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Found 475569 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:469799 (history)  Vaccinated:2012-10-16
Age:8.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-16, Days after onset: 0
Location:Texas  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURA055A IMLA
Administered by: Public     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives visible on arms, ears, back and face. Minimal itching per patient behind right ear and arm. 2 tsp. Children''s liquid Benadryl administered per guardian (grandmother).

VAERS ID:469803 (history)  Vaccinated:2012-10-16
Age:21.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:Indiana  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12038010IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chest pain, Dizziness, Dysphagia, Dyspnoea, Feeling jittery, Rash, Rash erythematous, Syncope, Throat tightness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Red rash on face, feels jittery, dizzy, faint, chest pain difficulty breathing, tightening of throat, difficulty swallowing.

VAERS ID:469944 (history)  Vaccinated:2012-10-16
Age:17.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:Tennessee  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None - at ER - started dehydrated
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURC4261AA UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA UNRA
Administered by: Other     Purchased by: Private
Symptoms: Epistaxis, Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient, fainted fell out of hard back chair & nose bled from fall.

VAERS ID:469952 (history)  Vaccinated:2012-10-16
Age:62.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:Arkansas  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA728AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Dysgeusia, Hyperhidrosis, Respiration abnormal
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Vestibular disorders (broad)
Write-up: Patient recieved flu vaccine in our depatment. After the flu was administered the patient left feeling fine. Around 5 minutes later the patient came back in stating she felt dizzy, sweaty, breathing funny, and a weird taste in her mouth. We laid her down on the exam table and patient stated she felt better. BP 138/74. We sat patient up and gave her water. She stated she felt completely fine now. We stood patient up and BP 151/68. Walked patient to car and informed patient if she has any shortness of breath to call 911 and if she feels dizzy to lay down.

VAERS ID:470115 (history)  Vaccinated:2012-10-16
Age:37.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:Connecticut  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AB0IMUN
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Dyspnoea, Malaise, Panic reaction
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: First influenza vaccination; within minutes c/o "not feeling well" ; clutching chest; c/o difficulty breathing; became panicky. EPIPEN given; sx began to subside in < 1 minute. Transported to ER via ambulance.

VAERS ID:470269 (history)  Vaccinated:2012-10-16
Age:68.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:New Jersey  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Shellfish allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP504081UNLA
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia oral, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Tingling of lips and tongue, scratchy throat - gave EPIPEN x 1 dose called 911 - pt brought to hospital.

VAERS ID:470311 (history)  Vaccinated:2012-10-16
Age:32.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:Colorado  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: "Oral mouth allergies to pistachios"
Diagnostic Lab Data: Temp 100.3; Diffuse muscle spasms; Clear airway
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Severe rigors, myalgia, fevers, and body aches. No rash or allergic reaction.

VAERS ID:470063 (history)  Vaccinated:2012-10-16
Age:52.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-17, Days after onset: 0
Location:Nebraska  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Woke up to use the bathroom and was extremely dizzy - almost fell down. I never have dizziness spells. I am still somewhat dizzy at 8:30 AM on 10/17/12 and am developing a headache.

VAERS ID:470066 (history)  Vaccinated:2012-10-16
Age:0.8  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-17, Days after onset: 1
Location:Texas  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Allergic Rhinitis
Diagnostic Lab Data: none.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL)SANOFI PASTEURC4184AA1IMLL
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Sudden onset of fever of 102.8 and vomiting within 2 hours of receiving vaccine.

VAERS ID:470069 (history)  Vaccinated:2012-10-16
Age:0.9  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Iowa  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory symptoms
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLL
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on face arms and torso. Lasted until 10/17/2012 am most had cleared up by the morning.

VAERS ID:470079 (history)  Vaccinated:2012-10-16
Age:29.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Texas  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ20240IN 
Administered by: Military     Purchased by: Military
Symptoms: Chills, Dizziness, Headache, Myalgia, Nausea, Oropharyngeal pain, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Nausea, vomiting, headache, muscle aches, chills, sore throat, dizziness. Treated at home with Tylenol and rest. Nausea and vomiting lasted approximately 12 hours, other symptoms still ongoing as of 11:00 AM next day post vaccination.

VAERS ID:470138 (history)  Vaccinated:2012-10-16
Age:18.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Minnesota  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Musk Melon= Hives; Right sided severe congenital neurosensory hearing loss at high frequencies only; Eczema
Diagnostic Lab Data: VASOVAGAL SYNCOPE, LACERATION, and two chipped teeth
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH759AA0IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Laceration, Loss of consciousness, Syncope, Tooth disorder, Tunnel vision, Visual impairment
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), Accidents and injuries (narrow), Hostility/aggression (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Patient was leaving clinic getting off the elevator. She felt like her vision was getting dark, developed tunnel vision, and then passed out.

VAERS ID:470141 (history)  Vaccinated:2012-10-16
Age:0.5  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-17, Days after onset: 0
Location:Washington  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B351BA0IMLL
Administered by: Private     Purchased by: Public
Symptoms: Hypophagia, Injection site erythema, Injection site induration, Irritability, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad)
Write-up: Low grade fever 100.9 with erythema and induration at site of Pediarix vaccination on left thigh. Subjective fussiness and decrased oral intake. Area is ~3x4cm size.

VAERS ID:470314 (history)  Vaccinated:2012-10-16
Age:49.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Missouri  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to PCN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B093BA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Joint swelling, Oedema peripheral, Sensation of foreign body
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Patient was given BOOSTRIX (Tdap) in LD around 11:30 10-16-12. She states she ran errands & then went home to take a nap. When she woke up around 1600 on 10-16-12, she noticed swelling bilaterally in all 4 extremities & she felt like she had something in her throat. She called her primary Dr. office & was Rx liquid BENADRYL. Spoke with patient this AM & she states only swelling noted to (L) ankle.

VAERS ID:470330 (history)  Vaccinated:2012-10-16
Age:73.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Illinois  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hyperlipidemia; depression; anxiety
Diagnostic Lab Data: Reaction happened at site PNEUMOVAX was administered
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1706AM1IMLA
Administered by: Other     Purchased by: Public
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Patient had immediate swelling/redness at injection site. By evening, she had redness down to elbow and intense itchiness. After taking BENADRYL every 4-6 hours, it is now only red/swollen at injection site and itching has resolved.

VAERS ID:470340 (history)  Vaccinated:2012-10-16
Age:57.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Kansas  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207201 UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Chest discomfort, Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: About 5 minutes after receiving vaccine pt said she had intense itchiness and her chest was heavy and she was having a little difficulty breathing. RPh gave 50mg of liquid diphenhydramine for reaction. Patient rested about 20 min and felt better.

VAERS ID:470344 (history)  Vaccinated:2012-10-16
Age:51.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Oregon  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to strawberries
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA0UNLA
Administered by: Unknown     Purchased by: Private
Symptoms: Chest discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Tightness in chest and throat 4-5 hours following injections. In ER; nebulizer tmt given and cortisone. Rx for Prednisone 20 mg 2 QD x 3 days.

VAERS ID:470213 (history)  Vaccinated:2012-10-16
Age:4.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-18, Days after onset: 1
Location:South Carolina  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 4 LL
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 5 RL
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1 RL
Administered by: Unknown     Purchased by: Public
Symptoms: Gait disturbance, Pruritus, Pyrexia, Rash erythematous, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Red spots growing bigger, swelling, fever, itching and hard to walk.

VAERS ID:470218 (history)  Vaccinated:2012-10-16
Age:79.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:California  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Post TIA.
Preexisting Conditions: Post TIA
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Public     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 swollen area around injection site. Redness, Pain, very warm to the touch.

VAERS ID:470295 (history)  Vaccinated:2012-10-16
Age:79.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Arizona  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMRA
Administered by: Public     Purchased by: Other
Symptoms: Blister, Rash vesicular
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (narrow)
Write-up: Small, fluid filled blisters on arms, chest, abdomen, waist, behind ears, and smaller blisters on inner thighs. Patient states blisters resemble "Chicken Pox".

VAERS ID:470297 (history)  Vaccinated:2012-10-16
Age:30.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Michigan  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA733AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Feeling of body temperature change, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Hot/cold spells, nausea headache. Headache persists on and off, varying in intensity/duration.

VAERS ID:470298 (history)  Vaccinated:2012-10-16
Age:69.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Male  Submitted:2012-10-18, Days after onset: 0
Location:California  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: allergy to several anti-biotics
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Sore throat.

VAERS ID:470302 (history)  Vaccinated:2012-10-16
Age:66.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 2
Location:Rhode Island  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: not reported
Preexisting Conditions: Adverse reaction to SIMVASTATIN
Diagnostic Lab Data: no previous reaction reported
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1235031IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Pruritus, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Injection site red and swollen about 4 inches in diameter. Patient reported itchy skin all over body. Cool compress applied at home. Ice pack applied at flu clinic on 10/18/2012 when patient returned. Patient referred to primary care.

VAERS ID:470303 (history)  Vaccinated:2012-10-16
Age:86.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:New Jersey  Entered:2012-10-18
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: cortisol, amlodipine
Current Illness: none reported
Preexisting Conditions: Diverticulitis; Macular degeneration; Cushing''s disease s/p adrenalectomy, steroid dependent
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4492BA IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013847 IM 
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Diarrhoea, Electrocardiogram ST segment depression, Endotracheal intubation, Hypotension, Hypothermia, Intensive care, Nausea, Pain in extremity, Tachypnoea
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad), Noninfectious diarrhoea (narrow)
Write-up: 86 y.o. year old female with h/o Hypertension, CAD, Bilateral Adrenal Gland removal with resultant Cushing''s disease on chronic Prednisone. Pt was seen in PMD''s office yesterday for a flu shot. At that time, the pt''s PMD discontinued Norvasc secondary to pt having a low normal BP. Pt developed right arm pain and nausea later on in the evening and did not take her evening Prednisone dose or AM dose. Pt''s family states that pt was "normal" yesterday and even prepared dinner for the family. Today, pt developed worsening nausea, diarrhea and felt weak. She initially declined going to the hospital but asked family to call 911 when she felt worse. In ER, pt was hypotensive and tachypneic and was intubated. Pt was hypothermic with profound hypotension despite 6 liters of fluid requiring pressors. She was placed on Dopamine and Levophed. Pt given a STAT dose of Hydrocortisone 100mg IVP x 1 and another liter of IVF. Pt also found to have ST depressions on EKG and Cardiology was also consulted. Transferred to ICU for further management.

VAERS ID:470309 (history)  Vaccinated:2012-10-16
Age:65.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Alaska  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: COPD/emphysema, environmental allergies, hypertension, pernicious anemia, diverticulitis, gastric ulcers, and C. diff. colitis following antibiotics.
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP500083IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Injection site pain, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Extreme pain at injection site. Could not raise arm above head. It felt hot, but was not red or swollen.

VAERS ID:470325 (history)  Vaccinated:2012-10-16
Age:56.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Montana  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions: No allergies. Healthy baseline. No prescription medications. Healthy weight/BMI.
Diagnostic Lab Data: None. Physical Exam and vital signs.
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206501 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Headache, Insomnia, Nasal congestion, Sinus headache, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Kept her from sleeping: sneezing, nasal congestion, sinus pressure. Throbbing headache. No fevers. No nausea or vomiting. No treatment, just tried to stay hydrated and drank water. No Benadryl or other OTC medications taken.

VAERS ID:470345 (history)  Vaccinated:2012-10-16
Age:61.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Florida  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness, received flu shot at pharmacy, Insurance paid for it.
Preexisting Conditions: Demerol Allergy
Diagnostic Lab Data: none
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Abdominal discomfort, Diarrhoea, Flatulence
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Discomfort in stomach, gas then diarrhea through the night...diarrhea next day in afternoon...the next day morning and afternoon.

VAERS ID:470351 (history)  Vaccinated:2012-10-16
Age:1.4  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Florida  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: MOTHER DENIES ANY ILLNESS AT TIME OF VACCINATION.
Preexisting Conditions: MOTHER DENIES ANY PRE-EXISTING CONDITIONS AT TIME OF VACCINATION.
Diagnostic Lab Data: N/A
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DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B329AB0IMRA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0130AE0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site urticaria, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: MOTHER REPORTS NOTING 1 LARGE RAISED WELT ON CHILD''S LEG AFTER HER BATH, AROUND 7:30 PM. THE FOLLOWING MORNING, SHE NOTED 4 WELTS, AND BY AROUND 3:30 PM, AFTER HER NAP ON 10/17/12, THE CHILD WAS REPORTEDLY "COVERED WITH HIVES. THERE WERE 17 ON HER LEGS, AND SEVERAL MORE ON HER ARMS AND TORSO." CHILD WAS GIVEN 3/4 TSP DIPHENHYDRAMINE AT THAT TIME, WHICH WAS SUCCESSFUL IN ELIMINATING THE WELTS. NO FURTHER MEDICATION WAS NEEDED.

VAERS ID:470357 (history)  Vaccinated:2012-10-16
Age:58.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 2
Location:North Carolina  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA728AA IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4393BA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Erythema, swelling, pain and induration at injection site 3cm x 5cm. Advised warm compresses and Tylenol for pain with follow up tomorrow (10/19/12). Cellulitis not suspected.

VAERS ID:470358 (history)  Vaccinated:2012-10-16
Age:73.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-18, Days after onset: 1
Location:California  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: COPD
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Injection site pain, Tenderness
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Increasing confluent redness and tenderness of proximal left upper extremity extending just below elbow.

VAERS ID:470369 (history)  Vaccinated:2012-10-16
Age:29.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-18, Days after onset: 0
Location:Kansas  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH718AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Pain, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 3in by 3in red and warm area. Painful and itchy. Applied ice and took ibuprofen. Will take a Benadryl tonight.

VAERS ID:470371 (history)  Vaccinated:2012-10-16
Age:4.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Colorado  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Discomfort, Injection site erythema, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Mother called 10/17 with a complaint the child had a 2 inch circle around injection site that was red and warm to the touch, states the child complained of itching in the area, no other complaints. Encouraged to take Tylenol for discomfort and Benadryl and to call back if the reaction worsened. Mother called on 10/18 to report the reddened area had grown to 3-4 inches with center area returned to normal color and redness decreasing.

VAERS ID:470469 (history)  Vaccinated:2012-10-16
Age:66.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Georga  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0125790SCRA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red raised area around injection site. Came up slightly after injection. Does not appear to be getting worse. Some itching. No pustules. Advised covering and keeping watch. Let PCP know if it does not go away or gets worse.

VAERS ID:470486 (history)  Vaccinated:2012-10-16
Age:14.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-18, Days after onset: 0
Location:Michigan  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH21400IN 
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB646AA0UNRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AE0UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4256AA0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B085CA0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0660AE1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: C/O pain at injection site, area of redness noted about 50mm x 70mm, 10mm swollen area, warm to touch. Symptoms began 10/17/12 PM, injection was 10/16/12, site of varicella vaccination.

VAERS ID:470491 (history)  Vaccinated:2012-10-16
Age:13.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Ohio  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2143 IN 
HEPA: HEP A (VAQTA)MERCK & CO. INC.0628AE0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0097460IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4289AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B088AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Skin discolouration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: After the last injection was given (HPV), the child''s color changed slightly and she fainted (put her head in her lap). We moved her to a lying down position. She recovered quickly and we monitored her for about 15 minutes, gave her juice and she left with no problems.

VAERS ID:470492 (history)  Vaccinated:2012-10-16
Age:59.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Ohio  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Report multiple allergies
Diagnostic Lab Data: None ordered at present
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12231P IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0135811IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pain, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 10-16-12 Pt. noted redness/swelling shortly after vaccine rec''d. By evening arm was red, swollen, hot to touch and "throbbing". Pt. reports multiple allergies. Took allergy med. and ADVIL. Stopped at MD''s office, not seen by MD, told to report reaction to health dept. This RN I/S MD visit or ER visit.

