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Case Details (Sorted by Age)

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VAERS ID:479188 (history)  Vaccinated:2012-12-20
Age:13.0  Onset:2012-12-20, Days after vaccination: 0
Gender:Male  Submitted:2012-12-25, Days after onset: 5
Location:Massachusetts  Entered:2012-12-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.NASAL SPRAY IN 
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Loss of consciousness, Syncope, Tinnitus
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Extreme weakness; Fainted; Loud ringing in ears after regaining consciousness for 5 minutes.

VAERS ID:480099 (history)  Vaccinated:2012-10-24
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-01-02
Location:California  Entered:2013-01-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness
Preexisting Conditions: None
Diagnostic Lab Data: No testing has been done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0630AE2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Skin papilloma
SMQs:
Write-up: She developed diffuse warts over lower body, buttock and right arm after the third HPV vaccine.

VAERS ID:480352 (history)  Vaccinated:2012-07-24
Age:13.0  Onset:2012-08-05, Days after vaccination: 12
Gender:Female  Submitted:2013-01-06, Days after onset: 154
Location:New Jersey  Entered:2013-01-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: EKG; EEG; CAT scan; MRI
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1229AA2IMUN
Administered by: Unknown     Purchased by: Other
Symptoms: Computerised tomogram, Electrocardiogram, Electroencephalogram, Grand mal convulsion, Nuclear magnetic resonance imaging
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: Grand mal seizure.

VAERS ID:481240 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Male  Submitted:2013-01-14
Location:Colorado  Entered:2013-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNLA
Administered by: Private     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:
Write-up: Left axillary adenopathy 3 days following immunization with GARDASIL into left deltoid.

VAERS ID:481306 (history)  Vaccinated:2013-01-12
Age:13.0  Onset:2013-01-12, Days after vaccination: 0
Gender:Male  Submitted:2013-01-14, Days after onset: 2
Location:Illinois  Entered:2013-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07549221A0IMAR
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Nausea, Presyncope, Visual impairment
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Vagal response - dizziness, trouble seeing, nausea, called EMT''s after pt sat for several mins. was ok and walked out without help & was cleared by EMT''s.

VAERS ID:481367 (history)  Vaccinated:2013-01-08
Age:13.0  Onset:2013-01-08, Days after vaccination: 0
Gender:Male  Submitted:2013-01-15, Days after onset: 7
Location:Maryland  Entered:2013-01-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1301USA005222
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0311Y IMUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 13 years old male patient. On 08-JAN-2013, the patient was vaccinated with an expired dose of GARDASIL (lot # 0311Y; expiration date: 13-JUN-2010) (dose, route, indication and duration not reported). No adverse effect reported. Additional information has been requested.

VAERS ID:481473 (history)  Vaccinated:2012-11-19
Age:13.0  Onset:2012-11-20, Days after vaccination: 1
Gender:Female  Submitted:2013-01-15, Days after onset: 56
Location:Missouri  Entered:2013-01-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Epipen as needed
Current Illness: None
Preexisting Conditions: Most antibiotic & bee sting allergy/anaphylaxis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4311BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site joint swelling, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Whole deltoid area/shoulder was swollen for 1 day, 1 day following the injection on left side.

VAERS ID:481496 (history)  Vaccinated:2013-01-02
Age:13.0  Onset:2013-01-02, Days after vaccination: 0
Gender:Male  Submitted:2013-01-16, Days after onset: 14
Location:Unknown  Entered:2013-01-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1301USA001337
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report was received from a healthcare worker concerning an approximately 13 year old male patient. The patient was vaccinated with first and second dose of 0.5 milliliter (ml) GARDASIL (lot number, expiry date unspecified), intramuscularly in the right arm on 12-JAN-2012 and on 02-JAN-2013 (today) respectively. No concomitant medications were reported. No adverse effects were reported. Additional information is not expected.

VAERS ID:481569 (history)  Vaccinated:2013-01-15
Age:13.0  Onset:2013-01-15, Days after vaccination: 0
Gender:Male  Submitted:2013-01-16, Days after onset: 1
Location:Illinois  Entered:2013-01-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: C-spine - negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1397AA2SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Fall, Head injury, Spinal X-ray normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt received vaccine (L) deltoid - less than 1 minute later he fainted - falling face first off exam table to floor. He came to within 2 minutes & was responsive. Injury to head from fall. (No redness or swelling at injection site).

VAERS ID:481656 (history)  Vaccinated:2013-01-16
Age:13.0  Onset:2013-01-16, Days after vaccination: 0
Gender:Male  Submitted:2013-01-17, Days after onset: 1
Location:Minnesota  Entered:2013-01-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: No.
Preexisting Conditions: None. (Slight adhesive allergy.)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Private     Purchased by: Other
Symptoms: Abdominal discomfort, Feeling cold, Headache, Injection site pain, Nausea, Nervousness, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), 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: Shaky and cold, 12:00 midnight stomach upset and nausea, 01/17/2013 6:30 AM headache and ongoing nausea and shakiness. Arm is very sore and a bit swollen but does not appear red. Bicep sore below injection site (shoulder).

VAERS ID:481752 (history)  Vaccinated:2013-01-17
Age:13.0  Onset:2013-01-17, Days after vaccination: 0
Gender:Female  Submitted:2013-01-18, Days after onset: 1
Location:Arizona  Entered:2013-01-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Depression
Diagnostic Lab Data: Had blood work and head CT pending per ER
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0629AE1IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0685AE1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Blood test, Bradycardia, Computerised tomogram head, Hypopnoea, Muscle twitching, Respiratory rate decreased, Slow response to stimuli, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Vaccines given, patient in waiting room shortly afterward, I was called to see her as she was not responding appropriately. When I first saw her she was slumped to her left, sitting in a chair, not responding to me, eyes closed mostly, right arm twitching a bit, bradycardic. I asked her dad to lay her down on the floor. I bent her knees. She continued to be unresponsive. Secretary called 911. Heart rate was 44, BP 68/30s, repeat was about the same. I placed a dissolvable sugar candy in her cheek. Breathing was slow and regular, she was swallowing normally. Capillary refill was brisk. Slight response to painful stimuli. Initial pulse ox 89% but resolved to 99% quickly. Within a minute or two her heart rate and BP slowly started to increase, and at the time of EMS arrival were 60s-70s and 101/60s respectively. She remained unresponsive as she was taken away by EMS.

VAERS ID:481771 (history)  Vaccinated:2011-07-27
Age:13.0  Onset:2012-08-01, Days after vaccination: 371
Gender:Female  Submitted:2013-01-18, Days after onset: 170
Location:Georgia  Entered:2013-01-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1301USA007059
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1271Z1UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR42932AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Activities of daily living impaired, Computerised tomogram, Convulsion, Migraine, Nuclear magnetic resonance imaging, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: This spontaneous report as received from approximately a consumer (patient''s mother) regarding an approximately 15-year-old female patient with no pertinent medical history and drug reactions/allergies. Approximately on an unknown date in July 2010, the patient was vaccinated with a dose of GARDASIL (lot number, expiry date, dose and route were not reported). No concomitant medications were reported. The patient''s mother reported that after receiving 2 vaccinations of GARDASIL her daughter experienced adverse reactions. On an unknown date in January 2012, the patient developed stomach pains. The doctors had performed the Computed Axial Tomography (CAT) scan and Magnetic Resonance Imaging (MRI) on an unknown date in 2012 to determine the primary issue (the test results were not reported). On an unknown date in May 2012, the patient developed extreme migraine headaches. On an unknown date in August 2012, the patient frequently vomited and suffered from seizures. The patient was a very active person and now after the administration of GARDASIL she was bed ridden, can no longer exercise and go to school. The patient sought medical attention and was treated for the events systematically (details were not provided). The outcome of all the reported events was unknown. Upon internal review, the event suffered from seizures was considered as other medically important event. Additional information has been requested.

VAERS ID:481814 (history)  Vaccinated:2013-01-11
Age:13.0  Onset:2013-01-11, Days after vaccination: 0
Gender:Female  Submitted:2013-01-15, Days after onset: 4
Location:Georgia  Entered:2013-01-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Melatonin
Current Illness: Chronic headaches for 2 mos.
Preexisting Conditions: Concussion during volleyball (11/2011)
Diagnostic Lab Data: Normal BMP; negative urine & serum drug screens; negative urine pregnancy
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AL21550IN 
HPV4: HPV (GARDASIL)MERCK & CO. INC.0420AE0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Abnormal behaviour, Confusional state, Dizziness, Drug screen negative, Feeling abnormal, Feeling drunk, Headache, Immediate post-injection reaction, Metabolic function test normal, Pregnancy test urine negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Within 4 hrs of receiving first HPV vaccine, she became confused, dazed, acting as if intoxicated. This behavior change lasted 48 hrs. She also had headache and dizziness develop immediately after the vaccine, which has persisted. Taken to local ER. No treatment given.

