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Case Details (Sorted by Age)

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VAERS ID:497020 (history)  Vaccinated:2013-07-17
Age:12.0  Onset:2013-07-17, Days after vaccination: 0
Gender:Male  Submitted:2013-07-17, Days after onset: 0
Location:California  Entered:2013-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None; Received immunotherapy
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0202491SCLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives about 1 hr after vaccine administered. BENADRYL = treatment.

VAERS ID:497357 (history)  Vaccinated:2013-06-21
Age:12.0  Onset:2013-06-21, Days after vaccination: 0
Gender:Female  Submitted:2013-07-22, Days after onset: 31
Location:California  Entered:2013-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Full blood count (CBC) (unknown date): result not reported
CDC 'Split Type': WAES1306USA01396
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J003727 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Full blood count, Gaze palsy, Headache, Hyperhidrosis, Hypotonia, Menorrhagia, Oropharyngeal pain, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (broad)
Write-up: This spontaneous report as received from another health professional (healthcare worker) refers to a 12 year old female patient. The patient had no relevant medical history and no concomitant medication. On 21-JUN-2013 at 3 pm, the patient was vaccinated with GARDASIL(dose number not reported) lot # J003727, 0.5 ml, intramuscular. The patient was observed for 15 minutes afterward with no adverse effects. The healthcare worker reported that later that night, the patient had fainted at home, was limp, pale, sweaty and her eyes rolled back in her head. The patient was seen in the ER of unspecified hospital at 12:45 am and complained of sore throat and a headache. The patient was treated with sodium chloride 0.9% IV and ibuprofen. The patient reported to the healthcare worker that today (25-JUN-2013) she began menstruating and that it was heavier than normal and she was experiencing severe abdominal pain. The patient was planned to be seen in the office later today. The outcome of patient fainted at home, headache, sore throat, her eyes rolled back in her head, sweaty, pale and was limb was reported as recovering/resolving. The outcome of menstruation heavier than normal and experiencing severe abdominal pain was unknown. Reporter causality assessment was not provided. Additional information has been requested.

VAERS ID:497368 (history)  Vaccinated:2013-07-12
Age:12.0  Onset:2013-07-12, Days after vaccination: 0
Gender:Female  Submitted:2013-07-18, Days after onset: 6
Location:Minnesota  Entered:2013-07-22, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4051AA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Muscle rigidity, Oropharyngeal discomfort, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Client had a syncopial episode approx. 15 min. after injection. Arms and legs become rigid. Very pale. Able to respond. Stated throat felt "funny". Benadryl given per standing order. Condition improved. Vital signs stable. Client able to walk out of clinic unassisted.

VAERS ID:497386 (history)  Vaccinated:2013-07-16
Age:12.0  Onset:2013-07-16, Days after vaccination: 0
Gender:Female  Submitted:2013-07-22, Days after onset: 6
Location:Missouri  Entered:2013-07-22
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.0692AA0UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Hypoaesthesia, Throat tightness, Visual impairment
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: 7/16/13 at 12:35 pm patient received HPV vaccine. After a few moments patient c/o feeling dizzy and vision changes. Patient remained alert and oriented breathing exercises initiated. C/o numbness to arms legs and tightness in throat airway maintained. Within few minutes sx improved. Pt taken by parents to her doctor. EMS had been called per parents request but did not transferred patient due to improvement of symptoms. Mom called to tell us patient was fine.

VAERS ID:497402 (history)  Vaccinated:2013-07-09
Age:12.0  Onset:2013-07-09, Days after vaccination: 0
Gender:Male  Submitted:2013-07-22, Days after onset: 13
Location:Texas  Entered:2013-07-22
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: Asthma
Diagnostic Lab Data:
CDC 'Split Type': TX130017PU
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA0 LA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B107BA0 LA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Welts to deltoid area (over ~ 5x6 cm) with mildly erythema base. Given 25 mg Diphenhydramine.

VAERS ID:497454 (history)  Vaccinated:2013-07-22
Age:12.0  Onset:2013-07-22, Days after vaccination: 0
Gender:Female  Submitted:2013-07-22, Days after onset: 0
Location:New York  Entered:2013-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy: BIAXIN; tegaderm
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.H0142780IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0026411IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient experienced dizziness/lightheadedness 15 min post injection = she remained supine until sx resolved.

VAERS ID:497630 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2013-07-23
Location:Unknown  Entered:2013-07-25, 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: Not reported
Diagnostic Lab Data: Not reported
CDC 'Split Type': 201307820
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Initial report was received from a consumer on 16 July 2013. A 12-year-old male patient had received an injection of RABIES VACCINE (manufacturer, lot number, route, site and date of administration not reported) and an unspecified amount of time later experienced Guillain-Barre Syndrome (GBS). The reporter did not have any further information regarding the event as the patient was not in their practice at the time of vaccination. Outcome was reported as recovered. Documents held by sender: None.

VAERS ID:497690 (history)  Vaccinated:2013-07-24
Age:12.0  Onset:2013-07-24, Days after vaccination: 0
Gender:Female  Submitted:2013-07-25, Days after onset: 1
Location:Nevada  Entered:2013-07-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B103AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.UF836AA1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Heart rate decreased, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Approximately 15 minutes after vaccination, patient fainted while existing the exam room. She revived within a minute - Her B/P was normal, but her pulse was slow. She received O2 in office and was referred to a cardiologist.

VAERS ID:497694 (history)  Vaccinated:2013-05-16
Age:12.0  Onset:2013-05-17, Days after vaccination: 1
Gender:Female  Submitted:2013-07-25, Days after onset: 69
Location:Texas  Entered:2013-07-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Drug hypersensitivity
Preexisting Conditions: Penicillin (unspecified)
Diagnostic Lab Data:
CDC 'Split Type': WAES1307USA009316
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0209100IMUN
Administered by: Other     Purchased by: Other
Symptoms: Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On 16-MAY-2013, the patient was vaccinated with the first dose of GARDASIL Lot # H020910, 0.5 ml, intramuscular (IM), (indication reported as recommendation). Concomitant medication was reported as none. On 17-MAY-2013, the patient broke out in a red rash that was itching on both arms and legs for 2 days. No treatment was given for the event. Laboratories were not performed. The event did not represent a significant disability or incapacity. On an unspecified date, the patient sought medical attention. On 19-MAY-2013, the patient recovered of the red rash that was itching on both arms and legs for 2 days. Additional information has been requested.

VAERS ID:497732 (history)  Vaccinated:2013-03-22
Age:12.0  Onset:2013-03-22, Days after vaccination: 0
Gender:Female  Submitted:2013-07-26, Days after onset: 126
Location:Illinois  Entered:2013-07-26
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': WAES1307USA014754
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0459AE2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 12 year old female patient. On 06-AUG-2012 and on 28-NOV-2012, the patient was previously vaccinated with the first and the second dose of GARDASIL. On 22-MAR-2013, the patient was vaccinated with third dose of GARDASIL (lot # 0459AE, expiry date was 13-DEC-2014, route and dose were not reported)that was improperly stored at temperature 29 Fahrenheit (F) to 29F. No reactions of any kind was reported. This is one of the four reports received from the same reporter (MARRS# 1305USA017145, 1306USA003145 and 1307USA014755). Additional information is not expected.

VAERS ID:497799 (history)  Vaccinated:2013-07-22
Age:12.0  Onset:2013-07-23, Days after vaccination: 1
Gender:Female  Submitted:2013-07-26, Days after onset: 3
Location:California  Entered:2013-07-26
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: No known allegies or medical conditions
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4597AB0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4667AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0177062SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site urticaria, Local swelling, Malaise, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt called clinic with questions about localized swelling to R arm and fever upon waking the day after immunizations were given. Pt was seen in clinic today because symptoms were not better. Pt also developed malaise and runny nose. Has been taking ibuprofen and Tylenol for fever, mother states initial fever was 101.4, has not let it go with out medication since, pt came to clinic with fever of 99.2 after receiving Tylenol 1.5 hours before visit. Ice packs have been applied consistently to arm. Reddened welted area approx. 10 cm in diameter to R deltoid (Menactra injection site), L deltoid with light red patch around injection site apporx. 4 cm in diameter (Tdap injection site).