VAERS ID:470493 (history)  Vaccinated:2012-10-16
Age:26.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Arizona  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205701 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash.

VAERS ID:470500 (history)  Vaccinated:2012-10-16
Age:33.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Maryland  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertrophic cardiomyopathy (myectomy July 2010); MRSA 2008 in C-sect
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4467BA0IDLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pain, Pruritus, Rash, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: "Huge, big, raised circle (size of orange) on arm". Red, warm (99.9 via laser therm.), sl. itchy, sore to touch not with movement.

VAERS ID:470538 (history)  Vaccinated:2012-10-16
Age:1.8  Onset:0000-00-00
Gender:Male  Submitted:2012-10-18
Location:California  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy = Amoxicillin
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH21090IN 
Administered by: Public     Purchased by: Public
Symptoms: Unevaluable event
SMQs:
Write-up: None.

VAERS ID:470539 (history)  Vaccinated:2012-10-16
Age:12.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-18, Days after onset: 1
Location:Michigan  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None. Physical
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4422AA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0073291SCRA
Administered by: Private     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: Redness & swelling at the injection site for Varicella vaccine.

VAERS ID:470540 (history)  Vaccinated:2012-10-16
Age:18.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:California  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to Aspirin - results hives/swelling
Diagnostic Lab Data: Normal
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH732AB0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA110420IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0096381SCRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt was given Varicella in (R) upper arm on 10/16/12. Pt the next morning noticed swelling and redness. Increasing by 10/18/12. Pt seen by Physician Asst. Pt informed to take Ibuprofen and ice. Return if worsens.

VAERS ID:470544 (history)  Vaccinated:2012-10-16
Age:67.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 2
Location:California  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: CAD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH752AB IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0106610IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4152AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Decreased appetite, Injection site erythema, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient developed fever Tmax 102.2 12 hrs following injection. Fever/chills symptoms x 36 hours. Decreased appetite. Redness and warmth of skin 9cm x 6cm at injection site, (R) deltoid. Seen today, temperature improved. Will continue to follow.

VAERS ID:470441 (history)  Vaccinated:2012-10-16
Age:21.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 2
Location:Georga  Entered:2012-10-19, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: Client''s mother reports MRI, blood work, & lumbar puncture were performed at medical center. Denies abnormal results.
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH759AB IMLA
Administered by: Public     Purchased by: Private
Symptoms: Blood test normal, Dysarthria, Headache, Hypoaesthesia, Lumbar puncture normal, Muscle spasms, Nuclear magnetic resonance imaging normal, Somnolence, VIIth nerve paralysis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Within 2 hours of receiving flu vaccine, client was observed by parents to have (L) sided facial drooping, (L) arm numbness, drowsiness, & c/o headache. Brought to ER by mother at 4 pm with reported slurred speech & muscle spasms. Hospitalized overnight for testing per mother.

VAERS ID:470461 (history)  Vaccinated:2012-10-16
Age:70.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-19, Days after onset: 2
Location:Arizona  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: UNKNOWN
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105151 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Injection site pain, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, swelling, tenderness, pain at injection site in left deltoid.

VAERS ID:470462 (history)  Vaccinated:2012-10-16
Age:37.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-19, Days after onset: 2
Location:New Jersey  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Migraines
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3083SCRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Erythema, Headache, Myalgia, Oedema, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Local erythema, edema, muscle aches, paresthesia, arthralgia, headaches.

VAERS ID:470471 (history)  Vaccinated:2012-10-16
Age:64.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-19, Days after onset: 1
Location:Florida  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205201 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: RASH ON FACE. WENT TO URGENT CARE @ 11:30 AM. TOLD TO TAKE ANTIHISTIMINES.

VAERS ID:470472 (history)  Vaccinated:2012-10-16
Age:86.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:Oklahoma  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: Prescribed Prednisone
CDC 'Split Type':
Vaccination
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMRA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red spot at the injection site, swelling, redness decending to the wrist from deltoid, warm to touch.

VAERS ID:470475 (history)  Vaccinated:2012-10-16
Age:39.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 2
Location:Illinois  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Pre existing environmental allerigies. Never been tested for food allergies.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Unknown     Purchased by: Other
Symptoms: Dyspnoea, Immediate post-injection reaction, Local reaction, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Localized reaction immediately after injection given. Wheezing and shortness of breath at 09:00 PM.

VAERS ID:470527 (history)  Vaccinated:2012-10-16
Age:3.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 2
Location:Missouri  Entered:2012-10-19, 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: Multiple food allergies; PCN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4485EA4UNRL
Administered by: Private     Purchased by: Private
Symptoms: Cough, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Given flu vaccine 10-16-12 that evening and next am SOB, cough - needed nebulizer tx.

VAERS ID:470531 (history)  Vaccinated:2012-10-16
Age:42.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-19, Days after onset: 3
Location:Massachusetts  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Amoxicillin allergy -$g rash; Rheumatoid arthritis; Increased chol.; PH urticaria with angioedema
Diagnostic Lab Data: WBC, 10/18/12, 20,000
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4482AB UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010916 UNLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site pain, Nausea, Pyrexia, Tremor, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt received flu vaccine in his (L) deltoid and PNEUMOVAX in his (L) deltoid late afternoon of 10/16/12. That evening he developed shaking chills. He developed a fever off & on up to 101.5. Developed shaking chills again 10/18am. (+) Nausea, (-) vomiting, (-) HA. Seen in PCPs office 10/18 - 13-15cm area of erythema with tenderness & induration noted (L) lateral deltoid. Pt. admitted for IV antibiotics & hydration 10/18.

VAERS ID:470567 (history)  Vaccinated:2012-10-16
Age:4.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-19, Days after onset: 1
Location:California  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC0B187AA1IMRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH720AB5IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0008AE2SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0067832SCRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Induration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 50cm erythematous induration non tender mild swelling.

VAERS ID:470574 (history)  Vaccinated:2012-10-16
Age:75.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:Pennsylvania  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Chills, Cough, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Nausea, cough, chills. Symptoms were extreme.

VAERS ID:470580 (history)  Vaccinated:2012-10-16
Age:60.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:Wisconsin  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to Percocet, Augmentin, Vicodin, Hx of diverticulosis, Dupuytrens disease and oral herpes simplex.
Diagnostic Lab Data:
CDC 'Split Type':
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Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURC4328AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Diarrhoea, Nausea, Pain, Pain in extremity, Pruritus, Pyrexia, Skin reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Arm severly painful. 4-6 hours later hives, red itchy on affected arm, chest and back on same side as vaccine given. 7 hours later abdominal pain which increased in severity lasting 24-48 hours. Nausea and small amount diarrhea 8 hours after. Slight fever 100. Achy all over.

VAERS ID:470583 (history)  Vaccinated:2012-10-16
Age:1.1  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-19, Days after onset: 2
Location:Missouri  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU44828A0IMRL
Administered by: Public     Purchased by: Public
Symptoms: Decreased appetite, Diarrhoea, Pyrexia, Teething, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Mom found him with vomit in his crib in the morning. Low grade fever(99). He is also cutting teeth. Vomited again after arising. Decreased appetite, mild diarrhea.

VAERS ID:470586 (history)  Vaccinated:2012-10-16
Age:28.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:Washington  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
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Manufacturer
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52BO80CA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Cough, Dizziness, Facial pain, Glossodynia, Headache, Hyperhidrosis, Hypoaesthesia, Nausea, Pain in jaw, Paraesthesia, Swelling face, Swollen tongue, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Vestibular disorders (broad), Osteonecrosis (broad), Hypersensitivity (narrow)
Write-up: Severe Headache, Jaw pain, numbness, tingling, pain and swelling in left cheek and tongue, diaphoresis, nausea/vomiting, light headedness, tightness in chest, and uncontrolled coughing.

VAERS ID:470590 (history)  Vaccinated:2012-10-16
Age:53.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 2
Location:Missouri  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: N/A
Diagnostic Lab Data: On 10/19/12 patient came into pharmacy and said she went to doctor office where they prescribed her prednisone and antibiotics and told her that these would render the vaccine ineffective. Pharmacy is unaware of any other tests that may have been performed on patient.
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012519 SCLA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient called and said she had some swelling about the size of a quarter and some itchiness too.

VAERS ID:470612 (history)  Vaccinated:2012-10-16
Age:57.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:Texas  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: All tetracyclines- allergy
Diagnostic Lab Data:
CDC 'Split Type':
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Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Other     Purchased by: Private
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)
Write-up: Large red area on arm below vaccination, swollen, extreme soreness of arm.

VAERS ID:470728 (history)  Vaccinated:2012-10-16
Age:70.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Minnesota  Entered:2012-10-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Lisinopril - cough; Wellbutrin - shakes, spaces out; Lactose intol.
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4499AA11IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Flu shot given (L) deltoid on 10-16-12. Redness, warmth, pain at injection site the following day. No other symptoms. Evaluated 10-18-12 - erythema, warmth 12x15cm area (L) upper arm. No fever or other complaints. Improving today.

VAERS ID:470747 (history)  Vaccinated:2012-10-16
Age:62.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-18
Location:California  Entered:2012-10-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H013021 SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blister, Erythema, Induration, Rash, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Skin rash of mild swelling, scattered clear vesicles 4 x 7 cm oval shaped red/indurated area. No systemic symptoms.

VAERS ID:470755 (history)  Vaccinated:2012-10-16
Age:11.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Arizona  Entered:2012-10-19, 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: None
Preexisting Conditions: Allergies; Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH711AB IMLA
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURERM120100IMRA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red raised warm firm patches at sites of both injections measuring 2 x 3 on RUE and 3 x 5 on LUE; KEFLEX antibiotic given for suspected cellulitis and BENADRYL for reaction.

VAERS ID:470956 (history)  Vaccinated:2012-10-16
Age:63.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 2
Location:California  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Breast cancer s/p (B) mastectomy$g Sublego.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0618AE SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Local redness

VAERS ID:475628 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-19, Days after onset: 3
Location:Unknown  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008613
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0595AA SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: Information has been received from a pharmacist regarding to a patient of unknown age and gender. On 16-OCT-2012, the patient was vaccinated with an expired dose of PNEUMOVAX 23 INJ, (dose and route were not provided) (lot number 669579/0595AA, expiration date 30-AUG-2012). No symptoms reported. Additional information has been requested.

VAERS ID:475635 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-19, Days after onset: 3
Location:Ohio  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA007911
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse refers to a newborn infant. The patient was vaccinated intramuscularly with dose 1 and 2, 0.5 ml RECOMBIVAX HB (lot# not reported) on 16-OCT-2012. The doses were given a few hours apart. No other co-suspects were reported. No concomitant medications were reported. No adverse effect was reported. Additional information has been requested.

VAERS ID:471007 (history)  Vaccinated:2012-10-16
Age:0.5  Onset:2012-10-17, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:Massachusetts  Entered:2012-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4211AA2IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4481BA0IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH134012SCLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF724942IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1808AA2PO 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: High fever of 104.

VAERS ID:470737 (history)  Vaccinated:2012-10-16
Age:26.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-22, Days after onset: 5
Location:Florida  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Per patient CT was done at ER
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0118891SCLA
Administered by: Other     Purchased by: Private
Symptoms: Computerised tomogram, Headache
SMQs:
Write-up: Headache.

VAERS ID:470768 (history)  Vaccinated:2012-10-16
Age:82.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 6
Location:Virginia  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: On amoxicillin after shot same day
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Redness and itching of both arms, (some on) chest, and a lot in groin area. Redness to all areas accompanied by hotness to the touch.

VAERS ID:470776 (history)  Vaccinated:2012-10-16
Age:64.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-22, Days after onset: 6
Location:Ohio  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0653AE1IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injected limb mobility decreased, Injection site erythema, Injection site reaction, Injection site warmth, Myalgia, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: On 10/16 patient noticed itching in response to vaccination given that day. By 10/17, the reaction was redness below the injection site, muscle pain from injection site to elbow, warm to touch; inability to hold arm down by side.

VAERS ID:470785 (history)  Vaccinated:2012-10-16
Age:49.0  Onset:2012-10-21, Days after vaccination: 5
Gender:Female  Submitted:2012-10-22, Days after onset: 1
Location:California  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B093BA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site reaction, Mobility decreased, Muscle swelling, Pain in extremity, Vaccination site pain
SMQs:, Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left deltoid muscle with swelling and pain at vaccine site and limmited ROM and pain on patient''s left arm. No redness, no fever, no chills reported. Patient states was seen at the ER department yesterday.

VAERS ID:470787 (history)  Vaccinated:2012-10-16
Age:63.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-22, Days after onset: 5
Location:California  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: NONE, RECOVERING SLOWLY. AS OF TODAY I CAN GET UP EASIER AND FEEL MUCH BETTER. I WOULD SAY I AM AT 75%.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Mobility decreased, Renal pain
SMQs:, Retroperitoneal fibrosis (broad), Parkinson-like events (broad)
Write-up: PAIN IN LOWER BACK, HARD TO GET UP FROM BED, COUCH OR WHERE EVER I WAS SITTING. PAIN FELT LIKE PAIN IN KIDNEYS AND LASTED THREE DAYS.

VAERS ID:470805 (history)  Vaccinated:2012-10-16
Age:29.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 6
Location:New Hampshire  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Other     Purchased by: Public
Symptoms: Herpes zoster
SMQs:
Write-up: Shingles developed within 4 hours of shot. Went to doctor the next day and they confirmed shingles. I had never had it before.

VAERS ID:470819 (history)  Vaccinated:2012-10-16
Age:85.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-22, Days after onset: 4
Location:Oklahoma  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy List: LIPITOR; Morphine Derivatives; VYTORIN; ZOCOR
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AB IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4149AA IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness with edema at injection site x 1 week. Dr. prescribed Cephalexin.

VAERS ID:471012 (history)  Vaccinated:2012-10-16
Age:4.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 2
Location:California  Entered:2012-10-22, 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: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSAC20B196BA IMLA
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH21090IN 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1023AA1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1212AA1SCRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Erythema annulare, Injection site reaction, Pyrexia, Rash, Rash vesicular, Skin lesion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Developed erythema both arms and lesions similar to pox on anterior neck and trunk. Fever x 1 day resolved with TYLENOL. 3.5 cm annular erythema at inj site both arms random "pox" spots anterior mid neck x 1 multiple spots posterior trunk mostly on (L) trunk - crosses midline.

VAERS ID:471198 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0125760SCLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site discolouration, Injection site erythema, Injection site swelling, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Few in swollen diameter. Red, purple, yellow & raised around injection site. Looks like blisters forming 3 days after injection.

VAERS ID:471226 (history)  Vaccinated:2012-10-16
Age:72.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-22, Days after onset: 6
Location:Delaware  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Previous surgery and may have had nerve damage because they had to go up under ribs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Axillary pain, Erythema, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Contacted pharmacy next morning to state (R) arm was very sore, swollen, red. He took TYLENOL #3 for pain (helped). Area was swollen/red/sore under armpit (not deltoid).

VAERS ID:471233 (history)  Vaccinated:2012-10-16
Age:47.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:Wisconsin  Entered:2012-10-22, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714AA3IMRA
Administered by: Public     Purchased by: Private
Symptoms: Sensation of foreign body
SMQs:, Anaphylactic reaction (broad)
Write-up: 90 minutes after receiving vaccine, felt like had an apple in her throat. Went to walk in clinic; 10/16/12 at 12:45 pm and given Epinephrine 0.3 mg SQ, SOLUMEDROL 125 mg IM, BENADRYL 50mg IV, Prednisone 60 mg PO, then Prednisone 60 mg orally x 3 days.

VAERS ID:471234 (history)  Vaccinated:2012-10-16
Age:10.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Pennsylvania  Entered:2012-10-22, 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: NKA
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AA4IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: (L) deltoid - erythema and warmth border drawn with pen to monitor over 24 hrs. ZYRTEC 10 mg daily. BENADRYL nightly.

