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Case Details (Sorted by Age)

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VAERS ID:313210 (history)  Vaccinated:2008-05-21
Age:11.0  Onset:2008-05-22, Days after vaccination: 1
Gender:Female  Submitted:2008-05-23, Days after onset: 1
Location:Washington  Entered:2008-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: hx of asthma, acid reflux PMH: Seizure in 2006. Allergic rhinitis. family hx of DM, asthma, allergy & obesity.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB222AA0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1967U0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2563AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B016BA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Areflexia, Asthenia, Erythema, Fatigue, Hypoaesthesia, Injected limb mobility decreased, Musculoskeletal pain, Neuropathy peripheral, Paraesthesia, Radial nerve palsy, Sensory loss
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad)
Write-up: Left arm had a radial nerve palsy after receiving 2 vaccines in it. HPV and MCV4 given in the left arm. 6/24/08 Reviewed PCP medical records & vax records of 5/21-6/10/08. FINAL DX: left arm neuropathy Records reveal patient w/concerns about weight, thyroid check up, acid reflux & occasional nosebleeds on day of vax. Day after vax, had left finger tingling, numbness, unable to move left arm well & had fatigue. RTC on 5/30 w/left arm redness, forearm & finger numbness, no pain in deltoid but had pain w/movement of arm from shoulder. Decreased left biceps & triceps strength, absent left arm reflexes, decreased sensation. Referred to peds neuro. RTC 6/10 with same symptoms. Had been seen by consultant & was to start accupuncture.

VAERS ID:313358 (history)  Vaccinated:2005-01-01
Age:11.0  Onset:2007-07-17, Days after vaccination: 927
Gender:Male  Submitted:2008-05-16, Days after onset: 304
Location:Connecticut  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Liver transplant
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA03264
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received from a physician concerning a 11 year old male with a history of 2 liver transplants in his life, who in approximately 2005 "a couple of years ago" was vaccinated with a dose of VARIVAX. On approximately 17-JUL-2007 "a couple of days ago" the patient developed shingles and was hospitalized. At the time of this report the patient was still in the hospital and had not recovered. No product quality complaint was involved. Additional information has been requested.

VAERS ID:313408 (history)  Vaccinated:2007-10-09
Age:11.0  Onset:2007-10-09, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 220
Location:New Jersey  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0711USA02064
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1118U1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella, Varicella post vaccine
SMQs:
Write-up: Information has been received from a physician concerning a 11 year old male who on 27-MAY-1997 and 09-OCT-2007 was vaccinated SC with a first and second (lot number: 658375/1118U) dose of VARIVAX. Subsequently, the patient developed a severe case of chicken pox and was hospitalized. The case of chicken pox was considered to be disabling. No additional information. Unspecified medical attention was sought. The outcome was reported as not recovered. There was no product quality complaint. Additional information has been requested.

VAERS ID:313419 (history)  Vaccinated:1997-02-20
Age:11.0  Onset:2007-07-23, Days after vaccination: 3805
Gender:Male  Submitted:2008-05-16, Days after onset: 298
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Rash varicelliform~Varicella (no brand name)~UN~7~In Sibling
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0709USA03362
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0997D0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1352D0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Skin lesion
SMQs:
Write-up: Information has been received from a registered nurse concerning an 11-year-old male with no pertinent medical history or allergies who on 20-FEB-2007 was vaccinated in his left thigh with his first dose of VARIVAX (Oka/Merck) (Lot # 612219/1352D). It was unknown if there were any illnesses at the time of vaccination. On 20-FEB-1997 concomitant vaccination in the right thigh included a first dose of MMR II (Lot # 619799/0997D). On 23-JUL-2007 the patient developed 1 lesion on his abdomen. The patient was treated with ZOVIRAX 800 mg twice a day for 5 days. No diagnostic labs were performed. The patient recovered from the adverse event on 29-AUG-2007. The event was considered to be an other important medical event by the reporter. It was noted that the patient''s brother (WAES#0709USA03363) experienced an adverse event. This is one of several reports received from the same source. Further information is not expected.

VAERS ID:313489 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Unknown  Submitted:2008-05-16
Location:Washington  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA03411
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0838U1UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a physician concerning an 11 year old patient who was vaccinated with the second dose of varicella virus vaccine live (Oka/Merck) (Lot #658059/0838U). Subsequently, the patient experienced abnormal swelling and abnormal redness at injection site. The patient''s outcome was not reported. Additional information has been requested.

VAERS ID:313609 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:2007-09-24
Gender:Female  Submitted:2008-05-16, Days after onset: 235
Location:Maryland  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0709USA04305
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a registered nurse concerning a 11-year-old female who was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). On 24-SEP-2007, the patient developed chickenpox. The patient''s mother sought medical attention via phone call with the school nurse who contacted the health department. No diagnostic labs were performed. At the time of the report the patient''s status was recovering. A product quality complaint was not involved. This is one of several reports received from the same source. Follow-up information indicated the patient was not vaccinated at the health department. Her "condition resolved" on an unspecified date. No further information is available.

VAERS ID:313638 (history)  Vaccinated:2008-02-26
Age:11.0  Onset:2008-02-28, Days after vaccination: 2
Gender:Male  Submitted:2008-05-16, Days after onset: 77
Location:Virginia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: body temp 02/28/08-low grade temperature
CDC Split Type: WAES0803USA00949
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1762U1SC 
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Injection site urticaria, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning a 11 year old male who on 26-FEB-2008 was vaccinated with a second dose subcutaneously in the left arm of varicella virus vaccine live (Oka/Merck) (lot# 659696/1762U). On 28-FEB-2008, the patient developed a large welt at the site of the varicella virus vaccine live (Oka/Merck) injection. It was indicated that he also developed itchiness (site unspecified), pain (site unspecified), and low grade temp. Current patient status was not reported. A product quality complaint was not reported. Additional information has been requested.

VAERS ID:313644 (history)  Vaccinated:2007-09-12
Age:11.0  Onset:2007-09-12, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 247
Location:Missouri  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA03695
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1088F1UNUN
Administered by: Public     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning an 11 year old male who on 25-JUL-2007 and 12-SEP-2007 was vaccinated with his first and second (lot# 654813/1088F) 0.5ml doses of varicella virus vaccine live (Oka/Merck). There was no other concomitant medication. On 12-SEP-2007, the patient developed a rash on his face which was mainly on his nose. On that same day medical attention was sought through the health department. At the time of this report the patient was not recovered. There was no product quality complaint. Additional information has been requested.

VAERS ID:313666 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-16
Location:Oregon  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: General symptom
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0803USA00590
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.657715/0609U UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a medical assistant concerning an 11 year old male patient who was vaccinated with varicella virus vaccine live (Oka/Merck) (Lot #657715/0609U). Subsequently the patient developed an injection site reaction described as injection site swelling and injection site itching. The patient sought unspecified medical attention. There was no product quality complaint. This report is one of several from the same source. Additional information has been requested. Follow-up: Concomitant vaccines administered on 30-AUG-2007. Concomitant vaccines administered on 30-AUG-2007 included a first intrmuscular dose of hepatitis A virus vaccine inactivated (lot # 652293/0249U) adminsitered in the left arm and a first intramuscular dose ADACEL (lot # C2825AA) administered in the left arm. On 31-AUG-2007 the patient developed as injection site reaction described as injection site swelling and injection site itching. It was also noted on 31-AUG-2007 the patient experienced a 4 cm red, swollen area over VARIVAX site that was painful to touch. The patient sought unspecified medical attention.

VAERS ID:313674 (history)  Vaccinated:2007-09-21
Age:11.0  Onset:0000-00-00
Gender:Unknown  Submitted:2008-05-16
Location:Texas  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA04074
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1117U UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a licensed visiting nurse concerning a patient who on 21-SEP-2007 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck) (lot # 658374/1117U) who experienced redness and induration at the injection site following vaccination. At the time of the report the patient''s status was unknown. A product quality complaint was not involved. This is one of several reports from the same source. Additional information not expected.

VAERS ID:313746 (history)  Vaccinated:1998-01-12
Age:11.0  Onset:2007-11-27, Days after vaccination: 3606
Gender:Female  Submitted:2008-05-16, Days after onset: 170
Location:Texas  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0711USA06634
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0806E UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a physician concerning a 11-year-old female who on 12-JAN-1998 was vaccinated with a 0.5 mL dose of varicella virus vaccine live (Oka/Merck) (lot # 623654/0806E). On 27-NOV-2007, the patient developed more than 50 chicken pox lesions on her body even after being vaccinated. The patient sought unspecified medical attention. At the time of the report the patient''s status was unknown. At the time of the report the patients status was unknown. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:313769 (history)  Vaccinated:2000-08-06
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0712USA01634
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a registered nurse concerning a male who on 06-AUG-2000 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). On an unspecified date the patient developed varicella. At the time of reporting the patient''s status was unknown. It was also reported the patient''s sibling had an adverse experience WAES # 0710USA02657. Follow-up information received on 26-FEB-2008 indicated the reporter could not not identify the patient in their records from the information that was provided. Additional information is not expected.