VAERS ID:497822 (history)  Vaccinated:2013-07-25
Age:12.0  Onset:2013-07-26, Days after vaccination: 1
Gender:Female  Submitted:2013-07-26, Days after onset: 0
Location:Ohio  Entered:2013-07-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAB527EA0UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA11042 UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H014561 UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS73942 UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J006109 UNRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left upper arm reported as red, swollen, indurated and warm to touch-given BENADRYL, ice to arm, ibuprofen-went to ER as this did not improve condition.

VAERS ID:497833 (history)  Vaccinated:2008-04-28
Age:12.0  Onset:2013-07-21, Days after vaccination: 1910
Gender:Male  Submitted:2013-07-26, Days after onset: 5
Location:Tennessee  Entered:2013-07-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Wheezing
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1307USA013611
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Blister, Drug administered to patient of inappropriate age, Herpes zoster, Pain, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a physician refers to a 12 and a half years old male patient with wheezing. The patient did not have known allergies. On 11-DEC-2001, the patient received the first dose of VARIVAX (Merck) (Lot # not reported) (0.5ml, subcutaneous) and the second dose of VARIVAX (Merck) (Lot # not reported) (0.5ml, subcutaneous) was administered on 28-APR-2008. There was no concomitant medications. On 21-JUL-2013, the patient experienced a rash and then vesicles appeared with pain and the patient sought medical attention, was diagnosed with shingles at an unspecified medical clinic, the patient was not admitted to the hospital. At the time of the report the patient''s outcome was unknown. It was reported that therapy with VARIVAX (Merck) was not discontinued. Additional information has been requested.

VAERS ID:497857 (history)  Vaccinated:2013-07-22
Age:12.0  Onset:2013-07-23, Days after vaccination: 1
Gender:Male  Submitted:2013-07-23, Days after onset: 0
Location:Missouri  Entered:2013-07-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSE59570IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Tdap vaccine yesterday afternoon. At 2AM had fever of 101.2. Tx with ADVIL. At 10AM had fever of 103. No other symptoms.

VAERS ID:497870 (history)  Vaccinated:2013-06-14
Age:12.0  Onset:2013-06-15, Days after vaccination: 1
Gender:Female  Submitted:2013-07-24, Days after onset: 39
Location:California  Entered:2013-07-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1229AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3921AA0UNLA
Administered by: Public     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: (+) Swelling, warm and redness @ injection site (L) deltoid (of arm). Advised to treat sx with ice pack to affected site BID-TID to reduce swelling and OTC TYLENOL for pain control.

VAERS ID:497879 (history)  Vaccinated:2013-07-26
Age:12.0  Onset:2013-07-26, Days after vaccination: 0
Gender:Male  Submitted:2013-07-29, Days after onset: 3
Location:Maryland  Entered:2013-07-29
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0129680IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4593AC0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0169201SCRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Redness back of arm and redness at injection site with itching, mom gave Benadryl, cool compresses.

VAERS ID:497938 (history)  Vaccinated:2012-03-30
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2013-07-29
Location:Unknown  Entered:2013-07-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Food allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1307USA006300
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1171AA0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: This spontaneous report was received from a medical assitant refers to currently 13 year old female patient with eggs allergy and no other pertinent medical history. On 30-MAR-2012 the patient was vaccinated with the first dose of GARDASIL (intramuscular, 0.5 ml) lot number: 670049/1171AA, exp. date 11-NOV-2013. No further doses have been administered. There was no concomitant medication. Reporting medical assistant did not have further details of what the specific symptoms were. On an unknown date the patient experienced injection site reaction. No lab test reported. There was no treatment given for the patient''s event. The outcome of injection site reaction was reported as recovered/resolved (date unspecified). The relatedness for GARDASIL was not reported. The patient did not sought medical attention. Additional information has been requested.

VAERS ID:497945 (history)  Vaccinated:2013-07-29
Age:12.0  Onset:2013-07-29, Days after vaccination: 0
Gender:Female  Submitted:2013-07-29, Days after onset: 0
Location:Virginia  Entered:2013-07-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Patient has had history of convulsions and fainting. Patient is being followed by Neurology/Cardiology.
Diagnostic Lab Data: NO TESTING DONE IN ER
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA120970IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4618AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0011741SCRA
Administered by: Military     Purchased by: Military
Symptoms: Convulsion, Dizziness, Dizziness postural
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Patient began to get lightheaded and dizzy. Patient was laid down and feet elevated. Patient begin to have beginning signs of a seizure but mom intervened by talking with patient and patient begin to talk to mom and patient responded by. Patient was unable to stand without being lightheaded so patient was sent to the ER.

VAERS ID:498011 (history)  Vaccinated:2013-07-29
Age:12.0  Onset:2013-07-29, Days after vaccination: 0
Gender:Female  Submitted:2013-07-29, Days after onset: 0
Location:New Mexico  Entered:2013-07-29
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: Vasovagal Syncope - 780.2, Syncope - 780.2
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB641AA1UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B077AA0UNRA
Administered by: Private     Purchased by: Public
Symptoms: Pallor, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: ADministered vaccines and within 5 min of administration pt. became very pale and proceeded to faint. When coming to she began to shake for 15 sec and then was alert. Applied oxygen to pt and had pt stay at clinic 45 min for observation.

VAERS ID:498024 (history)  Vaccinated:2013-07-16
Age:12.0  Onset:2013-07-17, Days after vaccination: 1
Gender:Female  Submitted:2013-07-19, Days after onset: 2
Location:Oklahoma  Entered:2013-07-30, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1073AA0UNLA
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Dysstasia, Feeling abnormal, Loss of consciousness, Muscular weakness, Nausea, Pain in extremity
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Severe thigh aches, weakness in legs so severe could hardly stand upright. Bad headache, lightheaded, almost passed out. Extreme nausea and stomach cramps. Overall bad feeling.

VAERS ID:498059 (history)  Vaccinated:2013-07-30
Age:12.0  Onset:2013-07-30, Days after vaccination: 0
Gender:Male  Submitted:2013-07-30, Days after onset: 0
Location:Florida  Entered:2013-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient with no complaints
Preexisting Conditions: None
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4313AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient felt dizzy at check out, HR 122, had near syncope.

VAERS ID:498071 (history)  Vaccinated:2013-07-30
Age:12.0  Onset:2013-07-30, Days after vaccination: 0
Gender:Female  Submitted:2013-07-30, Days after onset: 0
Location:Virginia  Entered:2013-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Scheduled for sleep study; Prior history of asthma
Diagnostic Lab Data: None done
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB541DA IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0196811SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema with minimal swelling at injection site of varicella vaccine (left arm given subcutaneously) no tenderness or warmth on palpation no induration improved with 25 mg of BENADRYL given orally (No systemic symptoms).

VAERS ID:498093 (history)  Vaccinated:2013-07-02
Age:12.0  Onset:2013-07-10, Days after vaccination: 8
Gender:Female  Submitted:2013-07-31, Days after onset: 21
Location:California  Entered:2013-07-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1307USA015577
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a physician refers to a 12 year old female patient. On 29-APR-2002 and on 02-JUL-2013 the patient was vaccinated with the first dose and the second dose of VARIVAX (Merck) (lot # H020249, expire date unspecified), injection, subcutaneously. Concomitant therapies included diphtheria toxoid, pertussis acellular vaccine (unspecified), tetanus toxoid and meningococcal vaccine (unspecified). On 10-JUL-2013, the patient developed rash and was diagnosed with shingles after received the second dose of VARIVAX (Merck). On 10-JUL-2013, the patient noticed the rash on left hand and it spread to her arm. The patient saw the physician on 12-JUL-2013 and prescribed the triamcinolone cream 0.1%. But the next day she developed vesicular rash and was diagnosed with shingles. She was prescribed acyclovir. The event outcome was reported as recovered/resolved, but the date was unspecified. Additional information has been requested.