VAERS ID:471261 (history)  Vaccinated:2012-10-16
Age:18.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-22, Days after onset: 5
Location:Ohio  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4374AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Influenza like illness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Patient presented to ER with fever & flu like symptoms (headache & myalgia) with 24 hrs of MENACTRA booster.

VAERS ID:472153 (history)  Vaccinated:2012-10-16
Age:27.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-22
Location:New Jersey  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Smear cervix, Abnormal
CDC 'Split Type': WAES1210USA008028
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Colposcopy, Cryotherapy, Inappropriate schedule of drug administration, Smear cervix abnormal
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 27 years old female patient. The patient was vaccinated with the first dose of GARDASIL on 18-JUL-2012, the second dose on 18-SEP-2012 and the third dose on 16-OCT-2012. Lot numbers were unspecified. It was reported that the patient had a colposcopy on 18-JUL-2012 based on results from a PAP then had a "cryo" procedure (cryotherapy) done on 18-SEP-2012. The patient had a follow up visit for the "cryo" procedure on 16-OCT-2012 at which time the patient asked about the third dose of GARDASIL and it was given early accidentally. The outcome of patient was unknown. Additional information has been requested.

VAERS ID:476037 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-22, Days after onset: 6
Location:Unknown  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA009746
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0895AA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Chills, Night sweats, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This spontaneous report as received from a registered nurse refers to a patients of unknown age and gender. The patient''s medical history and drug reactions/allergies were not reported. The patients was vaccinated intramuscularly with PNEUMOVAX 23 on 16-OCT-2012. Lot # (670187/0895AA). No other co-suspects were reported. No concomitant medications were reported. Later the same day (16-OCT-2012) the patient reported to the nurse alternating chills and night sweats with fever. The nurse did not have any specific information for the patient. No treatment information was reported. The outcome of alternating chills, night sweats and fever was unknown. The relatedness for alternating chills, night sweats and fever was unknown for PNEUMOVAX 23. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:476038 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-22, Days after onset: 6
Location:Unknown  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008776
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0895AA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling, Injection site warmth, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a registered nurse refers to 3 patients of unknown age and gender. The patients'' medical history and drug reactions/allergies were not reported. The 3 patients were vaccinated intramuscularly with PNEUMOVAX 23 on 16-OCT-2012. Lot # (670187/0895AA). No other co-suspects were reported. No concomitant medications were reported. Later the same day (16-OCT-2012) the three patients reported the nurse a sore arm with swelling and warmth at the injection site. The nurse did not have any specific information for the patients. No treatment information was reported. The outcome of sore arm, warmth at the injection site and swelling at the injection site was unknown. The relatedness for sore arm, warmth at the injection site and swelling at the injection site was unknown for PNEUMOVAX 23. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:470981 (history)  Vaccinated:2012-10-16
Age:57.0  Onset:0000-00-00
Gender:Male  Submitted:2012-10-23
Location:Washington  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12060010IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site haematoma, Injection site pain, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Mild pain in shoulder where shot was administered beginning 10/18/12, followed by the appearance 10/22/12 of bruises at the shot site and 2 additional locations a few inches below the shot site. Each bruise has underlying mild pain.

VAERS ID:470989 (history)  Vaccinated:2012-10-16
Age:41.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-23, Days after onset: 7
Location:Kentucky  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None documented
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH755AB0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain and redness at the site, swollen enlarged lymph note in Axilla.

VAERS ID:471352 (history)  Vaccinated:2012-10-16
Age:56.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 7
Location:Alabama  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205401 UNLA
Administered by: Private     Purchased by: Other
Symptoms: Burning sensation, Musculoskeletal pain, Pain, Rash vesicular, Secretion discharge
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: Evening of vaccination, developed 2-3 cm area of burning, stinging vesicular rash, weeping. Left shoulder hurt, still hurts and rash persists.

VAERS ID:471372 (history)  Vaccinated:2012-10-16
Age:37.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-23, Days after onset: 6
Location:Minnesota  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergies: PCN and sulfa
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA733AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Chest discomfort, Fatigue, Headache, Nausea, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Hives, fatigue, headache, nausea and vomiting, stomach ache, chest pressure x 1 week. Tx - BENADRYL and rest.

VAERS ID:471385 (history)  Vaccinated:2012-10-16
Age:17.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Michigan  Entered:2012-10-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: No previous flu vaccine; No history of sinusitis asthma congestion
CDC 'Split Type':
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH21400IN 
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB550CA1IMUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.1561AA2IMUN
Administered by: Public     Purchased by: Public
Symptoms: Headache, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: 6-8pm - Receiving 3 vaccines at health department - started with mod-severe headache, congested; runny nose; sore throat. Feverish, body aches. Symptoms continue 48 hours after vaccines. 10-19-12 Reinterviewed client. Headache, congestion continues 72 hours after FLUMIST.

VAERS ID:471419 (history)  Vaccinated:2012-10-16
Age:65.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-23, Days after onset: 5
Location:Michigan  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to epinephrine
Diagnostic Lab Data:
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011427 SCLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient got ZOSTAVAX shot on 10/16/12 to left arm. Complained about redness on 10/19/12. Redness spreaded & aching, pain swelling got worsened on 10/20/12. Visited after hr clinic got some antibiotics. Now symptoms improving.

VAERS ID:471438 (history)  Vaccinated:2012-10-16
Age:54.0  Onset:2012-10-21, Days after vaccination: 5
Gender:Female  Submitted:2012-10-23, Days after onset: 2
Location:Wisconsin  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Being treated for clavicle fx
Diagnostic Lab Data: None
CDC 'Split Type':
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TDAP: TDAP (ADACEL)SANOFI PASTEUR04335AA IMUN
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pruritus, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: TDAP given 10-16-12 redness 21cm x 9cm started 10-21-12 & tenderness with itching.

VAERS ID:476130 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 7
Location:Unknown  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008077
Vaccination
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Accidental exposure, No adverse event, Product quality issue
SMQs:
Write-up: This spontaneous report as received from a female pharmacist of unknown age concerning herself. The pharmacist called to report of topical skin exposure and eye exposure to herself after some reconstituted ZOSTAVAX (lot# was unknown) sprayed out during withdrawing of the solution in a syringe on 16-OCT-2012. No adverse effect reported. PQC filed. Additional information is not expected.

VAERS ID:476139 (history)  Vaccinated:2012-10-16
Age:54.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-23, Days after onset: 7
Location:Florida  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood pressure abnormal; Neoplasm malignant; Bronchitis
Preexisting Conditions: Uterine cancer; Hysterectomy
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA009720
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  UNLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1599AA SCRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site mass, Injection site swelling, Rash vesicular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a registered nurse refers to a 54 years old female patient with intermittent bronchitis, carcinoma, abnormal blood pressure and no known drug allergies. The patient''s medical history included hysterectomy for uterine cancer. The patient was vaccinated subcutaneously in the right deltoid with lot # (672428/1599AA), 0.65 ml dose of ZOSTAVAX on 16-OCT-2012. No other co-suspects were reported. Concomitant medications included an unspecified blood pressure medication. The registered nurse reported that within 24 hours of receipt of the dose the patient contacted the nurse and reported that she was experiencing redness, swelling and lumpiness of the injection site, her right deltoid. On 18-OCT-2012 the patient appeared to be developing a vesicular rash. The patient was given BENADRYL and was applied cold compresses as treatment for the events. No lab diagnostic tests were performed. At the time of the report the injection site appeared to be worsening. The relatedness for vesicular rash, lumpiness, swelling and redness of the injection site was not provided for ZOSTAVAX. Additional information has been requested.

VAERS ID:471282 (history)  Vaccinated:2012-10-16
Age:52.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-24, Days after onset: 7
Location:Washington  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: rash, numbness, pain improving, as of today, 8 days after MMR given
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN1IMRA
Administered by: Private     Purchased by: Other
Symptoms: Headache, Hypoaesthesia, Pain in extremity, Rash erythematous, Rash macular, Rash pruritic, Tenderness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Right arm soreness, about 12 patches of red raised blotchy slt itchy, slt tender rash on Right arm and R thumb, numbness in all fingers of right hand, now only thumb and index. Also headache, bandlike.

VAERS ID:471289 (history)  Vaccinated:2012-10-16
Age:86.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 7
Location:California  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine, Lipitor, atenolol, amlodipine, calcium, vitamin D
Current Illness: None
Preexisting Conditions: Sulfa
Diagnostic Lab Data: Audiogram was performed on Oct. 18, 2012. Test showed no usable hearing in the left ear.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Audiogram abnormal, Blood test, Cardiac monitoring, Computerised tomogram, Deafness unilateral, Electrocardiogram
SMQs:, Hearing impairment (narrow)
Write-up: Complete loss of hearing in left ear upon waking. Called Dr''s office and spoke with triage nurse. She asked questions and took information and talked to Dr. who requested that we go immediately to the ER as the loss of hearing could be an "embolic stroke". We went to the ER immediately and in the intake gave the information we gave to the Dr.''s office. The ER did a blood test, EKG, monitored heart and oxygen, did a CT scan. After all tests, they concluded that we should see an ENT the next day. We went to the Clinic the next morning and they performed an urgent audiogram. The audiogram was compared to one done one year ago and showed that the right ear was the same as previously and the left ear now had no usable function (and a year ago was normal). A course of Prednisone was prescribed by Dr. and a return visit for a repeat audiogram was scheduled for Oct. 31st and a visit with Dr. on Nov. 1st. Currently, after 5 days of prednisone there has been no improvement in the left ear ability to hear.

VAERS ID:471452 (history)  Vaccinated:2012-10-16
Age:32.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-17, Days after onset: 1
Location:New York  Entered:2012-10-24, 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: Physical; Otitis media
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013399 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site swelling, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pain, swelling, redness at injection site. Arm stiffness. Body aches, fatigue.

VAERS ID:471458 (history)  Vaccinated:2012-10-16
Age:4.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-19, Days after onset: 2
Location:Georga  Entered:2012-10-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH745AC1UNLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.H0156190SCLA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash generalised, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt presented in office with finite maculopapular rash over face, chest, back, arms and legs. 24 hours post MMR is when rash began as well as fever.

VAERS ID:471459 (history)  Vaccinated:2012-10-16
Age:61.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-19, Days after onset: 1
Location:New Mexico  Entered:2012-10-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0130210SCLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient received ZOSTAVAX injection 10/16 in left arm. On 10/19 she returned to the pharmacy & her left elbow was red, warm & swollen. I gave her Diphenhydramine 25 mg & advised her to go to ER if swelling or redness persisted.

VAERS ID:471482 (history)  Vaccinated:2012-10-16
Age:11.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 0
Location:Minnesota  Entered:2012-10-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB523AA IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110820IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left upper arm swollen, red, warm - started approx 14 hrs after injection - lasted til visit 24 hr after injection.

VAERS ID:471568 (history)  Vaccinated:2012-10-16
Age:50.0  Onset:2012-10-19, Days after vaccination: 3
Gender:Female  Submitted:2012-10-19, Days after onset: 0
Location:Mississippi  Entered:2012-10-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Sent to doctor
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12043011UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA1UNLA
Administered by: Other     Purchased by: Public
Symptoms: Decreased appetite, Erythema, Malaise, Pain in extremity, Toothache
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Vaccine FLUVIRIN and PNEUMOVAX given on 10/16 in upper left arm 1 inch apart. Patient returned 10/19 said she had been sick and could barely eat. She complained of legs and teeth hurting. She had a large red area on left arm.

VAERS ID:471577 (history)  Vaccinated:2012-10-16
Age:26.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Pennsylvania  Entered:2012-10-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA735AA IMUN
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, 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)
Write-up: Hives on chest developed 6 hrs after vaccine. Injection site red, swollen, size of silver dollar. Patient treated w/ antihistamines.

VAERS ID:471582 (history)  Vaccinated:2012-10-16
Age:17.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 7
Location:Wisconsin  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0064631SCLA
Administered by: Private     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: Redness, warmth, swelling, pain at injection site.

VAERS ID:476232 (history)  Vaccinated:2012-10-16
Age:67.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-24
Location:Unknown  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA009567
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H009826 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site haematoma, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a Doctor of pharmacy refers to a female patient of unknown age with no drug reactions or allergies. The patient was vaccinated with a dose of PNEUMOVAX 23 (Lot # H009826, expiration date 11-FEB-2014) IM on 16-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. The pharmacist reported that on an unknown date, the patient experienced bruise at the injection site as well as reddish, swollen welts approximately 2 inches below the injection site. The patient was treated with TYLENOL. At the time of the report, the patient had not recovered. Additional information has been requested.

VAERS ID:476239 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-24, Days after onset: 8
Location:Unknown  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unable
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA009839
Vaccination
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1125AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered
SMQs:
Write-up: This spontaneous report as received from a Doctor of pharmacy refers to a patient of unknown age. The patient was vaccinated with an expired dose of ZOSTAVAX (Lot # 671454/1125AA, expiration date 12-OCT-2012) on 16-OCT-2012. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:471408 (history)  Vaccinated:2012-10-16
Age:35.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 9
Location:Minnesota  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Crepitus at injection site. (Air in the subcutaneous air at injection site).
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA727DA1IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Crepitations, Injection site reaction
SMQs:
Write-up: Patient noted crepitus (air under the skin at the injection site) and was evaluated in the Emergency Room.

VAERS ID:471505 (history)  Vaccinated:2012-10-16
Age:23.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-25, Days after onset: 9
Location:Hawaii  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: PmHx of Hay fever, and Pack Palsy
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3093IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Upper right arm pain 1 of 10 pain scale. Status post anthrax vaccination. Pt report tenderness of axilla, and erythema to effected arm from inferior aspect of deltoid to superior aspect right elbow. Pt denies any respiratory difficulties, numbness, palpitation, or any other symptoms. Pt has received 3 prervious anthrax IM injections without complaint.

VAERS ID:471522 (history)  Vaccinated:2012-10-16
Age:74.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-25, Days after onset: 9
Location:Michigan  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013847 IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The patient said she experienced redness, swelling, warmth, and pain in her right upper arm underneath the injection site. The reaction lasted 4 days.

VAERS ID:471667 (history)  Vaccinated:2012-10-16
Age:42.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:Virginia  Entered:2012-10-25, Days after submission: 9
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
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205501 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: After Flu shot was given, injection site became swollen, hard bump and injection site turned red. Instructed patient to take BENADRYL for the swelling.

VAERS ID:471828 (history)  Vaccinated:2012-10-16
Age:1.0  Onset:0000-00-00
Gender:Male  Submitted:2012-10-25
Location:Arizona  Entered:2012-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B154BA UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUH562AA UNRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0288AE UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H014194 UNLL
Administered by: Private     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash.

VAERS ID:471845 (history)  Vaccinated:2012-10-16
Age:59.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-22, Days after onset: 5
Location:New Jersey  Entered:2012-10-25, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetic; High Cholesterol; B/L peripheral neuropathy; HTN; Retinopathy; Kidney disease
Diagnostic Lab Data: Cellulitis - being Rx''d with antibiotics
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Diabetic foot
SMQs:
Write-up: Diabetic with ulceration on foot, now has cellulitis. Saw foot Dr., seeing ID, to see PMD 10/23/12. 10/25/12 Client is being treated for cellulitis in leg not related to flu shot.

VAERS ID:471698 (history)  Vaccinated:2012-10-16
Age:54.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-26, Days after onset: 9
Location:New Hampshire  Entered:2012-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Had root canal done on 10/22 showing much inflammation min pus no abscess. Note started on amoxicillin 10/20 changed to clindamyacin 10/22 no effect saw MD 10/24 STILL WITH HEADACHE, LEFT ARM PAIN, SWELLING, SWELLING STILL UNDER JAW, AND EAR PAIN. CBC, CHEM, SED RATE ALL WNL. STARtED ON AUGEMENTIN BID NOTE NO FEVER EVER NOTED.
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP505080IMLA
Administered by: Other     Purchased by: Private
Symptoms: Ear pain, Endodontic procedure, Full blood count normal, Headache, Injection site induration, Laboratory test normal, Oedema peripheral, Oropharyngeal pain, Pain in extremity, Pain in jaw, Red blood cell sedimentation rate normal, Stomatitis, Swelling, Tonsillitis, Toothache
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (broad)
Write-up: Left deltoid pain induration, left ear pain, frontal headache, swelling and pain under left submandibular arch (jaw), sore throat only on left developing on 10/20 with severe #18 tooth pain, white patches also noted on tonsils on 10/20.