VAERS ID:481857 (history)  Vaccinated:2013-01-15
Age:13.0  Onset:2013-01-16, Days after vaccination: 1
Gender:Female  Submitted:2013-01-18, Days after onset: 2
Location:Illinois  Entered:2013-01-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Taking to pediatrician this afternoon
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714AA IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Severe joint pain/hips/knees/elbos/neck/jaw/lower back.

VAERS ID:482234 (history)  Vaccinated:2012-07-26
Age:13.0  Onset:2012-07-17, Days after vaccination: -9
Gender:Female  Submitted:2013-01-22, Days after onset: 189
Location:Unknown  Entered:2013-01-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1301USA009648
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AE2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report was received from a Medical assistant refers to a female patient of unknown age who on 18-SEP-2009 was vaccinated with the first dose of GARDASIL (lot #, dose and route not reported). On 17-JUL-2012 and on 26-SEP-2012, the patient was vaccinated, respectively, with the second and third doses of GARDISIL (lot #, dose and route not reported). No other co-suspects were reported. No concomitant medications were reported. No adverse symptoms reported. Patient''s outcome unknown. Additional information has been requested.

VAERS ID:482302 (history)  Vaccinated:2011-09-09
Age:13.0  Onset:2011-09-12, Days after vaccination: 3
Gender:Female  Submitted:2013-01-16, Days after onset: 492
Location:New York  Entered:2013-01-23, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1229AA2IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4008AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed urticaria 2-3 d after receiving MENACTRA & GARDASIL vaccines.

VAERS ID:482308 (history)  Vaccinated:2013-01-08
Age:13.0  Onset:2013-01-08, Days after vaccination: 0
Gender:Male  Submitted:2013-01-15, Days after onset: 7
Location:Washington  Entered:2013-01-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1745AA1IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1170AA1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Pain in extremity, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Injection given (R) arm SQ. Mom stated area became red and raised. Issue resolved. Area was painful to the touch.

VAERS ID:482517 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:2012-10-31
Gender:Male  Submitted:2013-01-25, Days after onset: 86
Location:Unknown  Entered:2013-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1301USA011799
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a nurse concerning two twins patients (gender and age unknown). On unknown date, the patients was vaccinated with two doses of VARIVAX (Merck) (lot number not provided). No other co-suspects were reported. No concomitant medications were reported. It was reported that their county was experienced an out break of chickenpox. The nurse stated that this county had a very high right of parents who opt-out of vaccines. At the time of the report, the outcome of chickenpox was unknown. The relatedness for chickenpox was unknown for VARIVAX (Merck). This is one of the several reports of the same source. Follow up information has been received from the nurse concerning one of the two twins who is a 13 years old male patient. On an unknown dates, the patient was vaccinated with 2 doses of VARIVAX (Merck). On 31-OCT-2012, the patient experienced chickenpox. The patient had recovered from chickenpox. Additional information is not expected.

VAERS ID:482574 (history)  Vaccinated:2013-01-24
Age:13.0  Onset:2013-01-24, Days after vaccination: 0
Gender:Male  Submitted:2013-01-25, Days after onset: 1
Location:Florida  Entered:2013-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: ADHD
Diagnostic Lab Data: Dr evaluated the patient and administered fluids orally, checked BP, pulse and both were normal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA110720IMLA
Administered by: Private     Purchased by: Other
Symptoms: Communication disorder, Gaze palsy, Muscle rigidity
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Ocular motility disorders (narrow)
Write-up: Administered the vaccine and 1-2 minutes later the patient''s eyes rolled in the back of his head and he became very stiff and couldn''t communicate. It lasted for about 45 seconds then the patient came back and was talking.

VAERS ID:482579 (history)  Vaccinated:2013-01-07
Age:13.0  Onset:2013-01-12, Days after vaccination: 5
Gender:Female  Submitted:2013-01-25, Days after onset: 13
Location:Iowa  Entered:2013-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: No
Preexisting Conditions: Questionable allergy to ginger (red lips); celery allergy
Diagnostic Lab Data: 1-12-2013 EKG - normal Influenza - negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH734AA5IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abasia, Asthenia, Chills, Cyanosis, Dysphemia, Dyspnoea, Electrocardiogram normal, Fatigue, Hypoaesthesia, Hypoaesthesia oral, Influenza virus test negative, Lip disorder, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Eating at local restaurant on 1/12/13; suddenly noticed development of lower lip numbness, heaviness, and lips felt droopy. Developed intense body chills/ shivering. Developed global body weakness; fingers turned blue. Given Clarinex at home-breathing was tightening. Taken to local ER for evaluation. Unable to walk on own power. Follow-up appts: 1-16-2013 w/pediatrician, 1/21/13 w/neurologist. Reported persistent symptoms of global body weakness, easy fatigability, widespread muscle achiness, intermittent speech stuttering for 1-2days. Not able to feel hands/feet at initial onset 1-12-2013. Patient states she feels her symptoms are decreasing, although she is not yet back to baseline. Neurologist assessment: Possible patient has very mild Guillain-Barre-like syndrome post flu vaccination.

VAERS ID:482584 (history)  Vaccinated:2013-01-21
Age:13.0  Onset:2013-01-22, Days after vaccination: 1
Gender:Male  Submitted:2013-01-25, Days after onset: 3
Location:Connecticut  Entered:2013-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Vomiting~HPV (Gardasil)~1~12.00~Patient
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma; Allergic rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA708AB IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0129731IMLA
Administered by: Private     Purchased by: Public
Symptoms: Fatigue, Nausea, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: HPV vaccine ((L) deltoid) administered as well as influenza vaccine ((R) deltoid) on 1/21/13. Reported (L) arm soreness and generalized fatigue within hours of administration. Positive vomiting episodes 1/22/13 am, positive nausea. Mother recalls vomiting episode after HPV dose #1.

VAERS ID:482623 (history)  Vaccinated:2013-01-18
Age:13.0  Onset:2013-01-18, Days after vaccination: 0
Gender:Female  Submitted:2013-01-26, Days after onset: 8
Location:California  Entered:2013-01-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08049211A0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Feeling hot, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: Pt came with her parents and younger sister to receive flu shots at 7:10 pm on 1/18/13. At 7:15 pm her mom stated the pt had a reaction and was asked to call 911 first. The pt was complaining that she had blurry vision and felt hot and weak. Wet towel and ice pack were provided. No rash or edema was seen at injection site. Paramedic came in 5 minutes and checked pt''s blood pressure & oxygen level. Pt refused to go to hospital. Pt went home with her parents afterward.

VAERS ID:483032 (history)  Vaccinated:2013-01-30
Age:13.0  Onset:2013-01-30, Days after vaccination: 0
Gender:Female  Submitted:2013-01-30, Days after onset: 0
Location:New Jersey  Entered:2013-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS66521011510 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Radiculitis brachial, Vaccination site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Brachial neuritis. Started as pain at vaccine site but by 2 PM was numbness of arm and hand. Seen at 7 PM, numb forearm and hand.

VAERS ID:483296 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Unknown  Submitted:2013-02-02
Location:Unknown  Entered:2013-02-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1301USA013047
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report was received from a register nurse refers to a 13 years old patient, who on an unknown date, was vaccinated with PROQUAD (dose, route and lot not reported). No adverse effect was reported. No concomitant medications were reported. Additional information has been requested.

VAERS ID:483378 (history)  Vaccinated:2013-01-10
Age:13.0  Onset:2013-01-10, Days after vaccination: 0
Gender:Male  Submitted:2013-02-04, Days after onset: 25
Location:Washington  Entered:2013-02-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic to grass pollen, bee pollen, cats and mold
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA738AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: Pt received one dose of Flulaval which is indicated for adult use only. Injection was given in left deltoid. Per parent, patient did fine with no reactions.

VAERS ID:483623 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-02-06
Location:Unknown  Entered:2013-02-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1302USA001636
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This spontaneous report was received from a nurse practitioner concerning a 13 years old female patient. On an unknown date, the patient was vaccinated with GARDASIL (dose, route and lot number not reported). No other co-suspects were reported. No concomitant medications were reported. The patient after was administered GARDASIL developed a fever. The patient was treated with antibiotics. The outcome of the event was reported as recovered/resolved. The relatedness for the event was unknown for GARDASIL. Additional information is not expected.