VAERS ID:313909 (history)  Vaccinated:2007-11-30
Age:11.0  Onset:2007-12-01, Days after vaccination: 1
Gender:Male  Submitted:2008-05-16, Days after onset: 166
Location:Ohio  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~Varicella (no brand name)~1~1~In Sibling
Other Medications: acetaminophen (+) codeine mg/mL; Zyrtec 10 mg; Zyrtec 7.5 mL; Flonase 50 microgm; Flonase 50 microgm
Current Illness: Seasonal allergic rhinitis
Preexisting Conditions: Closed fracture of unspecified part of forearm
Diagnostic Lab Data: physical examination 12/03/07 - right thigh swelling; physical examination 12/03/07 - cellulitis s/p vaccination
CDC Split Type: WAES0712USA03900
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1355U1SCRL
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Erythema, Oedema peripheral, Pain in extremity, Physical examination, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Information has been received from a physician concerning an 11 year old male who on 30-NOV-2007 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck) (lot# 658965/1355U). Suspect vaccination administered on that same day included a dose of Menactra in the left leg. Other concomitant drug therapy included Zyrtec and Flonase. On 01-DEC-2007 the patient was diagnosed with cellulitis characterized by pain in his leg (limped the entire day), a rash on the knee and into the groin and swelling in the interior thigh of his right leg. The patient sought unspecified medical attention. Subsequently, the patient recovered. There was no product quality complaint. Follow-up information from the reporting physician and medical records indicated that an 11 year old male with seasonal allergic rhinitis since 02-OCT-2006, a history of closed fracture of distal forearm (not specified) 09-NOV-2006 and no other medical conditions or allergies who on 30-NOV-2007 at 15:30 was vaccinated SC with his second dose of varicella virus vaccine live (Oka/Merck) (lot# 658965/1355U) in the right leg. There was no illness at the time of vaccination. Concomitant vaccination administered on that day at 15:30 included a dose of Menactra in the left leg. Other concomitant drug therapy initiated on 16-OCT-2007 included Zyrtec 10 mg chewables 1 tablet PO once daily and Flonase 50 mcg 2 sprays each nostril BID. PM 26-OCT-2007 the patient was started on acetaminophen (+) codeine 120-12 mg/5 mL solution 10 mL PO every 3 to 4 times per day. On 01-DEC-2007, at 9:00 the patient experienced pain, tenderness, and redness of the right leg. The patient was given Tylenol by his (a nurse in a pediatric outpatient department) for some relief from pain and swelling. The patient sought medical attention through a pediatric office visit on 03-DEC-2007. Remarkable exam findings included an alert, non-ill appearance with large erythema of right leg at the anterior thigh with swelling. There was no induration, drainage or purulence, but 2 small pimples

VAERS ID:313921 (history)  Vaccinated:2007-12-01
Age:11.0  Onset:2007-12-05, Days after vaccination: 4
Gender:Male  Submitted:2008-05-16, Days after onset: 162
Location:North Carolina  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0712USA08041
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash, Rash pustular, Scab, Skin lesion, Varicella
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 10.5 year old male who on 01-DEC-2007 was vaccinated with his first dose of varicella virus vaccine live (Oka/Merck) (Lot # not provided). On 05-DEC-2007 the patient developed a varicella rash, consisting of 10-15 itchy lesions on the trunk, neck, shoulder and two crusted pustules. The patient sought unspecified medical attention. At the time of reporting, the patient was recovering. There was no product quality complaint involved. Follow-up information indicated no new information. This is one report of two received from the same source. Additional information is not expected.

VAERS ID:313928 (history)  Vaccinated:2007-12-03
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-16
Location:Massachusetts  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0712USA08240
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1522U0UNUN
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: Information has been received from a health professional concerning an 11 year old male who on 03-DEC-2007 was vaccinated with varicella virus vaccine live (Oka/Merck) (lot# 1352U). Concomitant therapy included DTaP-IPV and meningococcal vaccine (unspecified). Subsequently, the patient fainted after the vaccination. Prior to the vaccination the patient appeared to be nervous. Unknown medical attention was sought. The patient''s outcome is unknown. No product quality complaint was involved. This is one of the multiple reports from the same source. Further information has been requested.

VAERS ID:313931 (history)  Vaccinated:2007-09-27
Age:11.0  Onset:2007-09-27, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 232
Location:Maryland  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0710USA01036
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Private     Purchased by: Other
Symptoms: Pyrexia, Varicella post vaccine
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a physician concerning an 11 year old female who on 27-SEP-2007 was vaccinated with a second 0.5mL dose of varicella virus vaccine live (Oka/Merck), (lot number not reported). On 27-SEP-2007, the patient developed a chicken pox rash that started on the patient''s scalp and then moved to her face, chest, arms and legs. The patient also developed a fever of 101 degrees F. No further information was available. The outcome was reported as recovered. Unspecified medical attention was sought. There was no product quality complaint. Follow up information has been received from a physician concerning an 11 year old female with no pre-existing allergies, or medical conditions who on 23-MAR-1998 was vaccinated subcutaneously into the right arm with a second dose of varicella virus vaccine live (Oka/Merck) (658293/1102U). Concomitant vaccine therapy administered within four weeks of varicella virus live included a first dose of Gardasil administered intramuscularly (IM) (Lot #656372/0243U), a sixth dose of Tripedia (Lot # C2770AA) administered IM into the left arm and a first dose of Menactra (Lot # N2339AA), administered IM. On 27-SEP-2007, at 10:00, the patient developed a rash on her scalp, and moved to her face, chest, arms and legs. The patient complained of severe itching. the patient was seen at the doctor''s office for a history of a fever up to 101 F. Observations at that time included a vesicular papular rash all over her face, arms, legs, chest and abdomen. The patient was advised to remain off from school at home, and isolated from siblings. No follow up was required unless problems should arise. No diagnostics labs studies obtained. There was no concomitant therapy. Medical attention was sought. There was not illness at the time of vaccination. There were no adverse events following previous vaccinations. At the time of reporting the patient''s status was unknown (previously reported as recovered). Additional information is not expected.

VAERS ID:313985 (history)  Vaccinated:2007-09-04
Age:11.0  Onset:2007-09-06, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 253
Location:Tennessee  Entered:2008-05-23, 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: Unknown
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0710USA02678
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB186AA0IMLL
HPV4: HPV (GARDASIL)MERCK & CO. INC.658558/1061U0IMLL
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR1061U0IMRL
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B024AA5IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.658422/1030U SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 11 year old female with no pertinent medical history, with an allergy to amoxicillin (+) clavulanate potassium (AUGMENTIN) who on 04-SEP-2007 was vaccinated subcutaneously into the left arm with a second dose varicella virus vaccine live (Oka/Merck) (Lot # 658422/1030U). Concomitant vaccine therapy that same day included a first dose of human papillomavirus vaccine, for the treatment of prophylaxis, administered intramuscularly into the left thigh (Lot # 658558/1061U), a first dose of hepatitis A vaccine (inactive) (HAVRIX) administered intramuscularly into the left thigh (Lot# AHAVB196AA), a fifth dose of diphtheria toxoid (+) pertussis acellular 3-component vaccine (+) tetanus toxoid (BOOSTRIX) administered intramuscularly into the right arm (Lot# AC52B024AA) and a first dose of meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA) administered intramuscularly into the right thigh (Lot # 1061U). On 06-SEP-2007 the patient developed a red, hard, welt "about the size of a silver dollar", which was warm to touch. There was no illness at the time of vaccination. There were no diagnostic tests performed. The patient had no prior history of adverse events following prior vaccinations. The patient recovered on an unspecified date. No further information is expected.

VAERS ID:314006 (history)  Vaccinated:2007-08-01
Age:11.0  Onset:2007-08-02, Days after vaccination: 1
Gender:Male  Submitted:2008-05-16, Days after onset: 288
Location:Illinois  Entered:2008-05-23, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0801USA04016
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0815U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pruritus, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered nurse concerning an 11 year old male who on 01-AUG-2007 was vaccinated SC on right arm with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657649/0815U). There was no illness at the time of vaccination. On 02-AUG-2007 at 14:50 PM, the patient experienced injection site "puffy" and swelling of 2-3". The patient''s body temperature was slightly elevated at 100.1. The patient had itchiness at injection site. On 05-AUG-2007, the patient recovered. No diagnostic laboratory tests were undertaken. Additional information has been requested. This is one of several reports received from the same source.

VAERS ID:314008 (history)  Vaccinated:2007-02-08
Age:11.0  Onset:2007-11-29, Days after vaccination: 294
Gender:Unknown  Submitted:2008-05-16, Days after onset: 168
Location:North Carolina  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0801USA04287
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash papular, Skin lesion
SMQs:
Write-up: Information has been received from a registered nurse concerning an 11 year old patient who on 31-AUG-2000 was vaccinated with the first dose of varicella virus vaccine live (Oka/Merck). On 08-FEB-2007, the patient was vaccinated with the second dose of varicella virus vaccine live (MSD). On 29-NOV-2007, the patient developed two papules on his wrist and about six lesions on his neck. Additional information has been requested.

VAERS ID:314155 (history)  Vaccinated:2007-10-11
Age:11.0  Onset:2007-10-13, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 216
Location:Arizona  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0710USA03758
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Limb discomfort, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Information has been received from a physician concerning an 11 year old female who on 11-OCT-2007, received a 0.5 ml second dose of varicella virus vaccine live (Oka/Merck). Concomitant vaccinations included human papillomavirus vaccine (MSD), meningococcal ACYW conjugated vaccine (diphtheria toxoid) (MENACTRA) and diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid. On 13-OCT-2007, she developed itchiness, soreness, as well as being red and swollen down back of right arm to the elbow. The patient sought unspecified medical attention. It was reported that the physician recommended hydrocortisone cream and diphenhydramine (BENADRYL). Current patient status was not reported. A product quality complaint was not reported. No further information was available. Additional information has been requested.

VAERS ID:314279 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:2007-11-03
Gender:Female  Submitted:2008-05-16, Days after onset: 195
Location:Maryland  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0711USA01749
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received from a physician concerning an 11 year old female who in 2001 was vaccinated with varicella virus vaccine live (Oka/Merck). On 03-NOV-2007, the patient developed zoster. The physician did not provide any additional information. The patient sought unspecified medical treatment. At the time of the report, the patient has not recovered. Additional information has been requested.