VAERS ID:471860 (history)  Vaccinated:2012-10-16
Age:50.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Unknown  Submitted:2012-10-19, Days after onset: 1
Location:Connecticut  Entered:2012-10-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Fibromyalgia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0125760UNLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient has red bump, size of softball at injection site. Told her to ice it, take BENADRYL & Ibuprofen.

VAERS ID:471892 (history)  Vaccinated:2012-10-16
Age:61.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Ohio  Entered:2012-10-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS101412A IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Lymphadenopathy
SMQs:
Write-up: Raised lymph node supraclavicular area about 5 cm. Had similar rx - 2010. No epitrochlear, axillary or infraclavicular lymph node enlargement (Rt) arm. No erythema or inflammation right deltoid injection.

VAERS ID:471894 (history)  Vaccinated:2012-10-16
Age:66.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 0
Location:California  Entered:2012-10-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen right deltoid. No redness. No fever.

VAERS ID:471906 (history)  Vaccinated:2012-10-16
Age:51.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:Texas  Entered:2012-10-26, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205301 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Vaccine given in Left deltoid - swelling and redness. Area approx 7 in x 7 in. Hot to the touch. Pt has applied ice packs and taken BENADRYL for swelling.

VAERS ID:471919 (history)  Vaccinated:2012-10-16
Age:7.0  Onset:0000-00-00
Gender:Male  Submitted:2012-10-17
Location:California  Entered:2012-10-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Insect bites
Preexisting Conditions: Nephrotic syndrome
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ21060IN 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever 103.5 x 6 hrs after FLUMIST.

VAERS ID:471928 (history)  Vaccinated:2012-10-16
Age:75.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-18, Days after onset: 2
Location:Arizona  Entered:2012-10-26, Days after submission: 8
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: Hypertension; Tremors
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4524AA UNLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Diarrhoea, Functional gastrointestinal disorder, Muscular weakness, Nausea, Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow)
Write-up: Severe chills, diarrhea, nausea, body aches, muscle weakness, fainted and loss bowel function.

VAERS ID:471721 (history)  Vaccinated:2012-10-16
Age:1.0  Onset:2012-10-25, Days after vaccination: 9
Gender:Female  Submitted:2012-10-27, Days after onset: 2
Location:Iowa  Entered:2012-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB667CB0IMLA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.H0113262IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0073290SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Large red area around injection site. Blisters.

VAERS ID:471740 (history)  Vaccinated:2012-10-16
Age:13.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-28, Days after onset: 12
Location:Texas  Entered:2012-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Public
Symptoms: Coordination abnormal, Gait disturbance, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Child reported numbness in both feet that over time went up his legs. After Dr apt in am he went back to school. He called from school reporting difficulty with coordination and walking. Took child to ER.

VAERS ID:471862 (history)  Vaccinated:2012-10-16
Age:31.0  Onset:2012-10-26, Days after vaccination: 10
Gender:Female  Submitted:2012-10-29, Days after onset: 3
Location:North Carolina  Entered:2012-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12065010SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain of skin
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left palm, wrist and mid arm - skin very painful to touch. Felt like horrible sunburn. Within 24 hours the pain spread up to upper arm, shot site, left shoulder and lower left neck. Slightest touch was painful. Pain meds would only dull the feeling. 10/29/12 - pain has dulled and receeded back down to just mid arm.

VAERS ID:471882 (history)  Vaccinated:2012-10-16
Age:58.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-29, Days after onset: 12
Location:California  Entered:2012-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS    
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Nausea, Somnolence, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: Vertigo, nausea, extreme fatigue, sleepiness.

VAERS ID:471989 (history)  Vaccinated:2012-10-16
Age:67.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-29, Days after onset: 13
Location:Virginia  Entered:2012-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204601 IMRA
Administered by: Public     Purchased by: Other
Symptoms: Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 4-5 hours post vaccine patient began experiencing nausea. Nausea has lasted 13 day. Vomited times one.

VAERS ID:472024 (history)  Vaccinated:2012-10-16
Age:65.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-29, Days after onset: 13
Location:New York  Entered:2012-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cardiac disorder
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA011997
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH715AB2IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0125750SCRA
Administered by: Other     Purchased by: Other
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a physician refers to a female patient in her 70''s who was a cardiac patient. The patient was vaccinated subcutaneously with 0.65 ml ZOSTAVAX (lot number not reported) "early last week" approximately on 16-OCT-2012. On the same date, the patient was also given an unspecified flu vaccine in the opposite arm. No concomitant medications were reported. "Early last week" approximately on 16-OCT-2012 the patient experienced anaphylactic reaction. She went to an unspecified hospital where she was given epinephrine and was admitted for 24 hours and then released. The hospital report stated that this might have been a reaction to neomycin, but only because that was mentioned in the prescribing information. The outcome of the event was reported as recovered/resolved. Additional information has been requested.

VAERS ID:472169 (history)  Vaccinated:2012-10-16
Age:44.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 14
Location:New Mexico  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not acutely ill
Preexisting Conditions: Allergic to peanuts, erythromycin, red dye, benzoin, betadine, iodine, latex, onions, artificial sweetners, milk and citrus; ankylosing spondylitis, multiple allergies, anaphylaxis and asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204901 IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Intensive care, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt experienced hives. She had taken oral toradol earlier in the day stated she has had this medication and has received influenza shots in the past in without problems. She went to the hospital was admitted and observed in the ICU. Received IV fluids discharged on day 4 with an ENT eval, and referral to an allergist and pulmonologist.

VAERS ID:472211 (history)  Vaccinated:2012-10-16
Age:43.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-23, Days after onset: 6
Location:Delaware  Entered:2012-10-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Sulfa, Iodine, PCN Allergies; Shellfish; Hypothyroidism
Diagnostic Lab Data: Pending
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50708 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0109161IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Hypoaesthesia, Lethargy, Neck pain, Oedema peripheral, Pain in extremity, Pyrexia, Skin warm, White blood cell count increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Patient felt tightness of chest, 102-103 degree fever, lethargic, pain and swelling in shoulder/upper arm, warm to touch. Went to local Emergency Room, increased WBC''s. Numb face, sore neck.

VAERS ID:472218 (history)  Vaccinated:2012-10-16
Age:44.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-30, Days after onset: 14
Location:Georga  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP58807 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Arm hurt when getting shot and still hurts 2 weeks later when put on jacket, etc.

VAERS ID:472222 (history)  Vaccinated:2012-10-16
Age:43.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-30, Days after onset: 14
Location:South Carolina  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: Allergic to Bees, High Blood Pressure, Plantar Fasciitis
Diagnostic Lab Data: Returned to doctor on 10/29 and going again on 11/2.
CDC 'Split Type':
Vaccination
Manufacturer
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DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain, Musculoskeletal pain, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Extreme pain at time of shot, especially when needle pulled out of arm. Progressively worsening pain in shoulder and upper arm. Some tingling in fingers. No relief to date.

VAERS ID:472224 (history)  Vaccinated:2012-10-16
Age:77.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-30, Days after onset: 12
Location:Colorado  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted.
Preexisting Conditions: Sulfonamide allergy, sympathomimetic allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0113320SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient had Zostavax immunization on 10/16/12. Two days after immunization, patient reported hot, stinging, itching, painful area around injection site of right arm with 1 1/2" x 3" swollen area with white ring around it. Patient called the pharmacy to report reaction, and then called her PCP on 10/19/12. PCP instructed patient to take 25mg diphenhydramine daily and to go to med center if symptoms do not improve or get worse by 10/21. Patient also used aloe topically to reduce itchiness. Patient also reported having general itchiness on multiple areas of her body around the same time as the reaction in her arm, which lasted about 12-24 hours. Patient''s symptoms began to improve upon beginning diphenhydramine on 10/20/12, and resolved completely by 10/23/12.

VAERS ID:472287 (history)  Vaccinated:2012-10-16
Age:57.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 2
Location:Colorado  Entered:2012-10-30, 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: NSAID; Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204521 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient developed hives around midnight on evening of shot. Medicated with BENADRYL. Pt. still experiencing reaction with use of diphenhydramine.

VAERS ID:472382 (history)  Vaccinated:2012-10-16
Age:55.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 14
Location:Illinois  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12042010IMAR
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Shoulder pain for 2 wks since flu shot.

VAERS ID:474864 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-30, Days after onset: 14
Location:Unknown  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA010565
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0096Z IMUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a patient of unknown age. The patient was inadvertently vaccinated with 0.5 ml GARDASIL (lot # 666595/0096Z, expire date 14-OCT-2012) intramuscularly on 16-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effects reported. It was unspecified if the patient had sought medical attention. Additional information is not expected. This is one of several reports received from the same source.

VAERS ID:476820 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-10-30, Days after onset: 14
Location:Unknown  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008816
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a patient of unknown age. The patient was vaccinated with VARIVAX (merck) (route, dose and lot # were unknown) instead of a dose of ZOSTAVAX on 16-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. No adverse effect reported. The outcome of event was unknown. It was unknown, if the patient sought medical attention. Additional information has been requested.

VAERS ID:472263 (history)  Vaccinated:2012-10-16
Age:67.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 2
Location:Arizona  Entered:2012-10-31, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4498BA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0098260IMLA
Administered by: Other     Purchased by: Public
Symptoms: Nausea, Oedema peripheral, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient reported swelling of arm 10-20 minutes after administration. While at home, patient became nauseous, fainted & began vomiting. She called EMS who took her to hospital. She reported hospital did not treat her for allergic reaction.

VAERS ID:472330 (history)  Vaccinated:2012-10-16
Age:8.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-31, Days after onset: 14
Location:Arizona  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH11962 IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0119621SCLA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Erythema, Herpes zoster, Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Mother aclled to inform nurse that she had called pediatrician because patient had come home from school and his left arm was swollen and red, hot to touch and painful. Dr. advised her to apply cool compress elevate and Tylenol. 2 days later she took patient in to see dr and was dx with shingles and cellulitis. Child was put on cephalexin and acyclovir. This info per mom. I called to check on child.

VAERS ID:472372 (history)  Vaccinated:2012-10-16
Age:39.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-31, Days after onset: 14
Location:Arizona  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMRA
Administered by: Public     Purchased by: Private
Symptoms: Pain, Skin exfoliation, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: PAIN AND SWELLING FOR SEVERAL DAYS. QUARTER SIZE PIECE OF SKIN REMOVED WITH BANDAGE REMOVAL.

VAERS ID:472374 (history)  Vaccinated:2012-10-16
Age:51.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-31, Days after onset: 14
Location:Arizona  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206201 IMRA
Administered by: Public     Purchased by: Private
Symptoms: Fatigue, Headache, Secretion discharge, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: HEADACHE, FATIGUE, NEXT DAY SWELLING AND OOZY.

VAERS ID:472637 (history)  Vaccinated:2012-10-16
Age:66.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Unknown  Submitted:0000-00-00
Location:Florida  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1203901 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Discomfort, Erythema, Insomnia, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: Patient had fever, and large red spread out about 8 inches on the opposite side of injection, warm when touched. Patient felt very uncomfortable, unable to sleep. 10/19/12 got better, redness disappeared.

VAERS ID:472740 (history)  Vaccinated:2012-10-16
Age:0.8  Onset:2012-10-19, Days after vaccination: 3
Gender:Male  Submitted:0000-00-00
Location:Georga  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rash on face
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSU4545AD0IMLL
Administered by: Private     Purchased by: Unknown
Symptoms: Condition aggravated, Cough, Dysphagia, Rash
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow)
Write-up: Developed rash on face and cough, hard to swallow. Went to E.R. last night they suggested BENADRYL. Mom will get BENADRYL.

VAERS ID:472743 (history)  Vaccinated:2012-10-16
Age:46.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 1
Location:Nebraska  Entered:2012-10-31, Days after submission: 13
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: Cleft lip/palate; PCN; periodic chest pain
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH748AA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Axillary mass, Injection site pain, Nausea, Neck pain, Tenderness
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: 10/16 Immediately or with 5 minutes after getting shot had neck pain, nausea. Approximately neck pain continued off & on worse in the night - nauseated in the night no emesis. Pain at injection site and kinda the upper arm. Felt good on Wed 10/17. Took ADVIL. Night of 10/17-18 felt tenderness in my Rt armpit. In AM noted 8cm soft lump in the Rt axilla. Has happened with previous flu shots. No other time.

VAERS ID:472747 (history)  Vaccinated:2012-10-16
Age:70.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-20, Days after onset: 4
Location:South Carolina  Entered:2012-10-31, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205301 IMUN
Administered by: Other     Purchased by: Public
Symptoms: Injection site cellulitis, Pain in extremity
SMQs:
Write-up: Patient said arm was painful the night after immunization. Visited Dr the next day, diagnosed with cellulitis around administration site. Prescribed antibiotic.

VAERS ID:472889 (history)  Vaccinated:2012-10-16
Age:40.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-30, Days after onset: 14
Location:Oregon  Entered:2012-10-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: PHN recommended anti-HBs testing
CDC 'Split Type': OR201218
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC047AA0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient reports right-sided rash developed 5-6 hours after immunization. Rash is red & sl. itchy. Patient called 10/23/12 to report rash. Patient reports previously completing Hep B series in ''1990''s - never had titre done. Advised to get titre drawn & see PCP for evaluation of rash & discussed comfort measures. Advised not to get further Hep B vaccines if titre "positive". 10/29/12 - rash persists. No fever, no malaise, no N & V. Not recovered from rash on torso as of 10/30/12.

VAERS ID:472892 (history)  Vaccinated:2012-10-16
Age:1.3  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-23, Days after onset: 6
Location:Florida  Entered:2012-10-31, 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
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4211AA3IMLL
HEPA: HEP A (VAQTA)MERCK & CO. INC.0392AE0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Injection site urticaria, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash started on 10/17. Patient seen in office with hives on 10/23 that extend from left knee to hip.

VAERS ID:472941 (history)  Vaccinated:2012-10-16
Age:70.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-30, Days after onset: 13
Location:Florida  Entered:2012-10-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013581 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Chills, Headache, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Arthritis (broad)
Write-up: Chills, all joints ached, low grade fever, headache (pounding) sore throat (3 days).

VAERS ID:472956 (history)  Vaccinated:2012-10-16
Age:35.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-24, Days after onset: 7
Location:North Carolina  Entered:2012-10-31, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Back pain (possibly muscle spasm)
Preexisting Conditions: NKDA; Nicotine dependence
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4247AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site swelling, Neck pain, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: About 32 hrs after injection = swelling, redness and pain at injection site. Day 2 - Localized rash and itching, increased pain spreading to (R) side of neck. Day 3 - ZYRTEC 10mg after increased symptoms. Day 5 - Redness in (R) side of face. Treated with Triamcinolone 0.1% cream TID. Day 9 - Decreased swelling, decreased redness, no itching, no rash. Still slight tenderness at injection site.

VAERS ID:472959 (history)  Vaccinated:2012-10-16
Age:16.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-17, Days after onset: 0
Location:Texas  Entered:2012-10-31, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0135P10IMLA
Administered by: Other     Purchased by: Private
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: Patient was given Pneumonia vaccine when he asked for Meningitis vaccine. No adverse event reported with incorrect vaccine requested.