VAERS ID:483698 (history)  Vaccinated:2013-02-06
Age:13.0  Onset:2013-02-06, Days after vaccination: 0
Gender:Female  Submitted:2013-02-07, Days after onset: 1
Location:New York  Entered:2013-02-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Dysphagia, Headache, Insomnia, Muscle spasms, Musculoskeletal stiffness, Neck pain
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Arthritis (broad)
Write-up: Dysphagia, neck pain/stiffness difficulty raising arm, headache, muscle spasm (cen cal) insomnia.

VAERS ID:484027 (history)  Vaccinated:2013-01-30
Age:13.0  Onset:2013-01-30, Days after vaccination: 0
Gender:Female  Submitted:2013-02-06, Days after onset: 7
Location:New York  Entered:2013-02-11, 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: Multivitamin
Current Illness: None
Preexisting Conditions: None noted
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4473AA0IDRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0113500IMLA
Administered by: Private     Purchased by: Public
Symptoms: Cough, Fatigue, Pain, Pyrexia, Vaccination error
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Pt received intradermal vaccine in error. Mom states since administration of vaccine pt has been sick with fever, cough, & fatigue and body aches.

VAERS ID:484313 (history)  Vaccinated:2013-01-17
Age:13.0  Onset:2013-01-19, Days after vaccination: 2
Gender:Female  Submitted:2013-01-29, Days after onset: 10
Location:Michigan  Entered:2013-02-13, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit D; Calcium
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AA IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Pruritus, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Immunization given late Thursday woke up in the night Fri night / Sat AM with itchy red, swollen face - responded to BENADRYL within 24 hours no sense of any swelling.

VAERS ID:484859 (history)  Vaccinated:2013-01-08
Age:13.0  Onset:2013-01-08, Days after vaccination: 0
Gender:Female  Submitted:2013-02-13, Days after onset: 36
Location:Unknown  Entered:2013-02-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1302USA003795
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Headache
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: This spontaneous report as received from a reporter (details unspecified) refers to a 13 year old female patient with no medical history. On 08-JAN-2013, the patient was vaccinated with a first dose (1 dose) of GARDASIL, intramuscular. No concomitant medications were taken. On 08-JAN-2013, the patient who saw her menstrual cycle was complaining about abdominal pain and headache the same day after receiving the dose one of GARDASIL. No laboratory test was performed. The event menstrual cycle, abdominal pain and headache disappeared without treatment on 11-JAN-2013 (reported as after 3 days). The outcome of unexpected therapeutic was unknown. Additional information is not expected.

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

VAERS ID:484904 (history)  Vaccinated:2012-06-13
Age:13.0  Onset:2012-11-05, Days after vaccination: 145
Gender:Female  Submitted:2013-02-20, Days after onset: 107
Location:Arizona  Entered:2013-02-20
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: She has multitudes of tests with no outcome. High platelets, I will soon have her tested for any way to prove that Gardasil did it.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1359AA2IMUN
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain upper, Back pain, Hypoaesthesia, Laboratory test normal, Pain in extremity, Pain of skin, Platelet count increased, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fever every day!!!! Now going on four months. Wakes with 101.6 and night around 102.9. Daily pain in stomach, legs, back, hair follicles, numbness in hands.

VAERS ID:485048 (history)  Vaccinated:2013-01-15
Age:13.0  Onset:2013-01-18, Days after vaccination: 3
Gender:Male  Submitted:2013-01-21, Days after onset: 3
Location:Alaska  Entered:2013-02-20, Days after submission: 30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL with cod; Ibuprofen
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CBC; Rheumatoid factor; ANA panel; Sed rate; C-reactive protein; CMP
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AK21180IN 
HPV4: HPV (GARDASIL)MERCK & CO. INC.1696AA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4245BA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B080CA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Antinuclear antibody, C-reactive protein, Full blood count, Metabolic function test, Pain in extremity, Red blood cell sedimentation rate, Rheumatoid factor, Weight bearing difficulty
SMQs:
Write-up: 3 days 1/18/13 post vaccine - pt awoke with pain & inability to bear weight (L) foot -$g joint seen ED - 1/20/13 2 days later (R) foot with pain & difficulty bearing weight. ED visit - lower leg splint.

VAERS ID:485053 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Male  Submitted:2012-09-27
Location:Unknown  Entered:2013-02-20, Days after submission: 146
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2012SE75397
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Chills, Fatigue, Headache, Influenza, Migraine
SMQs:
Write-up: A report has been received from a health professional concerning a 13 year old male patient. Concomitant medications and patient history were not reported. During autumn 2011 the patient received nasal FLUMIST. After that he experienced severe symptoms of flu, chills, migraines, fatigue and headache. The outcome of the events was unknown. The report was considered to be non-serious by company physician.

VAERS ID:485040 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Unknown  Submitted:2013-02-21
Location:Unknown  Entered:2013-02-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Sickle cell anaemia
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1302USA008298
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Meningitis pneumococcal, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This literature marketed report as received from author refers to a 13 year old patient of unknown gender with sickle cell anemia. A single sickle cell center started a pilot screening program of antibody response to pneumococcal vaccination in patients with sickle cell disease (SCD). Patients were chosen for screening based on frequency of hospitalization and acute chest syndrome. Medical records of 5 patients less than 19 years old were reviewed to date for infections, pneumococcal vaccination, and response to pneumococcal vaccines. As a result 5 patients reviewed had different genotypes of SCD (2HbSS, 2 HbSC, and 1 Hemoglobin S-beta-thalassemia). Within this cohort, 1/5 (20 percent) had an adequate response to pneumococcal vaccination, defined as greater than 70 percent of serotype-specific pneumococcal IgG antibodies to 23 serotypes with serum levels of at least 1.3microgram/milliliter. On an unknown date, the patient was vaccinated with a dose of pneumococcal vaccine, polyvalent (23-valent)(manufacturer unknown)(lot number, expiry date, route and dose were not reported). On an unknown date, the 13 year old patient developed streptococcus pneumonia meningitis despite vaccination (medically significant). The outcome of the event was unknown. The author considered the events as related to Pneumococcal Vaccine, Polyvalent (23-valent)(manufacturer unknown). All 5 patients had received adequate vaccination with both polysaccharide and conjugate pneumococcal vaccines. The author concluded that the prevalence of sickle cell patients with low pneumococcal titers was unknown. Patients with SCD who had inadequate response to vaccination were at increased risk for invasive pneumococcal disease and could benefit from early, routine screening. If confirmed, poor response to pneumococcal vaccination may provide a rationale for continuing sickle cell patients on lifetime penicillin prophylaxis. Additional information has been requested.

VAERS ID:485371 (history)  Vaccinated:2013-01-10
Age:13.0  Onset:2013-01-14, Days after vaccination: 4
Gender:Female  Submitted:2013-02-23, Days after onset: 40
Location:California  Entered:2013-02-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Seizure~Vaccine not specified (no brand name)~UN~0.50~Patient|Seizure~Vaccine not specified (no brand name)~UN~3.83~Patient
Other Medications: No medications were being taken. Patient was administered a Depo Provera shot on 1/10/2013.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0146450IMUN
Administered by: Unknown     Purchased by: Other
Symptoms: Insomnia
SMQs:
Write-up: Patient began experiencing severe insomnia.

VAERS ID:485556 (history)  Vaccinated:2009-11-30
Age:13.0  Onset:2009-11-30, Days after vaccination: 0
Gender:Female  Submitted:2013-02-25, Days after onset: 1183
Location:Massachusetts  Entered:2013-02-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Drug hypersensitivity
Preexisting Conditions: Penicillin, Drug hypersensitivity; Amoxicillin, Hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1302USA009121
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0672Y0UNAR
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site anaesthesia
SMQs:, Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a a registered nurse refers to a 13 year old female patient with penicillin allergy and amoxicillin allergy and no pertinent medical history. On 30-NOV-2009, the patient was vaccinated with the first dose of GARDASIL (Lot # 0672Y, Exp date: 19-SEP-2011). On 29-NOV-2010, the patient was vaccinated with the second dose of GARDASIL (Lot # 0992Z, Exp date: 14-OCT-2012). The patient had no concomitant medications. The nurse reported that the patient developed numbness in the arm (injection site arm) immediately following the first and second dose of GARDASIL. No treatment was given. No laboratories were performed. The numbness resolved after an unspecified time period after each dose of GARDASIL. The patient sought medical attention, contacted office. The nurse had no other information about the numbness at the time of the call. Additional information has been requested.