VAERS ID:498159 (history)  Vaccinated:2013-07-31
Age:12.0  Onset:2013-07-31, Days after vaccination: 0
Gender:Female  Submitted:2013-07-31, Days after onset: 0
Location:Kansas  Entered:2013-07-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB692AA IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0555AE IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM11052 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4383AA IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H014193 SCRA
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Incoherent, Malaise, VIIth nerve paralysis, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient injected with Gardisil Vaccine, on L deltoid at 01:15 PM shortly after patient verbalized "I''m not feeling well" skin color on face was pale, patient was slightly coherent, perspire and vomiting. This nurse helped patient to sit back in chair and cold wet cloth applied on back of neck. Patient had vomited all milk that had consumed per mom. Requested mother to give her a well balanced meal before next appointment, with plenty of fluids. Instructed mother to verbalized the nursing staff to lay patient down for following injections. Mother verbalized understanding. Mother stated" all of her sisters do the same thing when getting vaccination".

VAERS ID:498213 (history)  Vaccinated:2013-07-23
Age:12.0  Onset:2013-07-23, Days after vaccination: 0
Gender:Male  Submitted:2013-07-23, Days after onset: 0
Location:Alabama  Entered:2013-08-01, 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
TDAP: TDAP (ADACEL)SANOFI PASTEURC4250AA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0001911SCLA
Administered by: Unknown     Purchased by: Public
Symptoms: Dyskinesia, Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Tdap and varicella given and seconds after varicella given to child his body fell back in chair with head jerk (fainted). This lasted about 30 sec. wet his face and fanned him and improved in seconds. Instructed mom to follow up with dr.

VAERS ID:498224 (history)  Vaccinated:2013-07-31
Age:12.0  Onset:2013-07-31, Days after vaccination: 0
Gender:Female  Submitted:2013-07-31, Days after onset: 0
Location:Texas  Entered:2013-08-01, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None declared
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4445AB0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3974AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0001911SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Chills, dizziness, sweating, light headedness, nausea without vomiting. No syncope occurred.

VAERS ID:498227 (history)  Vaccinated:2013-07-23
Age:12.0  Onset:2013-07-24, Days after vaccination: 1
Gender:Male  Submitted:2013-07-26, Days after onset: 2
Location:New Hampshire  Entered:2013-08-01, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4418BA0UNLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red, warm, firm area to injection site.

VAERS ID:498230 (history)  Vaccinated:2013-07-15
Age:12.0  Onset:2013-07-16, Days after vaccination: 1
Gender:Female  Submitted:2013-07-24, Days after onset: 8
Location:Connecticut  Entered:2013-08-01, 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:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0218610IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticarial rash began day after vaccine. Still present 7/24/13.

VAERS ID:498239 (history)  Vaccinated:2013-07-25
Age:12.0  Onset:2013-07-25, Days after vaccination: 0
Gender:Male  Submitted:2013-07-26, Days after onset: 1
Location:Tennessee  Entered:2013-08-01, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0023471IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM120270IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Local swelling, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Right arm had slight welling, redness, and warm to the touch. Symptoms began on the night of the injection.

VAERS ID:498327 (history)  Vaccinated:2013-07-30
Age:12.0  Onset:2013-07-31, Days after vaccination: 1
Gender:Female  Submitted:2013-08-01, Days after onset: 1
Location:New Jersey  Entered:2013-08-02, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Hx asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0001921SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injected limb mobility decreased, 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: Patient with swelling and redness at injection site (Left arm) did not want to use her arm 2" x 1.5 " induration.

VAERS ID:498375 (history)  Vaccinated:2013-08-02
Age:12.0  Onset:2013-08-02, Days after vaccination: 0
Gender:Female  Submitted:2013-08-02, Days after onset: 0
Location:Texas  Entered:2013-08-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown.
Current Illness: Healthy child, per mother.
Preexisting Conditions: None.
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4445AB0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4247AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Muscular weakness, Nausea, Pallor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Child sat in lobby after receiving vaccines, Tdap and MVC4. After about 5 minutes, mom said child looked pale and was weak in her arms. Upon assessing child. She was pale and said she felt a little dizzy and nauseated. Allow patient to lie down in nurse''s office for 15 minutes, and gave her a Coke. BP 122/84, no signs of breathing difficultly. Pt sat back in waiting room for another 15 minutes. Mother took child home.

VAERS ID:498386 (history)  Vaccinated:2013-07-31
Age:12.0  Onset:2013-07-31, Days after vaccination: 0
Gender:Female  Submitted:2013-08-03, Days after onset: 3
Location:Arizona  Entered:2013-08-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No reactions to Tdap or Polio. No other vaccines given.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Receiving Blood Work soon.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURA121280IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pain, Pain in extremity, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Tingling, and shooting pains up and down arm. Pain in all old injury areas. Rash under arm. Leg pain on 3rd day.

VAERS ID:498528 (history)  Vaccinated:2013-08-02
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2013-08-05
Location:Tennessee  Entered:2013-08-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSJR7371IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4365AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0011821IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Edema, warmth, redness, larger than size of dollar coin (LA).

VAERS ID:498538 (history)  Vaccinated:2013-07-26
Age:12.0  Onset:2013-07-26, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Nebraska  Entered:2013-08-05
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0218610IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4633BB0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4617AA5IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, 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: A few hours after the immunization, the child developed a pink-red area around the injection site that spread over the next 3 days until seen. The patient had chills on the first day. It was swollen and tender to the touch. Prescribed prednisone and ZYRTEC.

VAERS ID:498560 (history)  Vaccinated:2013-07-26
Age:12.0  Onset:2013-07-26, Days after vaccination: 0
Gender:Male  Submitted:2013-07-26, Days after onset: 0
Location:New Mexico  Entered:2013-08-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B110CA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Approximately 2 minutes after administration the patient fainted.

VAERS ID:498582 (history)  Vaccinated:2013-07-29
Age:12.0  Onset:2013-07-29, Days after vaccination: 0
Gender:Male  Submitted:2013-08-05, Days after onset: 7
Location:Unknown  Entered:2013-08-06, 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:
CDC 'Split Type': PHEH2013US016133
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA12128 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Case number PHEH2013US016133, is an initial spontaneous report received from a medical assistant on 29 Jul 2013. This report refers to a 12-year-old male patient. His medical history and concomitant medication were not reported. He was vaccinated with MENVEO (batch number: A12128), intramuscularly on 29 Jul 2013. On the same day after vaccination, he fainted. He was awakened with ammonia, given popsicle and Hershey bar. His vitals were rechecked, blood pressure and heart rate were okay. Physician checked eyes and ears of the patient and he was kept in office for an additional 20 minutes before he was discharged from the office. The outcome was reported as unknown. The seriousness and causality of the event were not reported.

VAERS ID:498605 (history)  Vaccinated:2013-07-01
Age:12.0  Onset:2013-07-01, Days after vaccination: 0
Gender:Female  Submitted:2013-08-06, Days after onset: 36
Location:Unknown  Entered:2013-08-06
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': WAES1308USA001800
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Pallor, Presyncope, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: This spontaneous rep rot as received from the director of a health department refers to 12 year old female patient. Information on medical history was not reported. It was reported that in July 2013 reported as last week, the patient was vaccinated with GARADASIL (lot#, expiry date not provided)(dose, strength, route, frequency, indication not reported) and two other unspecified vaccines. Immediately after administration the patient started to see spots and her skin color became pale. It was also reported that the patient did not fully faint. The outcome of the events was unknown. The reporter did not assess relationship between the therapy with GARDASIL and the adverse events. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:498666 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Male  Submitted:2013-08-06, Days after onset: 1
Location:Florida  Entered:2013-08-06
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSJR73771UNLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H021608 UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA12129 UNLA
Administered by: Public     Purchased by: Public
Symptoms: Loss of consciousness, Presyncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Vasovagal reaction after HPV injection. Seconds of loss of consciousness. All vitals stable.

