OCT-2011 the outcome was reported as recovering. According to the reporter, the reactions were possibly related to both vaccines. Follow up information has been received from the health care professional via the Health Authority on 23-NOV-2011. The symptoms began with body pain, later described as influenza-like symptoms (onset 06-OCT-2011, hours post vaccination). C-reactive protein measured in October 2011 showed 198 mg/l decreasing to 160 mg/l. There were also observed injection site reactions, as redness, warmth and tenderness, in left arm (where the pneumococcal vaccine) had been injected, onset date not reported. The patient received corrective treatment with penicillin (manufacturer unknown, IV) and amoxicillin (manufacturer unknown, tablet for 10 days). The patient had a medical history of chronic pneumonia. At the time of reporting the outcome was recovering. According to the reporter, the injection site reactions were probably related to the pneumococcal vaccine and pain, influenza like illness, vomiting and diarrhoea possibly related to the pneumococcal vaccine. The injection site reactions were unlikely related to the influenza vaccine whilst pain, influenza like illness, vomiting and diarrhoea were possibly related to the influenza vaccine. No further information expected. Other business partner numbers include E2011-06374.

VAERS ID:446113 (history)  Vaccinated:2011-10-06
Age:5.0  Onset:2011-10-07, Days after vaccination: 1
Gender:Unknown  Submitted:2011-12-21, Days after onset: 75
Location:Foreign  Entered:2011-12-22, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No medical history reported; No concomitant therapy reported
Diagnostic Lab Data: Not reported
CDC Split Type: 201112313
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)SANOFI PASTEURE5985 SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site reaction, Oedema, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Case received from Health Authorities (reference number PLURPLOCR20111123005) on 13 December 2011 under local reference number 2011/0364. A 05-year-old patient, with no reported medical history and concomitant therapy, had received a subcutaneous dose of IMOVAX POLIO (batch number E5985, site of administration not reported) on 06 October 2011. On 07 October 2011, the patient experienced intense reaction at the injection site exceeding the nearest joint and lasting for more than 3 days, and fever at 38-38.4 degrees C. According to the doctor, oedema was caused by the stay of the patient on swimming pool the same day that the patient was vaccinated. The patient was hospitalized (dates of hospitalization not reported). The patient recovered on an unspecified date. The Health Authorities coded injection site reaction and fever.

VAERS ID:446584 (history)  Vaccinated:2011-10-06
Age:7.0  Onset:2011-10-19, Days after vaccination: 13
Gender:Male  Submitted:2011-12-27, Days after onset: 69
Location:Foreign  Entered:2012-01-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1112USA03890
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Impetigo
SMQs:
Write-up: This case was received from the Health Authorities on 19-DEC-2011 (reference number PEI2011040646). The case was medically confirmed. A 7-year-old male patient received the second dose of MMR SC on 06-OCT-2011, manufacturer, lot-no, and site of administration were not reported. On 19-OCT-2011, thirteen days after the administration, the patient developed severe facial impetigo contagious. The patient did not require hospitalization and had not recovered at the time of the report to the HA (08-DEC-2011). The final outcome was not reported. The first dose of MMR (manufacturer, lot-no and date of administration) was tolerated well. The HA assessed the seriousness criteria to be medically significant. Other business partner numbers include E2011-08211. Additional information has been requested.

VAERS ID:447456 (history)  Vaccinated:2011-10-06
Age:85.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Female  Submitted:2012-01-16, Days after onset: 100
Location:Foreign  Entered:2012-01-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Erythrocyte sedimentation rate, $g80, Unknown
CDC Split Type: 2012030776
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Musculoskeletal stiffness, Myalgia, Pain, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: This health authority report (initial receipt 11-Jan-2012) concerns an 85-year-old female patient. On 06-Oct-2011 the patient received influenza vaccine intramuscularly. On 08-Oct-2011, two days after vaccination, the patient developed widespread muscle stiffness and pain. Erythrocyte sedimentation rate (ESR) was greater than 80 and the event was clinically like polymyalgia. The event outcome was ongoing as the patient had so far declined to take steroids. Action taken with drug was not applicable. Rechallenge was unknown. The reporter considered the event to be serious as the event caused disability/incapacity.

VAERS ID:447809 (history)  Vaccinated:2011-10-06
Age:85.0  Onset:2011-10-08, Days after vaccination: 2
Gender:Female  Submitted:2012-01-23, Days after onset: 107
Location:Foreign  Entered:2012-01-23
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Erythrocyte sedimentation rate, Greater than 80
CDC Split Type: B0774664A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal stiffness, Myalgia, Pain, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by a regulatory authority (GB-MHRA-EYC 00078141) and described the occurrence of muscle stiffness in a 85-year-old female subject who was vaccinated with Influenza vaccine. On 6 October 2011 the subject received unspecified dose of Influenza vaccine (intramuscular). On 8 October 2011, 2 days after vaccination with Influenza vaccine, the subject experienced muscle stiffness and pain. The regulatory authority reported that the events were disabling. Erythrocyte sedimentation rate greater than 80 and clinically like polymyalgia. Ongoing as patient has so far declined to take steroids. At the time of reporting the events were unresolved. MHRA Verbatim Text: Developed widespread muscle stiffness and pain two days after having vaccination. Erythrocyte sedimentation rate greater than 80 and clinically like polymyalgia. Ongoing as patient has so far declined to take steroids.