VAERS ID:485622 (history)  Vaccinated:2013-02-25
Age:13.0  Onset:2013-02-25, Days after vaccination: 0
Gender:Female  Submitted:2013-02-26, Days after onset: 1
Location:Alaska  Entered:2013-02-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: No current illnesses at time of injection
Preexisting Conditions: Allergy to Latex
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0420AE1IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema mouth, Pruritus, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Red hives on forehead, behind both ears, itching to face and neck, "throat clearing," (possible itching in throat but pt denied itching) gave 50mg of Benadryl at 4:15PM. Pt continued to have itching on face and neck progressing to back of neck, redness, hives, and slight swelling around mouth and hives in right armpit continuing down upper right arm. 0.30mg of Epi was given in Right deltiod at 4:36PM. Itching, redness, and hives started to disappear at 4:42PM. By 4:57PM hives, redness, itching, and "throat clearing" all disappeared. Pt discharged from clinic at 5:00PM and was given Claritin 10mg and Prednisone 50mg.

VAERS ID:486203 (history)  Vaccinated:2013-03-04
Age:13.0  Onset:2013-03-04, Days after vaccination: 0
Gender:Female  Submitted:2013-03-05, Days after onset: 1
Location:Illinois  Entered:2013-03-05
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: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H020020IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4372AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0146281SCLA
Administered by: Public     Purchased by: Private
Symptoms: Malaise, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 3/4/13 1610 Client received Gardasil, Varicella, & Menactra. At approx 1615 client was standing next to her mom & states "I don''t feel well" RN & Mom took clients arm as syncope episode happened. Pale in color. Lowered client to floor and elevated her feet. Client aroused in less than a minute. BP 110/72. After approx 5 min assisted Client to standing and walked into exam room. 1625 patient reports feeling well, color pink, smiling walked out with Mom at side.

VAERS ID:486224 (history)  Vaccinated:2013-02-28
Age:13.0  Onset:2013-03-01, Days after vaccination: 1
Gender:Female  Submitted:2013-03-05, Days after onset: 4
Location:Wisconsin  Entered:2013-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD 0PO 
Administered by: Unknown     Purchased by: Other
Symptoms: Chest discomfort, Lip swelling, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: VIVOTIF oral vaccine given at home eve of 2/28/13 as directed. VIVOTIF not prescribed at facility - it was prescribed at an outside travel clinic. Mother called facility A.M. of 3/1/13 to report that patient had swollen lips, was c/o chest tightness and throat discomfort. Mom instructed to give child BENADRYL (total 50mg given). Child was seen at facility in A.M. of 3/1/13. Chest & throat discomfort resolved following po BENADRYL. Patient did present with swollen facial lips in clinic.

VAERS ID:486259 (history)  Vaccinated:2012-03-19
Age:13.0  Onset:2012-03-19, Days after vaccination: 0
Gender:Female  Submitted:2013-03-06, Days after onset: 352
Location:Unknown  Entered:2013-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1303USA000596
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 13 year old female patient. On 19-MAR-2012 the patient was vaccinated with dose 3, GARDASIL (lot#, expiration date and route not reported). On 21-OCT-2011, the patient was vaccinated with dose 1, GARDASIL (lot#, expiration date and route not reported). On 16-JAN-2012, the patient was vaccinated with dose 2, GARDASIL (lot#, expiration date and route not reported). No adverse effect was observed or reported. Additional information has been requested.

VAERS ID:486915 (history)  Vaccinated:2013-02-25
Age:13.0  Onset:2013-02-26, Days after vaccination: 1
Gender:Male  Submitted:2013-03-14, Days after onset: 15
Location:Wisconsin  Entered:2013-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None; note that vaccine provided by outside provider, lot numbers not immediately available
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Negative limited food skin testing panel
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTDUNK, PROV OSH0PO 
Administered by: Private     Purchased by: Private
Symptoms: Lip swelling, Pharyngeal oedema, Rash, Skin test negative, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Swollen upper lip, sensation of swollen throat without stridor or dyspnea. Throat was not itchy. Upon review of systems, no nausea/vomiting/diarrhea, wheezing, dysphagia, acute nasal congestion or scleral injection, angioedema, presyncope/syncope or other anaphylactic symptoms developed. She took Benadryl 50mg aggregate and visited the PCP''s office. She was advised to stop the course of antihistamines. The following evening, she developed a rash on her back and hives on her lower abdomen which became itchy, for which she was treated with 50mg Benadryl with resolution. She had a few doses of cetirizine or Benadryl subsequently, then no recurrences. + antecedent URI 1 month prior.

VAERS ID:486987 (history)  Vaccinated:2013-03-15
Age:13.0  Onset:2013-03-15, Days after vaccination: 0
Gender:Female  Submitted:2013-03-15, Days after onset: 0
Location:Missouri  Entered:2013-03-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None noted
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0628AE0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0139770IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B088AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dyskinesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt with syncope episode and jerking motions lasting <10 seconds upon standing approx 2 min after vaccination with 3 vaccines.

VAERS ID:487152 (history)  Vaccinated:2013-03-13
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-18
Location:Unknown  Entered:2013-03-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1303USA007874
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: This spontaneous report as received from a registered nurse refers to a 13 year old female patient. On 13-MAR-2013, the patient was vaccinated with a first dose of GARDASIL(lot number, expiry date, route and dose were not reported).Approximately on an unknown date in March 2013, the patient developed stomach pain. The patient sought medical attention and no treatment was provided. Laboratory test performed was none. The event stomach pain was reported as not recovered/not resolved. This is one of the report received from the same reporter. Additional information has been requested.

VAERS ID:487311 (history)  Vaccinated:2013-03-09
Age:13.0  Onset:2013-03-09, Days after vaccination: 0
Gender:Female  Submitted:2013-03-13, Days after onset: 3
Location:Maryland  Entered:2013-03-20, 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: Chronic Renal Insufficiency
Preexisting Conditions: Mycophenolate mofetil 750mg BID; Losartan 37.5mg
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.H010870UNAR
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4585AB0UNAR
Administered by: Private     Purchased by: Private
Symptoms: Cough, Dyspnoea, Eye swelling, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 1 1/2 hours after the vaccination, pt began to have swollen eye, face, hives all over her body, began to have coughing & difficulty breathing. Immediately saw in E.R. was treated with EPIPEN and steroid.

VAERS ID:487457 (history)  Vaccinated:2012-08-24
Age:13.0  Onset:2012-08-24, Days after vaccination: 0
Gender:Female  Submitted:2013-02-28, Days after onset: 188
Location:Ohio  Entered:2013-03-20, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluticasone propionate; Loratadine
Current Illness: Unknown
Preexisting Conditions: No alcohol or tobacco use.
Diagnostic Lab Data: UNK
CDC Split Type: A0991345A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS 0UNLA
Administered by: Public     Purchased by: Private
Symptoms: Accidental overdose
SMQs:, Drug abuse and dependence (broad)
Write-up: This case was reported by a physician and described the occurrence of unintentional overdose in a 13-year-old female subject who was vaccinated with HAVRIX (GlaxoSmithKline). On 24 August 2012 at 10:10 the subject received unspecified dose of HAVRIX (unknown, left arm) "14,040" units and experienced unintentional overdose. The physician reported the vaccine was unidose and disposed of in the sharps container. Lot number was not available. This is one of two cases reported by the physician, for the second case please see A0991622A. Follow-up information was received on 27 September 2012 via physician. Concurrent medications included FLUTICASONE and Loratadine. The physician reported an adult dose was given in place of pediatric dose. The physician noted the subject''s mother was called to inform her of the dosage error and to call the physician to inform them of any signs/symptoms other than local soreness at in the site. Immunization series with HAVRIX was not delayed or discontinued. The unintentional overdose was due to erroneous administration. The physician considered the event was "definitely" related to vaccination with HAVRIX.

VAERS ID:487472 (history)  Vaccinated:2013-03-18
Age:13.0  Onset:2013-03-18, Days after vaccination: 0
Gender:Female  Submitted:2013-03-21, Days after onset: 3
Location:Unknown  Entered:2013-03-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1303USA009974
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 13 year old female patient. On 18-MAR-2013, the patient was vaccinated with a second dose of GARDASIL (lot number, expiry date, route and dose were not reported) who had received the first dose approximately on an unknown date in October 2011 9reported as over a year and a half ago). Additional information has been requested.