VAERS ID:498735 (history)  Vaccinated:2013-07-31
Age:12.0  Onset:2013-07-31, Days after vaccination: 0
Gender:Male  Submitted:2013-08-06, Days after onset: 6
Location:Unknown  Entered:2013-08-06
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': WAES1308USA001857
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
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 8 year old male patient who on 05-AUG-2009, was vaccinated with the first dose of GARDASIL and on 31-JUL-2013, was vaccinated with the second dose of GARDASIL (doses, routes and lot numbers not reported). No adverse events were reported. Additional information is not expected.

VAERS ID:498776 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Female  Submitted:2013-08-07, Days after onset: 2
Location:California  Entered:2013-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0218610IMLA
Administered by: Private     Purchased by: Other
Symptoms: Headache, Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt had emesis x1 with a syncopal episode. Pt returned on 8/7/2013 with persistant nausea, vomiting and headaches.

VAERS ID:498777 (history)  Vaccinated:2013-07-29
Age:12.0  Onset:2013-07-30, Days after vaccination: 1
Gender:Male  Submitted:2013-08-07, Days after onset: 8
Location:Kansas  Entered:2013-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': KS2013003
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB690CA1IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0176980IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSX120930IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURV4421AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0011810SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Large warm red hard area on right deltoid.

VAERS ID:498789 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-07, Days after vaccination: 2
Gender:Male  Submitted:2013-08-07, Days after onset: 0
Location:Tennessee  Entered:2013-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS739Y20IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0104471SCRA
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: Erythema and swelling at injection site. Treatment: Cephalexin and sma/tmp.

VAERS ID:498794 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Female  Submitted:2013-08-06, Days after onset: 1
Location:California  Entered:2013-08-07, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0037271IMRA
Administered by: Private     Purchased by: Public
Symptoms: Dysphemia
SMQs:
Write-up: 4 1/2 hrs after vaccine pt. had stuttering speech. Slow reaction.

VAERS ID:498800 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Male  Submitted:2013-08-07, Days after onset: 2
Location:Unknown  Entered:2013-08-07
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': WAES1308USA002848
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report was received from a registered nurse refers to a 12 year old male patient. On 31-JUL-2012, the patient received the first dose of GARDASIL (lot #, expiry not reported) and the second dose was administered on 05-AUG-2013. No adverse effects reported. Additional information has been requested.

VAERS ID:498871 (history)  Vaccinated:2013-06-10
Age:12.0  Onset:2013-06-10, Days after vaccination: 0
Gender:Female  Submitted:2013-08-08, Days after onset: 59
Location:Iowa  Entered:2013-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertralline, 50mg
Current Illness: None
Preexisting Conditions: Anxiety
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB703AA0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213460IMLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad)
Write-up: Day of vaccine around 18:00 pt. started experiencing itching/burning sensation over whole body. Pt. described as "stinging". Pt. developed pin head size dots on body, received BENADRYL at 19:00.

VAERS ID:498875 (history)  Vaccinated:2013-08-01
Age:12.0  Onset:2013-08-01, Days after vaccination: 0
Gender:Male  Submitted:2013-08-08, Days after onset: 7
Location:Ohio  Entered:2013-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS5449M1IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0131AE1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110501IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B088AA1IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0001922SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Hyperhidrosis, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient became pale, dizzy, and diaphoretic after receiving vaccines. Patient fainted.

VAERS ID:498891 (history)  Vaccinated:2013-06-03
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2013-08-08
Location:Unknown  Entered:2013-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: 2013, Nuclear magnetic resonance imaging brain, demyelination of optic chiasm
CDC 'Split Type': WAES1308GRC003572
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Demyelination, Nuclear magnetic resonance imaging brain abnormal, Visual acuity reduced
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad)
Write-up: Case received from paediatrician on 15-Jul-2013 via the contractual partner VIANEX under the reference number SPV13031. Case medically confirmed. A 12-year-old female patient had received the first dose of GARDASIL, (batch number not reported) 6 weeks before 15-Jul-2013 and 3 weeks post-vaccination, she developed decreased visual acuity. Brain MRI revealed demyelination foci in the area of optic chiasm. The patient''s status remained stable up to now. No treatment was administered. The patient had no relevant medical history, no concurrent medication were administered. The patient had a family history of demyelinating disorder. The reporting paediatrician considered the case as possibly related to vaccination.

VAERS ID:498952 (history)  Vaccinated:2013-08-08
Age:12.0  Onset:2013-08-08, Days after vaccination: 0
Gender:Female  Submitted:2013-08-08, Days after onset: 0
Location:New Hampshire  Entered:2013-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB692AA0UNRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0218611UNLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0684AE1UNRA
Administered by: Private     Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Fainting.

VAERS ID:498999 (history)  Vaccinated:2013-08-08
Age:12.0  Onset:2013-08-08, Days after vaccination: 0
Gender:Female  Submitted:2013-08-09, Days after onset: 1
Location:Texas  Entered:2013-08-09
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4434AD0SYRLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3927AA0SYRLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0001910SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Fall
SMQs:, Accidents and injuries (narrow)
Write-up: Patient had no signs and symptoms after having injections of any reactions during time of course when patient walked out side she fell to ground and ambulance was called.

VAERS ID:499006 (history)  Vaccinated:2013-07-30
Age:12.0  Onset:2013-08-01, Days after vaccination: 2
Gender:Male  Submitted:2013-08-02, Days after onset: 1
Location:Texas  Entered:2013-08-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0208480IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J006109 SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Redness and swelling at site of HPV vaccine Redness, swelling, rash surrounding site of varicella vaccine.

VAERS ID:499112 (history)  Vaccinated:2013-08-09
Age:12.0  Onset:2013-08-09, Days after vaccination: 0
Gender:Male  Submitted:2013-08-09, Days after onset: 0
Location:Texas  Entered:2013-08-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB641AA IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4445AB IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3976AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J000191 SCLA
Administered by: Other     Purchased by: Public
Symptoms: Cold sweat, Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Immunizations were given at 3 pm. We asked pt to wait in waiting area for 15 min per VIS recommendation. Within 5 minutes pt was c/o light headedness, dizzy, pt appeared pale and clammy. Nurse practitioner examined pt. We gave him water and crackers to drink and eat. Pt feeling well after 25 minutes passed and left with mother.

VAERS ID:499040 (history)  Vaccinated:2013-08-09
Age:12.0  Onset:2013-08-09, Days after vaccination: 0
Gender:Female  Submitted:2013-08-10, Days after onset: 1
Location:Michigan  Entered:2013-08-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J000366 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Tearfulness, Tremor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: During checkout after appt, patient leaned against the wall and slumped down, with approx 5-10 seconds of shaking. She was assisted to the floor, where she was unresponsive for approximately 1 minute. Upon regaining consciousness, she was tearful and rather quiet. She was allowed to rest on the floor an additional 2 minutes, then returned to the exam room, where she was observed for another 20 minutes, after which time she was alert and oriented, with stable vital signs, taking PO well.

VAERS ID:499156 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Female  Submitted:2013-08-07, Days after onset: 2
Location:New Mexico  Entered:2013-08-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSJR7370IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216081IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0187831SCRA
Administered by: Private     Purchased by: Other
Symptoms: Emotional distress, Pain, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: Rubar, calor, dolor all present in her rash, which appeared w/ in one day of vaccine. Patient is distressed.

VAERS ID:499178 (history)  Vaccinated:2013-08-12
Age:12.0  Onset:2013-08-12, Days after vaccination: 0
Gender:Female  Submitted:2013-08-12, Days after onset: 0
Location:Minnesota  Entered:2013-08-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses
Preexisting Conditions: Being seen in clinic for toe injury. Diagnosed with a toe fracture.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BH20292IN 
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB667BB0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Dyskinesia, Eye movement disorder, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt started with reaction as needle for Hep A immunization was removed from her arm. Her eyes rolled back in her head, she got very pale, and her arms were making jerking movements. This lasted about 90 seconds.

VAERS ID:499186 (history)  Vaccinated:2013-08-12
Age:12.0  Onset:2013-08-12, Days after vaccination: 0
Gender:Female  Submitted:2013-08-12, Days after onset: 0
Location:Kansas  Entered:2013-08-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216080IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B093AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0142721SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Dizziness, Fainting, Nausea.