VAERS ID:453447 (history)  Vaccinated:2011-10-06
Age:0.19  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2012-04-11, Days after onset: 188
Location:Foreign  Entered:2012-04-11
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: First and only child of the mother born in June 1977. Occurrence of gravidic diabetes during pregnancy. Born at 38 weeks of amenorrhea, normal delivery, birth weight 3460 g, height 50 cm, APGAR score at 10/10, head circumference at 34, weight on 31 July 2011 3107 g. No relevant medical history until first vaccination. Excellent psychomotor development with rolling from tummy to back.
Diagnostic Lab Data: Body temperature, 06Oct2011, normal; Body temperature, 03Nov2011, 37 Cels. deg
CDC Split Type: B0768728A
Vaccination
Manufacturer
Lot
Dose
Route
Site
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALSA21CB1420UNUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF36279 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Breath holding, Crying, Diarrhoea, Hypotonia, Pallor, Tremor, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: This case was reported by a physician and described the occurrence of vomiting in a two-month-old subject of unspecified gender who was vaccinated with INFANRIX HEXA (GlaxoSmithKline) and INFANRIXQUINTA (GlaxoSmithKline). Medical conditions and concurrent medications, if any, were unspecified. IN 2011, at two months old, the subject received a first dose of INFANRIX HEXA (batch, route and injection site unknown). After vaccination, the subject experienced vomiting without fever which resolved within an unspecified timeframe. In 2011, at three months old, the subject received a second dose of INFANRIXQUINTA (batch, route and injection site unknown). After vaccination, the subject experienced diarrhea without fever which resolved within an unspecified timeframe. At the time of reporting, the events were resolved. The reporter''s assessment was not provided. Follow-up received from the agency (reference MA20120760) on 24 April 2012: The subject was a female. She was the first and only child of the mother born in June 1977. Occurrence of gravidic diabetes during pregnancy. Born at 38 weeks of amenorrhea, normal delivery, birth weight 3460 g, height 50 cm, APGAR score at 10/10, head circumference at 34, weight on 31 July 2011 3107 g. The subject had no relevant medical history until first vaccination and psychomotor development was excellent with rolling from belly to back. The mother and maternal grandmother had hypoglycemic episodes of unknown etiology. On 06 October 2011, the subject received a first dose of INFANRIX HEXA (batch A21CB142A, intramuscular, injection site unknown) and a first dose of PREVENAR 13 (batch F36279, route and injection site unknown). Twelve hours after vaccination, the subject experienced projectile vomiting with a mild pallor for one hour without fever. On 03 November 2011, the subject received a second dose of INFANRIX QUINTA (batch A20CA719A, route and injection site unknown). Twelve hours after vaccination, the subject had diarrhea for two hours with a mild pallor without vomiting or fever. The subject''s tonus was normal. Those events were considered as a moderate recurrence (positive rechallenge). On 08 December 2011, the subject received a third dose of INFANRIX HEXA (batch A21CB168B, route and injection site unknown) and a second dose of PREVENAR 13 (batch F57963, route and injection site unknown). About 24 hours later, the subject had an episode of crying and projectile vomiting for one hour which recurred in the evening for three hours associated with hypotonia and tremor without sweating. The mobile medical unit contacted by phone recommended watching over the subject and staying in contact (they lived at 1h30 of the first hospital). All events resolved spontaneously within an unspecified timeframe. Those events were considered as positive rechallenge. In March 2012, the subject was doing well. Her psychomotor development was normal. At six months old, the subject did not stay seated but was able to roll from back to tummy. At seven months old, she could stay seated for one minute at home. She presented with breath holding spell and crying at view of strangers. At eight months old, she could stay seated in the doctor''s office. The regulatory authority reported that the events were clinically significant (or requiring intervention) and the case was upgraded to serious upon receipt of additional information. At the time of reporting, the events were resolved. The agency assessed the causal relationship of INFANRIX HEXA, INFANRIX QUINTA and PREVENAR 13 with vomiting and pallor as probable according to the method of assessment. The causal relationship of INFANRIX HEXA, INFANRIX QUINTA and PREVENAR 13 with diarrhoea, crying, hypotonia and tremor was not provided.

VAERS ID:455934 (history)  Vaccinated:2011-10-06
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2012-05-17
Location:Foreign  Entered:2012-05-21, Days after submission: 4
Life Threatening? No
Died? Yes
   Date died: 2012-03-05
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: GBSCRATCHP001070
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV1: JAPANESE ENCEPHALITIS (IXIARO)INTERCELL AG 1IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature, Brain injury, Death, Dizziness, Encephalitis viral, General physical health deterioration, Influenza like illness, Speech disorder
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad)
Write-up: The following information was received from a nurse via distributor on 04 May 2012 (initial and follow up information received on the same day and reported in summary here). Reporter did not comment on causality. Part of the information has been published in a public newspaper on 26 Apr 2012, which was also supplied by the reporter. A 26 year old female received her first IXIARO vaccination (batch number JEV10G58A) on 22 Sep 2011, followed by a second dose on 06 Oct 2011 (day 14, rather than day 28), prior to a year long backpacking journey. Concomitant medication included yellow fever and rabies vaccinations, doxycycline for malaria prophylaxis, and other unspecified pre-travel vaccinations for travel to foreign countries. She had no relevant medical history and did not take other concomitant medication. After leaving foreign countries, and while in another foreign country, patient developed a temperature and flu-like symptoms, felt dizzy, and had difficulty speaking. Her health deteriorated and she was subsequently airlifted to a hospital. Viral encephalitis (not specified further) and associated brain damage were diagnosed. She died five days after arrival (approximately one week after symptom onset) on 05 Mar 2012 from viral encephalitis.

VAERS ID:486736 (history)  Vaccinated:2011-10-06
Age:29.0  Onset:2011-11-01, Days after vaccination: 26
Gender:Male  Submitted:2013-03-12, Days after onset: 497
Location:Foreign  Entered:2013-03-12
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: D0079068A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB230AF UNUN
Administered by: Other     Purchased by: Other
Symptoms: Myofascitis, Paraesthesia, Sciatica
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by a physician, via a regulatory authority (# DE-PEI-PEI2013013318) and described the occurrence of lumboischialgia in a 29-year-old male subject who was vaccinated with TWINRIX adult (GlaxoSmithKline). Previous 3 vaccinations with TWINRIX adult on 22 July 1999, 26 August 1999 and 1 November 2000 were well tolerated. On 6 October 2011 the subject received 4th dose of TWINRIX adult (unknown route and application site). In the beginning of November 2011, approximately 1 month after vaccination with TWINRIX adult, the subject experienced lumboischialgia, paresthesia-leg and suspected macrophagic myofascitis. The physician reported that the events were disabling. At the time of reporting, on 28 February 2013, the events were unresolved. No further information will be available.

VAERS ID:488093 (history)  Vaccinated:2011-10-06
Age:53.0  Onset:2011-11-01, Days after vaccination: 26
Gender:Female  Submitted:2013-03-27, Days after onset: 512
Location:Foreign  Entered:2013-03-29, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHFR2011GB006764
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS110221 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Influenza
SMQs:
Write-up: Case number PHFR2011GB006764 is a spontaneous report received initially from a pharmacist on 23 Nov 2011, with a follow-up received on 04 Feb 2013 with a follow-up received from Quality Assurance Department on 06 Mar 2013: This report refers to an adult female patient. The patient was vaccinated with FLUVIRIN (batch number: 110221) intramuscularly on 06 Oct 2011. The patient "apparently" got the flu in Nov 2011. She was advised that the vaccine was based viral predictions stemming from a foreign flu outbreak and would need to establish if patient had influenza or a common coryza. The event seriousness, causality and outcome were not reported. Batch review report concluded that, a batch specific review could not be performed. Based on the Annual Product Review (APR) of FLUVIRIN vaccine, it was concluded that manufacturing process was operated at a good level of overall control and the supporting systems are effective in supporting the compliant production, testing and supply processes for FLUVIRIN vaccine. From this conclusion there was no reason or explanation to account for the reported adverse event. Follow-up was received on 04 Feb 2013: The patient''s demographics, QA number (208264) and other relevant clinical information were updated. Follow-up received from Quality Assurance Department on 06 Mar 2013: Updated batch review report.