VAERS ID:487514 (history)  Vaccinated:2013-03-19
Age:13.0  Onset:2013-03-19, Days after vaccination: 0
Gender:Female  Submitted:2013-03-21, Days after onset: 2
Location:Arizona  Entered:2013-03-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H014645 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Patient recieved HPV vaccine. Patient did not eat before she came in. Informed patient to sit down for 5 to 10 minutes to make sure she felt ok. Mother insisted they had to leave. I informed mother that if patient did not feel well to have her lay down immediately. As patient was walking out of the room the mother yelled for my name. I approached patient and mother was holding her sitting up on the ground. As I approached patient was fainting with seizure activity. I immediately placed patient flat on the ground. After a few seconds patient started to recover. After 30 seconds patient was fully recovered. BP 124/61. Patient laid for a few minutes. Sat patient up BP 116/80. Stood patient up BP 117/74 and walked patient to car. Notified patient to lay down if she starts to not feel good again and to go to ER or 911 if patients does not recover. Also informed patient to eat when she gets up in the morning.

VAERS ID:487550 (history)  Vaccinated:2012-10-09
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-21
Location:Texas  Entered:2013-03-22, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Strabismus; Allergy: PCN, cephalosporins
Diagnostic Lab Data: Orthostatic BP - 73/50; Low vit D
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2108 IN 
Administered by: Private     Purchased by: Private
Symptoms: Hypersomnia, Hypotension, Lethargy, Vitamin D decreased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)
Write-up: Progressive lethargy - now sleeps approximately 14-16 hrs/day, worsens with greater activity. Also, hypotension.

VAERS ID:487741 (history)  Vaccinated:2009-03-04
Age:13.0  Onset:2009-07-27, Days after vaccination: 145
Gender:Female  Submitted:2013-03-25, Days after onset: 1337
Location:Ohio  Entered:2013-03-25
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS1297X0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0072Z0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2568AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURUF457CA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Asthenia, Blood glucose increased, Pancreatic disorder, Pollakiuria, Thirst, Type 1 diabetes mellitus, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient was showing signs of weakness, vomiting, extremely thirsty, using bathroom a lot, after taking her to doctor her blood sugar was well over 600 therfore causing her to be sent straight to hospital where she wad diagnosed with pancreatic failure and is now insulin dependant.

VAERS ID:487757 (history)  Vaccinated:2013-03-20
Age:13.0  Onset:2013-03-21, Days after vaccination: 1
Gender:Female  Submitted:2013-03-25, Days after onset: 4
Location:Nebraska  Entered:2013-03-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1SYRAR
Administered by: Private     Purchased by: Other
Symptoms: Abdominal pain upper, Anxiety, Confusional state, Dizziness, Dyspnoea, Eye swelling, Fear, Feeling abnormal, Headache, Injection site pain, Mental impairment, Nausea, Pain, Pain in extremity, Somnolence
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Very confused, out of it, brain wasn''t working, couldn''t think, pain of injection site, eyes swollen, very bad headache, very dizzy, nausea 7 AM - trouble breathing, very difficult to breathe, very dizzy, very confused, brain fuzzy/not working right, shortness of breath, leg aching, bad stomach ache, body hurt. That lasted all day and into the next day. Very, very worried and scared patient!! Doctor on call said to take Zyrtec and 2 Benadryl and see if that helped. Patient was very sleepy but still had symptoms... got a bit better, then worse with confusion. Very confused at times. Still on 3-25 - still confused and brain not clear.

VAERS ID:488080 (history)  Vaccinated:2013-03-25
Age:13.0  Onset:2013-03-25, Days after vaccination: 0
Gender:Female  Submitted:2013-03-28, Days after onset: 3
Location:Nevada  Entered:2013-03-28
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0139771UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0172431UNLA
Administered by: Private     Purchased by: Public
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Skin rash on arms, back, abdomen and itching.

VAERS ID:488060 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-29
Location:Illinois  Entered:2013-03-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1303USA013573
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Headache, Nervous system disorder, Psychogenic seizure, Wheelchair user
SMQs:
Write-up: This spontaneous report was received from a physician via company representative refers to a 13 year old female patient. On an unknown date, the patient was vaccinated with a second dose of GARDASIL, (lot number, expiry date and route was not reported). On an unknown date, the patient developed pseudo-seizures (disability), other central nervous system issues (disability) and headache (disability) 2 weeks after receiving the second dose of GARDASIL. Due to these adverse events the patient had to use a wheel chair. The outcome of the reported events were not recovered. The patient sought medical attention (patient saw the physician). Additional information has been requested.

VAERS ID:488177 (history)  Vaccinated:2009-08-17
Age:13.0  Onset:2009-09-17, Days after vaccination: 31
Gender:Female  Submitted:2013-04-01, Days after onset: 1292
Location:Minnesota  Entered:2013-04-01
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 49 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Desmopressin
Current Illness: No
Preexisting Conditions: No! Perfectly healthy.
Diagnostic Lab Data: Patient was diagnosed with Myasthenia Gravis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0216Y2IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Asthenia, Dysphagia, Dyspnoea, Eyelid ptosis, Fall, Fatigue, Myasthenia gravis, Speech disorder
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: Began having swallowing issues, talking issues, weakness, breathing problems, droopy eyelid. The symptoms started out with her feeling tired and weak not long after the shot. By April and may she started having difficulties with swallowing and she started to fall down. I began calling doctors in may and struggled to get appointments with specialists. A pediatric neurologist didn''t diagnose anything. It was a neurologist who ordered more testing. He sent her to the facility on July 14, 2010. Patient was diagnosed with Myasthenia Gravis at the age of 14.

VAERS ID:488204 (history)  Vaccinated:2013-03-19
Age:13.0  Onset:2013-03-19, Days after vaccination: 0
Gender:Female  Submitted:2013-04-01, Days after onset: 13
Location:Michigan  Entered:2013-04-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1303USA011135
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Crying, Dizziness, Feeling abnormal, Headache, Immediate post-injection reaction, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a consumer refers to her daughter, a 13 year old female. The medical history, drug reaction and allergies were reported as none. On 19-MAR-2013, the patient received "her first and last'' standard dose of GARDASIL, via intramuscular. On 19-MAR-2013, immediately after vaccination the patient developed headache. This reaction was followed by nausea, vomiting, lightheadedness, severe stomach ache, until she was in tears. The patient also developed fever. The reporter explained that the patient developed these symptoms after being hit in the arm where she had received the vaccine. The patient told that the impact on her arm was the "strangest feeling that she''d ever felt". Therapy with GARDASIL was discontinued. No laboratory test was performed. No treatment was given for the adverse event. The patient sought unspecified medical attention. The outcome of limb discomfort, headache, stomach ache, lightheadedness, nausea, vomiting, limb injury and crying were unknown. Additional information has been requested.

VAERS ID:488405 (history)  Vaccinated:2012-10-29
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-03
Location:Florida  Entered:2013-04-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA000623
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0101AE1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report was received from a registered nurse concerning a 13 year old female patient. Weight of the patient was reported as 104 (units unspecified). As reported as 64 inches. On 29-OCT-2012, at 14:57:25, the patient was vaccinated with dose 2 of improperly stored (that was exposed to 31 Fahrenheit for up to 68 hours) GARDASIL (lot number and expiry date reported as 672721/0101AE and 10-OCT-2014 respectively), intramuscularly in the left arm at a private doctor office or hospital with the private funds. No concomitant medications were reported. No adverse effects were reported. A signed informed consent form was obtained in which the parent of the patient had signed. This is one of two reports from the same source. Additional information is not expected.

VAERS ID:488563 (history)  Vaccinated:2012-08-01
Age:13.0  Onset:0000-00-00
Gender:Male  Submitted:2013-04-05
Location:Unknown  Entered:2013-04-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA002262
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report was received from a mother refers to her 13 year old son (who is also the patient). On an unknown date in JUN-2012, the patient was vaccinated with first dose of GARDASIL, (lot number, expiry date and route was not reported). On an unknown date in AUG-2012, the patient was vaccinated with secod dose of GARDASIL, (lot number, expiry date and route was not reported). The patient was yet to receive the third dose of the vaccine and it was well beyond the time frame for dosing listed in the Pl and no side effects was reported. This is one of the two reports received from the same reporter. Additional information is not expected.