VAERS ID:314310 (history)  Vaccinated:2007-11-09
Age:11.0  Onset:2007-11-09, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 188
Location:New Jersey  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: blood pressure 11/09/07 60/42 - right after vaccination; blood pressure 11/09/07 72/48 - repeat after 10 min.; blood pressure 11/09/07 90/70 - after 15 min; blood pressure 11/10/07
CDC Split Type: WAES0711USA03295
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2476HA2UN 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1367U1UN 
Administered by: Private     Purchased by: Public
Symptoms: Blood pressure decreased, Dizziness, Pain, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a physician concerning an 11 year old 79 1/2 lb. 55 1/2 in. female who on 09-NOV-2007 at 11:00 hours received her second dose of varicella virus vaccine live (Oka/Merck) (lot#659156/1367U). Concomitant vaccination included Fluzone (lot # U2476HA). There was no reported illness at the time of vaccination. On 09-NOV-2007, after receiving the vaccination, it was reported that the patient felt something shooting down her upper extremity, felt dizzy and was pale. Her pulse rate was reported as 80 to 90 with a blood pressure of 60/42. A repeat blood pressure in 10 minutes was 72/48. After 15 minutes, her blood pressure was 90/70. Reported treatment measures were oral fluids (water) and to rest. It was reported that she left the physicians office after about 30 minutes. It was reported she presented on 10-NOV-2007 to the physicians office with dizziness. It was reported that on 10-NOV-2007, her blood pressure was 80/60. Follow up information from the physician indicated that on 15-NOV-2007, she had recovered. A product quality complaint was not reported. Additional information has been requested.

VAERS ID:314347 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-16
Location:New York  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0711USA03987
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1174U1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: Information has been received from a physician concerning an 11 year old male who on an unspecified date was vaccinated with a second dose of varicella virus vaccine live (Oka/Merck) (lot# 658288/1174U). It was reported that on an unspecified date after receiving the vaccine, the patient developed cellulitis in the arm. The patient sought treatment in an emergency department. It was not specified if the patient was hospitalized. It was reported that on an unspecified date the patient had recovered. A product quality complaint was not reported. This is one of three reports from the same source. Additional information has been requested.

VAERS ID:314372 (history)  Vaccinated:2007-06-26
Age:11.0  Onset:2007-06-28, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 323
Location:Virginia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA04120
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0602U1SC 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a health professional concerning an 11 year old female who on 26-JUN-2007 was vaccinated SC on the left arm with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657618/0602U). On 28-JUN-2007, the patient developed injection site red, swelling and itching. No medical attention was sought. Additional information has been requested.

VAERS ID:314381 (history)  Vaccinated:2007-06-25
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Kentucky  Entered:2008-05-23, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA05040
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC269CAA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0715U1SCRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Information has been received from a health professional concerning an 11 year old female with no allergies who on 25-JUN-2007 was vaccinated SC on right arm with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657403/0715U). Concomitant therapy included IM sixth dose on left arm of Adacel (Lot # C269CAA). At the time of vaccination there was no illness. It was reported that the patient developed redness, swelling and pain after vaccination. No medical attention was sought. At the time of report the patient had recovered. Additional information has been requested. This is one of several reports from the same source.

VAERS ID:314382 (history)  Vaccinated:2007-06-19
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Kentucky  Entered:2008-05-23, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA05041
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2331AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC261CAA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.657404/0592U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Pruritus, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Information has been received from a health professional concerning a 11 year old white female with no allergies who on 19-JUN-2007 was vaccinated SC on left arm with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657404/0592U). Concomitant therapy included a IM first dose on right arm of meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA) (Lot # U2331AA) and an IM sixth dose on left arm of diphtheria toxoid (+) pertussis acellular 5-component vaccine (+) tetanus toxoid (ADACEL) (Lot # C261CAA). There was no illness at the time of vaccination. It was reported that the patient developed a red hard knot that was itchy, warm to touch and slightly tender after vaccination. No medical attention was sought. At the time of report the patient had recovered. Additional information has been requested. This is one of the several reports received from the same source.

VAERS ID:314430 (history)  Vaccinated:2007-07-17
Age:11.0  Onset:2007-07-19, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 302
Location:Virginia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA00115
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0776U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Information has been received from a health care worker concerning an 11-year-old female who on 17-JUL-2007 was vaccinated subcutaneously in the left arm with a second dose of varicella virus vaccine live (Oka/Merck) (lot# 654282/0776U). On 19-JUL-2007, the patient experienced a red, hot to touch area the size of a"playing card". No medical attention was sought. The outcome was not reported. This is one of several reports from the same reporter. Additional information has been requested.

VAERS ID:314433 (history)  Vaccinated:2007-07-24
Age:11.0  Onset:2007-07-26, Days after vaccination: 2
Gender:Male  Submitted:2008-05-16, Days after onset: 295
Location:Virginia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA00121
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0776U1SCRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received concerning an 11 year old male who on 24-JUL-2007 was vaccinated subcutaneously in the right arm with a second dose of varicella virus vaccine live (Oka/Merck) (lot#654282/0776U). On 26-JUL-2007, the patient developed a red and swollen injection site. No further information was provided. Additional information has been requested. This is one of several reports from the same source.

VAERS ID:314439 (history)  Vaccinated:2007-06-07
Age:11.0  Onset:2007-06-08, Days after vaccination: 1
Gender:Unknown  Submitted:2008-05-16, Days after onset: 343
Location:Colorado  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA00481
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0516U1UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Induration
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Information has been received from a health professional concerning an 11 year old patient who on 07-JUN-2007 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck) (lot# 657406/0516U). On 08-JUN-2007, the patient experienced an area of 6.5cm X 6.5cm, mild erythema and induration. Medical attention was sought, patient was treated with Keflex. Subsequently, the patient recovered from mild erythema and induration. No product quality complaint was involved. Additional information has been requested.

VAERS ID:314521 (history)  Vaccinated:2007-08-07
Age:11.0  Onset:2007-08-08, Days after vaccination: 1
Gender:Male  Submitted:2008-05-16, Days after onset: 282
Location:Texas  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0708USA02034
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.652724/0459U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, 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: Information has been received from a nurse concerning an 11 year old male with no pertinent medical history, drug reactions or allergies who on 07-AUG-2007, at 14:00, was vaccinated subcutaneously with a second dose of varicella virus vaccine live (Oka/Merck) in the right arm (Lot# 652724/0459U). On 08 AUG 2007, the patient developed the following injection site reactions in the right arm: rash (12 cm x 10 cm), swelling, induration (3 cm x 3 cm), and erythema (dark red in the center and pink in the periphery). The area, which was not painful, was reported to resemble a "wasp sting". There was no illness at the time of vaccination. Unspecified medical attention was sought. The patient recovered on an unspecified date. There were no lab diagnostic studies performed. There was no product quality complaint. Additional information has been requested.

VAERS ID:314538 (history)  Vaccinated:2007-07-27
Age:11.0  Onset:2007-07-27, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 294
Location:Georgia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0708USA02442
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURPMCC2609AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0599U1SC 
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning an 11-year-old male with no pertinent medical history or allergies, who on 27-JUL-2007 was vaccinated subcutaneously in the right arm with a second dose of 0.5 milliliter''s of varicella virus vaccine live (Oka/Merck) (lot# 657455/0599U). There was no concomitant medication. On 10-AUG-2007, the patient developed as rash all over his body. Unspecified medical attention was sought. No laboratory or diagnostic tests were performed. The outcome was reported as recovering. No product quality complaint was involved. Follow-up information was received concerning a male student with no pre-existing allergies, birth defects or medical conditions, who was vaccinated at 9 AM with a second dose of varicella virus vaccine live (Oka/Merck). Concomitant vaccination included an intramuscular first dose in the left deltoid of Adacel (lot # PMCC2609AA) (Sanofi Pasteur) at 9 AM. There was no illness at the time of vaccination. On 09-Aug-2007, (previously reported as 10-AUG-2007) at 8 AM, the patient developed a light rash on his abdomen and trunk area. There was no fever. The rash was slightly raised and non-puritic. The patient was advised to stay out of school until the rash was cleared. The outcome was reported as recovered and the patient returned to school on 18-Aug-2007. Additional vaccinations received includes a dose of diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid (manufacturer unknown) on 12-Jan-1996, 22-Mar-1996, 13-May-1996, 04-Mar-1997 and 03-Apr-2000; a dose of hepatitis B virus vaccine (unspecified) (manufacturer unknown) on 12-Jan-1996, 22-Mar-1996 and 16-Jul-1996; a dose of Hib conj vaccine (unspecified carrier) (manufacturer unknown) on 12-Jan-1996, 22-Mar-1996, 13-May-1996 and 01-Nov-1996; a dose of poliovirus vaccine inactivated (unspecified) (manufacturer unknown) on 03-Apr-2000; a dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (HPV

VAERS ID:314616 (history)  Vaccinated:2007-05-21
Age:11.0  Onset:2007-05-23, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 359
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA00107
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.656576/0446U1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a nurse practitioner concerning an 11-year-old female with no pertinent medical history or allergies, who on 21-May-2007 was vaccinated subcutaneously with a second 0.5 milliliters dose of varicella virus vaccine live (Oka/Merck) (lot# 656576/0446U). There was no concomitant medication. The nurse practitioner reported that on 23-May-2007 the patient experienced pain and swelling at the injection site. Unspecified medical attention was sought. No laboratory or diagnostic tests were performed. Subsequently, the patient recovered from the swelling and pain at injection site. No product quality complaint was involved. Additional information has been requested.