VAERS ID:499212 (history)  Vaccinated:2013-08-07
Age:12.0  Onset:2013-08-07, Days after vaccination: 0
Gender:Female  Submitted:2013-08-08, Days after onset: 1
Location:California  Entered:2013-08-12, 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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H017698 UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSX12013 UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B097BA UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1439AA UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Patient has redness on the right arm and pain. The pain started late in the evening on 8/7/13. Pt has no temp. It was warm to touch.

VAERS ID:499220 (history)  Vaccinated:2013-08-10
Age:12.0  Onset:2013-08-10, Days after vaccination: 0
Gender:Male  Submitted:2013-08-10, Days after onset: 0
Location:Nevada  Entered:2013-08-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216081UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 08/10/2013 Moderate Other. Pt''s father asked about serious RXN and denied at time of administration once syncope occurred. Pt''s father stated that he had a similar RXN to first HPV vaccine. EMS responded to RXN and assisted pt.

VAERS ID:499266 (history)  Vaccinated:2013-08-06
Age:12.0  Onset:2013-08-06, Days after vaccination: 0
Gender:Female  Submitted:2013-08-12, Days after onset: 6
Location:Mississippi  Entered:2013-08-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Adverse event
Preexisting Conditions: CERVARIX, Adverse event with the third dose
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA003753
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213462IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, Interchange of vaccine products
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 12 year old female patient. On 06-AUG-2013, the patient was inadvertently vaccinated with a single dose of GARDASIL (Lot # H021346, expiration date 01-OCT-2015) intramuscularly after the patient had received three doses of CERVARIX. The physician stated that this was an other than indicated use of GARDASIL. It was also reported that the patient had an unspecified reaction after receiving the third dose of CERVARIX. The patient did not have a reaction to GARDASIL. Additional information has been requested.

VAERS ID:499274 (history)  Vaccinated:2013-07-23
Age:12.0  Onset:2013-07-23, Days after vaccination: 0
Gender:Female  Submitted:2013-08-12, Days after onset: 20
Location:Michigan  Entered:2013-08-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA003691
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 3IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 12 year old female patient. On 05-AUG-2013 the patient was vaccinated with the fifth dose of GARDASIL (lot # and expiration date unspecified) injection (dose, route and anatomical location unspecified) for prophylaxis. The physician reported that patient received 5 doses of GARDASIL. The patient received the first dose on 22-NOV-2011, the second dose on 13-JUL-2012, the third dose on 15-JAN-2013, the fourth dose on 23-JUL-2013 and the fifth dose on 05-AUG-2013 (dose, route and anatomical location unspecified for all). No adverse effect reported. The physician reported that the patient was a foster child and then adopted, the patient''s initials changed, so he did not realize the patient was in the registry twice, so the patient received 5 doses of GARDASIL all together. The patient''s outcome was unknown. Additional information has been requested.

VAERS ID:499241 (history)  Vaccinated:2013-07-15
Age:12.0  Onset:2013-07-15, Days after vaccination: 0
Gender:Female  Submitted:2013-08-13, Days after onset: 29
Location:Ohio  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B110DA5IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213460IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110510IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0011821SCLA
Administered by: Private     Purchased by: Private
Symptoms: Defaecation urgency, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow)
Write-up: While pt was being given Gardasil she passed out. Laid her down and elevated her feet--Upon arousing was nauseated and felt the need to have a BM.

VAERS ID:499244 (history)  Vaccinated:2013-08-01
Age:12.0  Onset:2013-08-01, Days after vaccination: 0
Gender:Female  Submitted:2013-08-13, Days after onset: 12
Location:Arkansas  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None The following information was obtained through follow-up and/or provided by the government. 8/22/13 PMH: Strep pharyngitis. Tonsillectomy.
Diagnostic Lab Data: Hep A Vaccine given July 31st, 2013; CT scan; Lumbar puncture; EBV, Hep A, Mono; blood cultures, urine cultures; CBC-anemia; CMP liver enzymes elevated; ECHO being done 8-13-13 The following information was obtained through follow-up and/or provided by the government. 8/22/13 Representative Labs and Diagnostics: Urinalysis - Orange color, cloudy, Protein 2+, Ketones trace, Bilirubin 3+, Blood 3+, Urobilinogen 2.0 (H), Leuk Est 2+, Epithelial Cells 2+, Bacteria moderate. EBV IGG 4.26 (H), EBV Early AG AB IGG $g5.00 (H). CHEM - Sodium 129 mmol/l (L) Potassium 3.1 mmol/l (L) Chloride 95 mmol/l (L) Glucose 131 mg/dl (H) Calcium 8.0 mg/dl (L) Creatinine 0.5 mg/dl (L) Total Protein 4.8 g/dl (L) Albumin 2.6 g/dl (L) Bilirubin total 2.2 mg/dl (H) Al
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB703AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS432TJ0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Abasia, Abdominal pain, Alanine aminotransferase increased, Anaemia, Arthralgia, Aspartate aminotransferase increased, Bacterial test, Bacterial test negative, Blood albumin decreased, Blood alkaline phosphatase increased, Blood bilirubin increased, Blood calcium decreased, Blood chloride decreased, Blood creatinine decreased, Blood culture, Blood glucose increased, Blood potassium decreased, Blood sodium decreased, Blood urine present, Chromaturia, Computerised tomogram, Computerised tomogram head normal, Cough, Culture urine, Decreased appetite, Dehydration, Diarrhoea, Epstein-Barr virus antibody positive, Epstein-Barr virus test, Full blood count abnormal, Haematocrit decreased, Haemoglobin decreased, Headache, Hepatic enzyme increased, Hepatitis A virus test, Hyperacusis, Irritability, Joint swelling, Laboratory test normal, Leukocytosis, Liver function test abnormal, Lumbar puncture, Lymphocyte count decreased, Lymphocyte percentage decreased, Metabolic function test, Mononucleosis heterophile test, Nausea, Neck pain, Neutrophil count increased, Neutrophil percentage increased, Oedema peripheral, Oral mucosal blistering, Oropharyngeal pain, Photophobia, Protein total decreased, Protein urine present, Pyrexia, Red blood cell count decreased, Skin exfoliation, Strawberry tongue, Streptococcus test negative, Urinary sediment present, Urinary tract infection, Urine abnormality, Urine bilirubin increased, Urine ketone body present, Urine leukocyte esterase positive, Viral pharyngitis, Vomiting, Weight bearing difficulty, Weight increased, White blood cell count increased, White blood cells urine positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Angioedema (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad)
Write-up: Severe headaches, joint pain in knees, strawberry tongue, nausea and vomiting, severe diarrhea, neck pain, blisters in mouth, irritability, light and sound sensitivity, swelling in palms and ankles/feet, peeling of hands and feet, elevated liver enzymes, anemia. She was taken to ER x 2 for treatment of 103 fever and headache. Was given morphine, IVF and Zofran in ER. Spent approx 5 hours in ER. 2nd trip to ER within 12 hours for fever 103, headache, nausea and vomiting, diarrhea (severe, nearly uncontrolled bowel movements), given Tylenol, IVF, morphine, Zofran, Tylenol. CT of head was negative. Urine culture with some blood and WBC (was not a clean catch sample, and pt started menstral cycle). Was treated with IV Rocephin, IVF. Lumbar puncture offered but waited to see if antibiotics would help first. 3rd day of illness (Monday) she was unable to walk or bear weight on feet, severe pain in knees. Was taken to pediatrician and LP was attempted unsuccessfully. Was admitted to ER for worsening of symptoms, continued fever above 102. HA, nausea and vomiting, sore throat. Strep cultures negative. Swelling in lower extremities and hands. Weight gain of 13 pounds within 3 days. No appetite and did not take anything by mouth for 3 days. Extremely irritable. Was monitored 4 days in hospital, several test ran, all negative results. She was discharged from hospital 8-8-13. Follow up with pediatrician 8-12-13. The following information was obtained through follow-up and/or provided by the government. 8/22/13 ER/Hospital records/ DC summary received. Serivce dates 8/3/13 to 8/4/13, 8/5/13 to 8/8/13. Diagnosis: Dehydration, viral pharyngitis, leucocytosis, lower urinary tract infection. Anemia unspecified. Elevated LFT''s. Patient presents with headache, fever, nausea, and vomiting. Slight cough, sore throat, body aches, sore neck, drinking fluids less than usual. Tachycardia. Improved somewhat with fluids and medication. Continues with vomiting and explosive diarrhea. Minor abdominal pain. Recommend fluids, Zofran, Tylenol as needed. Admitted for IV hydration, ceftriaxone/doxycycline, lumbar puncture. Discharged home on Omnicef.