VAERS ID:472584 (history)  Vaccinated:2012-10-16
Age:35.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-01, Days after onset: 16
Location:Kansas  Entered:2012-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: None. Warm compresses were recommended.
CDC 'Split Type':
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP583060IMLA
Administered by: Public     Purchased by: Other
Symptoms: Axillary pain, Chest discomfort, Hyperhidrosis, Irritability, Lymphadenopathy, Muscle spasms, Palpitations
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad)
Write-up: "Adverse reaction to flu vaccine rec''d in left arm on 10/16/2012. That night I experienced sweating, leg cramps, irritibility, and chest pressure. Those symptoms subsided by the following day. 10/17/2012, I noticed a sore spot in my left armpit. Palpating the area, I could feel a lump under my skin that felt like a swollen lymph node. I do not have this on the other side of my body. Thursday, 10/18/12, the lump was larger and more sore, and that''s when I made the connection that it might be related to the vaccine. Today, 10/19/12, it is more sore, but not larger."

VAERS ID:473035 (history)  Vaccinated:2012-10-16
Age:70.0  Onset:2012-10-20, Days after vaccination: 4
Gender:Male  Submitted:2012-11-01, Days after onset: 12
Location:Wisconsin  Entered:2012-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0467AE SCLA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Blister, Chest pain, Paraesthesia, Pruritus, Scab
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Tingling, soreness, blisters and itching on (R) side of chest and back. Some blisters have broke open and have scabbed over and some have not. Feels better than it did last week per patient. Recvd shingles shot on 10/16/12 at 2:37pm. Stated he felt these symptoms the following Saturday. No MD visit at time of my conversation with patient.

VAERS ID:473040 (history)  Vaccinated:2012-10-16
Age:67.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 1
Location:North Carolina  Entered:2012-11-01, 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
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117800SCLA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Chest pain, Dyspnoea, Local reaction, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Systemic reaction urticaria, hives, asthma attack, severe local reaction, chest pain, SOB.

VAERS ID:472705 (history)  Vaccinated:2012-10-16
Age:1.6  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-02, Days after onset: 16
Location:Nevada  Entered:2012-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash developed around the injection site, which was on her left thigh, and then spread to the rest of her left leg. Within days it spread to her left side of abdomen, left arm and slowly spread to her right side as well, although less pronounced on her right side. So far, it has not spread to feet, hands, or face.

VAERS ID:472711 (history)  Vaccinated:2012-10-16
Age:52.0  Onset:2012-10-22, Days after vaccination: 6
Gender:Female  Submitted:2012-11-02, Days after onset: 11
Location:New York  Entered:2012-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50208 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster
SMQs:
Write-up: Developed shingles.

VAERS ID:473240 (history)  Vaccinated:2012-10-16
Age:65.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-26, Days after onset: 9
Location:Florida  Entered:2012-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 10/26/12 - Spoke with pt. Feeling much better. Took about 4 days before fever & soreness subsided. States still small "lump" at injection site
CDC 'Split Type':
Vaccination
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105150SCUN
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site mass, Injection site pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt called day after injection c/o soreness & small area redness at injection site. Advised to take BENADRYL & use cool compresses. Came to office 10/18/12 c/o fever (99.3), pain at injection site, vomiting & chills, erythema at injection site had increased from 2 cm to 5 cm. (+) induration without fluctuance. Advised ibuprofen 800 mg bid, hydroxyzine 25 mg 1/2 tab 1 tab qd. Clobetasol topical bid.

VAERS ID:472824 (history)  Vaccinated:2012-10-16
Age:40.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-04, Days after onset: 19
Location:Washington  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma, hypothyroidism, PCOS
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Drug administered at inappropriate site, Musculoskeletal pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Debilitating shoulder pain in the arm where the shot was given - especially with lateral raise movement and inward rotation. The shot was given much higher in my arm than I ever remember it being given before - I don''t know if it was that or the shot itself. It has not resolved or improved in almost 3 weeks. I will go see my physician this week. I''ve had discomfort with flu shots before, but never more than a few days and never debilitating like this.

VAERS ID:472833 (history)  Vaccinated:2012-10-16
Age:53.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-04, Days after onset: 18
Location:Florida  Entered:2012-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left shoulder pain with most movement.

VAERS ID:473065 (history)  Vaccinated:2012-10-16
Age:62.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 20
Location:Tennessee  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: None Reported
Diagnostic Lab Data: None at this time
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59407A4IMLA
Administered by: Other     Purchased by: Private
Symptoms: Nodule, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient reports arm is still swollen and painful with a knot after almost 3 weeks.

VAERS ID:473602 (history)  Vaccinated:2012-10-16
Age:27.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 20
Location:Pennsylvania  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH756AA SYRUN
Administered by: Other     Purchased by: Unknown
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Muscle pain 2 week after injection pt. did not seek treatment because she does not have insurance.

VAERS ID:473656 (history)  Vaccinated:2012-10-16
Age:33.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-10-25, Days after onset: 7
Location:Michigan  Entered:2012-11-05, 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: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205801 UNRA
Administered by: Public     Purchased by: Private
Symptoms: Dry skin, Oedema peripheral, Rash generalised
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Rash-like dried skin over complete body. Swelling in hands & ft. Given vaccine in PM on 10-16-12 - woke up with rash in AM on 10-18-12. Rash disappeared by AM on 10-22-12. Discontinued breast feeding infant.

VAERS ID:477284 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2012-11-05, Days after onset: 20
Location:Illinois  Entered:2012-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008646
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: Information has been received from a healthcare worker concerning a patient of unknown age and gender, who on 18-SEP-2012 and on 16-OCT-2012 was vaccinated with the first and second dose of PNEUMOVAX 23, intramuscularly (doses, and lot #s not reported). No adverse effects reported. Additional information has been requested.

VAERS ID:473286 (history)  Vaccinated:2012-10-16
Age:68.0  Onset:2012-10-23, Days after vaccination: 7
Gender:Female  Submitted:2012-11-06, Days after onset: 14
Location:New Jersey  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Kidney stones; Vitamin B 12 deficiency
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site erythema, Rash erythematous, Tongue disorder
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Redness below injection site of L deltoid extending to elbow. Rash R arm red and bumpy. Bump tip of tongue.

VAERS ID:474012 (history)  Vaccinated:2012-10-16
Age:74.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-11-06, Days after onset: 20
Location:Florida  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Milk; Soy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU44988A IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pruritus
SMQs:
Write-up: Itching at site of injection. Persisted for 2 weeks.

VAERS ID:474014 (history)  Vaccinated:2012-10-16
Age:45.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2012-10-22, Days after onset: 5
Location:Washington  Entered:2012-11-06, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No, onset of symptoms 9 hours later
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4498BA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Lethargy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Vaccine administered about 4:16 PM Oct 16, 2012... At 1:30 AM on Oct 17, 2012 pt. woke up with fever, and became lethargic ("wiped out") for the next 24 hours. Took Ibuprofen to manage fever. Wife said symptoms completely resolved by October 18 - October 19th.

VAERS ID:475952 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-06, Days after onset: 21
Location:Ohio  Entered:2012-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA010092
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a healthcare worker refers to a female patient of unknown age. The healthcare worker reported that the patient who received her first 0.5 ml dose of GARDASIL intramuscularly on 02-OCT-2012, received her second 0.5 ml dose of GARDASIL intramuscularly on 16-OCT-2012. At the time of the report, no adverse effect reported. Additional information has been requested.

VAERS ID:473478 (history)  Vaccinated:2012-10-16
Age:50.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2012-11-07, Days after onset: 20
Location:Maryland  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1231210IMRA
Administered by: Public     Purchased by: Other
Symptoms: Malaise, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Sore throat followed a few days later by congestion, malaise, low grade fever, runny nose, and a few days later by vomiting. Lasted almost 2 weeks. This was a mandatory vaccine at work, many people had flu symptoms. We were not informed to report any of this to CDC. Everyone just called out sick. Lot # 123121 from Novartis.

VAERS ID:474455 (history)  Vaccinated:2012-10-16
Age:48.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-11-07, Days after onset: 22
Location:Texas  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: Patient reports has taken flu vaccine in the past with no reaction
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1027021 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient reported itching an hour after vaccine administration. When returned home, he noted hives to entire body, they did go away in a few days. Patient did not go to MD. He stated he took BENADRYL to control symptoms.

VAERS ID:477708 (history)  Vaccinated:2012-10-16
Age:60.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-22, Days after onset: 6
Location:Unknown  Entered:2012-11-07, 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: No known allergies.
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011430 SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Injection site erythema, Injection site mass, Injection site pain, Injection site warmth, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This patient was given a subcutaneous injection of Merck brand varicella zoster vaccine -ZOSTAVAX- in the right deltoid area in the early afternoon of 10/16/2012. The reaction began as a vague soreness at the area of injection in the evening. The patient reported that the reaction reached its peak the next day with a tennis ball sized lump at the site of injection accompanied by redness, warmth and was sore to the touch. She also reported body aches and headache. The patient had read the literature provided and correctly applied ice and took acetaminophen for her symptoms. On the second day, the above symptoms were still present but had diminished. Today she reports that symptoms of soreness at the site of injection are still present but slight. The lump has disappeared along with the systemic symptoms described above.

VAERS ID:477712 (history)  Vaccinated:2012-10-16
Age:56.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 22
Location:California  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA008045
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011052 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Muscle spasms, Pain
SMQs:, Dystonia (broad)
Write-up: This spontaneous report as received from a pharmacist refers to a 56 years old female patient. The patient had no pertinent medical history and no drug reaction. The patient was vaccinated with 0.65 ml ZOSTAVAX (lot number reported as H011052, expire date 05-SEP-2013) subcutaneously on 16-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. The pharmacist mentioned the patient received ZOSTAVAX around 1:30pm on 16-OCT-2012 and the patient called 1 hour later to report cramps in the left ankle that was pretty painful and radiating from the site. No treatment was given for adverse event. No laboratory diagnostics studies were performed. The outcome of adverse events was reported as not recovered. The patient had sought medical attention via phone call to pharmacist. Additional information has been requested.

VAERS ID:477885 (history)  Vaccinated:2012-10-16
Age:72.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 23
Location:Unknown  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylaxis
Preexisting Conditions: Pneumococcal vaccine (unspecified)
Diagnostic Lab Data:
CDC 'Split Type': WAES1210USA009984
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR  UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138470IMAR
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This spontaneous report as received from a pharmacist refers to a 72 years old female patient with prophylaxis. The patient was vaccinated with dose 1, 0.5 ml PNEUMOVAX23 (intramuscular, Lot# H013847, exp 14-MAR-2015 on 16-OCT-2012. Other suspect therapies included FLUZONE with dosage information as (UNK) on 16-OCT-2012. No concomitant medications were reported. On 16-OCT-2012 the patient reported she received an unspecified pneumococcal vaccination at an unspecified time last year. Patient stated that she was experiencing fever and the arm where vaccine administered was "distorted" but no tenderness or rash. Reporter stated FLUZONE HD was administered concomitantly with PNEUMOVAX 23 on 16-OCT-2012. Additional information is requested.

VAERS ID:473810 (history)  Vaccinated:2012-10-16
Age:29.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-09, Days after onset: 23
Location:Pennsylvania  Entered:2012-11-09
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: Hydridintis supervata
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Injected limb mobility decreased, Muscle strain, Nerve compression, Pain in extremity
SMQs:, Dementia (broad), Accidents and injuries (narrow)
Write-up: The next morning I woke up with pain in my arm, I was told by the nurse that it was normal. On Nov. 1, 2012 I was still in pain and not able to lift my arm so I was unable to work, I went to the ER and I was diagnosed with a pinched nerve and neck spasms. I go to see a neurologist on Nov, 20, 2012 to find out if I have any nerve damage due to the injection hitting my nerve. I also was forced to leave my job due to not being able to preform.

VAERS ID:477956 (history)  Vaccinated:2012-10-16
Age:60.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-09, Days after onset: 23
Location:Arkansas  Entered:2012-11-09
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': WAES1210USA013900
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H012575 SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report was received from a healthcare professional refers to a 60 years old female patient. The patient was vaccinated with a dose of ZOSTAVAX (dose, route not reported, lot # reported as H012575) on 16-OCT-2012. On 17-OCT-2012 the patient experienced baseball size around injection site, red from shoulder to elbow. The patient was advised to take BENADRYL as directed and apply cold compress. It was reported that the patient did not seek medical attention. The outcome of adverse events was reported as unknown. The relatedness for baseball size around injection site and red injection site, from shoulder to elbow is unknown for ZOSTAVAX. Additional information is not expected.

VAERS ID:473837 (history)  Vaccinated:2012-10-16
Age:52.0  Onset:2012-11-03, Days after vaccination: 18
Gender:Female  Submitted:2012-11-10, Days after onset: 7
Location:South Carolina  Entered:2012-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Currently suffering illness, using Valacyclovir and pain medication.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA33AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Back pain, Blister, Herpes zoster
SMQs:, Severe cutaneous adverse reactions (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (broad)
Write-up: Severe pain in upper back joint; broke out in Shingles blisters on 11/06/12.

VAERS ID:474239 (history)  Vaccinated:2012-10-16
Age:14.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-28, Days after onset: 12
Location:Minnesota  Entered:2012-11-12, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH746AA SYRLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fall, Headache, Laceration, Rhinalgia, 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), Accidents and injuries (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Gave guest her flu shot, seemed fine tolerated procedure well. I was walking out of exam room with her mom and heard her fall from exam table to floor. She was unresponsive about 45 seconds but color & VS stable. She was transported by parent car to ER after about 25-30 minutes recovery. She had 2 small facial lacerations & complained of nasal pain, headache.

VAERS ID:474246 (history)  Vaccinated:2012-10-16
Age:54.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-10, Days after onset: 24
Location:Arizona  Entered:2012-11-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207101 UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site swelling, Oedema peripheral, Pruritus, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Bay 10/17/12 started to swell & itch, scratching produced redness, swelling. Left arm. 10/18/12 Redness & swelling increased from injection site to elbow. Ice, BENADRYL - swelling decreased.

VAERS ID:473937 (history)  Vaccinated:2012-10-16
Age:79.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-26, Days after onset: 10
Location:Kansas  Entered:2012-11-13, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKA; Asthma; COPD; Borderline diabetic; Heart stents; BPH; GERD; Angioplasty with stent placement; Hypercholesterolemia; Hypertension; Osteoarthritis; Prostate procedures x 2; Foot surgery; Thumb joint replacements
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4493AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Body temperature increased, Confusional state, Dysstasia, Insomnia, Restlessness, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Symptoms began the evening of vaccination, unable to sleep, very restless. When he did sleep, very hard to wake up, out of it. Next morning very weak, could hardly stand. Slightly confused. Temp 100.8 on admission to hospital. Given IV fluids and monitored. Hospital stay was one day. Has recovered completely.

VAERS ID:474352 (history)  Vaccinated:2012-10-16
Age:10.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-11-01, Days after onset: 16
Location:Oregon  Entered:2012-11-13, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Amoxicillin
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH729AA1UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4412AA UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4152AA UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Crying, Irritability
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: "Fussiness, irritability, crying for over an hour" x 3 days.

VAERS ID:474385 (history)  Vaccinated:2012-10-16
Age:49.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-02
Location:California  Entered:2012-11-13, 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) (AFLURIA)CSL LIMITED06649211A UNLA
Administered by: Public     Purchased by: Public
Symptoms: Dry throat, Oropharyngeal pain, Pain, Rhinitis
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Body aches all over, sore & dry throat, rhinitis. Felt better after 2 wks.

VAERS ID:474397 (history)  Vaccinated:2012-10-16
Age:69.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-06, Days after onset: 21
Location:North Carolina  Entered:2012-11-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Iodine; Thimerosal; Tetanus Toxoid
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP585070IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Body temperature increased, Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: 10-16-12 Evening had elevated temp up to 101 oral. Muscles and joints ached. Had 2 further incidents of temp 101. Continued muscle and joint aches. Headaches on daily basis. Progressive fatigue throughout day.