VAERS ID:314656 (history)  Vaccinated:2007-08-07
Age:11.0  Onset:2007-08-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 283
Location:Tennessee  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy, Drug hypersensitivity
Preexisting Conditions: Hives
Diagnostic Lab Data: None
CDC Split Type: WAES0708USA03657
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.657192/0362U1SCUN
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Injection site erythema, Injection site induration, Injection site mass, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered nurse concerning a 11 year old male with no medical history, a penicillin and CECLOR allergy (causes hives) who on 07-AUG-2007 was vaccinated SC with a 0.5 ml dose of varicella virus vaccine live (Oka/Merck). On approximately 07-AUG-2007 (within 24 hours of vaccination) the patient experienced an injection site reaction. The patient had a hard raised swelling area the size of a "half dollar" following the varicella virus vaccine live (Oka/Merck) vaccination. The overall size of the swelling was about 6 to 8 inches in diameter on the arm. It was reported the patient contacted their physician. No diagnostic laboratory tests were performed. At the time of the report the patient was recovering. A product quality complaint was not involved. Follow-up information was received on 13-SEP-2007. Follow-up information has been received from a registered nurse concerning an 11-year-old white male with a penicillin and cefaclor (CECLOR) allergy who on 07-AUG-2007 was vaccinated subcutaneous in the right thigh with his second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657192/0362U). Concomitant vaccines administered on 07-AUG-2007 included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid (GlaxoSmithKline) (Lot # AC52B011CA), hepatitis A virus vaccine (unspecified) (GlaxoSmithKline) (Lot # AHAVB186AA) and meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA) (Sanofi Pasteur) (lot # U2379BA). On 07-AUG-2007 (at approximately 20:00 hour) the patient experienced "severe pain at sight", temperature of 104.4, redness and swelling at injection site, small knot at injection site about the size of one half dollar with redness surrounding the site. The patient required an emergency room visit due to extreme pain, fatigue, and fever. No diagnostic labs were performed. The patient recovered from all adverse experiences on approximately 13-AUG-2007. This is one of several reports received from the same source. Additional information is not expe

VAERS ID:314674 (history)  Vaccinated:2007-08-21
Age:11.0  Onset:2007-08-21, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 269
Location:Tennessee  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Peanut allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0708USA04069
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB186AA0IMRL
HPV4: HPV (GARDASIL)MERCK & CO. INC.0469U0IMRL
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2391BA0IMLL
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B024AA4IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.658178/1013U1SCLL
Administered by: Private     Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site induration, Injection site mass, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 11 year old female with peanut allergy who on 27-SEP-1996 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck) (Lot # 658178/1013U). On 21-AUG-2007, the patient was vaccinated subcutaneously in the left thigh with a 0.5 mL dose of varicella virus vaccine live (Oka/Merck), a dose of meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA, lot # 62391BA, mfr. Sanofi Pasteur) "in the same thigh but many inches apart", a dose of GARDASIL vaccine (yeast) (lot # 0469U), diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid (lot# AC52B024AA, mfr. GSK) and hepatitis A virus vaccine (unspecified) (lot# AHAVB186AA, mfr. GSK). The registered nurse reported that within 20 minutes post vaccination the patient experienced an injection site reaction with redness 1 to 1.5 inches in diameter. The patient sought unspecified medical attention. No treatment required. There was no product quality complaint involved. Follow-up information was received on 05-SEP-2007. Follow-up information was received via a telephone call with a registered nurse who stated she did not know if the patient had recovered. Follow-up information was received on 13-SEP-2007. Follow-up information was received via a telephone call with a registered nurse who updated the varicella virus vaccine live (Oka/Merck) lot number (658178/1013U). Follow-up information was received on 25-SEP-2007 from a registered nurse concerning a 11-year-old (also reported as 12 years old) white female with a peanut allergy who on 27-SEP-1996 was vaccinated with her first dose of varicella virus vaccine live (Oka/Merck) and her second subcutaneous 0.5 ml dose administered in her left thigh on 21-AUG-2007 (lot # 658178/1013U). There were no illnesses at the time of the report. Concomitant vaccines administered on 21-AUG-2007 (lot # 658178/1013U). There were no illnesses at the time of the report. Concomitant vaccines administered on 21-AUG-2007 included a first intramuscul

VAERS ID:314717 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA05096
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site mass, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a nurse concerning an 11 year old male who''s mother called 24 hours after the patient was vaccinated with his second dose of varicella virus vaccine live (Oka/Merck). Subsequently, the patient experienced a 2 inch circle of bumpy redness around the injection site area and skin was hot to the touch. The patient''s 2 inch circle of bumpy redness around the injection site area and skin was hot to the touch persisted. Unspecified medical attention was sought. Additional information is expected.

VAERS ID:314835 (history)  Vaccinated:2007-08-27
Age:11.0  Onset:2007-08-27, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 263
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0708USA05239
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse concerning a male between the ages of 11 and 12 years of age who on 27-AUG-2007 was vaccinated with one dose of varicella virus vaccine live (Oka/Merck). In the evening of 27-AUG-2007, the patient experienced a rash. The nurse reported that she thought the patient was "already exposed to chicken pox". The patient was seen in the office for the event and was noted to be recovering. Additional information has been requested.

VAERS ID:314864 (history)  Vaccinated:2006-07-01
Age:11.0  Onset:0000-00-00
Gender:Unknown  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA00016
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: Information has been received from a physician concerning an 11 year old who on an unknown date between July 2006 to 05-MAR-2007 was vaccinated with the second dose of varicella virus vaccine live (Oka/Merck) (unknown lot number). Subsequently, within two to three days post vaccination, the patient developed a large, two to three inch injection site reaction on the upper arm. The reaction lasted approximately one week. Unspecified medical attention was sought; no treatment was required. No additional information to report. There was no product quality complaint involved. This is one of several reports from the same source.

VAERS ID:314917 (history)  Vaccinated:2007-08-01
Age:11.0  Onset:2007-08-01, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 289
Location:Arizona  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA01012
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Injection site erythema, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Information has been received from a physician concerning an 11 year old female consumer who "about one month ago" was vaccinated with a second dose of varicella virus vaccine live (Oka/Merck). Additional suspect therapy included a second dose of Gardasil (MSD). Other concomitant vaccination may have included Menactra. " Soon after vaccination" the patient developed nausea, dizziness, injection site redness and injection site swelling. The patient was examined by the physician. Subsequently, the patient recovered. No further information was provided. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:314929 (history)  Vaccinated:2007-08-24
Age:11.0  Onset:2007-08-25, Days after vaccination: 1
Gender:Female  Submitted:2008-05-16, Days after onset: 265
Location:Unknown  Entered:2008-05-23, 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: Unknown
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA05099
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.10294 IMUN
Administered by: Private     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: Information has been received from a physician concerning an 11 year old female with drug hypersensitivity who on 24-AUG-2007 was vaccinated with varicella virus vaccine live (Oka/Merck) (Lot number "10294"). On 25-AUG-2007, the patient experience significant swelling, warmth and redness at the injection site. Subsequently, the patient recovered from significant swelling, warmth and redness at the injection site. No further information is available.

VAERS ID:314930 (history)  Vaccinated:2007-09-05
Age:11.0  Onset:2007-09-05, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 254
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA01096
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a health professional concerning an 11 year old male who on 05-SEP-2007 was vaccinated with varicella virus vaccine live (Oka/Merck) ("Lot # 05976"). On 05-SEP-2007, the patient developed a nickel size red mark at injection site, that was painful to touch. At the time of reporting the patient was not yet recovered. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.

VAERS ID:314955 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:2007-04-26
Gender:Unknown  Submitted:2008-05-16, Days after onset: 386
Location:Maryland  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA01853
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a health professional concerning an 11 year old patient who was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). On 26-APR-2007, the patient was diagnosed with chickenpox. Medical attention was sought. The patient''s outcome was unknown. No product quality complaint was involved. This is one of several from the same source. Further information has been requested.

VAERS ID:315039 (history)  Vaccinated:2007-06-14
Age:11.0  Onset:2007-06-14, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 337
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA02760
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a licensed practical nurse concerning her 11 year old daughter who on 14-JUN-2007 was vaccinated with a varicella virus vaccine live (Oka/Merck) via intramuscular route. Concomitant vaccination included tetanus toxoid. The patient experienced injection site pain which was being treated with acetaminophen and cold compresses. The patient''s injection site pain persisted. No product complaint was reported. Additional information has been requested.

VAERS ID:315107 (history)  Vaccinated:2007-05-29
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA00623
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.656821/0174U0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site urticaria, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning a female who on 29-MAY-2007 was vaccinated, subcutaneously in the right arm, with varicella virus vaccine live (Oka/Merck) (lot# 656821/0174U). Subsequently the patient experienced local reaction around the injection site. "Symptoms included swelling, redness, and "slightly raised" around the injection site. Also, medical chart lists "+/- pink and purple" with the symptoms. BENADRYL and ice packs were instructed for treatment." The patient sought unspecified medical attention. Subsequently, the patient recovered from local reaction around the injection site. This is one of two cases for this physician. Additional information has been requested.

VAERS ID:315172 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0707USA00552
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Varicella
SMQs:
Write-up: Information has been received from a consumer concerning her 11 year old daughter with no drug reations/allergies or pertinent medical history who was vaccinated with varicella virus vaccine live (Oka/Merck) at age 14 months. There was no concomitant medication reported. The patient experienced a mild case of chickenpox which the patient''s mother felt might have been due to receiving an unspecified anti-viral. The patient''s outcome was not reported. No additional information was available.

VAERS ID:315176 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:2000-01-01
Gender:Female  Submitted:2008-05-16, Days after onset: 3057
Location:Maine  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Eczema
Diagnostic Lab Data: None
CDC Split Type: WAES0707USA00800
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPH: DTAP + HIB (TRIHIBIT)SANOFI PASTEUR  UNUN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a certified medical assistant concerning an 11-year-old female with no allergies and a history of eczema who in 1997 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). Concomitant vaccinations included TriHIBit and poliovirus vaccine live oral (manufacturer unknown). Three years later, in 2000, the patient developed "a mild case of" chickenpox. Unspecified medical attention was sought. No laboratory or diagnostic tests were performed. The outcome was reported as recovered. No product quality complaint was involved. Additional information has been requested.