VAERS ID:499246 (history)  Vaccinated:2013-08-02
Age:12.0  Onset:2013-08-02, Days after vaccination: 0
Gender:Male  Submitted:2013-08-13, Days after onset: 11
Location:Michigan  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/a
Preexisting Conditions: N/a
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS 0IMRA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Local reaction
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Large red local reaction on right arm.

VAERS ID:499327 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2013-08-13
Location:Nevada  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Obesity; Tourette''s
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H021608 IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 90 minutes afer injection of MENACTRA and GARDASIL, patient was itching intensely, itching subsided after 4-5 hrs.

VAERS ID:499379 (history)  Vaccinated:2013-08-09
Age:12.0  Onset:2013-08-09, Days after vaccination: 0
Gender:Female  Submitted:2013-08-14, Days after onset: 5
Location:California  Entered:2013-08-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS432TJ5IMRA
Administered by: Public     Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Syncope following immunization - while leaving immunization room; became awake while laying down Pt. on exam table with legs elevated.

VAERS ID:499404 (history)  Vaccinated:2013-08-14
Age:12.0  Onset:2013-08-14, Days after vaccination: 0
Gender:Female  Submitted:2013-08-14, Days after onset: 0
Location:West Virginia  Entered:2013-08-14
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
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0009850SYRRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216080SYRLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4445AB0SYRLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSE59570SYRRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0205871SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red itchy 50 cent size area at site of vaccine injection.

VAERS ID:499407 (history)  Vaccinated:2013-08-07
Age:12.0  Onset:2013-08-07, Days after vaccination: 0
Gender:Male  Submitted:2013-08-08, Days after onset: 1
Location:South Dakota  Entered:2013-08-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Amoxicillin
Diagnostic Lab Data: UA-ok; CBC -? more viral shift
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J003727 UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA12092 UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSZR45M UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Dysuria, Full blood count, Headache, Pain, Pyrexia, Urine analysis normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Received vaccines on 8/7/13 at 3 PM. That evening developed headache, fever (101.4) and body aches. dysuria x 2. Tx: Supportive cares at home.

VAERS ID:499530 (history)  Vaccinated:2013-08-10
Age:12.0  Onset:2013-08-10, Days after vaccination: 0
Gender:Male  Submitted:2013-08-13, Days after onset: 3
Location:Michigan  Entered:2013-08-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CVAE0472013
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD 1PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: After 1st dose: nausea/headache.

VAERS ID:499443 (history)  Vaccinated:2013-08-12
Age:12.0  Onset:2013-08-13, Days after vaccination: 1
Gender:Female  Submitted:2013-08-15, Days after onset: 2
Location:Missouri  Entered:2013-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4618AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient woke up with area feeling very warm to the touch. Area is red and puffy over entire right deltoid region. Also complains of itching in same area.

VAERS ID:499452 (history)  Vaccinated:2013-08-13
Age:12.0  Onset:2013-08-13, Days after vaccination: 0
Gender:Male  Submitted:2013-08-14, Days after onset: 1
Location:Minnesota  Entered:2013-08-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0026410IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4633AA0IMUN
TDAP: TDAP (ADACEL)SANOFI PASTEURU4646AA0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Received T-DAP, MENACTRA and HPV #1 at 3pm - became sick with fever 101 degrees lightheadedness, nausea and severe headache at 7pm.

VAERS ID:499625 (history)  Vaccinated:2013-08-13
Age:12.0  Onset:2013-08-13, Days after vaccination: 0
Gender:Female  Submitted:2013-08-16, Days after onset: 3
Location:Unknown  Entered:2013-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA006916
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AA0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report was received from a medical assistant refers to a 12 year old female patient. On 13-AUG-2013, the patient was vaccinated with an expired dose of GARDASIL, (lot number 0636AA, expiry date 11-AUG-2013, route not reported). No adverse effects were reported. This is one of the two reports received from the same reporter. Additional information has been requested.

VAERS ID:499643 (history)  Vaccinated:2013-08-13
Age:12.0  Onset:2013-08-13, Days after vaccination: 0
Gender:Male  Submitted:2013-08-16, Days after onset: 3
Location:Unknown  Entered:2013-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA007146
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report was received from a medical assistant refers to a male patient of unknown age. On 13-AUG-2013, the patient was vaccinated with an expired, second dose of GARDASIL, (lot number 0636AA, expiry date, 11-AUG-2013, route not reported). No adverse effects were reported. This is one of the two reports received from the same reporter. Additional information has been requested.

VAERS ID:499675 (history)  Vaccinated:2013-08-16
Age:12.0  Onset:2013-08-16, Days after vaccination: 0
Gender:Male  Submitted:2013-08-16, Days after onset: 0
Location:Mississippi  Entered:2013-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4667AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Loss of consciousness, Urinary incontinence
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: About 2 minutes after getting shot, patient was found laying on ground passed out in front of pharmacy while his father held him. He appeared to be passed out for about 15-20 seconds. Pt. had pulse and was breathing. Emergency response was activated. Pt. urinated on himself. Pt. remained on ground after he came to for about 10 minutes just so we could make sure he was ok. We gave him an ice pack and some water. Pt. was evaluated by the emergency response team and did not want to be taken away in ambulance. Checked in with patient and hour later, and father said he was doing fine.

VAERS ID:499677 (history)  Vaccinated:2013-08-12
Age:12.0  Onset:2013-08-14, Days after vaccination: 2
Gender:Female  Submitted:2013-08-16, Days after onset: 2
Location:Missouri  Entered:2013-08-16
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: Strawberries, Tomatoes, Keflex
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.H0142781IMUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0126080IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA110510IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B081BA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0011821SCLA
Administered by: Public     Purchased by: Public
Symptoms: Hypersensitivity, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Mom called to say that her daughter had an allergic reaction to the vaccine given in the back of her left arm. Mom stated that the client''s symptoms were tenderness to the area, redness, swelling, and the area was warm to touch.

VAERS ID:499791 (history)  Vaccinated:2013-08-14
Age:12.0  Onset:2013-08-14, Days after vaccination: 0
Gender:Male  Submitted:2013-08-16, Days after onset: 2
Location:Nebraska  Entered:2013-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0003660IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0218610IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4611AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4432AB0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient given HPV, Hep A, ADACEL and MENACTRA. Within 1-2 min after vaccine given patient fainted only out less than 1 minute. Then acting fine.

VAERS ID:499797 (history)  Vaccinated:2013-08-14
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2013-08-15
Location:California  Entered:2013-08-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H017698 UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM11052 UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4383AA UNUN
Administered by: Other     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever 103.9. MOTRIN 400mg q 6-8h pm.

VAERS ID:499826 (history)  Vaccinated:2013-08-15
Age:12.0  Onset:2013-08-16, Days after vaccination: 1
Gender:Male  Submitted:2013-08-16, Days after onset: 0
Location:California  Entered:2013-08-17, 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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR43979AA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Patient''s mother called and said there is a rash and a bump that has firmed where the vaccine was injected.