VAERS ID:476936 (history)  Vaccinated:2012-10-16
Age:79.0  Onset:2012-11-06, Days after vaccination: 21
Gender:Female  Submitted:2012-11-06, Days after onset: 0
Location:New York  Entered:2012-11-14, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0114260SCRA
Administered by: Other     Purchased by: Private
Symptoms: Herpes zoster, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient received ZOSTAVAX 10-16-12, called today, described rash on trunk, advised pt to call MD. MD called me to confirm shingles and prescribed VALTREX 1gm.

VAERS ID:474304 (history)  Vaccinated:2012-10-16
Age:49.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-11-15, Days after onset: 30
Location:California  Entered:2012-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Sore left shoulder to the point that raising arm above head or across body is very painful.

VAERS ID:474564 (history)  Vaccinated:2012-10-16
Age:68.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-16, Days after onset: 30
Location:New York  Entered:2012-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS123104 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Injection site reaction, Joint stiffness, Muscle tightness
SMQs:, Dystonia (broad), Arthritis (broad)
Write-up: Pt states on the day following vaccination, she began feeling a "tightening in left shoulder" feeling eventually crossed her back. This progressed to joint pain in distal joints, lower & mid-back. Patient resorted to muscles relaxers.

VAERS ID:474583 (history)  Vaccinated:2012-10-16
Age:57.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-10-22, Days after onset: 5
Location:Washington  Entered:2012-11-16, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA731AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dysphoria, Dyspnoea, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (narrow)
Write-up: Breathing problems - harsh, dysphoric x 2 days then 10-19 rash noted on Lt upper thigh which has progressed to bilat knees to abdomen, bilat arms.

VAERS ID:474950 (history)  Vaccinated:2012-10-16
Age:88.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-08, Days after onset: 22
Location:Massachusetts  Entered:2012-11-20, 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: CHF
Preexisting Conditions: CHF
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4525AA IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Pulmonary oedema, Pyrexia
SMQs:, Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A day after vaccine, felt feverish & tired. 36 hrs after hospitalized. Patient said fluid in her lungs could be pneumonia.

VAERS ID:475022 (history)  Vaccinated:2012-10-16
Age:51.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-20
Location:Georga  Entered:2012-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Autoimmune Disease
Preexisting Conditions: Hypothyroid; Mixed Connective Tissue Disease
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH718AB IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0225AE0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Painful swelling and redness to area of injection the next day. Area stayed red for 3 weeks.

VAERS ID:475242 (history)  Vaccinated:2012-10-16
Age:82.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-12, Days after onset: 26
Location:Connecticut  Entered:2012-11-20, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH711AA UNLA
Administered by: Other     Purchased by: Other
Symptoms: Diplopia, Joint stiffness, Mastication disorder, Oral fungal infection, Oral herpes, Swelling face, Temporomandibular joint syndrome
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Ocular motility disorders (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: Pt states after received FLUZONE vaccine, she had facial swelling, cold sores, stiffened jaw & problems chewing, double vision. However, didn''t go to MD until 11/9 where she was diagnosed with a fungal mouth infection & TMJ. Not sure if even vaccine related, but started right after.

VAERS ID:478510 (history)  Vaccinated:2012-10-16
Age:70.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Male  Submitted:2012-11-22, Days after onset: 35
Location:Florida  Entered:2012-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity; Diabetes mellitus; Hypertension
Preexisting Conditions: Herpes zoster; Penicillin, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA007194
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a 70 years old male patient with high blood pressure, diabetes and penicillin allergy refers to himself. The patient had a shingles outbreak on his foot (side unspecified) a few years ago. The size of a "half dollar" and it cleared up in 6 weeks. The patient was vaccinated with ZOSTAVAX (lot # unspecified) subcutaneously one month ago (16-OCT-2012). No other co-suspects were reported. Concomitant medications included some unspecified high blood pressure and diabetes medications. The next day after vaccination (17-OCT-2012) the patient had a very severe rash across his back. Two days after vaccination (18-OCT-2012) he had a shingles outbreak on his right shoulder that spread to his chest and down his right arm. The patient contacted his physician and was being treated with steroids. The patient described his condition was recovering. The physician did a culture with no result provided. Additional information has been requested.

VAERS ID:475545 (history)  Vaccinated:2012-10-16
Age:3.0  Onset:2012-11-07, Days after vaccination: 22
Gender:Female  Submitted:2012-11-15, Days after onset: 8
Location:North Carolina  Entered:2012-11-28, Days after submission: 13
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: Blood sugar elevated - 540; Glucose high in urine
CDC 'Split Type': NC12013
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.H0111831IMUN
Administered by: Private     Purchased by: Private
Symptoms: Blood glucose increased, Glucose urine present, Hyperphagia, Polydipsia, Polyuria, Thirst, Type 1 diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad)
Write-up: 10-16-12 patient received Hepatitis B vaccine, came into our office 11-7-12 with excessive thirst for couple weeks - dx with diabetes Type I. Onset of polydipsia, polyphagia, polyuria, onset after 10/23/12.

VAERS ID:478745 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 44
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011149
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 16-OCT-2012 17:39, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478749 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 44
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011148
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0294AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 16-OCT-2012 16:47, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot # were involved and the lot # were reported as: 0294AE, expiry date on 06-SEP-2013; and 0385AE, expiry date on 08-nov-2014. it was unspecified which lot # the patient was administered. the outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478750 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-29, Days after onset: 44
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011150
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0294AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn female patient of unknown age. On 16-OCT-2012 18:01, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot # were involved and the lot # were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot # the patient was administered. The outcome of the event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478805 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 44
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011147
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 16-OCT-2012 16:47, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:478831 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-29, Days after onset: 44
Location:Unknown  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011146
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn (female) patient of unknown age. On 16-OCT-2012 09:48, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:479146 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-11-30, Days after onset: 45
Location:Unknown  Entered:2012-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1211USA011065
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a newborn male patient of unknown age. On 16-OCT-2012 10:36, the patient was vaccinated with RECOMBIVAX HB that had been exposed to temperatures below 32F for 6 hours. During that 6 hour time period, the vaccine was exposed to 28.8F for 1.5 hours. Administration route was not reported. Two lot# were involved and the lot# were reported as: 0294AE, expiry date on 06-SEP-2014; and 0385AE, expiry date on 08-NOV-2014. It was unspecified which lot# the patient was administered. The outcome of event was unknown. It was unspecified if the patient sought medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:475974 (history)  Vaccinated:2012-10-16
Age:35.0  Onset:2012-10-31, Days after vaccination: 15
Gender:Female  Submitted:2012-12-02, Days after onset: 32
Location:Arizona  Entered:2012-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205901 IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Was told by patient on 11/30/2012 that she was admitted to hospital (I think that she said on 10/31) and was diagnosed with Guillain-Barre due to vaccination.

VAERS ID:476338 (history)  Vaccinated:2012-10-16
Age:65.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:Kentucky  Entered:2012-12-04, Days after submission: 46
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Feeling hot, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 10/16/12 Tuesday pt given ZOSTAVAX inj. SQ (L) upper arm. 4" diam. whelp is evident with heat and redness. Rec: ibuprofen & BENADRYL x 3-4 days.

VAERS ID:477192 (history)  Vaccinated:2012-10-16
Age:36.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 45
Location:Texas  Entered:2012-12-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Brain damage, unknown cause; osteoporosis; chronic constipation; hypothyroidism; chronic acne; amenorrhea; scoliosis; febrile seizures
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR 1UNUN
Administered by: Unknown     Purchased by: Public
Symptoms: Convulsion, Excessive eye blinking, Gait disturbance, Grand mal convulsion
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: Seizure activity described as "rapid eye blinking and dragging her right foot" was seen approx 3 hours post administration of Tdap. Family stated she had generalized tonic-clonic seizures with previous ($g10 yrs ago) administration of DPT.

VAERS ID:478080 (history)  Vaccinated:2012-10-16
Age:67.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-12-05, Days after onset: 50
Location:California  Entered:2012-12-14, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI of shoulder
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207201A0SYRAR
Administered by: Other     Purchased by: Private
Symptoms: Drug administered at inappropriate site, Musculoskeletal pain, Nuclear magnetic resonance imaging, Pain, Rotator cuff syndrome
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Received vaccine administered high up on shoulder. Shoulder pain with arm movement. Began shortly after. After seeing several doctors and taking medication for pain condition developed and diagnosed as torn shoulder cuff tendon. I think vaccination contributed to this condition.

VAERS ID:478190 (history)  Vaccinated:2012-10-16
Age:36.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-12-14, Days after onset: 59
Location:Ohio  Entered:2012-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH728AA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 45 minutes afer shot (1:45 - 4:30) from wrist down through hands bilaterally were itchy, red; approximately 5:00 PM while in waiting room at urgent care, reported scalp itching and some sign of hives. Treatment at urgent care between 5:00 - 6:00 PM: reported an IM injection and Benadryl given. Symptoms resolved with no reoccurence when questions 2 days later.

VAERS ID:479612 (history)  Vaccinated:2012-10-16
Age:66.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-17, Days after onset: 32
Location:Unknown  Entered:2012-12-28, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: I do not smoke or drink. Female, 2 pregnancies and deliveries, the Wegener''s was discovered in Aug 2009 while trying to figure out some gastrointestinal issues I was having. After kidney biopsies in Aug 2009 I was put on CYLOXAN/prednisone which put me into remission. I''m taking MONOPRIL and NORVASC for mildly elevated blood pressure. I have GERD and take NEXIUM and amitriptyline. Mild allergies to Russian sage and dust. I have had the shingles shot -2006-, all the hepatitis vaccines and get yearly influenza vaccines. I also have mild Raynaud''s/
Diagnostic Lab Data: Biopsies; Skin upper midline back - lichenoid dermatitis; Skin left dorsal hand - lichenoid dermatitis; Skin right lower leg - lichenoid dermatitis Microscopic description; Papular spongiosis papillary dermal edema, lichenoid inflammation. Hyperkeratosis and parakeratosis are present. IgA Civatte bodies lgM Civatte bodies lgG Civatte bodies Fibrinogen Civatte bodies -the hand and leg specimens also had a hint of superficial small vascular deposit. I do not have the blood/urine results from my doctor at this point be he monitors them every 3-6 months and reports no changes. My p-anca is always very mildly elevated since I have the Wegener''s.
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.05556AE UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Antineutrophil cytoplasmic antibody increased, Biopsy skin abnormal, Blood test normal, Diarrhoea, Dry skin, Headache, Hyperkeratosis, Immunology test, Injection site erythema, Injection site mass, Injection site pain, Injection site rash, Injection site swelling, Lichenoid keratosis, Nausea, Parakeratosis, Rash generalised, Skin discolouration, Skin oedema, Urine analysis normal
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vasculitis (broad), Skin tumours of unspecified malignancy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: I received the pneumococcal PPV23 Merck & Co. Lot number 0556AE .5 mL VIS version 10/6/09 at the clinic on 10/16/2012. By that evening I was experiencing redness, soreness around the injection sight, headache, nausea but did not have a fever. By the next day there was a 4 inch circular raised rash at the sight and a very swollen and extremely tender lump 1 1/2 inch around anterior to the injection site. I still had the headache, nausea, and some diarrhea. I went back to the shot clinic and a doctor looked at it quickly but said the shot may have hit a lymph node and not to worry. After about the 3rd day the lump and tenderness as well as the headache had subsided. The rash, however, remained for a few more days. I had noticed some roughness on my upper back but couldn''t see much. On October 29 after showering I noticed probably 20 purple oval/irregular spots on each of my lower legs. I am IN REMISSION for Wegener''s Granulomatosis -6 months oral CYTOXAN and prednisone ending in Feb 2010- and knew the disease could show up on skin or in my lungs. Oct 30 In went to a local Emergi-Care and the doctor drew some bloodwork/urine sample and looked online and felt the purple spots looked like vasculitis photo and showed to me. She called my immunologist. He wanted the lab results. We were leaving town the next morning for 12 days but my doctor felt I could go. The labs came back negative over the following 12 day the rash spread to my stomach, upper and lower back, thighs and arms, and chest. During that time my immunologist was monitoring my rash via photos I had emailed. He recommended skin biopsies using immunofluorescence staining. I went to a dermatologist for the biopsies. He took three and they all came back Lichenoid Dermatitis. My immunologist felt that this indicated the rash was from a drug interaction or from the vaccine. Since there had been no changes to my medications that left the pneumococcal vaccine as the likely cause. I had bloodwork/urine sample repeated on my return Nov. 13, 2012 and they were ruling out the Wegeners.

VAERS ID:480652 (history)  Vaccinated:2012-10-16
Age:84.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-12-19, Days after onset: 64
Location:Oregon  Entered:2013-01-08, Days after submission: 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) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207201A1UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site discolouration, Injection site haematoma, Injection site swelling, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: (L) deltoid area w/discoloration - yellow/greenish bruising noted as well as swelling on posterior of upper arm since vaccine on 10/16. Patient stated felt painful w/palpation and if he leaves his arm up/elevated for any length of time, arm becomes painful. Pt on clopidogrel, warfarin, and ASA.

VAERS ID:481089 (history)  Vaccinated:2012-10-16
Age:31.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-11-30, Days after onset: 45
Location:Unknown  Entered:2013-01-10, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pregnant: No
Diagnostic Lab Data:
CDC 'Split Type': 2012033692
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59908 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysgeusia, Immediate post-injection reaction
SMQs:, Taste and smell disorders (narrow), Hypersensitivity (narrow)
Write-up: This medically confirmed spontaneous report (initial receipt: 16-Oct-2012) concerns a 31-year-old female patient, who had no pertinent medical history or drug allergies. She was not taking any concomitant medication. On 16-Oct-2012 the patient received AFLURIA (batch number: P59908) injection at a dose of 0.5 mL intramuscularly. On 16-Oct-2012 the patient experienced dysgeusia immediately after administration of AFLURIA. No lab diagnostic study was performed. The patient sought medical attention in the pharmacy. No treatment was given to treat the event. The event outcome was not recovered.

VAERS ID:483363 (history)  Vaccinated:2012-10-16
Age:58.0  Onset:2012-11-16, Days after vaccination: 31
Gender:Female  Submitted:2013-02-04, Days after onset: 80
Location:Arizona  Entered:2013-02-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Information not provided by patient
Current Illness:
Preexisting Conditions: The following information was obtained through follow-up and/or provided by the government. 02/07/13 PMH: Optic neuritis, hypertension, hyperlipidemia, depression, spinal stenosis, cauda equina syndrome with bowel incontinence and back pain, paroxysmal atrial fibrillation. Back surgery/Lumbar fusion.
Diagnostic Lab Data: The following information was obtained through follow-up and/or provided by the government. 02/07/2013 Labs and Diagnostics: CBC Platelets 602 TH/UL (H) Poly 44.6% (H) Mono 10.1% (H) Baso 2.2% (H). CHEM - Sodium 129 mmol/l (L) Potassium 3.5 mmol/l (L) Chloride 91 mmol/l (L) BUN 26 mg/dl (H) Glucose 152 mg/dl (H) Total Protein 6.0 g/dl (L) EMG/NCS - Abnormal. QM1 IGG/IGM 72 IV (H). MRI Lumbar Spine - Post-Operative changes. CT Lumbar Spine - Post-Operative changes. MRI Cervical Spine - Abnormal, cervical spondylosis, neural foraminal stenosis.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH752AA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Basophil percentage increased, Blood chloride decreased, Blood glucose increased, Blood potassium decreased, Blood sodium decreased, Blood urea increased, Constipation, Demyelinating polyneuropathy, Differential white blood cell count abnormal, Electromyogram abnormal, Fall, Guillain-Barre syndrome, Hypoaesthesia, Immunology test abnormal, Monocyte percentage increased, Muscular weakness, Nerve conduction studies abnormal, Nuclear magnetic resonance imaging abnormal, Paraesthesia, Platelet count increased, Protein total decreased, Spinal osteoarthritis, Vertebral foraminal stenosis, White blood cell count
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic leukopenia (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Demyelination (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (narrow), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad)
Write-up: Reported by patient that they were diagnosed with Guillain-Barre'' syndrome approximately 1 month after receiving influenza vaccination. The following information was obtained through follow-up and/or provided by the government. 02/07/2013 Hospital records and discharge summary received. Service dates 11/23/12 to 11/27/12. Diagnosis: Demyelinating polyneuropathy. Patient reports falling 10 days after spinal surgery, subsequent numbness and tingling bilateral upper and lower extremities. Weakness of lower extremities and repeated falls. Constipation. Improved with PT/OT. Discharged to rehabilitation.