VAERS ID:538582 (history)  Vaccinated:2011-10-06
Age:17.0  Onset:2012-05-01, Days after vaccination: 208
Gender:Female  Submitted:2014-08-01, Days after onset: 822
Location:Foreign  Entered:2014-08-01
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Body temperature, 08Apr2012, 38Deg. C
CDC Split Type: B1010982A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSAHPVA146AA0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Asthenia, Asthma, Condition aggravated, Constipation, Convulsion, Cough, Diarrhoea, Feeling of body temperature change, Headache, Hypersensitivity, Hypoaesthesia, Malaise, Memory impairment, Menstruation irregular, Muscle rigidity, Myalgia, Pain, Prosopagnosia, Pyrexia, Visual acuity reduced, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Pseudomembranous colitis (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Fertility disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a physician and described the occurrence of bronchial asthma in a 18-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent vaccination included 1st and 2nd doses of CERVARIX, (GlaxoSmithKline, intramuscular; unknown site of injection and batch number) given on unspecified dates. On 30 March 2012, the subject received 3rd dose of CERVARIX (intramuscular, unknown site of injection and batch number). In May 2012, 2 months after vaccination with CERVARIX, the subject experienced generalized pain. At the time of reporting, the outcome of the event was unspecified. Follow-up information received on 24 July 2014 from a physician: This case was upgraded to serious. 6 October 2011, the subject was vaccinated with the 1st dose of CERVARIX (intramuscular, unknown site of injection). On 9 October 2011, 3 days after vaccination with CERVARIX, the subject experienced bronchial asthma. On 23 October 2011, bronchial asthma improved in 2 weeks. On 8 November 2011, the subject was vaccinated with the 2nd dose of CERVARIX (intramuscular, unknown site of injection). On an unknown date, bronchial asthma developed again after the second vaccination with CERVARIX and improved in 2 weeks. On 30 March 2012, the subject was vaccinated with the 3rd dose of CERVARIX (intramuscular, unknown site of injection). On 8 April 2012, 9 days after vaccination with 3rd dose of CERVARIX, the subject experienced pyrexia (38 Deg. C), cough, and numbness. From 8 April 2012, LYRICA, DEPAKENE R and MUCOSTA were administered as therapeutic drugs. In April 2012, (at the same time as the development of pyrexia, cough, and numbness) the subject also experienced malaise, headache, myalgia, arthralgia, diarrhoea and constipation. On 18 April 2012, pyrexia, cough, and numbness improved in 10 days. From May 2012, feelings of weakness, general bodily rigidity, reduced visual acuity, memory impairment and prosopagnosia was developed. From June 2012, arthralgia was aggravated. The subject had difficulty in sitting up in the morning. From October 2012, the subject experienced decreased weight. From November 2012, extreme menstrual irregularity developed. Although the subject was a student, the subject took a leave from school because the subject could not go to school. In February 2014, the subject experienced convulsion. From February 2014, abnormal temperature sensation developed. From March 2014, the subject began to present with allergic symptoms after taking food. On 1 July 2014, the subject visited a facility for the first time. The subject was hospitalised. The physician considered that the event was disabling. As of 24 July 2014, malaise, headache, myalgia, arthralgia, diarrhoea, constipation, feelings of weakness, general bodily rigidity, reduced visual acuity, memory impairment and prosopagnosia still persisted. The physician reported that the events were related to vaccination with CERVARIX.

VAERS ID:539962 (history)  Vaccinated:2011-10-06
Age:  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2014-08-14, Days after onset: 1043
Location:Foreign  Entered:2014-08-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: B1022169A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALS 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Asthenia, Back pain, Chest pain, Convulsion, Dizziness, Dyskinesia, Encephalitis, Enuresis, Gait disturbance, Glossoptosis, Headache, Hyperventilation, Malaise, Memory impairment, Muscle spasms, Musculoskeletal stiffness, Nausea, Nystagmus, Palpitations, Paralysis, Photophobia, Respiratory arrest, Restless legs syndrome, Sleep disorder, Stiff person syndrome, Tinnitus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Arthritis (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a consumer (ombudsperson) via a foreign regulatory authority and described the occurrence of convulsion in a female subject aged between 10 and 19 years old who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent vaccination included 1st dose of CERVARIX (GlaxoSmithKline) given on 1 September 2011. The subject had no pain or swelling after the first vaccination with CERVARIX. On 6 October 2011, the subject received 2nd dose of CERVARIX (intramuscular, unknown injection site and batch number). On 6 October 2011, less than one day after vaccination with CERVARIX, the subject experienced severe headache, malaise, restless legs and nocturnal enuresis. On 19 March 2012, the subject received 3rd dose of CERVARIX (intramuscular, unknown injection site and batch number). On 19 March 2012, less than one day after vaccination with 3rd dose of CERVARIX, the subject experienced photophobia. In April 2012, the subject was enrolled in nursing school with giddiness, tinnitus and nystagmus. In July 2013, the subject experienced sudden cramp in the right hand by which a racket was held during participating in a club activity. Thereafter, the subject experienced hyperpnoea, palpitations, difficulty in walking, involuntary movement, queasy feeling, weakness, sleep disorder and glossoptosis. In October 2013, association with the vaccine was pointed out for the first time in the department of gynaecology where the subject''s mother visited for consultation. Contact was made by phone to a victim''s association after seeing a blog by a victim of vaccination and the correlation was assured. In November 2013, the subject took a leave of absence from the school. Stiffness became severe (stiff person syndrome). In April 2014, the subject was enrolled in a correspondence high school. Respiratory arrest and memory impairment developed. On unspecified date, the subject experienced convulsion, paralysis, chest pain, back pain and encephalitis. The regulatory authority reported that the events were clinically significant (or requiring intervention). At the time of reporting, the outcome of the events was unspecified. No further information was available, therefore the case was closed.

VAERS ID:437349 (history)  Vaccinated:2011-10-07
Age:68.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-08, Days after onset: 1
Location:Florida  Entered:2011-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma, allegic to penicillin and codeine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR4928103896510IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Cough, Dysphonia, Oropharyngeal pain, Sneezing
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: hoarseness, terrible cough, sneezing, sore throat, some chest pains

VAERS ID:437383 (history)  Vaccinated:2011-10-07
Age:52.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-09, Days after onset: 2
Location:New Hampshire  Entered:2011-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: noen
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT425AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Headache, Heart rate increased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Chills for over two hours with fever/ headache increased heartrate of 120 - 140 for over eight hours. Contacted ED department was told it was not reaction.

VAERS ID:437385 (history)  Vaccinated:2011-10-07
Age:43.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-09, Days after onset: 2
Location:Louisiana  Entered:2011-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR4T451AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Meningism, Neck pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On the 1st I had fever with pain when flexing my neck and pain when bending my legs [meningismus]. Lasted for 2 days.

VAERS ID:437462 (history)  Vaccinated:2011-10-07
Age:67.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Male  Submitted:2011-10-09, Days after onset: 2
Location:Illinois  Entered:2011-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH452AB0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Chills, Diarrhoea, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: 6 hours after vaccination, I had sudden adverse reaction. I was overcome by nausea, diarrhea, weakness, chills and headache. I could barely get to my bathroom where I dropped to the floor too weak to lift my head for about 20 to 30 minutes. Possibly, I was unconscious for parts of that time. I finally got to my bed for 16 hours before recovery. If this occurred while I was outside my home, I am sure I would have been hospitalized. Note: I am in very good health.