VAERS ID:315179 (history)  Vaccinated:2007-06-08
Age:11.0  Onset:2007-06-09, Days after vaccination: 1
Gender:Male  Submitted:2008-05-16, Days after onset: 342
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA01082
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURERAHAVB143BA1UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.656819/0172U1SCUN
Administered by: Private     Purchased by: Public
Symptoms: Decreased appetite, Erythema, Pain, Skin reaction, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 11 year old male who on 08-JUN-2007 was vaccinated with varicella virus vaccine live (Oka/Merck lot# 656819/0172U). On 09-JUN-2007 the patient''s mom had indicated that her son experienced a localized skin reaction, 2 1/2 inch area of skin red and warm. On 10-JUN-2007 the patient was achy and had decreased appetite and no fever. The patient was taken to urgent care and started on Keflex. The patient''s mom was to call back for further concerns but never called back. As of 11-JUN-2007, the patient was reported as recovering. No product quality complaint was involved. Additional information is not expected.

VAERS ID:315183 (history)  Vaccinated:2007-07-06
Age:11.0  Onset:2007-07-08, Days after vaccination: 2
Gender:Male  Submitted:2008-05-16, Days after onset: 313
Location:Massachusetts  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dermatitis contact; Sulfonamide allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA01326
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC528013AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0716U1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Dermatitis contact, Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse concerning an 11 year old 75 lb male with a sulfa allergy who on 06-JUL-2007 was vaccinated with his second dose of varicella virus vaccine live (Oka/Merck) (lot.no 657650/0716U) and Menactra in the R arm and diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid in the L deltoid. At the time of the vaccination, the patient had contact dermatitis described as an itchy rash on his trunk and extremities. He was treated with fluocinolone, cool compress, Benadryl, bacitracin and Calamine. On 09-JUL-2007, the patient was seen in follow up of the poison ivy on his face, ear, left finger and arm, R hand, back and under R arm. He also had a 1 1/2 inch circle of induration, redness and some slight tenderness 1 1/2 inches below the varicella injection site of his R arm, which occurred on 08-JUL-2007. The patient''s poison ivy and injection site induration, redness and tenderness persisted (in follow up, the outcome was reported as unknown). He was prescribed oral prednisone for the contact dermatitis but it was discontinued on 12-JUL-2007 due to behavioral side effects. Additional information is not expected.

VAERS ID:315368 (history)  Vaccinated:2007-07-23
Age:11.0  Onset:2007-07-23, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 298
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA03859
Vaccination
Manufacturer
Lot
Dose
Route
Site
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: Information has been received from a registered nurse concerning an 11 year old male who on 23-JUL-2007 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). Subsequently, the patient fainted. Unspecified medical attention was sought. At an unspecified time the patient recovered. No other information was provided. There was no product quality complaint involved. Additional information received indicated that no additional information is available.

VAERS ID:315374 (history)  Vaccinated:2007-05-23
Age:11.0  Onset:2007-05-25, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 357
Location:Virginia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA04114
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0457U SCRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a health professional concerning an 11 year old female who on 23-MAY-2007 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck) (656692/0457U) subcutaneously in the right arm. On 25-MAY-2007, the patient experienced red area and itching at injection site. No illness at the time of vaccination. Outcome of the patient not reported. No further information is available.

VAERS ID:315391 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA04356
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella, Varicella post vaccine
SMQs:
Write-up: Information has been received from a consumer concerning her 11 year daughter who on an unreported date was vaccinated with varicella virus vaccine live (Oka/Merck). The patient, at 11 years of age, recently (2007) developed a case of chickenpox. The patient, along with her older sisters (16) and (13), had all been previously immunized. The 13 year old had a breakthrough at the same time as her 11 year old sister. The patient did not develop chickenpox following past exposures to the virus years ago when her oldest sister (16) exhibited a breakthrough case of chickenpox. This is one of several reports received from the same. Additional information has been requested.

VAERS ID:315398 (history)  Vaccinated:2007-07-16
Age:11.0  Onset:2007-07-16, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 305
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: WBC count 07/16/07 Norma; body temp 07/17/07 - low grade fever
CDC Split Type: WAES0707USA04383
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Injection site erythema, Injection site induration, Injection site rash, Injection site warmth, Pain, Pyrexia, White blood cell count
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning an 11 year old female who on 16-JUL-2007 was vaccinated subcutaneously with a second single dose of varicella virus vaccine live (Oka/Merck) (Lot# 657620/0536U). Additional suspect vaccination included Gardasil vaccine (MSD). Other concomitant therapy included Menactra and diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid (manufacturer unknown). Within 12 hours of being vaccinated the patient developed a severe injection site reaction that continued to become "more severe." The injection site rash was about 7 inches in diameter and wrapped around the patients arm, was warm, hard to touch in the middle and was less red on the outside of the rash. On a follow-up visit to the doctor the next day (on 17-JUL-2007) the patient had a low grade fever and a general feeling of achiness. Nurse practitioner was concerned that the patient might have cellulitis. On the third day following vaccination the patient returned for another follow up visit, the rash had stabilized. It was noted that the nurse practitioner treated the patient with Benadryl. Lab studies for a white blood cell count were normal. No other information was provided. There was no product quality complaint involved. Additional information has been requested. This is one of several reports from the same source.

VAERS ID:315523 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA02167
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a nurse practitioner concerning an 11-year-old male who was vaccinated with a second dose of varicella virus vaccine live (Oka/Merck). Subsequently, the patient experienced minor varicella-like rash. Medical attention was sought. The patient''s outcome was unknown. No product quality complaint was involved. Additional information from the nurse practitioner indicated that she could not remember the patient''s name. No further information was available.

VAERS ID:315555 (history)  Vaccinated:2007-04-17
Age:11.0  Onset:2007-04-17, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 395
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Latex allergy, Allergic reaction to antibiotics, Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA04334
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0113U IMUN
Administered by: Other     Purchased by: Other
Symptoms: 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: Information has been received from a health care worker concerning a 11 year old female with latex allergy, allergic reaction to amoxicillin (+) clavulanate potassium and diphenhydramine hydrochloride, and no pertinent medical history, who on 17-APR-2007 was vaccinated intramuscularly with varicella virus vaccine live (Oka/Merck) (lot # 656290/0113U). There was no concomitant medication. On 17-APR-2007 the patient experienced increased swelling of the upper right arm with warmth and tenderness noted at the injection site. Unspecified medical attention was sought. There were no lab diagnostic studies performed. There was no product quality complaint. Additional information has been requested.

VAERS ID:315687 (history)  Vaccinated:1995-08-01
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-16
Location:Pennsylvania  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA06272
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received from a physician concerning an approximately 11 or 12 year old male who in August 1995, was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). Concomitant therapy included montelukast sodium (MSD). In 2006 the patient developed shingles under arm and lasted for approximately 2 weeks. At the time of report, the patient had full recovery from shingles. Unspecified medical attention was sought. a product quality complaint was not involved. Additional information has been requested.

VAERS ID:315764 (history)  Vaccinated:2007-04-04
Age:11.0  Onset:2007-04-09, Days after vaccination: 5
Gender:Male  Submitted:2008-05-16, Days after onset: 403
Location:Georgia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA01519
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular, Skin lesion
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a health professional concerning an 11 year old male with no medical history and no allergies who on 04-APR-2007 was vaccinated with a booster dose of varicella virus vaccine live (Oka/Merck). There were no concomitant medications. On 09-APR-2007 the patient developed a cropped vesicular rash less than 50 lesions on his abdomen and back. He was seen in the office on 16-Apr-2007 where it was determined he was recovering and cleared to go back to school. On 07-May-2007, he was seen in the office with the same symptoms as on 09-Apr-2007, "varicella like lesions" on his back and abdomen. These lesions were new lesions on the same location as the initial "outbreak". No varicella zoster virus (VZV) analysis was done with the initial rash nor with the later recurrence. A teacher is in her first trimester and shows no symptoms but is concerned about exposure because of the "relapse". At the time of this report, the patient had not recovered. There were no laboratory or diagnostic tests performed. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested.

VAERS ID:315788 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:2007-05-01
Gender:Male  Submitted:2008-05-16, Days after onset: 381
Location:Florida  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02379
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a physician concerning an approximately 11 year old male who "10 years ago", in approximately 1997, was vaccinated with varicella virus vaccine live (Oka/Merck). "This week", in May 2007, the patient experienced normal breakthrough. No further information was available at the time of this report. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested.

VAERS ID:315792 (history)  Vaccinated:2007-05-08
Age:11.0  Onset:2007-05-10, Days after vaccination: 2
Gender:Male  Submitted:2008-05-16, Days after onset: 372
Location:Georgia  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, ALLEGRA, SINGULAIR
Current Illness: Penicillin allergy, Seasonal allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA02486
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEUR 0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0362U1SCLA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, 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: Information has been received from a registered nurse concerning an 11 year old male child with a penicillin allergy and seasonal allergies who on 08-MAY-2007 was vaccinated SC in the back of the left arm with the second 0.5ml dose of varicella virus vaccine live (Oka/Merck) (657192/0362U). It was reported that the patient did not have a reaction with his first dose of varicella virus vaccine live (Oka/Merck). Concomitant vaccine given the same day included in the right deltoid a dose of meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA) and in the left deltoid a dose of diphtheria toxoid (+) pertussis acellular 1-component vaccine (+) poliovirus vaccine inactivated (Vero) (+) tetanus toxoid (DTAP-IPV). Concomitant medications include fexofenadine hydrochloride (ALLEGRA), montelukast sodium (MSD) and albuterol. On 09-MAY-2007 the patient experienced redness and swelling at the injection site. On 10-MAY-2007 it was reported via a phone call that the patient''s arm was more swollen and the red spot was larger. On 11-MAY-2007 the child was seen in the office at 15:15 pm and the child''s arm was tender at the injection site and swollen about 5 inches in diameter with an irregular circle noted. The inner circle was red with a darker red on the outer circle. The child was treated with cephalexin (KEFLEX). The patient''s status at the time of the report was not recovered. No product quality complaint was involved. Additional information has been requested. Follow-up information received from a registered nurse stated that the patient received a concomitant intramuscular dose of diphtheria toxoid (+) pertussis acellular 5-component vaccine (+) tetanus toxoid (ADACEL) (Lot # "C2644AA") in the left arm. The lot # for MENACTRA was "U2227AA". On 10-MAY-2007, the patient''s left arm (back of arm) became swollen, red, and tender to touch. The patient called the office on 10-MAY-2007 and was advised to come in. The patient was seen on 11-MAY-2007 and diagnosed with cellulitis and place on cephalexin (KEFLEX) 250mg, 1 tablet, t