VAERS ID:488582 (history)  Vaccinated:2013-04-01
Age:13.0  Onset:2013-04-03, Days after vaccination: 2
Gender:Female  Submitted:2013-04-04, Days after onset: 1
Location:Massachusetts  Entered:2013-04-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200021IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on upper torso and neck on 4-3-13. BENADRYL given, good effect noted by mother.

VAERS ID:488772 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Ohio  Entered:2013-04-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H020022SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site haemorrhage, No adverse event
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: While injecting, I noted bright red blood in hole - I removed the needle syringe, pushed the sm amt blood out, used a new needle and re-injected at a different (L) deltoid site. There were no apparent adverse effects.

VAERS ID:488802 (history)  Vaccinated:2013-04-08
Age:13.0  Onset:2013-04-08, Days after vaccination: 0
Gender:Female  Submitted:2013-04-09, Days after onset: 1
Location:Kansas  Entered:2013-04-09
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 PASTEURU4285AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4347AA0UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0167581UNRA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Rec''d vaccinations at approx 9-10 a.m. Started breaking out in hives over chest area and back and legs at 500 p.m. Went to ER and rec''d BENADRYL I.V.

VAERS ID:488932 (history)  Vaccinated:2013-04-10
Age:13.0  Onset:2013-04-10, Days after vaccination: 0
Gender:Male  Submitted:2013-04-10, Days after onset: 0
Location:California  Entered:2013-04-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0155552IMLA
Administered by: Public     Purchased by: Military
Symptoms: Presyncope
SMQs:, Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient was given PPD and HPV Immunization and had vasovagal reaction 10 mins later. Patient got up on his own and was sent to ED for further evaluation.

VAERS ID:489038 (history)  Vaccinated:2011-06-17
Age:13.0  Onset:2011-06-17, Days after vaccination: 0
Gender:Female  Submitted:2013-04-11, Days after onset: 664
Location:California  Entered:2013-04-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA002538
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0477AA0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Convulsion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This spontaneous report as received from a certified medical assistant refers to a 13 year old female patient with no medical history or drug reactions/allergies reported. On 17-JUN-2011 the patient was vaccinated with the first dose of GARDASIL (lot # 668819/0477AA, exp 29-JUN-2013), intramuscularly. After receiving the first dose of GARDASIL, on 17-JUN-2011, the patient fainted and developed a seizure. Oxygen was given to the patient. No lab diagnostics studies were performed. Patient''s outcome was reported as recovered on 17-JUN-2011. The patient sought medical attention, the physician saw the patient. Upon internal review, seizure was considered as other medically important event. This is 2 of 4 cases reported. Additional information has been requested.

VAERS ID:489276 (history)  Vaccinated:2009-05-13
Age:13.0  Onset:2013-04-08, Days after vaccination: 1426
Gender:Female  Submitted:2013-04-12, Days after onset: 4
Location:Massachusetts  Entered:2013-04-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CONCERTA 36 mg; YAZ 0.02 mg tablets
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Unk
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCUN
Administered by: Private     Purchased by: Other
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt at present time on exchange program. Fever occurred 2 weeks before eruption of rash.

VAERS ID:489422 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-16
Location:Unknown  Entered:2013-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA006502
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Varicella
SMQs:
Write-up: This spontaneous report as received from a health care worker and follow up information received from a licensed practitioner nurse refers to a 13 year old female patient. On an unknown date the patient was vaccinated with a dose of (Merck) VARIVAX (lot#, dose and route was not reported). On an unknown date following vaccination of (Merck) VARIVAX the patient developed around 30 chicken pocks. And the patient was not pregnant. It was not known if the patient sought medical attention. The outcome of event was reported as not recovered/not resolved. Additional information is not expected.

VAERS ID:489460 (history)  Vaccinated:2013-04-09
Age:13.0  Onset:2013-04-10, Days after vaccination: 1
Gender:Female  Submitted:2013-04-16, Days after onset: 6
Location:Nevada  Entered:2013-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0139771UNLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Hot flush, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Headaches, nausea, dizziness, and hot flashes in her body.

VAERS ID:489791 (history)  Vaccinated:2013-04-01
Age:13.0  Onset:2013-04-06, Days after vaccination: 5
Gender:Female  Submitted:2013-04-22, Days after onset: 16
Location:California  Entered:2013-04-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Permethrin
Current Illness: ??Scabies
Preexisting Conditions: No
Diagnostic Lab Data: 4/13/13: samples of right wrist, left hip, suprapubic area vaccinia positive by DFA. 4/15/13: samples (right wrist and left hip) PCR positive for Non-Variola Orthopox
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A IDUN
Administered by: Military     Purchased by: Military
Symptoms: Immunology test abnormal, Infection transmission via personal contact, Polymerase chain reaction, Rash papular, Viral test positive
SMQs:, Hypersensitivity (broad)
Write-up: Contact transmission. 21yo female who had intimate contact with a person, primary vaccinee on 4/1/13 (vaccination date 3/18/13). According to the pt there was no dressing on the "scabbed lesion". According to the patient the lesion was covered with a band-aid. On 4/2/13 the pt applied the other person''s Permethrin cream to her body for self diagnosed scabies (the primary vaccinee was treated for scabies on March 19, 2013). On 4/6/13 the pt noted a papular lesion one her right wrist; on 4/7/13 she noted a lesion on her left hip and on 4/9/13 she noted a lesions in her right groin and several (about 10 lesions) in her suprapubic area. On 4/9/13 she went to the ER and the physician notified the CDC of the possibility of a contact transmission. On 4/11/13 the pt noted 4 lesions on her gluteal cleft. The pt was treated with VIG at ER on 4/14/13. Lesions from the right wrist, left hip and suprapubic area were positive for vaccinia by DFA and PCR.

VAERS ID:489788 (history)  Vaccinated:2013-01-08
Age:13.0  Onset:2013-01-09, Days after vaccination: 1
Gender:Female  Submitted:2013-04-23, Days after onset: 103
Location:South Dakota  Entered:2013-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Novalog, Lantus
Current Illness: No
Preexisting Conditions: Good health but Type 1 Diabetes.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 1IN 
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0SYRRA
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Musculoskeletal discomfort
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site started out with a bean size red mark and grew to a grapefruit size swelling mark with pain and joint discomfort.

VAERS ID:489853 (history)  Vaccinated:2013-04-12
Age:13.0  Onset:2013-04-12, Days after vaccination: 0
Gender:Female  Submitted:2013-04-23, Days after onset: 11
Location:Unknown  Entered:2013-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA008068
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered
SMQs:
Write-up: This spontaneous report as received from a nurse refers to a 13 year old female patient. On 12-APR-2013 the patient should have received the second dose GARDASIL (dosing information and route were not provided). However the patient was inadvertently administered two doses of GARDASIL on the same day (12-APR-2013). The outcome of patient was inadvertently administered two doses of GARDASIL on the same day is unknown. Additional information has been assistant.

VAERS ID:489962 (history)  Vaccinated:2013-02-25
Age:13.0  Onset:2013-03-05, Days after vaccination: 8
Gender:Female  Submitted:2013-04-24, Days after onset: 49
Location:California  Entered:2013-04-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen
Current Illness: Tonsillar concretions
Preexisting Conditions:
Diagnostic Lab Data: All labwork including CBC, ESR and rheumatological testing was negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0190881IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Abdominal pain, Arthralgia, Asthenia, Fatigue, Full blood count normal, Joint swelling, Red blood cell sedimentation rate normal, Rheumatoid factor negative, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: 1 month of symptoms starting 10 days after her 2nd HPV vaccine Gardisal (1st HPV on 2/24/12, 2nd 2/25/13) multiple joint pain, intermittent migratory joint pain and abdominal pain, weakness and fatigue lasting about a month. 10 days after vaccine ago woke up in the night with bilateral knee pain with mild swelling; over the next few days had bilateral ankle and wrist pain. The joint pain seemed to migrate to different areas, moving around every 5-10 minutes, no more than 1 hour in one particular joint. The swelling was present over the wrist / ankles / knees, resolved in around 2 weeks. The pain seems to persist however until 1 month. Cold water tends to help the pains. Upon waking the morning she has no pain or no stiffness. She has been waking up in the middle of the night with pain, but less so this week than last week. Chest, back, abdominal pain present 5 days after the joint pains. Each pain was brief in duration. Chest pain is resolved. Abdominal pain is bilateral periumbilical, but improved. No diarrhea / vomiting / blood in stool.