VAERS ID:437496 (history)  Vaccinated:2011-10-07
Age:67.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Female  Submitted:2011-10-09, Days after onset: 1
Location:California  Entered:2011-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN allergy; OA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH488AB IMUN
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Pain
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 24 hours after red and painful approximately 6 inch diameter; circular started to reduce in size 2 days after spontaneously.

VAERS ID:437916 (history)  Vaccinated:2011-10-07
Age:65.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-10, Days after onset: 3
Location:Wisconsin  Entered:2011-10-11, 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: No
Preexisting Conditions: Diabetes type II; Allergy hx; Lisinopril
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH452AC IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Dizziness, Feeling abnormal, Heart rate increased, Hypersensitivity, Respiratory rate increased, Throat tightness, Tremor, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 10/10/2011 1:45 PM ED provider note impression was allergic reaction - flu vaccine. Pt was treated with CIPRO MEDROL and BENADRYL IV, 1 L normal saline, advised to f/u with pcp for further eval of allergic reaction, stop taking flu shots. TC to pt. Reports that she is feeling well today. All sx reported 10/7/11 have completely resolved. Says that when she arrived 10/7/11 had also developed "the shakes" and was vomiting. Pt advised to f/u with, MD. Pt says she will f/u with provider at next ofv, will call sooner with any further questions or concerns. 10/10/2011 9:39 AM Addendum shows pt arrived at ED approx 5:05pm. 10/11/2011 2:21 PM Addendum TC from pt. Concerned that she is having reaction to flu shot given today around 1pm; EMR shows high dose flu vaccine given 10/7/11. About 10 min before phone call, approx 4:20pm, pt began having increasing heart rate, increased rate of breathing, "just doesn''t feel right". Feels like sx are continuing to get worse. Throat feels a little tight and had begun to have slight cough. Slightly dizzy. Denies any itching or rash. Pt has had flu vaccine in the past without any problems, but this is first time receiving high dose flu vaccine. Strongly advised pt to go to ED immediately. Pt is agreeable, does not want to call ambulance, says her husband can drive her to ED, thinks she can get there in about 15 min. Advised pt if she cannot leave immediately, should call 911; sx have worsened significantly in 10min period of time. Pt agreeable.

VAERS ID:438222 (history)  Vaccinated:2011-10-07
Age:4.0  Onset:2011-10-10, Days after vaccination: 3
Gender:Female  Submitted:2011-10-13, Days after onset: 3
Location:Massachusetts  Entered:2011-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC3957AA4UNRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH455AB0UNLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURG10833UNLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0446AA1UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0784AA1UNLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site pain, Injection site rash, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Pain rash under arm and shoulders.

VAERS ID:438355 (history)  Vaccinated:2011-10-07
Age:60.0  Onset:2011-10-10, Days after vaccination: 3
Gender:Female  Submitted:2011-10-14, Days after onset: 4
Location:South Carolina  Entered:2011-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1101001 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient stated that the evening after her flu shot was given (10/10/2011) she noticed that the arm was sore, red, and slightly raised the in area. Patient ignored it but the redness and swelling continued to increase over night. Patient was concerned so she stopped by the pharmacy to have me look at it on 10/11/2011. I visualized a silver dollar sized red, raised area on the should. It was warm to the touch. Patient denied any tenderness in the area and denied any other symptoms. Patient was instructed to see a physcian if her symptoms remained for more than 48 hours of they continued to get worse.

VAERS ID:438376 (history)  Vaccinated:2011-10-07
Age:4.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Male  Submitted:2011-10-10, Days after onset: 2
Location:Idaho  Entered:2011-10-14, 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: None
Preexisting Conditions: Eczema
Diagnostic Lab Data: None
CDC Split Type: ID11023
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3925AA0IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0190AA1IMRL
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: Lt ant. thigh swelling & erythema around injection site 10-12 cm diam.

VAERS ID:438380 (history)  Vaccinated:2011-10-07
Age:50.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Female  Submitted:2011-10-12, Days after onset: 4
Location:Kentucky  Entered:2011-10-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Angioedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: FLUARIX vaccine 10/7. Presented to ER 10/9 with angioedema.

VAERS ID:438419 (history)  Vaccinated:2011-10-07
Age:2.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-14, Days after onset: 7
Location:Hawaii  Entered:2011-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 2IJLL
Administered by: Unknown     Purchased by: Private
Symptoms: Gait disturbance, Immediate post-injection reaction, Injection site pruritus, Injection site rash, Injection site swelling, Injection site urticaria, Irritability, Weight bearing difficulty
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: ON OCTOBER 7, 2011 PATIENT RECEIVED A THIRD DTaP VACCINATION. HER LEFT LEG IMMEDIATELY SWELLED UP AND STAYED SWOLLEN FOR 5 DAYS. IT HAD A RASH AND WAS ALSO VERY ITCHY IN THE AREA WERE SHOT WAS GIVEN. PATIENT LIMPED AROUND FOR 5 DAYS SHE COULDN''T PUT MUCH PRESSURE ON HER LEFT LEG. ON THURSDAY OCTOBER 13, 2011 I NOTICED HIVES IN THE AREA WHERE SHOT HAD BEEN GIVEN. IT WAS NO LONGER A RASH BUT HIVES ONLY IN AREA WERE SHOT HAD BEEN ADMINISTERED. PATIENT HAS ALSO BEEN VERY IRRITABLE SINCE SHOT WAS ADMINISTER.

VAERS ID:438423 (history)  Vaccinated:2011-10-07
Age:20.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Male  Submitted:2011-10-15, Days after onset: 7
Location:Texas  Entered:2011-10-15
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: None
Diagnostic Lab Data: Physical examination.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Unknown     Purchased by: Other
Symptoms: Dizziness, Erythema, Fatigue
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial lightheadedness/dizziness/tiredness after injection for about two hours. Next day: Red spot appeared on arm. Slowly grew in size over the course of two days to 3" diameter and about 1/4" high.

VAERS ID:438439 (history)  Vaccinated:2011-10-07
Age:6.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Female  Submitted:2011-10-15, Days after onset: 7
Location:Ohio  Entered:2011-10-15
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
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Itchy, red, hot to the touch, small size hive at injections site that grew to be adult palm size over the next four days.

VAERS ID:438535 (history)  Vaccinated:2011-10-07
Age:61.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Male  Submitted:2011-10-17, Days after onset: 9
Location:New York  Entered:2011-10-17
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: HTN. Hyperlipidemia. Nonobstructive calcified CAD. BPH. Colitis. Mild intermittent thrombocytopenia 5/7/10, 3/7/11.
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH462AC0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Eye inflammation, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Corneal disorders (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Arthralgia, intermittent sweats, bilateral medial conjunctival inflammation.