VAERS ID:313384 (history)  Vaccinated:2008-05-12
Age:11.0  Onset:2008-05-12, Days after vaccination: 0
Gender:Female  Submitted:2008-05-23, Days after onset: 11
Location:Unknown  Entered:2008-05-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Syncope
Diagnostic Lab Data: Pulse oximetry, 05/12/08
CDC Split Type: WAES0805USA03613
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cyanosis, Fall, Jaw fracture, Oxygen saturation, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a physician concerning a 11 year old female with a history of fainting, who on 12-MAY-2008 was vaccinated with a first dose of GARDASIL. Concomitant vaccination included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid. On 12-MAY-2008 the nurse had the patient wait for around five minutes post vaccination. The nurse left the room for a second. The patient fainted and fell off of the exam table. The patient was found lying face down and started to turn blue, but had a pulse. The patient was rushed to the hospital and ended up having a maxillary fracture. At the time of the report, the outcome of the patient was unknown. No product quality complaint was involved. The physician considered the fainting, fall off the exam table, turning blue, and maxillary fracture to be other important medical events. Additional information has been requested.

VAERS ID:313457 (history)  Vaccinated:2008-05-19
Age:11.0  Onset:2008-05-20, Days after vaccination: 1
Gender:Male  Submitted:2008-05-21, Days after onset: 1
Location:Massachusetts  Entered:2008-05-27, 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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1894U1SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Rash, pink 2x3 inches at site of injection. Not fluctuant. No fever. Present x 2 h

VAERS ID:313808 (history)  Vaccinated:2008-05-05
Age:11.0  Onset:0000-00-00
Gender:Unknown  Submitted:2008-05-07
Location:Wisconsin  Entered:2008-05-28, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC528016BA IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0086 SCLA
Administered by: Other     Purchased by: Public
Symptoms: No adverse event
SMQs:
Write-up: No adverse events reported. Child inadvertently given booster without consent of parent.

VAERS ID:313822 (history)  Vaccinated:2008-05-20
Age:11.0  Onset:2008-05-22, Days after vaccination: 2
Gender:Male  Submitted:2008-05-23, Days after onset: 1
Location:Colorado  Entered:2008-05-28, 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: Allergic: Amoxicillin, Ceforl
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy
SMQs:
Write-up: Significant axillary right swelling (?edema) on side with TDaP and Hep A. 24 hours later and increased over 24 hour noted some shotty axillary adenopathy.

VAERS ID:313827 (history)  Vaccinated:2008-05-19
Age:11.0  Onset:2008-05-19, Days after vaccination: 0
Gender:Male  Submitted:2008-05-21, Days after onset: 2
Location:Minnesota  Entered:2008-05-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fever/severe path~DTaP (no brand name)~UN~0~In Sibling
Other Medications: Lexapro, Abilify, Pulmicort, Albuterol, Singulair
Current Illness: none
Preexisting Conditions: Pervasive developmental disorder, asthma
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC28899AA0UNRL
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Body temperature increased, Chest discomfort, Diarrhoea, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Severe leg/thigh pain,12 hrs after administration abdominal pain - day#2, with nausea, diarrhea (5/20/); Temp 100.4 day #3, sternal chest discomfort - responded to Albuterol (history of asthma) (5/21)

VAERS ID:313830 (history)  Vaccinated:2008-05-21
Age:11.0  Onset:2008-05-22, Days after vaccination: 1
Gender:Female  Submitted:2008-05-22, Days after onset: 0
Location:California  Entered:2008-05-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Arm swelled up to the size of an egg, bumpy and very red

VAERS ID:313854 (history)  Vaccinated:2008-05-28
Age:11.0  Onset:2008-05-28, Days after vaccination: 0
Gender:Male  Submitted:2008-05-28, Days after onset: 0
Location:Unknown  Entered:2008-05-28
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: no tests performed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0383U1IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2403AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2572AA0IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Dizziness, Vomiting, Wrong technique in drug usage process
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: administered Tdap, Menactra, Hep A IM and drew up and administered sterile diluent solution SC instead of diluting varicella vaccination solid and then administering. immediately upon administration of sterile diluent, pt. complained of lightheadedness, was too dizzy to walk. Sat in chair and vomited x2. Several minutes later, pt. stated sxs were gone. 1/2 hr later, patient left clinic with family.

VAERS ID:313868 (history)  Vaccinated:2008-05-22
Age:11.0  Onset:2008-05-22, Days after vaccination: 0
Gender:Female  Submitted:2008-05-28, Days after onset: 6
Location:New York  Entered:2008-05-28
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: allergic to penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2688AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Blood pressure, Heart rate, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Malaise, Stomach discomfort
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Mother reports upset stomach and a general feeling of "not feeling well" for four days after vaccination. Mother states child was afebile, but blood pressure was 171/93 and pulse was 141 on 05/26/2008. Vital signs were taken by family RN when child complained of not being "feeling good". Site of vaccination has "red, hard, hot area the size of an egg". Parent advised to follow-up with family physician.

VAERS ID:314082 (history)  Vaccinated:2008-05-08
Age:11.0  Onset:2008-05-08, Days after vaccination: 0
Gender:Female  Submitted:2008-05-22, Days after onset: 14
Location:Wyoming  Entered:2008-05-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2563AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: None reported. Previous dose of MCV4 given on 11-26-07.

VAERS ID:314083 (history)  Vaccinated:2008-05-06
Age:11.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Female  Submitted:2008-05-22, Days after onset: 14
Location:Wyoming  Entered:2008-05-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B012AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: None reported. Previous dose of Tdap given on 8-1-07.

VAERS ID:314109 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-29, Days after vaccination: 0
Gender:Female  Submitted:2008-05-29, Days after onset: 0
Location:Colorado  Entered:2008-05-29
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: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1740U0IMLA
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: 5 minutes after vaccine given, patient fainted while seated. She was aided to the floor where in a supine position she quickly came to. After 15-20 minutes she felt well enough to sit up. She was able to walk out of the clinic after another 10 minutes.

VAERS ID:314137 (history)  Vaccinated:2008-05-27
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-29
Location:Illinois  Entered:2008-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chest pain, poss. reactive airway
Preexisting Conditions: Family history of Antithrombin 3 deficiency, Seasonal allergies, overweight.
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Wrong drug administered
SMQs:
Write-up: Varivax was ordered by MD/ZOSTAVAX given by error. Both meds side by side on freezer shelf. Merck contacted, observe child. Child was without any side effects after 24 hours. Mother reporting some headache but improving with time and red area at injection site and also improving with time.

VAERS ID:314138 (history)  Vaccinated:2008-03-18
Age:11.0  Onset:2008-03-19, Days after vaccination: 1
Gender:Female  Submitted:2008-05-29, Days after onset: 71
Location:Indiana  Entered:2008-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: After receiving second HPV, later patient had a seizure.

VAERS ID:314396 (history)  Vaccinated:2008-01-22
Age:11.0  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-05-30, Days after onset: 128
Location:Maryland  Entered:2008-05-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Lab, EMG/NCV, abdominal ultrasound, allergy consult, neurology consult, complex disorder consult, Neurontin prescribed by neurologist. Labs and Diagnostics: NCS WNL. EMG WNL. Abd US unremarkable. Abd X-ray (-). CBC WNL. CMP WNL. ANA 132. RF (-). ESR 2. CK 90. CXR with minimal peribronchial thickening.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1265U UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2418AA UNUN
TDAP: TDAP (ADACEL)SANOFI PASTEURC2775AA UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1274U UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal X-ray, Abdominal pain, Abdominal pain upper, Antinuclear antibody increased, Asthenia, Blood creatine phosphokinase normal, Chest X-ray abnormal, Dizziness, Dyspnoea, Electromyogram normal, Fatigue, Full blood count normal, Headache, Immediate post-injection reaction, Influenza like illness, Laboratory test normal, Malaise, Muscle atrophy, Myalgia, Myositis, Nerve conduction studies normal, Pain in extremity, Red blood cell sedimentation rate normal, Rheumatoid factor negative, Ultrasound abdomen normal, Upper respiratory tract infection, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Immediate pain in arms and dizziness. Chronic stomach pain, chronic fatigue, roaming muscle pain and atrophy to muscle sites (upper extremity, lower extremities, headaches. 6/13/2008 MR received for OVs and consultations beginning 1/22/2008 with a healthy WCC. Vax given, TDaP, Varicella, Gardasil and Menactra. Seen again 2/13 and 2/28/08 with c/o Flu-like sx, stomach aches, feeling weak and tired, and abdominal pain. DX: URI. Periumbilical Pain. Fatigue and Malaise. Consult 3/11/08 for above c/o as well as SOB with Impression: Adverse reaction to vaccination-Gardasil. Drug Allergy. Fatigue and Malaise. Seen by PCP again with new c/o pain in the back and calf muscles. Continues to have abdominal pain. Added DX: Unspecified Myalgia and Myositis. W/U (-) thus far.

VAERS ID:314415 (history)  Vaccinated:2008-05-27
Age:11.0  Onset:2008-05-27, Days after vaccination: 0
Gender:Male  Submitted:2008-05-30, Days after onset: 3
Location:North Carolina  Entered:2008-05-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2927AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Vaccine given approximately 900 AM at school - patient had no symptoms of adverse reactions until 1015 PM - mom states symptoms occurred suddenly with severe itching, rash on back + arms. Pt was taken to local emergency department. Given steroid injection, BENADRYL cream, BENEDRYL po + prednisone rx x 9 days. "Told by ER not to take Tdap again".