VAERS ID:490068 (history)  Vaccinated:2013-04-15
Age:13.0  Onset:2013-04-15, Days after vaccination: 0
Gender:Male  Submitted:2013-04-25, Days after onset: 10
Location:Georgia  Entered:2013-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin
Current Illness: None
Preexisting Conditions: Latex, shellfish, Penicillin
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216080IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Asthenia, Balance disorder, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Dizziness, nausea, weak, wobbly.

VAERS ID:490088 (history)  Vaccinated:2012-01-01
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-25
Location:New Jersey  Entered:2013-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA009612
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incomplete course of vaccination
SMQs:
Write-up: This spontaneous report was received form a consumer concerning her 13 year old daughter. Approximately on an unknown date in October 2011 (reported as October or November 2011), the patient was vaccinated with the first dose of 0.5 milliliter (ml) (reported as standard dose) of GARDASIL (lot number and expiry date unspecified), intramuscularly. Approximately on an unknown date in January 2012, the patient was vaccinated with the second dose of 0.5 ml (reported as standard dose) of GARDASIL (lot number and expiry date unspecified), intramuscularly. The patient did not receive her third dose of GARDASIL. No concomitant medications were reported. This is one of the two reports from the same source. Additional information has been requested.

VAERS ID:490118 (history)  Vaccinated:2012-09-19
Age:13.0  Onset:2012-09-20, Days after vaccination: 1
Gender:Female  Submitted:2013-04-26, Days after onset: 218
Location:Unknown  Entered:2013-04-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA015152
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: This spontaneous report as received from a medical assistant via a field representative refers to a 13 year old female patient with no drug reactions or allergies, the medical assistant''s daughter. On 19-SEP-2012, 14-NOV-2012 and 21-MAR-2013, the patient was vaccinated with the three doses of GARDASIL because patient''s mother wanted her to have it, respectively. It was reported that the patient experienced stomach cramps and diarrhea within 24 hours of receiving each GARDASIL dose. The patient did not seek medical attention. No treatment was given for the events. No lab diagnostics studies were performed. The representative reported that the adverse events experienced lasted 24 hours. The outcome of diarrhea and stomach cramps was reported as recovered. Additional information has been requested.

VAERS ID:490254 (history)  Vaccinated:2013-04-26
Age:13.0  Onset:2013-04-26, Days after vaccination: 0
Gender:Female  Submitted:2013-04-26, Days after onset: 0
Location:Pennsylvania  Entered:2013-04-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: BP down 85/54, 90/55, blood glucose 103 in office, Hgb 11.5 in office.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0101AE0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3974AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood glucose normal, Blood pressure decreased, Dizziness, Haemoglobin normal, Pallor, Unresponsive to stimuli, Visual impairment
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: After pt received Tdap and GARDASIL today, pt became lightheaded (about 5 min after vaccines were given). Pt was helped to the floor by RN and pt''s mother. Pt was pale, pt c/o vision closing in on her LOC?. Pt''s eyes remained open however did not respond to questions for less than 1 min, pt began to feel better was observed in office after 5-10 min pt walked out with mother.

VAERS ID:490216 (history)  Vaccinated:2013-04-02
Age:13.0  Onset:2013-04-03, Days after vaccination: 1
Gender:Male  Submitted:2013-04-19, Days after onset: 16
Location:Colorado  Entered:2013-04-29, Days after submission: 10
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ibuprofen during prior week
Current Illness: Mild cough; Runny nose one week
Preexisting Conditions: Constipation; Microcytosis
Diagnostic Lab Data: Also had evidence of mycoplasma infection/ibuprofen use
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0146450IMLA
Administered by: Private     Purchased by: Private
Symptoms: Mycoplasma infection, Stevens-Johnson syndrome
SMQs:, Severe cutaneous adverse reactions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Stevens Johnson syndrome; onset one day after HPV vaccine dose #1.

VAERS ID:490228 (history)  Vaccinated:2013-01-11
Age:13.0  Onset:2013-01-18, Days after vaccination: 7
Gender:Female  Submitted:2013-04-11, Days after onset: 82
Location:New Mexico  Entered:2013-04-29, Days after submission: 18
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 14 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Eczema
Diagnostic Lab Data: (-) Varicella; (-) bronchitis; (-) zoster; abnormal creatinine 3.0 (+); (+) Stevens Johnson Syndrome; (+) Mycoplasma
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4482AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Blood creatinine increased, Chest X-ray normal, Dysphagia, Eye discharge, Eye pain, Intensive care, Mycoplasma test positive, Oral disorder, Skin lesion, Stevens-Johnson syndrome, Swelling, Varicella virus test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad)
Write-up: 1/18/2013: stomach ache, eye pain, lesions on left arm, lesions in mouth. 1/20/13: eye drainage, swelling. 01/21/13 taken to ER given Rx Acyclovir, Z-pak; 01/22/13 condition worsened unable to swallow, taken to Hospital ER. Admitted to PICU. Hospitalized for 15 days (11 ICU; 4 ward). PICC line, IV TPN. Dx: Stevens Johnson Syndrome.

VAERS ID:490377 (history)  Vaccinated:2013-04-29
Age:13.0  Onset:2013-04-29, Days after vaccination: 0
Gender:Female  Submitted:2013-04-30, Days after onset: 1
Location:Vermont  Entered:2013-04-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4034AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Pallor, Posture abnormal
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient became pale after receiving shot. She stood up and pitched forward and was caught by her dad and lower to the floor. She was responsive. Her pulse was strong and steady. After 10 minutes we helped her to the chair where she sat for another 5 minutes then said she was feeling woozy again so we laid her on the floor for another 20 minutes. After sitting for about 5 min she was ready to leave. I cautioned dad to hold on to her as they exited. He refused a call to 911.

VAERS ID:490614 (history)  Vaccinated:2013-04-25
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-01
Location:Unknown  Entered:2013-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA016288
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.H019104 IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200021UNRA
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a currently 13 year old female patient with no pertinent history, or drug reactions or allergies reported. On an unknown date when the patient was 9 years old, was vaccinated with GARDASIL (lot number and expiration date not specified) (dose, route and anatomical location not specified). No other suspect therapies or concomitant medications were reported. The medical assistant reported that the patient returned on 25-APR-2013 (reported as "today") to receive her second dose of GARDASIL. The patient is now 13 years old. Additional information has been requested.

VAERS ID:490752 (history)  Vaccinated:2013-04-26
Age:13.0  Onset:2013-04-28, Days after vaccination: 2
Gender:Male  Submitted:2013-04-29, Days after onset: 1
Location:New York  Entered:2013-05-03, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSX120241IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site swelling, Injection site warmth, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Large local reaction at injection site warm and swollen shoulder to elbow.

VAERS ID:490819 (history)  Vaccinated:2013-05-03
Age:13.0  Onset:2013-05-03, Days after vaccination: 0
Gender:Male  Submitted:2013-05-03, Days after onset: 0
Location:North Carolina  Entered:2013-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: WCC but had cold and not feeling well
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.H0191040IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4418AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0184600SCLA
Administered by: Private     Purchased by: Private
Symptoms: Pallor, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 5 minutes after vaccines pt standing and became pale and fainted. Vomited x 2. Patient laid down elevated feet drank 8 oz carbonated soda. Waited 20 minutes Dr checked pulse which was normal.

VAERS ID:490934 (history)  Vaccinated:2013-05-02
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-06
Location:Illinois  Entered:2013-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0155550IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Erythema, Feeling hot, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient came to clinic 2 days after administration of vaccine with complaint of redness, swelling warm sensation and tender. Patient was prescribed KEFLEX to take 1 capsule (500 mg) by mouth every 8 hours for 7 days.

VAERS ID:491003 (history)  Vaccinated:2013-02-14
Age:13.0  Onset:2013-02-14, Days after vaccination: 0
Gender:Male  Submitted:2013-05-06, Days after onset: 80
Location:Michigan  Entered:2013-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA001550
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0209100IMUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a physician via a company representative concerning a 13 year old male patient who on 14-FEB-2013 was vaccinated with the first dose of GARDASIL lot # H020910 expiration date 18-JUN-2015. No other co-suspect or concomitant medications were reported. The physician reported that on 14-FEB-2013, the patient broke out in hives after receiving his first dose of GARDASIL. The patient was given BENDARYL as treatment for the event. On an unknown date, the patient had recovered from the event and the physician stated that he would not be completing the series of GARDASIL. Additional information is not expected.