VAERS ID:438617 (history)  Vaccinated:2011-10-07
Age:64.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Female  Submitted:2011-10-12, Days after onset: 4
Location:California  Entered:2011-10-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Achy~Influenza (Seasonal) (no brand name)~UN~63.00~Patient|Achy~Influenza (Seasonal) (no brand name)~UN~62.00~Patient|Achy~Influ
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma; Diabetes
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Fatigue, Hypersomnia, Mobility decreased
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad)
Write-up: Extreme fatigue - unable to function at all on 10/8/11. Still extreme fatigue on 10/9/11; however could function somewhat. Went to work on 10/10/11; however was extremely tired. Much better on 10/11/11. 10/8 and 10/9 - slept most of the time.

VAERS ID:438709 (history)  Vaccinated:2011-10-07
Age:47.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-17, Days after onset: 10
Location:New York  Entered:2011-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: NKA; none disclosed
Diagnostic Lab Data: EKG; BP
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA675AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Electrocardiogram, Pallor, Staring, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient found unresponsive to verbal stimulus in chair at her desk with blank stare. Color pale. Lowered to floor. Patient breathing, eyes opened & gradually became alert & oriented. Seen at ER. No further intervention received.

VAERS ID:439072 (history)  Vaccinated:2011-10-07
Age:39.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Delaware  Entered:2011-10-18, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA694AA UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1211Z UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: Pt received influenza vaccine on 10/7/2011.

VAERS ID:438977 (history)  Vaccinated:2011-10-07
Age:  Onset:2011-10-07, Days after vaccination: 0
Gender:Male  Submitted:2011-10-17, Days after onset: 10
Location:New Jersey  Entered:2011-10-19, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient has a history of Type I Diabetes. He has allergies to CEFTIN and CEFZIL.
Diagnostic Lab Data: Not reported
CDC Split Type: 201109721
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 1IJAR
Administered by: Private     Purchased by: Unknown
Symptoms: Limb discomfort, Loss of consciousness, Pain in extremity
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Initial report was received on 07 October 2011 from a consumer who is also the patient. A male patient with a history of type I diabetes and allergies to CEFTIN and CEFZIL had received on 07 October 2011 an injection "above his deltoid" of INFLUENZA VACCINE (manufacturer, lot number and route of administration not reported) and upon vaccination his arm "felt weird". Two minutes after vaccination he "passed out" and states he has pain in his arm. Concomitant medications included LANTUS and HUMALOG. Illness at the time of vaccination and other vaccines given within four weeks of the suspect vaccine were not reported. Treatments were not reported. No further information was available at the time of the report. Outcome was reported as not recovered. Documents held by sender: none.

VAERS ID:438991 (history)  Vaccinated:2011-10-07
Age:65.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Indiana  Entered:2011-10-19, 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: She denied illness before vaccine
Preexisting Conditions: Asthma & Hypertension
Diagnostic Lab Data: Not known.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH452AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Sinus disorder, Throat tightness, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: 10/7/11 9:30A she received FLUZONE HIGH DOSE at Flu shot clinic - she came & ask to see us at 1:55 PM describing tightness in her throat that had gradually increasing - onset 11 AM - she also had c/o sinus drainage & cough - we called EMS & she was transferred to Emergency room - Dx was mild to moderate reaction to Flu vaccine. Tx with BENADRYL and prednisone.

VAERS ID:439004 (history)  Vaccinated:2011-10-07
Age:31.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Michigan  Entered:2011-10-19, 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: KEFLEX; COMPAZINE; Benzocaine; ASPERCREME & Seasonal (spring) tree pollen allergies.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH478AC IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest discomfort, Lung disorder, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Six hours after vaccination fever developed rising to 102.7 degrees F sustained even after 1000mg acetaminophen. Severe aches & pains & tightness in lungs. Went to Urgent Care Clinic. Was given albuterol inhaler & 600mg ibuprofen. Fever lasted 3 days, gradually abating. Still regaining strength at this time.

VAERS ID:439060 (history)  Vaccinated:2011-10-07
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2011-10-13
Location:Washington  Entered:2011-10-19, 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: Per pt: Animal/Food
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11074P1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed itching 10/9 & hives 10/10 - used OTC BENADRYL at home which helped, was seen by outside urgent care in her area was given steroids and advised to avoid Flu shots - has hx of food/animal allergies - was out with animals 10/9.

VAERS ID:439108 (history)  Vaccinated:2011-10-07
Age:37.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Male  Submitted:2011-10-11, Days after onset: 4
Location:Texas  Entered:2011-10-19, 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: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1100401 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received shot at 2pm, at 5:30pm started getting large bumps and whelps. Went to ER at 7:30pm. Was given prednisone & BENADRYL, et continues prednisone.

VAERS ID:439121 (history)  Vaccinated:2011-10-07
Age:67.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2011-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH458AA0UNRA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt. encountered diarrhea, stomach cramps at 2:00AM.

VAERS ID:439124 (history)  Vaccinated:2011-10-07
Age:34.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Male  Submitted:2011-10-07, Days after onset: 0
Location:New York  Entered:2011-10-19, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1100401 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dreamy state, Face injury, Immediate post-injection reaction, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: See attached sheet. Gave patient flu shot - pt stated that he had the flu shot many times before. I gave him his shot in the right arm. Pt then immediately had a syncopal episode when he fell from the chair and hit his face on the floor. Pt was unconscious for approximately 10 seconds. When he awoke he said that he felt like he was dreaming. I called 911 immediately and stayed with the pt until EMS arrived.

VAERS ID:439136 (history)  Vaccinated:2011-10-07
Age:1.28  Onset:0000-00-00
Gender:Female  Submitted:2011-10-19
Location:Puerto Rico  Entered:2011-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B072DA0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Drug administered to patient of inappropriate age
SMQs:, Medication errors (narrow)
Write-up: Inadequate administration of vaccine, at the moment reactions or other sequels are not known.

VAERS ID:439160 (history)  Vaccinated:2011-10-07
Age:1.25  Onset:0000-00-00
Gender:Female  Submitted:2011-10-19
Location:Wisconsin  Entered:2011-10-19
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
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Irritability, Middle insomnia, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Developed a mild fever, fussiness, night waking, moderate rash over face, neck and torso.

VAERS ID:439205 (history)  Vaccinated:2011-10-07
Age:0.39  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:2011-10-19
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3818AA1IMUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF046931IMUN
Administered by: Private     Purchased by: Public
Symptoms: Crying, Erythema, Irritability, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Baby received vaccines on 10/7; mom states (L) leg is reddened and sl edematous. Increased irritability and crying on the evening of 10/8.

VAERS ID:439225 (history)  Vaccinated:2011-10-07
Age:0.5  Onset:2011-10-08, Days after vaccination: 1
Gender:Male  Submitted:2011-10-10, Days after onset: 2
Location:Pennsylvania  Entered:2011-10-19, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Rash (L) leg~Pneumo (Prevnar)~2~0.30~Patient|Rash (L) leg~DTaP + IPV + Hib (Pentacel)~2~0.30~Patient
Other Medications:
Current Illness: Mild eryth. pap. rash - face/trunk
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC3834AA2IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHF046932IMRL
Administered by: Private     Purchased by: Public
Symptoms: Rash papular
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed eryth. papular rash the day after receiving Pert/Pneu #2 - (R) thigh. Also occurred with 2nd set of shots.