VAERS ID:484969 (history)  Vaccinated:2012-10-16
Age:6.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Female  Submitted:2012-11-09, Days after onset: 23
Location:Unknown  Entered:2013-02-20, Days after submission: 103
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2012SE79727
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2106 IN 
Administered by: Other     Purchased by: Other
Symptoms: Dark circles under eyes, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: A report has been received from registered nurse concerning a 6 year old, Female patient, who had been receiving Nasal FLUMIST. FLUMIST started on 17-Oct-2012. The patient experienced PURPLE CIRCLES UNDER THE CHILD''S EYES and ITCHY RASH which started on 18-Oct-2012. The outcome of the event of PURPLE CIRCLES UNDER THE CHILD''S EYES and ITCHY RASH is unknown. The report was considered to be non-serious. Summary of follow-up information received by AstraZeneca/Medimmune 09-Nov-2012: The outcome of the events changed from not recovered to recovered. Patient name provided and added to the reporter page. ''Administered by'' reporter field completed. LOT number of FLUMIST added. Corrected report 21-Nov-2012: The outcome of both events corrected from unknown to not recovered. Start date of the events and start date of the drug were amended.

VAERS ID:485242 (history)  Vaccinated:2012-10-16
Age:39.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2013-02-22, Days after onset: 129
Location:Florida  Entered:2013-02-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA73AA1IDLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Site of injection reddened, warm, swollen, hard, and stayed this way for one week.

VAERS ID:485445 (history)  Vaccinated:2012-10-16
Age:72.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Male  Submitted:2013-02-17, Days after onset: 123
Location:Michigan  Entered:2013-02-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H011049 SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient had a very large and swollen area approximately 6" in length around injection site the next day. It resolved in a couple of days with ice / cortisone treatment.

VAERS ID:486264 (history)  Vaccinated:2012-10-16
Age:3.0  Onset:2012-12-26, Days after vaccination: 71
Gender:Male  Submitted:2013-03-06, Days after onset: 70
Location:Massachusetts  Entered:2013-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Since my son received this vaccine, he has had a number of seizures. He never had a seizure before this vaccine. He has always been a very healthy child with no pre-existing medical condition.
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Private     Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Patient has had a number seizures since receiving this vaccine. He never had seizures or medical problems before the vaccine.

VAERS ID:488678 (history)  Vaccinated:2012-10-16
Age:28.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2013-04-08, Days after onset: 174
Location:Delaware  Entered:2013-04-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Only prenatal vitamins and an additional folic acid pill
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERN/A SYR 
Administered by: Other     Purchased by: Other
Symptoms: Abortion spontaneous, Foetal disorder
SMQs:, Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Baby stopped growing at 6 weeks 5 days and miscarried at 10 weeks 6 days.

VAERS ID:490290 (history)  Vaccinated:2012-10-16
Age:64.0  Onset:2013-04-10, Days after vaccination: 176
Gender:Male  Submitted:2013-04-29, Days after onset: 19
Location:Florida  Entered:2013-04-29
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': WAES1304USA016305
Vaccination
Manufacturer
Lot
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Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: This spontaneous report was received from a physician via a company representative concerning a 64 year old male patient. On 16-OCT-2012, the patient was vaccinated with a dose of ZOSTAVAX (lot number, expiry date and dose unspecified), subcutaneously. No concomitant medications were reported. On 10-APR-2013, the patient was diagnosed with shingles during an office visit. The patient sought medical attention (office visit), It was unspecified if any treatment was provided or if any lab tests were performed. The outcome of shingles was unknown. The relatedness for shingles was unknown for ZOSTAVAX. Additional information has been requested.

VAERS ID:492726 (history)  Vaccinated:2012-10-16
Age:46.0  Onset:2012-12-21, Days after vaccination: 66
Gender:Female  Submitted:2013-05-26, Days after onset: 155
Location:Florida  Entered:2013-05-29, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Recovering from gastric bypass
Preexisting Conditions: IV Iodine; Asthma; Acid reflux; no thyroid gland The following information was obtained through follow-up and/or provided by the government. 6/3/13 PMH: Recent viral illness. Thyroid cancer, asthma, GERD, Bowel Obstruction, Breast Biopsy (L). Appendectomy, cholecystectomy, thyroidectomy Allergies to Dilaudid, IV Iodine Contrast Dye.
Diagnostic Lab Data: The following information was obtained through follow-up and/or provided by the government. 6/3/13 Labs and Diagnostics: CHEM - ALT 85 U/L (H) AST 61 U/L (H). CBC - WBC 12.23 (H) RBC 4.05 (L) HGB 11.7 (L) MCHC 31.2 (L) Neut 78.1% (H) Lymph 10.5% (L) Mono 12.6% (H) Abs Neut 9.47 (H) Abs Mono 1.17 (H) MRI Cervical Spine - Abnormal, degenerative disc disease. 6/7/13 Labs and Diagnostics: NCS Report - Abnormal. EMG was not performed. CSF - VDRL Non-reactive, RBC 34 mm/3 (H), Lymph 34% (L). Serum Albumin 2900 mg/dl (L), IgG/Albumin Ratio 0.19 (H). Wound Culture (Abscess) - E coli (+), Strep Anginosis (+).
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA733AA UNLA
Administered by: Private     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Albumin globulin ratio increased, Aspartate aminotransferase increased, Blood albumin decreased, CSF white blood cell count positive, CSF white blood cell differential, Culture wound positive, Escherichia test positive, Fall, Flatulence, Gastric bypass, Guillain-Barre syndrome, Haemoglobin decreased, Hernia hiatus repair, Hiatus hernia, Hypoaesthesia, Immunoglobulin therapy, Intervertebral disc degeneration, Lymphocyte percentage decreased, Mean cell haemoglobin concentration decreased, Monocyte percentage increased, Muscular weakness, Nerve conduction studies abnormal, Neutrophil count increased, Neutrophil percentage increased, Nuclear magnetic resonance imaging abnormal, Obesity surgery, Pain in extremity, Polyneuropathy, Red blood cell count decreased, Red blood cells CSF positive, Sensory loss, Streptococcus test positive, Urinary tract infection, Vitamin B1 deficiency, Vitamin B12 deficiency, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Loss of sensation in the first 3 fingers of each hand and the soles of both feet up to about half way up the calves. Besides rehab, patient given NEURONTIN. Diagnosed with GBS. The following information was obtained through follow-up and/or provided by the government. 6/3/13 Hospital records and discharge summary received. Service dates 12/20/13 to 12/30/12. Diagnosis: Polyneuropathy. Bariatric surgery/gastric bypass, paraesophageal hernia repair - esophagogast fundoplast Nissen Belsy, with increased flatus since surgery. Patient presents with progressive numbness and pain on bottoms of feet, now numbess in hands and legs. Weakness of legs caused fall. B12 deficiency, probable thiamine deficiency. IVIG and IV thiamine administration. Lower urinary tract infection.

VAERS ID:496592 (history)  Vaccinated:2012-10-16
Age:50.0  Onset:2012-11-01, Days after vaccination: 16
Gender:Female  Submitted:2013-05-13, Days after onset: 193
Location:California  Entered:2013-07-12, Days after submission: 60
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tuberculin
Current Illness: Unknown
Preexisting Conditions: Concomitant medications and relevant medical history were unknown. It was unknown if adverse events occurred with previous vaccinations. The subject previously received flu shots but it was unknown if she experienced any reactions following the shots.
Diagnostic Lab Data: UNK
CDC 'Split Type': A1002963A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA702BA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Expired drug administered, Injected limb mobility decreased, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of arm pain in a 50-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). Concurrent medications included Tuberculin (TB skin test). On 16 October 2012 the subject received unspecified dose of FLUARIX (.5 ml, intramuscular, left arm). The healthcare professional stated the office carries two lots of FLUARIX, the subject may have received AFLUA702BA or AFLUA698AA, and both expire 30 June 2012. On 1 November 2012, 16 days after vaccination with FLUARIX, the subject experienced arm pain and unable to lift arm. The subject received FLUARIX and about two weeks later on 01 November 2012 she started noticing pain in her arm where she received the injection to the point that she can''t raise her arm up above her shoulder. The subject consulted her physician and has a scheduled appointment at the clinic. She had a TB test done one day before receiving FLUARIX. At the time of reporting the arm pain and unable to lift arm were unresolved.

VAERS ID:501180 (history)  Vaccinated:2012-10-16
Age:15.0  Onset:2012-10-18, Days after vaccination: 2
Gender:Female  Submitted:2013-09-02, Days after onset: 319
Location:Unknown  Entered:2013-09-02
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:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA013583
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H006536 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, Injection site induration, Injection site swelling, Injection site warmth, Muscle contusion
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from registered nurse refers to a 15 year old female patient, with none pertinent medical history. On 16-OCT-2012, the patient was vaccinated with a dose of VARIVAX (Merck) (Lot # H006536, exp date 09-MAR-2014) (dose and route not reported). Other suspect therapies included sterile diluent that was used to reconstitute the VARIVAX (Merck) (Lot # 6104Y, exp date February 2012). There was no concomitant therapy. On 18-OCT-2012, the patient''s mother reported that the vaccine site was swollen to the size of a grapefruit, warm and hard to the touch. The patient was examined by an unspecified physician on 19-OCT-2012 and 27-OCT-2012. The nurse stated that the unspecified physician stated the adverse symptoms were not an infection and they were probably the result of a bruised muscle. The nurse reported that the VARIVAX (Merck) that was administered was reconstituted with sterile diluent that had expired on an unspecified date in February 2012. No treatment was given for the adverse events. Laboratory diagnostic studies were not performed. It was reported that the patient recovered from the adverse events on 07-NOV-2012. Additional information has been requested.

VAERS ID:502249 (history)  Vaccinated:2012-10-16
Age:38.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2013-09-10, Days after onset: 329
Location:South Carolina  Entered:2013-09-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Patient''s medical history and concomitant vaccine were not reported.
Diagnostic Lab Data: Not reported; From 03 Sep 2013: Patient had a LEEP as a reported illness during pregnancy/ongoing.
CDC 'Split Type': 201209708
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED90656A IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amniotic cavity infection, Exposure during pregnancy, Loop electrosurgical excision procedure, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)
Write-up: Initial pregnancy report received from a healthcare professional on 17 October 2012. A 38-year-old female patient, whose medical history and concomitant medications were not reported, had received a first dose of ADACEL vaccine (Lot number: U4421AA, anatomical site of vaccination was not reported) intramuscularly on 16 October 2012. The patient was pregnant during vaccination. The patient''s last menstrual period was on 10 April 2012. The patient''s estimated date of delivery is 15 January 2013. As of 17 October 2012, the patient had not experienced any adverse events. The patient''s health during pregnancy, concomitant medications, medical history and risk factors were not reported. As of 17 October 2012, the patient''s outcome was unknown. Follow-up information was received on 03 September 2013 from a health care professional. The patient''s last menstrual period was reported as 20 April 2012. Relevant illness during pregnancy/ongoing included chorioamnionitis, PTL (premature labor) and LEEP (Loop electrosurgical excision procedure). Medication use during pregnancy included Tdap, Flu vaccine and terbutaline. According to the reporter, the patient had no adverse events following vaccination. The patient had 2 pregnancies. The end of pregnancy was reported as 04 January 2013 and the infant outcome was normal. List of documents held by the sender none.

VAERS ID:502613 (history)  Vaccinated:2012-10-16
Age:77.0  Onset:2013-08-31, Days after vaccination: 319
Gender:Female  Submitted:2013-09-16, Days after onset: 16
Location:New York  Entered:2013-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1309USA002031
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Rash
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report has been received from a 78 year old female patient concerning herself without any drug reactions/allergies. The patient''s medical history included asthma. On 16-OCT-2012 the patient was vaccinated with a sing injection of 0.65 ml ZOSTAVAX (lot number unspecified) subcutaneous at a local pharmacy. There was no concomitant medications. The patient stated she had broken out in a rash on her back that looked like "prickly heat". The rash began forming on 31-AUG-2013. The patient said she felt jabbing pains in the area of her back where the rash was. The outcome of the events was not recovered/not resolved. The patient had not yet contacted her doctor but planned to do so. Additional information has been requested.

VAERS ID:503295 (history)  Vaccinated:2012-10-16
Age:2.0  Onset:2012-12-23, Days after vaccination: 68
Gender:Female  Submitted:2013-01-24, Days after onset: 32
Location:Unknown  Entered:2013-09-20, Days after submission: 238
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: Tested positive for Influenza A
CDC 'Split Type': 2013SE02409
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Influenza A virus test positive
SMQs:
Write-up: A report has been received from a Health Professional concerning a 2 year old female patient. The patient''s concurrent diseases included Allergic rhinitis. No medical history and concomitant medications were reported. On 16-Oct-2012, the patient received nasal FLUMIST. Dosing and frequency were not reported. It was reported that 5 children got FLUMIST and then came back in and tested positive for Flu A. This patient was tested positive for Influenza A on 23-Dec-2012. The patient treatment medication included TAMIFLU. The patient recovered from the event of tested positive for Influenza A on an unspecified date. The report was considered to be non-serious by the reporter. Summary of follow-up information received 24-Jan-2013 from medical representative. Event outcome was updated from unknown to recovered. Reporters details updated. Concomitant disease was added. County of administrator was added. Corrected report: 28-Jan-2013: Action taken was changed corrected from unknown to not applicable.

VAERS ID:503544 (history)  Vaccinated:2012-10-16
Age:12.0  Onset:2013-01-06, Days after vaccination: 82
Gender:Female  Submitted:2013-03-07, Days after onset: 60
Location:Maryland  Entered:2013-09-20, Days after submission: 196
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': 2013SE01945
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Gastrointestinal disorder, Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: A consumer report has been received. The report concerns a 12 year old, Female consumer, who had been receiving Nasal FLUMIST. FLUMIST started on 16-Oct-2012. The patient experienced fever, GI symptoms, vomiting, diarrhea and feeling ill which started on 06-Jan-2013. The patient recovered from the event of fever, GI symptoms, vomiting, diarrhea and feeling ill on 10-Jan-2013. The report was considered to be non-serious by the reporter. Summary of follow-up information received by AstraZeneca/MedImmune on 07-Mar-2013 from consumer: event of Influenza B deleted, events of fever, GI symptoms, vomiting, diarrhea and feeling ill added. New reporter added, event stop dates and outcomes added. Narrative updated.

VAERS ID:503546 (history)  Vaccinated:2012-10-16
Age:14.0  Onset:2013-01-06, Days after vaccination: 82
Gender:Female  Submitted:2013-01-08, Days after onset: 2
Location:Maryland  Entered:2013-09-20, Days after submission: 254
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': 2013SE01943
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Influenza
SMQs:
Write-up: A report has been received from consumer, concerning a 15 year old, female patient (one of two sisters). The patient''s medical history and concomitant medications were not reported. On 16-Oct-2012, the patient received FLUMIST. On 06-Jan-2013, the patient and her sister, were both diagnosed with Influenza B. On 10-Jan-2013, the patient returned to school and was recovered. The report was considered to be non-serious by reporter. Summary of follow-up information received by AstraZeneca/MedImmune from consumer on 07-Mar-2013: event stop date entered, outcome changed from unknown to recovered. Corrected report 18-Mar-2013: third reporter, type other, entered.