VAERS ID:499786 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Female  Submitted:2013-08-19, Days after onset: 14
Location:Unknown  Entered:2013-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA003357
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV2: HPV (CERVARIX)GLAXOSMITHKLINE BIOLOGICALSJ0037271IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dysarthria, Slow response to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Vestibular disorders (broad)
Write-up: This spontaneous report as received from a treating physician (M.D.) via a company representative refers to a 12 year old female patient. On 05-AUG-2013 the patient was vaccinated with the second dose of GARDASIL (lot # J003727, expiry date 07-NOV-2015), route reported as injection (dose not specified). She was seen at the Emergency Room of an unspecified hospital that same evening (05-AUG-2013) with symptoms of dizziness, slurred speech and slow response to stimuli. The patient ws not kept overnight. on 06-AUG-2013 the slurred speech returned and the physician was contacted by the Parent. The patient was seen at the office of the physician again. The symptoms resolved after being given carbohydrates (unspecified), GATORADE to drink. It was not stated whether or not a third shot of GARDASIL would be given. Additional information has been requested.

VAERS ID:499834 (history)  Vaccinated:2013-08-12
Age:12.0  Onset:2013-08-13, Days after vaccination: 1
Gender:Male  Submitted:2013-08-13, Days after onset: 0
Location:California  Entered:2013-08-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4597AB0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4618AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0213861SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site cellulitis, Injection site erythema, Injection site induration, Injection site inflammation, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Site of the subcutaneous varicella #2 injection was inflamed red and itched a little, 24 hours after receiving the vaccine. At 48 hours post-vaccination, the indurated area was increasing so we prescribed antibiotics for presumed cellulitis on 8/14/13.

VAERS ID:499849 (history)  Vaccinated:2013-08-16
Age:12.0  Onset:2013-08-17, Days after vaccination: 1
Gender:Unknown  Submitted:2013-08-19, Days after onset: 2
Location:Nevada  Entered:2013-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Insect bites on arms near injection site
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4152AA0UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0023191UNRA
Administered by: Private     Purchased by: Public
Symptoms: 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 (broad)
Write-up: Redness and swelling on (R) deltoid where injection was given, complains of itchiness.

VAERS ID:499864 (history)  Vaccinated:2013-06-03
Age:12.0  Onset:2013-06-04, Days after vaccination: 1
Gender:Male  Submitted:2013-08-19, Days after onset: 76
Location:Massachusetts  Entered:2013-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: No
Preexisting Conditions: Subaortic stenosis (cardiac)
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4397AB0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Headache, Hyperhidrosis, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Woke up with 102.5 degF fever, chills, sweating, body aches, headache, treated with Motrin. By 6/4/13 evening untreated fever was around 99 degF, still with mild body aches and headache. No additional sypmtoms appeared. Constant headache lasted a couple days. Headache was intermittent for a couple of weeks.

VAERS ID:499872 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2013-08-10
Location:California  Entered:2013-08-19, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4137A1UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling and erythmeatous L after placing Tdap.

VAERS ID:499881 (history)  Vaccinated:2013-08-19
Age:12.0  Onset:2013-08-19, Days after vaccination: 0
Gender:Male  Submitted:2013-08-19, Days after onset: 0
Location:Florida  Entered:2013-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None, healthy otherwise.
Preexisting Conditions: None, healthy otherwise.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Eye pain, Immediate post-injection reaction, Loss of consciousness, Syncope, Vision blurred
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), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Immediately after the RN administered the Tdap vaccination today at the Health Dept., my son complained of "stinging of eyes", and a moment later complained of "dizziness", "blurred vision", and subsequently collapsed. I immediately held him and took him in my arms, and prevented free fall to the ground. My wife immediately notified the front desk receptionist at the clinic, and the RN who administered the Tdap Vaccine responded, and other clinic staff. Later ARNP on duty also joined. A serial BP and pulse reading were recorded, as my son regained consciousness, we were advised by the the RN and ARNP on duty that the incident report will be filed the same day, and I was advised to file report to the VAERS.

VAERS ID:499895 (history)  Vaccinated:2013-08-05
Age:12.0  Onset:2013-08-06, Days after vaccination: 1
Gender:Male  Submitted:2013-08-08, Days after onset: 2
Location:Iowa  Entered:2013-08-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0209100UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4278AA5UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, 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: Patient complained of (L) arm being very sore. By 8/9/13 entire upper arm - shoulder to elbow hard, swollen, hot and red. Took BENADRYL and ALEVE by mouth routinely for 3 days. By 8/10/13 area of redness only 4 inches of upper arm and deltoid, pink and swollen but not hard or hot to touch.

VAERS ID:499947 (history)  Vaccinated:2013-08-16
Age:12.0  Onset:2013-08-16, Days after vaccination: 0
Gender:Female  Submitted:2013-08-20, Days after onset: 4
Location:Kansas  Entered:2013-08-20
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS2YA5A2UNRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0026410IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0035351UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Convulsion, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: HPV vaccine administered in pts left deltoid. While attempting to lie down to rest, pt convulsed briefly for 2-3 seconds, passed out for a few seconds. Pt then came to and responded appropriately. Pt rested for 15 minutes with mom at bedside. Pt given granola and a drink, rested 5 more minutes then dismissed in stable condition.

VAERS ID:499950 (history)  Vaccinated:2013-08-13
Age:12.0  Onset:2013-08-13, Days after vaccination: 0
Gender:Female  Submitted:2013-08-15, Days after onset: 2
Location:Colorado  Entered:2013-08-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Latex - rash; Amox - rash
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0068502IMLA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Swelling face, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Received GARDASIL #3 into (L) arm IM about 1100 on 8/13/13. About 1730 pt. had hives on chest, back, arms and face. Mom gave 50 mg BENADRYL. Had 2 emesis and 2 diarrhea that nite w/facial swelling. Facial swelling continued on 8/14 - gone by 8/15.

VAERS ID:499985 (history)  Vaccinated:2013-08-07
Age:12.0  Onset:2013-08-07, Days after vaccination: 0
Gender:Female  Submitted:2013-08-09, Days after onset: 2
Location:Minnesota  Entered:2013-08-20, 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
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213460IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM121230IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain at injection site 8-7-13. Woke up during night with increased pain. In am 8/8 - large area of swelling over (R) deltoid-"hand sized"; warm took ALEVE, applied ice. Swelling was worse in evening, about c/o HA took ibuprofen, continued icing. Woke up 8/9/13 -swelling decreased - oral area 4 inches long. 3 inches wide. Reddish area around injection site 2 inches in diameter. Instructed to continue with cold pack x 20 min of off x 1 hour. Pain med. 1% hydrocortisone BID.

VAERS ID:499988 (history)  Vaccinated:2013-08-16
Age:12.0  Onset:2013-08-16, Days after vaccination: 0
Gender:Male  Submitted:2013-08-16, Days after onset: 0
Location:Texas  Entered:2013-08-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0218611UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Fall, Pallor
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient felt faint about 5 min''s after receiving vaccine for HPV. Pt fell back into mother''s arms and was pale. No loss of consciousness. Patient laid down and recovered, then went home.

VAERS ID:500232 (history)  Vaccinated:2013-07-15
Age:12.0  Onset:2013-07-15, Days after vaccination: 0
Gender:Female  Submitted:2013-08-21, Days after onset: 37
Location:Unknown  Entered:2013-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA006055
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213460IMUN
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This spontaneous report was received from a nurse via a company representative refers to a 12 years old female patient with no drug reaction/allergies. On 15-JUL-2013 the patient was vaccinated with the first dose of GARDASIL (lot# H021346, expiration date: 01-OCT-2015) of series of three intramuscular (dose unspecified) at unspecified location, a dose of VARIVAX (Merck) (lot# unspecified), unspecified route and dose at unspecified location, a dose of diphtheria toxoid, pertussis acellular vaccine (unspecified), tetanus toxoid (manufacturer unknown) and meningococcal vaccine (unspecified) (manufacturer unknown) during the routine check up. On 15-JUL-2013, the patient experienced syncope while receiving the first dose of GARDASIL. The nurse reported that she lied the patient down after the patient experienced syncope, and it took the 15 seconds for the patient to wake up. The patient had sought medical attention, the patient was in the doctor''s office when the adverse reaction happened. No treatment was given. None lab diagnostics studies was performed. On 15-JUL-2013, the patient recovered from syncope. Additional information has been requested.