VAERS ID:439246 (history)  Vaccinated:2011-10-07
Age:55.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-20, Days after onset: 13
Location:Ohio  Entered:2011-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURPUH454AB IMRA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Dizziness, Injection site pain, Nausea
SMQs:, Acute pancreatitis (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: States felt weakness, nausea, and dizziness for approx 24 hours. Stated some tenderness @ injection site. Went home from work on 10/07/11.

VAERS ID:439251 (history)  Vaccinated:2011-10-07
Age:1.03  Onset:2011-10-18, Days after vaccination: 11
Gender:Female  Submitted:2011-10-20, Days after onset: 2
Location:Oregon  Entered:2011-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: no culture was obtained
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB481BB0IMLL
HIBV: HIB (HIBERIX)GLAXOSMITHKLINE BIOLOGICALS144322IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0190AA0IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF137803IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0572AA0IMRL
Administered by: Unknown     Purchased by: Public
Symptoms: Injection site abscess
SMQs:
Write-up: Abscess at site of injection developed 13 days after the immunizations were administered. No initial local reaction was reported. Treated with TMP-SMX, improved at 2 day follow-up.

VAERS ID:439420 (history)  Vaccinated:2011-10-07
Age:72.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Male  Submitted:2011-10-20, Days after onset: 13
Location:Washington  Entered:2011-10-20
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH478AB IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site haematoma, Injection site pain, Injection site scab
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Scab at site, bruise, painful.

VAERS ID:439421 (history)  Vaccinated:2011-10-07
Age:70.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-20, Days after onset: 13
Location:Washington  Entered:2011-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH478AA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Cyanosis, Pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 3 inch ring, painful, bluish (still after 2 wks).

VAERS ID:439561 (history)  Vaccinated:2011-10-07
Age:50.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-19, Days after onset: 12
Location:Connecticut  Entered:2011-10-21, 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: Sulfa, morphine
Diagnostic Lab Data: To undergo allergy testing
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURLUTA72AA10UNLA
Administered by: Public     Purchased by: Private
Symptoms: Anxiety, Burning sensation, Chest discomfort, Eye swelling, Gingival pain, Lethargy, Lip swelling, Ocular hyperaemia, Respiratory tract congestion, Swelling face, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Oropharyngeal allergic conditions (narrow), Gingival disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 10/7/11 16:00 - Gums & lips burning, congested chest, eyes red. 16:15 Swelling face, eyes, lips & tongue. Intermittent chest discomfort, became anxious. 18:30 ED - Antihistamine, steroid - IV. Some decrease in symptoms. 10/8/11 Symptoms gone. 10/8 - 10/17 Still lethargic.

VAERS ID:439717 (history)  Vaccinated:2011-10-07
Age:7.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Male  Submitted:2011-10-10, Days after onset: 2
Location:Ohio  Entered:2011-10-24, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.YK20132IN 
Administered by: Private     Purchased by: Private
Symptoms: Chills, Cough, Fatigue, Headache, Influenza, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received flu vaccine. Flu dx chills, body aches, cough, congestion, fatigue, fever, headache, runny nose.

VAERS ID:439738 (history)  Vaccinated:2011-10-07
Age:59.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-08, Days after onset: 1
Location:Unknown  Entered:2011-10-24, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0614AA SYRUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient received PNEUMOVAX and within 12 hrs had redness, swelling and pain at injection site.

VAERS ID:439753 (history)  Vaccinated:2011-10-07
Age:41.0  Onset:2011-10-12, Days after vaccination: 5
Gender:Female  Submitted:2011-10-24, Days after onset: 12
Location:New Jersey  Entered:2011-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Latex and iodine allergy; no medical issues.
Diagnostic Lab Data: CBC, CMP, ESR, CRP, urinalysis.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A15 LA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, C-reactive protein, Full blood count, Metabolic function test, Pyrexia, Red blood cell sedimentation rate, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Joint pains in hands, elbow, shoulders, hips, knees, feet and low grade temperature.

VAERS ID:439796 (history)  Vaccinated:2011-10-07
Age:77.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-15, Days after onset: 8
Location:Florida  Entered:2011-10-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Sulfa; osteopenia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR  UNUN
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Heart rate increased, Pallor, Presyncope, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Dizziness (very close to fainting), threw up, very fast heart beat, difficult to breathe, very weak, very pale, fever, very chilled. Symptoms lasted from 4:30 PM (day of shot) until approximately noon next day. No treatment.

VAERS ID:439857 (history)  Vaccinated:2011-10-07
Age:75.0  Onset:0000-00-00
Gender:Female  Submitted:2011-10-20
Location:Illinois  Entered:2011-10-24, 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 known
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH436AC IJLA
Administered by: Other     Purchased by: Private
Symptoms: Bursitis, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt experienced pain at injection site during administration. Pt continued having arm pain she saw her MD who diagnosed bursitis that "may have been caused by vaccine. Pt was prescribed physical therapy."

VAERS ID:439938 (history)  Vaccinated:2011-10-07
Age:65.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-25, Days after onset: 18
Location:Pennsylvania  Entered:2011-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 11 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: atenolol/chlorthalidone, calcium + vitamin D, ergocalciferol, gabapentin, Miralax, multiple vitamin, Boost plus, vitamin B12, Zometa
Current Illness: No
Preexisting Conditions: Vitamin D deficiency, Retention of urine, anemia, osteoporosis, right breast cancer (s/p mastectomy, benign hypertension, radiation induced Brown- Sequard syndrome, head/neck squamous cell cancer (s/p radical neck dissection and radiation), Nontox multinodule goiter, right sided neuropathy sx from myelopathy
Diagnostic Lab Data: 10/11 CXR: incr interstitial markings w/ likely superimposed PNA 10/10 CXR: CHF w/ L base opacity c/f superimposed PNA, 10/10 BCx 4/4 Strep pneumo
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA618BA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0843AA SCLA
Administered by: Public     Purchased by: Other
Symptoms: Blood culture positive, Cardiac failure congestive, Chest X-ray abnormal, Cough, Decreased appetite, Dyspnoea, Lung disorder, Malaise, Mobility decreased, Pain, Pneumonia streptococcal, Pyrexia, Streptococcus test positive
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient reports feeling sick within a couple of hours after vaccination. "Felt sick" all weekend, "pain all over", fever (no temperature taken), shortness of breath, mild cough, poor appetite, and "in bed all day". Denies any chest pain, headache, or new dizziness.

VAERS ID:440002 (history)  Vaccinated:2011-10-07
Age:56.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-25, Days after onset: 18
Location:New Jersey  Entered:2011-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA673AA20IMLA
Administered by: Public     Purchased by: Public
Symptoms: Immediate post-injection reaction, Injection site pain, Joint range of motion decreased, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Left arm pain immediately, pain down arm for first 24 hours. After first 24 hours pain limited to elbow to shoulder area of left arm. Limited range of motion, painful to sleep on left side. Recommended for client to have evaluation by personal physician.