VAERS ID:314450 (history)  Vaccinated:2008-05-27
Age:11.0  Onset:2008-05-29, Days after vaccination: 2
Gender:Female  Submitted:2008-05-30, Days after onset: 1
Location:New Mexico  Entered:2008-06-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.U2569AA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR1061U0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 7.5 x 9 cm redness and induration; surrounding injection site at 72 hours

VAERS ID:314461 (history)  Vaccinated:2008-04-18
Age:11.0  Onset:2008-04-22, Days after vaccination: 4
Gender:Male  Submitted:2008-05-30, Days after onset: 38
Location:Michigan  Entered:2008-06-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Allergic rhinitis-no sx / asthma-no prob past yr PMH: family hx of seizures
Diagnostic Lab Data: EEG, med. abnl waking signal of freq. L temporal spike & wave complexes; L temporal irregular 2-3 Hz activity; Head CT, neg LABS: CBC & chemistry WNL. UA& drug screen neg. CT head WNL,
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1977U1SCUN
Administered by: Private     Purchased by: Private
Symptoms: Computerised tomogram normal, Convulsion, Drooling, Drug screen negative, Dysarthria, Electroencephalogram abnormal, Facial paresis, Full blood count normal, Laboratory test normal, Muscular weakness, Transient ischaemic attack, Urine analysis normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Ischaemic central nervous system vascular conditions (narrow), Convulsions (narrow), Embolic and thrombotic events, arterial (narrow), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (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), Generalised convulsive seizures following immunisation (narrow)
Write-up: Seizure 4/22/08 associated with ongoing EEG abnormalities, not previously recognized. Vaccine given (varicella 4/18/08). 6/26/08 Reviewed hospital medical records for 4/23/2008. FINAL DX: Seizure disorder vs TIA. Records reveal patient experienced slurred speech, drooling & left sided face & arm weakness. Symptoms largely resolved by the time reached ER. Admitted for observation. Neuro consult done. No further episodes & d/c to home to continue w/u as outpatient.

VAERS ID:314552 (history)  Vaccinated:2008-05-30
Age:11.0  Onset:2008-05-31, Days after vaccination: 1
Gender:Male  Submitted:2008-06-02, Days after onset: 2
Location:Connecticut  Entered:2008-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2620AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: HIVES,WHEEZING

VAERS ID:314563 (history)  Vaccinated:2008-04-22
Age:11.0  Onset:2008-04-23, Days after vaccination: 1
Gender:Male  Submitted:2008-04-25, Days after onset: 2
Location:New York  Entered:2008-06-02, Days after submission: 38
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: Had previous reaction to vaccines that parent did not disclose until after the child had a reaction. Mother descibed as "brainstem swelling after a varicella vaccination."
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2863AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 4/23/2008 pT DEVELOPED INCREASED REDNESS & SWELLING RIGHT ARM 27CM BY 16CM EXTENDING FROM SITE OF INJECTION TO THE RIGHT ELBOW. aFEBRILE. sEEN BY sCHOOL np & STARTED ON kEFLEX. 4/25 Redness almost reaching wrist, pt seen by MD.

VAERS ID:314565 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-29, Days after vaccination: 0
Gender:Male  Submitted:2008-06-02, Days after onset: 4
Location:Tennessee  Entered:2008-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB218BA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Headache, Local reaction, Skin lesion
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Localized erythema to Left upper outer arm. Bull''s eye type lesion measuring 6.5cm x 7 cm. Patient also c/o of mild headaches.

VAERS ID:314569 (history)  Vaccinated:2008-05-30
Age:11.0  Onset:2008-05-31, Days after vaccination: 1
Gender:Female  Submitted:2008-06-02, Days after onset: 2
Location:California  Entered:2008-06-02
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
TDAP: TDAP (ADACEL)SANOFI PASTEURC2889AA0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Wrong technique in drug usage process
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient had TDAP injection administered to right arm in subcutaneous tissue. area is reddenned, warm to touch. no complaints of pain. has some swelling.

VAERS ID:314594 (history)  Vaccinated:2008-05-22
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-27
Location:North Carolina  Entered:2008-06-02, 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: Sinus, AR, Asthmatic Bronchitis
Preexisting Conditions: Allergy to PCN
Diagnostic Lab Data:
CDC Split Type: NC08071
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU2355BA5IMRA
Administered by: Private     Purchased by: Public
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: Dtap given instead of Tdap. No adverse events to mention.

VAERS ID:314661 (history)  Vaccinated:2008-03-18
Age:11.0  Onset:2008-03-19, Days after vaccination: 1
Gender:Female  Submitted:2008-06-02, Days after onset: 75
Location:Florida  Entered:2008-06-03, 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: Convulsion; Brain lesion
Preexisting Conditions: Headache; Migraine
Diagnostic Lab Data: diagnostic procedure - spectrascopy test: normal
CDC Split Type: WAES0805USA04752
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1740U0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Convulsion, Diagnostic procedure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Information has been received from a certified medical assistant concerning a 11 year old female with seizure activity, temporal lobe lesion (is taking topiramate), no history of drug reactions/allergies, and a history of headache and migraine who on 18-MAR-2008 was vaccinated with a first dose of GARDASIL (lot # 659962/1740U) 0.5 ml IM In the left deltoid. Concomitant therapy also given on 18-MAR-2008 included MENACTRA, diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid. Other concomitant therapy included TOPAMAX. On 19-MAR-2008, the day after the first dose of GARDASIL, the patient experienced seizure activity at school, but it was not reported to the doctor''s office at that time. On 19-MAY-2008, the patient was vaccinated with a second dose of GARDASIL (lot # 659962/1740U) 0.5 ml IM in the left deltoid. That evening, the patient had a seizure. Medical attention was sought in the office. Spectrascopy test result was normal; unknown when the test was performed. There was no fever post vaccination. Subsequently, the patient recovered from the seizure. Upon internal review, the seizures were considered to be Other Important Medical Events. Additional information has been requested.

VAERS ID:314732 (history)  Vaccinated:2008-05-27
Age:11.0  Onset:2008-05-28, Days after vaccination: 1
Gender:Male  Submitted:2008-05-28, Days after onset: 0
Location:Ohio  Entered:2008-06-03, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2560AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2766AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Injected limb mobility decreased, Sensation of heaviness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: (Left) arm feels heavy and hard to move along with severe dizziness, had to be picked up by mother at school.

VAERS ID:314742 (history)  Vaccinated:2008-05-20
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-28
Location:Washington  Entered:2008-06-03, 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: ZOLOFT
Current Illness: None
Preexisting Conditions: NKMA, Spherocytosis/Spleenectomy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2430AA0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B019AA0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1511U1UNLA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Erythema, Lymphadenopathy, Pain, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 5-22-08 Presented with pain redness 7x5cm irreg bordered eryth. hot, tender swollen, axillary lymphadenopathy, cellulitis. KEFLEX x 7d - Right arm deltoid.

VAERS ID:314747 (history)  Vaccinated:2008-04-30
Age:11.0  Onset:2008-05-01, Days after vaccination: 1
Gender:Male  Submitted:2008-05-29, Days after onset: 28
Location:Arizona  Entered:2008-06-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2565AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2888AA0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1497U1SCLA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling and erythema after 1 day post vaccination. To ice, massage and use Tylenol or Ibuprofen for pain.

VAERS ID:314798 (history)  Vaccinated:2008-05-23
Age:11.0  Onset:2008-05-23, Days after vaccination: 0
Gender:Female  Submitted:2008-05-24, Days after onset: 1
Location:Wisconsin  Entered:2008-06-03, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoride
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURC2099A UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.19769 UNUN
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: Local erythema, swelling, pain at site of injection of Varicella and Tdap which were both given together at same area at Public Health- left tricep area

VAERS ID:314807 (history)  Vaccinated:2008-05-20
Age:11.0  Onset:2008-05-22, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Massachusetts  Entered:2008-06-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURERTD-182 IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site cyst, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient developed hard cyst at injection site 24 hrs after injection.

VAERS ID:314879 (history)  Vaccinated:2008-01-01
Age:11.0  Onset:2008-01-01, Days after vaccination: 0
Gender:Female  Submitted:2008-06-03, Days after onset: 153
Location:D.C.  Entered:2008-06-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Penicillin allergy
Preexisting Conditions: PMH: Allergy to PCN.
Diagnostic Lab Data: computed axial; sleep study, poly sleep latency tests; magnetic resonance, ordered. Labs and Diagnostics: Brain MRI WNL. CT scan WNL. TSH, T3 and T4 WNL.
CDC Split Type: WAES0805USA06185
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Blood thyroid stimulating hormone, Cataplexy, Computerised tomogram, Computerised tomogram normal, Dizziness, Dysarthria, Dyspnoea, Fatigue, Hallucination, Hypersomnia, Loss of control of legs, Movement disorder, Narcolepsy, Nuclear magnetic resonance imaging brain normal, Sleep disorder, Sleep study, Syncope, Thyroxine free normal, Tremor, Tri-iodothyronine free normal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Information has been received from a physician concerning an 11 year old female with penicillin allergy and no pertinent medical history who in January 2008, was vaccinated with a third dose of GARDASIL. There was no concomitant medication. In January 2008, the patient developed cataplexy 1 to 3 days after vaccination. About 2 months later in March 2008, the patient developed narcolepsy with hallucinations and a limb movement disorder. The patient was seen in the physician''s office and was treated with an unknown stimulant. On unspecified dates the patient had a computed axial tomography, poly sleep latency tests and an magnetic resonance imaging (MRI) was ordered. At the time of reporting the patient had not recovered. The physician considered the patient''s cataplexy and narcolepsy with hallucinations and limb movement disorder were considered to be disabling and other medical events. Additional information has been requested. 8/13/2008 Outpatient records received from 3/2008 to 6/2008 with fnal dx: narcolepsy. Pt initially developed sx of dizziness, fatigue, decreased energy, interupted sleep and episodes offalling asleep/losing bodily control but not fully passing out following 3rd HPV shot in 1/2008. Initially thought to be vasodepressive sx tx''d with increased salt and fluids without improvement. Seen once in ER in 2/2008 for episode of shuddering, weakness, excessive sleepines/syncope without dx. Seen by neuro with w/u WNL. Has had episodes of slurred speech and difficulty catching breath. Picture more c/w cataplexy/narcolepsy.