VAERS ID:500141 (history)  Vaccinated:2013-08-21
Age:12.0  Onset:2013-08-21, Days after vaccination: 0
Gender:Male  Submitted:2013-08-22, Days after onset: 1
Location:Iowa  Entered:2013-08-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None mentioned.
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB703AA0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0155550IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4397AB0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Nausea, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient was administered Immunizations by nurse and within a couple of minutes patient became pale, faint and sick to his stomach. Nurse assisted patient with a cool wash cloth and fan and two nurses assisted patient from chair to exam table with legs elevated. Patient stated he did not have lunch today. Mother present during fainting episode and support provided and monitored for 25 minutes prior to going home.

VAERS ID:500186 (history)  Vaccinated:2013-08-19
Age:12.0  Onset:2013-08-22, Days after vaccination: 3
Gender:Male  Submitted:2013-08-22, Days after onset: 0
Location:Nevada  Entered:2013-08-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110471IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B081AA6IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0217072SCRA
Administered by: Public     Purchased by: Public
Symptoms: Discomfort, Injection site erythema, Injection site warmth, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Mother of pt called clinic today, 8/22/13, to report a local reaction on patient''s R arm. Vaccines administered on R arm on 8/19/13, were Varicella and Menveo. Mother reported she called CDC and was advised by CDC to call us and report VAERS. Mother described the site as red, warm, diameter of about 5 cm, worse today. Advised to seek MD care today, fluids and home treatment to ease discomfort. Mother reported except for local reaction, child active, normal, afebrile, eating well. Mother stated will make MD appt today.

VAERS ID:500288 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2013-08-22
Location:Minnesota  Entered:2013-08-22
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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0023470IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0026410IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4648AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4668AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt received Hepatitis A IM LD on 8/20/13. Pt has hive type reaction 3" by 5" where vaccine was given.

VAERS ID:500317 (history)  Vaccinated:2013-07-29
Age:12.0  Onset:2013-07-29, Days after vaccination: 0
Gender:Male  Submitted:2013-08-23, Days after onset: 25
Location:Nevada  Entered:2013-08-23
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: Blood pressure (29-JUL-2013): normal; Pulse (29-JUL-2013): normal; Physical examination (29-JUL-2013): After the patient awoke, his ears, eyes and nose were checked and everything was ok
CDC 'Split Type': WAES1307USA016878
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0037270IMUN
Administered by: Other     Purchased by: Other
Symptoms: Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This spontaneous report as received from a medical assistant, who refers to a 12 year old male patient. There was no information about patient medical history and drug allergies or drug reactions. ON 29-JUL-2013 the patient was vaccinated intramuscularly with a first dose of GARDASIL, 0.5 ml (lot # J003727, exp. date 11-JUN-2015). Concomitant medications were not reported. On 29-JUL-2013, 4 min after administration of GARDASIL the patient fainted. Ammonia was immediately used to wake the patient. The medical assistant reported that after the patient awoke, his ears, eyes and nose were checked and everything was okay. The patient was a little pale and was given candy and popsicle to eat. The patient sought medical attention, via physician''s office. After 20 minutes, the patient''s blood pressure and pulse were determined to be normal and the patient was allowed to leave the physicians office. None laboratory diagnostic studies were performed. The patient recovered from adverse event on 29-JUL-2013. It was reported that the therapy with GARDASIL was continued. The relatedness between therapy with GARDASIL and adverse event was not reported. Additional information has been requested.

VAERS ID:500358 (history)  Vaccinated:2013-08-21
Age:12.0  Onset:2013-08-22, Days after vaccination: 1
Gender:Male  Submitted:2013-08-23, Days after onset: 1
Location:Nevada  Entered:2013-08-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: ITP
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110471IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B081AA5IMRA
Administered by: Public     Purchased by: Public
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: Pt walked in clinic w/ father c/o the R upper arm swelling, redness, tender to touch. Pt received Tdap and Menveo on R arm. Skin intact and T- 99.8. Advised of local reaction, ice, home treatment, and monitor for increased pain and swelling. Advised to seek MD care if worse. Parent agreed w/ plan.

VAERS ID:500489 (history)  Vaccinated:2013-07-29
Age:12.0  Onset:2013-08-01, Days after vaccination: 3
Gender:Male  Submitted:2013-08-08, Days after onset: 7
Location:Florida  Entered:2013-08-23, 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:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4397AB0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4365AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: VIIth nerve paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: Bell''s palsy treated with oral prednisolone.

VAERS ID:500374 (history)  Vaccinated:2013-08-23
Age:12.0  Onset:2013-08-23, Days after vaccination: 0
Gender:Male  Submitted:2013-08-24, Days after onset: 1
Location:California  Entered:2013-08-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: similar symptoms~DTP (no brand name)~~7.00~Patient
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  IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Injection site swelling, Muscle rigidity, Pain, Tenderness, Vaccination site pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Initial onset of severe pain to vaccination site that has not resolved. Severe swelling at injection site, continued severe pain; arm tender, red and muscle rigid; unable to move shoulder without severe pain. Swelling observed 8/24/13 AM by patient.

VAERS ID:500514 (history)  Vaccinated:2013-08-21
Age:12.0  Onset:2013-08-26, Days after vaccination: 5
Gender:Male  Submitted:2013-08-26, Days after onset: 0
Location:Nevada  Entered:2013-08-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol nebulizer TX- 8/20/13
Current Illness: None known
Preexisting Conditions: Shellfish- facial swelling; Asthma- contolled w/ meds
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216080IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110470IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B081AA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0217072SCLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Injection site pruritus, Local reaction, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Mother of pt called today w/ c/o pt''s local reaction on R arm -red, raised, swelling increased from yesterday, 8/25/13, reported diameter of local reaction $g 2 in, warm to touch but pt denies pain, afebrile, range of motion within normal, skin intact, states no red streaks on R arm, and site itchy. Mother stated applied-home treatment - ice x 2 days but redness and swelling worse today; no oral OTC meds given. Mom will continue ice and apply hydrocortisone to site. Mother instructed to seek MD care if no relief w/ home treatment and symptoms worse. Mother agreed w/ plan.

VAERS ID:500596 (history)  Vaccinated:2013-08-09
Age:12.0  Onset:2013-08-10, Days after vaccination: 1
Gender:Male  Submitted:2013-08-20, Days after onset: 10
Location:Iowa  Entered:2013-08-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Juvenile dermatomyositis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4648AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0011762SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Local swelling, Pain, Skin tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling, redness, (R) arm. Tightness, pain. Spoke with neuromuscular Dr. and not related to his disease.

VAERS ID:500603 (history)  Vaccinated:2013-08-20
Age:12.0  Onset:2013-08-21, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2013-08-26
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: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHABV641AA0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0109150IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4384AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0167401SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site discomfort, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Started with itching, redness, swelling and warmth in (L) arm where varicella vaccine given on 8/20/13. Redness, swelling and discomfort increased and pt was seen by Nurse Practitioner on 8/22/13. Pt was placed on cephalexin 250 mg 3 capsules in AM and 3 capsules in PM x 10 days.

VAERS ID:500666 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Oregon  Entered:2013-08-27
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: Dx well child 12 years old.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010916 UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS74AP3 UNLA
Administered by: Public     Purchased by: Private
Symptoms: Wrong drug administered
SMQs:
Write-up: MA was going in w/ Provider to assist w/ Biopsy. She shouted out both immunizations needed. I misheard her, she said meningococcal not pneumococcal Pneumococcal given. MOC notified. We will start verifying all immunizations. We usually do however MOC kept saying she was in a hurry to leave w/out double checking with another MA.

VAERS ID:500673 (history)  Vaccinated:2013-07-30
Age:12.0  Onset:2013-08-01, Days after vaccination: 2
Gender:Male  Submitted:2013-08-19, Days after onset: 18
Location:California  Entered:2013-08-27, 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: Denies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4137AA5IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 8-19-2013 at 10:55 pt. comes with mother and report onset of rash on chest and back two days after Tdap vaccine (7-30-2013). Denies fever, malaise or itchiness. Rash noted on all back and upper chest. Recommend to see the doctor for eval.

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