VAERS ID:440013 (history)  Vaccinated:2011-10-07
Age:66.0  Onset:2011-10-20, Days after vaccination: 13
Gender:Male  Submitted:2011-10-25, Days after onset: 5
Location:Florida  Entered:2011-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Artificial aortic valve Hyperlipidemia, Hypertension Allergies: Cubicin, Ampicillin, Gentamycin, Vancomycin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1056AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Pyrexia, Rash vesicular, Stomatitis, Varicella
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Diffuse vesicular rash, malaise, stomatitis and fever consistent with varicella.

VAERS ID:440108 (history)  Vaccinated:2011-10-07
Age:24.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-13, Days after onset: 6
Location:Maryland  Entered:2011-10-26, 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: None
Preexisting Conditions: Sulfa drugs; PCN; Latex
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT426AA UNAR
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Injection site swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling/lump at injection site. Hives across arms and back. BENADRYL.

VAERS ID:440139 (history)  Vaccinated:2011-10-07
Age:1.01  Onset:2011-10-16, Days after vaccination: 9
Gender:Male  Submitted:2011-10-18, Days after onset: 2
Location:Alabama  Entered:2011-10-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4197BA0IMLL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB533CA0IMRL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH9169223IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0819AA0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site inflammation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 10 days after vaccine given, pt presented with local inflammatory reaction at site.

VAERS ID:440191 (history)  Vaccinated:2011-10-07
Age:40.0  Onset:2011-10-16, Days after vaccination: 9
Gender:Female  Submitted:2011-10-26, Days after onset: 10
Location:Nebraska  Entered:2011-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.501107P0IN 
Administered by: Public     Purchased by: Private
Symptoms: Abasia, Dehydration, Fall, Vertigo, Vestibular neuronitis, Viral infection, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: 10/17 deveoped vertigo and advanced in severity on 10/18/11 was unable to walk with out falling due to vertigo also deveoped vomiting. 10/19/11 went to the Emergency Department due to continued symptoms and dehydration given Meclazine and Levequin. No improvment in symptoms and on 10/24 went to ENT doctor due to vertigo and diagnosed with vestibular neuronitis thought may have been induced by viral infection from Flu Mist. Treated with prednisone, Zofran and Valium. Reported 10/25 to Employee health continued symptoms but some improvement.

VAERS ID:440302 (history)  Vaccinated:2011-10-07
Age:21.0  Onset:2011-10-17, Days after vaccination: 10
Gender:Male  Submitted:2011-10-27, Days after onset: 10
Location:Unknown  Entered:2011-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: NKDA, pre-existing eczema as a child, no conditions at time of vaccination
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2810IMRA
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.501096P1IN 
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0 LA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURE03020IMRA
Administered by: Military     Purchased by: Military
Symptoms: Local reaction, Skin lesion, Vaccinia virus infection
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 1. VACCINIA FROM VACCINATION LOCALIZED: I believe that this patient has the beginning of vaccinia because the lesions are on the opposite side or where they would be if it were eczema. Due to the proximity of his deployment and the possibility of a vaccinia, the patient has been suspended from deployment at this time and he will receive a 10 day home leave anyway she will remain at home and he will be reevaluated in a week''s time. Public health has been alerted and has notified his squadron that the patient''s deployment will be delayed. The patient understands and acquiesces everything that we have told him regarding this. We feel that the wife is out of danger because she is also active duty and she has been previously immunized against smallpox. Released w/ Work/Duty Limitations: Profile: VACCINIA FROM VACCINATION LOCALIZED 999.39 from 25 Oct 2011 to 15 Nov 2011; Comment: May not deploy for three weeks. Follow up: 1 week(s) with PCM or sooner if there are problems. - Comments: Convalescent leave for 10 days given to isolate patient. Discussed: Diagnosis, Medication(s)/Treatment(s), Alternatives, Potential Side Effects with Patient who indicated understanding. - Comments: Wife in presence also.

VAERS ID:440417 (history)  Vaccinated:2011-10-07
Age:67.0  Onset:2011-10-18, Days after vaccination: 11
Gender:Male  Submitted:2011-10-27, Days after onset: 9
Location:California  Entered:2011-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Per patient discussion: history of irregular heartbeat, patient is scheduled for planned defibrillator implant in near future.
Diagnostic Lab Data: No test information available to reporter
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS110405 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3487AA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Basal ganglia stroke, Ischaemic stroke
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)
Write-up: Patient stated she sought medical treatment on 10/18/2011 and event was diagnosed as basal ganglia ischemic stroke. She wasn''t sure event was related to vaccines she received but wanted to let someone know she may have had a bad reaction. Symptom onset, duration and immediate treatment measures unknown to reporter. Patient received prescriptions for plavix 75mg daily and Lipitor 20mg daily. Pt declined to pick up Lipitor as of 10/25/11 but rx is now ready for pick-up on 10/27/11. Pt was to see neurologist on 10/26/11.

VAERS ID:440440 (history)  Vaccinated:2011-10-07
Age:75.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Male  Submitted:2011-10-27, Days after onset: 20
Location:Massachusetts  Entered:2011-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PROSCAR; Metoprolol; MVI; FLOMAX; Metformin; COUMADIN
Current Illness: AFIB
Preexisting Conditions: AFIB; Diabetes; HTN; Chronic cellular disorder; Lymphadenoma
Diagnostic Lab Data: PTT/INR results were WNL on visit 10/17/11; F/U with PCP on 10/28/11.
CDC Split Type:
Vaccination
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH462AB3IMLA
Administered by: Other     Purchased by: Other
Symptoms: Activated partial thromboplastin time normal, Injection site haematoma, Injection site haemorrhage, Injection site pain, International normalised ratio normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt. notices (L) upper arm is bruised and sore on 10/15/11. States injection site was tender initially #4-5 on scale/no ecchymosis. On 10/16 545 noted large area of ecchymosis down 4"x10" across (L) upper arm extending to above elbow. No ecchymosis at injection site. When injection was given no blood noted in chamber of syringe. No oozing. No edema. On 10/28 (L) upper arm has large fading ecchymosis.

VAERS ID:440610 (history)  Vaccinated:2011-10-07
Age:57.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Male  Submitted:2011-10-30, Days after onset: 22
Location:Colorado  Entered:2011-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Headache
SMQs:
Write-up: Headache(s), WHICH I NEVER GET!!!

VAERS ID:440719 (history)  Vaccinated:2011-10-07
Age:67.0  Onset:2011-10-18, Days after vaccination: 11
Gender:Unknown  Submitted:0000-00-00
Location:Iowa  Entered:2011-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin; Calcium; Vitamin D; 81 mg ASA all daily
Current Illness: None
Preexisting Conditions: Latex allergy
Diagnostic Lab Data: Seen in ER 10/18/11 and 10/21/11. EKG, head CT and MRI, lab work all ok, UTI noted
CDC Split Type:
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Unknown
Symptoms: Computerised tomogram head, Computerised tomogram normal, Disorientation, Electrocardiogram normal, Hot flush, Laboratory test normal, Syncope, Urinary tract infection, Vertigo
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Sudden onset of vertigo, hot/cold flashes, fainting and disorientation. Taken from home by ambulance to ER.