VAERS ID:314910 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-29, Days after vaccination: 0
Gender:Female  Submitted:2008-07-21, Days after onset: 53
Location:North Carolina  Entered:2008-06-04, Days after submission: 47
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: NC08072
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB224BA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURAC52B020AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1759U1SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Incorrect dose administered
SMQs:
Write-up: none. Patient received adult dose Hep A rather than pediatric/adolescent dose.

VAERS ID:314911 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-29, Days after vaccination: 0
Gender:Male  Submitted:2008-05-30, Days after onset: 1
Location:North Carolina  Entered:2008-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: NC08072
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB224BA1IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B02AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1759U1SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Incorrect dose administered
SMQs:
Write-up: None. Patient received adult dose HEP A rather than pediatric/adolescent dose.

VAERS ID:314914 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-29, Days after vaccination: 0
Gender:Female  Submitted:2008-05-30, Days after onset: 1
Location:North Carolina  Entered:2008-06-04, 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: None
CDC Split Type: NC08080
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB224BA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B020AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1759U1SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Incorrect dose administered
SMQs:
Write-up: None. Patient given adult dose HEP A rather than pediatric/adolescent dose.

VAERS ID:314916 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-29, Days after vaccination: 0
Gender:Male  Submitted:2008-05-30, Days after onset: 1
Location:North Carolina  Entered:2008-06-04, 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: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: NC08076
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB224BA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B020AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Incorrect dose administered
SMQs:
Write-up: Adult Hepatitis A given instead of pediatric dose

VAERS ID:314963 (history)  Vaccinated:2008-06-03
Age:11.0  Onset:2008-06-03, Days after vaccination: 0
Gender:Female  Submitted:2008-06-04, Days after onset: 1
Location:Louisiana  Entered:2008-06-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1226U1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2549AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Xanthopsia
SMQs:, Anticholinergic syndrome (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: client experienced lightheadedness and visual changes in which everything appeared yellow within 5 minutes of the injection. vital signs remained stable w/o resp distress. Denied any dizziness or nausea. Client observed on unit for 40 minutes w/o any worsening changes. Client left unit w/o apparent distress with improvement in vision.

VAERS ID:314967 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-29, Days after vaccination: 0
Gender:Male  Submitted:2008-06-04, Days after onset: 6
Location:Illinois  Entered:2008-06-04
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: Allergic rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB26BEA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2566AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2775AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Immediate post-injection reaction, Pallor, Pyrexia, Somnolence, Syncope vasovagal, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Patient had a severe vasovagal episode. He got extremely pale and fell asleep immediately after the vaccinations were given. He spiked a fever to 101 and began vomiting that evening. He was feeling better the following day.

VAERS ID:314984 (history)  Vaccinated:2008-06-02
Age:11.0  Onset:2008-06-03, Days after vaccination: 1
Gender:Male  Submitted:2008-06-05, Days after onset: 2
Location:Georgia  Entered:2008-06-05
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: After 48 hours the area began to subside, is now decreasing in size, and losing the redness. Dr.''s office notified 6-04-2008, spoke with the medical assistant who administered vaccine, reported all s/s above.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER00001SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: My son received Varicella vaccination on Monday,June 2, 2008. The medical assistant administered it sub-cutaneously left UE. Within 24 hours proximal to the injection site, he developed a raised reddened area measuring 2.25 inches by 1.75 inches with a bright red center, warm to touch. The area was painless, and did not itch. Over the next 48 hours the area increased to measurements of 3.5 inches by2.75 inches raised with a bright red center measuring 0.75 inches by0.75 inches. The entire area was warm to touch.

VAERS ID:315260 (history)  Vaccinated:2008-05-27
Age:11.0  Onset:2008-05-28, Days after vaccination: 1
Gender:Male  Submitted:2008-05-30, Days after onset: 2
Location:Wisconsin  Entered:2008-06-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR0389X1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.C2767AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Area of redness around injection site approx. 7.5cm x 5.5cm with 3cm superficial induration

VAERS ID:315249 (history)  Vaccinated:2008-06-03
Age:11.0  Onset:2008-06-04, Days after vaccination: 1
Gender:Female  Submitted:2008-06-05, Days after onset: 1
Location:New York  Entered:2008-06-06, 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: None
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU25730IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2927AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.C2927AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 6 1/2" width x 5 3/4" Length - reddened, hot area, symptoms started on 6-4-08 after receiving 2nd varicella vaccine, on back of right arm

VAERS ID:315625 (history)  Vaccinated:2008-05-29
Age:11.0  Onset:2008-05-30, Days after vaccination: 1
Gender:Male  Submitted:2008-06-04, Days after onset: 5
Location:North Carolina  Entered:2008-06-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: IMMODIUM-caused hives, syncope
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2937AA0IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Headache, Immunisation reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Developed fever of 103.7 degrees F and headache. Taken to primary care provider + diagnosed with reaction to Tdap. No other medical problems identified. Medical

VAERS ID:315636 (history)  Vaccinated:2005-08-17
Age:11.0  Onset:2005-08-17, Days after vaccination: 0
Gender:Male  Submitted:2008-06-09, Days after onset: 1027
Location:Pennsylvania  Entered:2008-06-09
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Regressive Autism-?~Hep B (Foreign)~2~0.10~Patient
Other Medications: Wellbutrin, abilify, allegra, nasacort at that time
Current Illness: Prexisting regressive autism, Allergic rhinitis, Gastrointestinal disorder,diffuse coordination difficulty related to autism that was not apparent and progressed as he got older. We are 2 physicians and have noted a significant motor and cognitive decline since this time. I tried to report this to the drug company and they were devoid in helping. This was before we ever considered that immunizations may have caused autism in our son and an autoimmune brain disorder.
Preexisting Conditions: He has been evaluated by Neurology at Hospital as he has smaller but well compensated vascularity on MRI and the entire department met and stated this has nothing to do with his deteriorating cognitive problem. Allergies(airborn) and PCN.
Diagnostic Lab Data: I have concerns that our family has Rheumatoid arthrtis and elevated TNF levels and these vaccines have caused a permanent disability in our son.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURAC52B003BA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Autism, Condition aggravated, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Patient has regressive autism that began at 2years old.He received this vaccination and in 4 hours developed a fever to 104 and severe headache that lasted 12 hours. I spoke with the Pediatrician''s office and was told there was not much information as this was a new vaccine. I called the drug company(I am an MD A&I) who would not discuss this with me. Patient has had further significant regression over the last 2 and 1/2 years. 1/21/2010 Patient became progressively more dysfunctional in Neurological state both on a cognitive and motor level and verabal from this. This affect was profound and temporally related.

VAERS ID:315643 (history)  Vaccinated:2008-04-30
Age:11.0  Onset:2008-04-30, Days after vaccination: 0
Gender:Female  Submitted:2008-04-30, Days after onset: 0
Location:Illinois  Entered:2008-06-09, Days after submission: 40
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 PASTEURU2582AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Consciousness fluctuating, Dizziness, Dizziness postural, Head injury, Heart rate normal, Injection site oedema, Injection site pain, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Department of Health mass immunization clinic at elementary and high school to provide meningococcal vaccine in a large group setting. Patient received vaccination at 10:00 am was monitored in the same area for 20 minutes post vaccination. Patient went back to class. Teacher called school nurse up to room at 11:00 am. Stating child was light headed. School nurse immediately call 911 and brought child back to immunization area in stretcher/chair. VS: Pulse 68. Patient semi in and out of conscious. Ambulance arrive. Parent called by school nurse. School nurse escorted child in ambulance and transported to hospital. Pt same day transfered to another Hospital. 6/24/08-records received for DOS 4/30/08-C/O pain in right upper arm after vaccine. Dizziness when standing up after vaccine. Some weakness in legs. While at school pushed by another student and had mild bump on head no LOC. PE:WNL, upper extremity (R) at injection site mild edema, tenderness. Neuro exam WNL. Assessment:probably reaction to injection now fine

VAERS ID:315704 (history)  Vaccinated:2008-05-31
Age:11.0  Onset:2008-06-01, Days after vaccination: 1
Gender:Female  Submitted:2008-06-04, Days after onset: 3
Location:Georgia  Entered:2008-06-09, 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: Pharyngitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2766AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1781U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Nausea, Oedema peripheral, Pallor, Pyrexia, Retching
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Nausea, dry heaves, paleness, fever, swelling shoulder to elbow with redness and tenderness - seen 6-4-08 - swelling below elbow. Benadryl - warm compresses - Prednisone. Follow-up Information 01-JUL-2008: Received steroids starting 6-4-08. Mother stated by the 2nd day of steroids was back to normal. However, on 6-13-08 mom called stating the site was itching again with long red streak that was not raised. Mom found out that child had not completed her steroid treatment and would finish it. Was to call if any further problems. As of 6-27-08 no further problems.

VAERS ID:315871 (history)  Vaccinated:2008-06-03
Age:11.0  Onset:2008-06-03, Days after vaccination: 0
Gender:Male  Submitted:2008-06-04, Days after onset: 1
Location:West Virginia  Entered:2008-06-10, 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:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.AHAVB268EA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2339AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURAC52B021AA4IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 2 cm hives on torso, front of chest and back. Father is a physician-described hives as macular papular. Father gave BENADRYL 25 mg. Capsule at 4 pm, at 10 pm 12 1/2 mg chewable and RANITIDINE to cover antihistamine receptors. Today hives gone-fever, 100

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