VAERS ID:503659 (history)  Vaccinated:2012-10-16
Age:7.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2013-02-08, Days after onset: 115
Location:Unknown  Entered:2013-09-20, Days after submission: 223
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': 2013SE09358
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH2140 IN 
Administered by: Other     Purchased by: Other
Symptoms: Rash, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: A report has been received from a Health Professional concerning a 7 year old, female subject, who had been receiving Nasal FLUMIST. FLUMIST started on 16-Oct-2012. The patient experienced BUMPS THAT LOOKED LIKE IMPETIGO and RUNNY NOSE which started on 16-Oct-2012. The patient recovered from the event of BUMPS THAT LOOKED LIKE IMPETIGO on an unspecified date and the outcome of the event of RUNNY NOSE is unknown. The report was considered to be non-serious.

VAERS ID:518336 (history)  Vaccinated:2012-10-16
Age:65.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2013-12-31, Days after onset: 441
Location:New Hampshire  Entered:2014-01-03, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hx of chronic capsulitis (L); Reflex sympathetic dystrophy
Diagnostic Lab Data:
CDC 'Split Type': NH010320141
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR55608 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Musculoskeletal pain, Neck pain, Tendonitis
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Left shoulder pain onset 3 hrs post vaccine admin. Pain radiates to upper arm, neck and posterior shoulder persisting x 2 mos. Doctor suspects tendonitis secondary to local pain from immunization. Referred to Physical Therapy.

VAERS ID:520917 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2014-01-27, Days after onset: 468
Location:Unknown  Entered:2014-01-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA008609
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0468AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: Information has been received from a registered nurse regarding an unknown age and gender patient. On 16-OCT-2012, the patient was administered an incorrectly stored dose of ZOSTAVAX, lot# 0468AE, expiration date: 04-APR-2013 (dose and route were not reported). No adverse experience had been reported. This is one of 182 reports from the same source. Additional information has been requested.

VAERS ID:520912 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2014-01-27, Days after onset: 468
Location:Unknown  Entered:2014-01-28, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA008608
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0468AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: Information has been received from a registered nurse regarding an unknown age and gender patient. On 16-OCT-2012, the patient was administered an incorrectly stored dose of ZOSTAVAX, lot# 0468AE, expiration date: 04-APR-2013 (dose and route were not reported). No adverse experience had been reported. This is one of 182 reports from the same source. Additional information has been requested.

VAERS ID:523117 (history)  Vaccinated:2012-10-16
Age:61.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2014-02-19, Days after onset: 491
Location:Alaska  Entered:2014-02-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hep C
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4784AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: Pt reports that he suffered no adverse effects.

VAERS ID:476504 (history)  Vaccinated:2012-10-16
Age:  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-12-05, Days after onset: 50
Location:Foreign  Entered:2012-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': PHHY2012DE110752
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FOREIGN)NOVARTIS VACCINES AND DIAGNOSTICS126102A SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Chest discomfort, Chest pain, Epigastric discomfort
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Case number PHHY2012DE110752 is an initial spontaneous report from a consumer received on 30 Nov 2012. This report refers to male patient (age not provided). His medical history and concomitant medication were not provided. It was reported that until vaccination he was completely healthy. He was vaccinated with BEGRIPAL (batch number: 126102A) on 16 Oct 2012. On the same day evening, he presented with back pain, pain beneath the sternum, and feeling of thoracic pressure. He was hospitalized by emergency ambulance due to retrosternal and epigastric disorder. He was discharged on 18 Oct 2012. The outcome of the events was not reported. It was reported that the consumer suspected that the events were related to BEGRIPAL. No further information was provided.

VAERS ID:476713 (history)  Vaccinated:2012-10-16
Age:0.1  Onset:2012-10-19, Days after vaccination: 3
Gender:Male  Submitted:2012-12-05, Days after onset: 47
Location:Foreign  Entered:2012-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0849161A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPVHIB: DTAP + IPV + HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALSA20CA832A IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dysphagia, Foaming at mouth, Opisthotonus, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (broad), Dystonia (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: This case was reported by a physician and described the occurrence of back arched backwards in a 2-month-old male subject who was vaccinated with INFANRIX-IPV/Hib (GlaxoSmithKline). On 16 October 2012, the subject received an unspecified dose of INFANRIX-IPV/Hib (intramuscular, unknown injection site). At an unspecified times after vaccination with INFANRIX-IPV/Hib, the subject experienced two episodes of back arched backwards, short-time dysphagia, foam in mouth and paleness of skin two times before the examination by the physician (dates unspecified) and that the subject''s condition required intervention of ambulance. On 19 October 2012, 3 days after vaccination with INFANRIX-IPV/Hib, during the examination by the reporting physician, the subject experienced a third episode of back arched backwards, dysphagia, paleness of skin and foam in mouth. This case was assessed as medically serious by GSK. The subject was referred to an hospital but there was no information about hospitalization. At the time of reporting, the dysphagia was resolved but the outcome of the events were was unspecified. The physician considered the events were possibly related to vaccination with INFANRIX-IPV/Hib.

VAERS ID:479816 (history)  Vaccinated:2012-10-16
Age:11.0  Onset:2012-10-21, Days after vaccination: 5
Gender:Female  Submitted:2012-12-29, Days after onset: 69
Location:Foreign  Entered:2012-12-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immunisation
Preexisting Conditions: Arthralgia
Diagnostic Lab Data: 11/02/2012, Blood test, No pathological finding; 11/02/2012, Borrelia test, Negative; C-reactive protein, Normal; 11/12/2012, Nuclear magnetic resonance imaging, MR right knee: Fibrous cortical defect; 11/02/2012, Red blood cell sedimentation rate, 6; 11/02/2012, Rheumatoid factor, $g4; 11/08/2012, Ultrasound scan, No pathologic findings in knees; 10/29/2012, X-ray, Cyst (1.5 cm x 0.6 cm) distal femur, right knee
CDC 'Split Type': WAES1212NOR011019
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Blood test normal, Borrelia test negative, Bursitis, C-reactive protein normal, Cyst, Fibrous cortical defect, Joint swelling, Nuclear magnetic resonance imaging abnormal, Red blood cell sedimentation rate normal, Rheumatoid factor negative, Tenderness, Ultrasound scan normal, X-ray limb abnormal
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Arthritis (broad)
Write-up: Case received from other health care professional via the Health Authorities on 19-Dec-2012 under the reference number NO-NOMAADVRE-FHI-2012-14988. Case medically confirmed. An 11-years-old female patient had received an injection of MMRVAXPRO (batch number NP233350, dose 2, 0.5 ml, parenteral) on 16-Oct-2012 and 21-Oct-2012 she experienced pain in hip and knee (duration: $g 5weeks). Later on unspecified date in November she experienced swelling of knees. Relevant medical history reported; "Pain if she is running for a long period". The patient''s pain in knee persisted. Clinically knee tenderness and swelling over her patella. The patient was clinically diagnosed with bursitis. X-ray of right knee resulted in pathological finding: sub cortical distal femur. Ultrasound and MRI did not add any further pathological findings. Blood tests are normal, including ESR, C-reactive protein, borrelia antibodies and tests for rheumatic diseases. After 5 weeks she was still in pain, particularly behind kneecaps and waiting for orthopaedic follow-up. Bursitis has been coded by the company as described in the narrative but not coded by the HA. At the time of reporting, the outcome of the pain in hip and knee was reported recovered and not recovered, respectively. The outcome of the swelling of knee was unknown. Contradictory information in the report from the HA for pain in knee, reported as both not recovered and a duration of 1 month. According to the reporter, the event reactions were possibly related to vaccination. No further information expected.

VAERS ID:483458 (history)  Vaccinated:2012-10-16
Age:5.0  Onset:2012-10-17, Days after vaccination: 1
Gender:Unknown  Submitted:2013-02-04, Days after onset: 110
Location:Foreign  Entered:2013-02-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Not reported
Diagnostic Lab Data:
CDC 'Split Type': 201301178
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURC3712AC0UNRA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERAOPVB541AB0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site reaction, Oedema, Oedema peripheral, Pyrexia, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Case received from the Health Authorities on 24 January 2013 under the reference number PLURPLN41/2013. A 05-year-old patient (gender not reported), with no reported medical history and concomitant therapy, had received the 1st dose of TRIPACEL (batch number C3712AC, route of administration not reported, expired date in February 2013) in the deltoid arm and the 1st oral dose of POLIO SABIN (other manufacturer, batch number A0PVB541AB, expired date in December 2012) on 16 October 2012. On 17 October 2012, the patient developed severe reaction at the injection site with oedema, redness and pain in diameter 3-5cm and rash limited to certain parts of body (neck, nape, medial surface of arms and forearms). The patient had also oedema of the palms on 17 January 2013 at "7", fever 36.8 degrees C, oedema (3-5) and rash. The patient was hospitalized for 1 day. The patient completely recovered on an unspecified date. HA''s comment: "In the whole primary vaccination schedule is conducted only with IVP products, OPV is given only as booster. In the report was given the information that child was vaccination with I dose of vaccines, including OPV. From the all of OPV vaccines, only one is registered POLIO SABIN. Oedema of the palms, oedema, rash are expected reaction for above vaccines. Oedema of the injection is expected reaction for TRIPACEL. In the report there is not information what oedema 3-5 cm in diameter concerned. Rash is expected reaction for both TRIPACEL and POLIO SABIN." The HA coded rash, edema at the application and injection site redness.

VAERS ID:484845 (history)  Vaccinated:2012-10-16
Age:  Onset:2013-01-01, Days after vaccination: 77
Gender:Female  Submitted:2013-02-18, Days after onset: 48
Location:Foreign  Entered:2013-02-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 01/2013, Influenza virus test, Significant, Positive, On an unspecified date in Jan 2013, laboratory result showed positive for anti- influenza Immunoglobulin G (IgG)
CDC 'Split Type': PHHY2013DE014305
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX FOREIGN (OPTAFLU)NOVARTIS VACCINES AND DIAGNOSTICS031011A IMAR
Administered by: Other     Purchased by: Other
Symptoms: Blood immunoglobulin G, Cough, Influenza like illness, Influenza virus test positive, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Case number PHHY2013DE014305 is an initial spontaneous report combining information received from a physician via Medical Information Center (reference number: 1-321091218) and through telephone on 13 Feb 2012: This report refers to an adult female patient. Her medical history and concomitant medication were not reported. She was vaccinated with OPTAFLU (batch number: 031011A) intramuscularly into upper arm on 16 Oct 2012. It was reported that since beginning of Jan 2013, she had been suffering from flu like symptoms with episodes of fever and cough. On an unspecified date in Jan 2013, laboratory result showed positive for anti-influenza Immunoglobulin G (IgG). The reporting physician suspected as one of several possibilities of an infection with influenza / lack of efficacy. The reporting physician was asked to perform polymerase chain reaction (PCR) test and second influenza IgG level determination, for analyzing whether this was a case of vaccination failure. The outcome of the events was reported as ongoing as of 13 Feb 2013. The seriousness and causality of the events were not reported by the physician.

VAERS ID:487926 (history)  Vaccinated:2012-10-16
Age:11.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2013-03-27, Days after onset: 162
Location:Foreign  Entered:2013-03-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Platelet count, 3000
CDC 'Split Type': B0876466A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSAHPVA153DA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Petechiae, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad)
Write-up: This case was reported by a physician via a regulatory authority (197137) and described the occurrence of asthenia in a 11-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 16 October 2012, the subject received an unspecified dose of CERVARIX (intramuscular, administration site unknown). On 16 October 2012, less than one day after vaccination with CERVARIX, the subject experienced asthenia, thrombocytopenia and skin petechiae. The subject was hospitalised. At the time of reporting, the outcome of the events was unspecified. The subject was still hospitalised for monitoring and investigation.

VAERS ID:488484 (history)  Vaccinated:2012-10-16
Age:0.5  Onset:2013-01-04, Days after vaccination: 80
Gender:Female  Submitted:2013-04-03, Days after onset: 88
Location:Foreign  Entered:2013-04-04, 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: TACHIPIRINA Suppository
Current Illness:
Preexisting Conditions: Fever
Diagnostic Lab Data: 11-JAN-2013, Alanine aminotransferase, 165 IU/l; 11-JAN-2013, Aspartate aminotransferase, 144 IU/l; 11-JAN-2013, Gamma-glutamyltransferase, 266 IU/l; 11-JAN-2013, Monocyte count, 2%; 11-JAN-2013, Platelet count, 743 x 10 9/l
CDC 'Split Type': 2013102602
Vaccination
Manufacturer
Lot
Dose
Route
Site
6VAX-F: DTAP+IPV+HEPB+HIB (FOREIGN)GLAXOSMITHKLINE BIOLOGICALSA21CB466B1IMUN
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHF989481IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Conjunctivitis, Gamma-glutamyltransferase increased, Immunoglobulin therapy, Kawasaki's disease, Monocyte percentage, Mucosal inflammation, Pyrexia, Rash, Rash macular, Upper respiratory tract inflammation
SMQs:, Liver related investigations, signs and symptoms (narrow), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Vasculitis (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: This is a spontaneous report from a contactable hospital physician from the foreign regulatory authority. Regulatory authority report number 198471. A 8-month-old female on 16Oct2012 received at the age of 5-months second dose of PREVENAR 13, lot number F98948, at 0.5 ml single dose, intramuscular and second dose of INFANRIX HEXA, lot number A21CB466B, at 0.5 ml single dose, intramuscular. Concomitant medication included TACHIPIRINA for fever. The patient on 04Jan2013 experienced Kawasaki''s disease with fever, inflammation of the upper respiratory tract, mucositis, non purulent conjunctivitis, erythematous-macular rash on trunk, on lower limbs and in the palmar-plantar area that required hospitalization. The patient on 11Jan2013 underwent lab tests and procedures which included monocyte count: 2%, gamma-glutamyltransferase: 266 IU/l, alanine aminotransferase: 165 IU/l, platelet count: 743 x 10 9/l, aspartate aminotransferase: 144 IU/l. Therapeutic measures taken as a result of event included treatment with immunoglobulins intravenous and CARDIRENE. The patient completely recovered on 17Jan2013.

VAERS ID:489323 (history)  Vaccinated:2012-10-16
Age:0.1  Onset:2012-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2013-04-15, Days after onset: 181
Location:Foreign  Entered:2013-04-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient did not experience post-vaccinal reaction in the past.
Diagnostic Lab Data: not reported
CDC 'Split Type': 201304591
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)SANOFI PASTEURG9586 IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site induration, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Case received from the Health Authorities through the local affiliate on 02 April 2013 under the HA number N1275/2012. A 06-week-old patient (unspecified gender), with no reported medical history and concomitant therapy, had received an intramuscular dose of ACTHIB (batch number G9585-1) in the left thigh on 16 October 2012 at 12:30. On the same day, at 4pm, the patient experienced on the left thigh oedema and warmth, without redness, and "increased compactness" (8 cm in diameter). The patient was examined 6 hours after vaccination. The patient was hospitalized because of the post-vaccinal reaction on unspecified dates. The patient did not experience any post-vaccinal reaction in the past. It was reported that before the vaccination, the vaccine was properly stored in the refrigerator at 6 degrees C. Aseptic technique was maintained during vaccination and the technique of vaccination was appropriate. 47 people have been vaccinated with the same vaccine lot, and no other reaction was reported with this lot. One week after the diagnosis of the post vaccinal reaction, the patient was completely recovered. The Health Authorities coded: "Very strong reaction at the injection site (diameter 6-9 cm)". Documents held by sender: none.

VAERS ID:491996 (history)  Vaccinated:2012-10-16
Age:82.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2013-05-17, Days after onset: 213
Location:Foreign  Entered:2013-05-17
Life Threatening? No
Died? Yes
   Date died: 2012-11-24
   Days after onset: 39
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Blood pressure, 22Nov2012, 101/67; Heart rate, 22Nov2012, 83; Physical examination, 22Nov2012, see text
CDC 'Split Type': B0892467A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA757AA SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dyspnoea exertional, Feeling abnormal, Hyporeflexia, Multi-organ failure, Nausea, <