VAERS ID:440722 (history)  Vaccinated:2011-10-07
Age:74.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Male  Submitted:2011-10-27, Days after onset: 19
Location:Texas  Entered:2011-10-31, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0759AA SCUN
Administered by: Other     Purchased by: Unknown
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Itchy rash that has moved. MD told him to get BENADRYL.

VAERS ID:440756 (history)  Vaccinated:2011-10-07
Age:  Onset:2011-10-10, Days after vaccination: 3
Gender:Female  Submitted:2011-10-21, Days after onset: 11
Location:California  Entered:2011-10-31, 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: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT437AB1UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Discomfort, Musculoskeletal pain, Neck pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: After each annual flu shot I normally end up having upper arm & the effected side ache in the neck which is mild & lasts about 2 days. However, this time the upper arm pain & especially the neck & between shoulder blade is severe & very uncomfortable & it is still bothering me.

VAERS ID:440757 (history)  Vaccinated:2011-10-07
Age:4.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Female  Submitted:2011-10-21, Days after onset: 13
Location:Washington  Entered:2011-10-31, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to AUGMENTIN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B196BA0UNLL
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.501103P0IN 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1671Z1UNLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1313Z1UNRL
Administered by: Private     Purchased by: Public
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling from groin to knee on anterior and medial left thigh. Treated with prednisone.

VAERS ID:440774 (history)  Vaccinated:2011-10-07
Age:29.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-31, Days after onset: 24
Location:Illinois  Entered:2011-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pregnant
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA603EA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pain, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Arm Sore all the time. Hurts to raise arm.

VAERS ID:440817 (history)  Vaccinated:2011-10-07
Age:7.0  Onset:0000-00-00
Gender:Female  Submitted:2011-10-31
Location:Unknown  Entered:2011-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinusitis
Preexisting Conditions: Diamond blackfan; Hypothyroid
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B118CA5UNLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4147AA5UNRA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH9166000UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1211Z0UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Body temperature increased, Injection site pain
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: C/O sight pain shortly after receiving shot and awoke around 2AM with Temp of 103.1.

VAERS ID:441239 (history)  Vaccinated:2011-10-07
Age:42.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Nebraska  Entered:2011-11-03, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AB IMRA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Extreme exhaustion, achy joints/muscles.

VAERS ID:441240 (history)  Vaccinated:2011-10-07
Age:31.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Nebraska  Entered:2011-11-03, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AB IMRA
Administered by: Other     Purchased by: Private
Symptoms: Limb discomfort
SMQs:
Write-up: The actual poke didn''t hurt, but the actual vaccine entering my arm was uncomfortable, it felt like it was expanding, w/in a few minutes my arm felt like I had "dead arm". I have had vaccines before & never had that strong of a reaction, the discomfort lasted all day, tapered off quickly over the weekend & is much better today.

VAERS ID:441241 (history)  Vaccinated:2011-10-07
Age:38.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Nebraska  Entered:2011-11-03, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AB IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Within an hour of receiving the vaccine, I felt pressure & pain at the injection site. It was difficult to raise my hand to eat. I felt intense pain for several hours after injection.

VAERS ID:441242 (history)  Vaccinated:2011-10-07
Age:45.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-10, Days after onset: 3
Location:Nebraska  Entered:2011-11-03, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AB IMRA
Administered by: Other     Purchased by: Private
Symptoms: Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pain and weakness in right arm for 2-3 days.

VAERS ID:441247 (history)  Vaccinated:2011-10-07
Age:36.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-13, Days after onset: 6
Location:Nebraska  Entered:2011-11-03, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AB IMRA
Administered by: Other     Purchased by: Private
Symptoms: Myalgia, Pain, Pain of skin
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Extreme muscle soreness and tenderness to the touch, sore with movement and lifting; ached in whole arm at times; took TYLENOL at approx 2:00 am.

VAERS ID:441393 (history)  Vaccinated:2011-10-07
Age:44.0  Onset:2011-10-08, Days after vaccination: 1
Gender:Female  Submitted:2011-11-04, Days after onset: 27
Location:Missouri  Entered:2011-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Childhood asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.501088P0IN 
Administered by: Public     Purchased by: Private
Symptoms: Cough, Retching, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Employee received FLUMIST on 10/07/11 about 11:00 am; bilaterally intranasal; employee noted next day about 11:00 am tickle in back of throat which has progressed to a daily cough episode. Over past month sometimes cough precipitates gag reflex.

VAERS ID:441424 (history)  Vaccinated:2011-10-07
Age:50.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Male  Submitted:2011-11-04, Days after onset: 28
Location:North Carolina  Entered:2011-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none per patient
Preexisting Conditions: High Blood pressure per patient
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB231AA0IMRA
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABA041A IMLA
Administered by: Public     Purchased by: Other
Symptoms: Musculoskeletal pain, Myalgia, Neck pain, Pain in extremity, Tenderness, Vasodilatation
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Muscle aches to both arms approximately 2 hrs. after vaccines. Tenderness started same day. Wakes up 4-5 times a night due to pain in arms. Pain in back of neck and across shoulders day after vaccines. Saw PA at Clinic. States told vaccines caused "blood vessels to swell". Given Flexeril one three times a day. Continues with pain in both arms today. Has followup appt with private MD on Monday per patient.

VAERS ID:441394 (history)  Vaccinated:2011-10-07
Age:77.0  Onset:2011-10-30, Days after vaccination: 23
Gender:Male  Submitted:2011-11-06, Days after onset: 7
Location:California  Entered:2011-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: HTN; Allergic rhinitis
Preexisting Conditions:
Diagnostic Lab Data: CSF 0 W, 1000 R; Glucose 59; Protein 72
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUH436AC1UNUN
Administered by: Private     Purchased by: Other
Symptoms: CSF glucose normal, CSF protein increased, CSF white blood cell count negative, Guillain-Barre syndrome, Red blood cells CSF positive
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Guillain Barre.

VAERS ID:441463 (history)  Vaccinated:2011-10-07
Age:53.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-11-06, Days after onset: 30
Location:Illinois  Entered:2011-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER9XP  LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Intense shoulder/arm main where shot was administered. Pain continues and has gotten worse since then. It has now been one month and patient can hardly move arm without extreme pain.

VAERS ID:441399 (history)  Vaccinated:2011-10-07
Age:43.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-11-05, Days after onset: 29
Location:Florida  Entered:2011-11-07, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI, CAT scan came up good. No signs of stroke. No diagnosis was given
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH110AA0UNUN
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Blindness, Computerised tomogram normal, Hypoaesthesia, Influenza like illness, Nuclear magnetic resonance imaging normal, Swelling face,