VAERS ID:491230 (history)  Vaccinated:2013-04-30
Age:13.0  Onset:2013-04-30, Days after vaccination: 0
Gender:Male  Submitted:2013-05-08, Days after onset: 8
Location:Unknown  Entered:2013-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA002232
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H016057 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site anaesthesia, Injection site erythema, Injection site reaction, Injection site swelling, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a medical assistant refers to a 13 year old male patient. On 30-APR-2013 the patient was vaccinated with VARIVAX (Merck) (lot # h016057, expiration date 30-APR-2013), 0.5 ml, via intramuscular (anatomical location unknown). On 30-APR-2013, the patient developed numbness, tingling, redness and swelling with no induration at the injection site. The patient sought medical attention (office visit) and no treatment was given at this time. The outcome of numbness, swelling, redness and tingling was reported as not recovered/not resolved. Additional information has been assistant.

VAERS ID:491231 (history)  Vaccinated:2013-04-12
Age:13.0  Onset:2013-04-19, Days after vaccination: 7
Gender:Male  Submitted:2013-05-08, Days after onset: 19
Location:Wisconsin  Entered:2013-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA002906
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:
Write-up: Information has been received from a consumer to report an adverse event on behalf of her 13 year old male son. No drug reactions/allergies were reported. No pertinent medical history was reported. On 12-APR-2013 the patient was vaccinated with a dose of GARDASIL (route of administration, lot and dose # not reported). No concomitant medications were reported. About one week after receiving GARDASIL (19-APR-2013), the patient suffered from right supraclavicular lymphadenopathy. Patient did seek medical attention from the physician and was treated for this adverse event. He was recovering. Additional information is not expected.

VAERS ID:491379 (history)  Vaccinated:2013-05-06
Age:13.0  Onset:2013-05-09, Days after vaccination: 3
Gender:Female  Submitted:2013-05-10, Days after onset: 1
Location:Tennessee  Entered:2013-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: High Fever~DTaP (no brand name)~3~0.75~Patient|High Fever~DTaP (no brand name)~4~1.50~Patient|High Fever~DTaP (no brand name)~5~
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to pertussis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB542AA IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H016238 IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4273AA IMLA
TD: TETANUS DIPHTHERIA (TENIVAC)SANOFI PASTEUR43696CA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H016738 SCRA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Swelling face
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Child awoke with swollen face and vesicles on hands. Mother treated with Benadryl.

VAERS ID:491613 (history)  Vaccinated:2013-05-13
Age:13.0  Onset:2013-05-13, Days after vaccination: 0
Gender:Male  Submitted:2013-05-14, Days after onset: 1
Location:Florida  Entered:2013-05-14
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.0420AE0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Patient mother called pcp last night to inform that he developed a high fever 105F less than 1 hr. after LD shot.

VAERS ID:491756 (history)  Vaccinated:2013-05-06
Age:13.0  Onset:2013-05-07, Days after vaccination: 1
Gender:Male  Submitted:2013-05-16, Days after onset: 9
Location:Unknown  Entered:2013-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA005458
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Tic
SMQs:, Dyskinesia (broad), Dystonia (broad)
Write-up: A spontaneous report was received from a company representative who learned of this information from a physician regarding a male consumer who on 07MAY2013 reportedly suffered symptoms of TIC disorder after the administration of GARDASIL injection on 06MAY2013. Legal issue involved AE sent to legal. The patient''s current status was reported as recovering. No further AE information was provided.

VAERS ID:491904 (history)  Vaccinated:2013-05-14
Age:13.0  Onset:2013-05-16, Days after vaccination: 2
Gender:Male  Submitted:2013-05-17, Days after onset: 1
Location:Oregon  Entered:2013-05-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ritilan
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: My require antibiotics for cellulitis that maybe developing.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB690BA1IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0218610IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0187911SCRA
Administered by: Unknown     Purchased by: Public
Symptoms: Erythema, Injection site pruritus, Skin warm, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (broad)
Write-up: 7mm Raised, red, very warm to the touch, injection site that itches, increased sleepiness.

VAERS ID:492012 (history)  Vaccinated:2013-05-14
Age:13.0  Onset:2013-05-15, Days after vaccination: 1
Gender:Male  Submitted:2013-05-17, Days after onset: 2
Location:Pennsylvania  Entered:2013-05-20, 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: Pt is on PEN VK; ROCEPHIN
Current Illness: Pharyngitis; Spherocytosis
Preexisting Conditions: NKDA; Hereditary spherocytosis; Laparoscopic splenectomy and cholecystectomy
Diagnostic Lab Data: 40K WBC (had fever and sore throat prior strep (-))
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1561AA2IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4097AA1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0157494IMLA
Administered by: Private     Purchased by: Public
Symptoms: Blood culture, Injection site erythema, Injection site induration, Pyrexia, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Fever/erythema and induration (L) deltoid. Blood culture sent/WBC 40K/ROCEPHIN.

VAERS ID:492085 (history)  Vaccinated:2013-05-07
Age:13.0  Onset:2013-05-08, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Minnesota  Entered:2013-05-20
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216082IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site swelling, redness, pruritus, tingling and heat on day 2. Rx Ibuprofen and ice.

VAERS ID:492290 (history)  Vaccinated:2013-05-07
Age:13.0  Onset:2013-05-09, Days after vaccination: 2
Gender:Male  Submitted:2013-05-22, Days after onset: 13
Location:Missouri  Entered:2013-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zrytec weekly environmental allergy injections
Current Illness:
Preexisting Conditions: Food and environmental allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 5-9-13 mild swelling left deltoid in AM becoming excessive after school. Redness extending from shoulder to elbow. Afebrile. To Dr evening of 5-9-13 low-dose steroid given.

VAERS ID:492313 (history)  Vaccinated:2013-05-20
Age:13.0  Onset:2013-05-20, Days after vaccination: 0
Gender:Female  Submitted:2013-05-22, Days after onset: 2
Location:Massachusetts  Entered:2013-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler prn only
Current Illness: None
Preexisting Conditions: Hx asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0155551IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt received GARDASIL (L) arm IM on 5/20/13 at 10am that evening pt developed itchy red rash on (R) wrist which spread to (R) inner elbow and then to back and belly and finally to (L) arm near inj site. No difficulty breathing. Parent called MD. BENADRYL given at 10 pm 5/20 and 330 am 5/22. Rash gone by 7 am 5/21/13.

VAERS ID:492347 (history)  Vaccinated:2013-05-13
Age:13.0  Onset:2013-05-13, Days after vaccination: 0
Gender:Female  Submitted:2013-05-22, Days after onset: 9
Location:Illinois  Entered:2013-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin; Lotrisone cream
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0459AE0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B081AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient received Tdap vaccination to left deltoid then patient received HPV vaccination to right deltoid after vaccination given pt had syncopal episode.

VAERS ID:492350 (history)  Vaccinated:2012-06-01
Age:13.0  Onset:2012-06-01, Days after vaccination: 0
Gender:Female  Submitted:2013-05-23, Days after onset: 356
Location:Unknown  Entered:2013-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Hypersensitivity; Contraception
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA011987
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1696AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Arthralgia, Blood test, Dyspnoea, Eye swelling, Nausea, Rash, Ultrasound scan, Vomiting, X-ray
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: This spontaneous report as received from a mother concerning her 13 year old daughter. In June 2012, the patient was vaccinated with GARDASIL dose 1, intramuscular. On October 2012, the patient was vaccinated with GARDASIL dose 2, intramuscular. Concomitant therapy included birth control and allergy medication. In June 2012, "soon after receiving her first dose of GARDASIL", the patient experienced various symptoms including nausea and vomiting, stomach cramping with severe stomach pain which was "constant and debilitating", joint pain, intermittent swelling around eyes, intermittent rashes and shortness of breath. The mother stated that her daughter was "significantly incapacitated due to the constant pain". The patient was unrelieved of these symptoms at this time and there was no diagnosis or resolution to her symptoms post-testing, including "multiple" hospitalizations. Ultrasound, x-ray and blood work were performed with no result provided. The hospital''s name and lengths of stay were undisclosed. The events were considered to be other important medical events. Stomach cramping with severe stomach pain which was "constant and debilitating" and joint pain were considered disabling. Additional information has been requested.

VAERS ID:492398 (history)  Vaccinated:2013-05-20
Age:13.0  Onset:2013-05-20, Days after vaccination: 0
Gender:Female  Submitted:2013-05-23, Days after onset: 3
Location:Unknown  Entered:2013-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA012705
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0306AA1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a healthcare worker and a licensed practical nurse refers to a 13 year old female patient. On 15-JUN-2012 the patient was vaccinated with first dose of GARDASIL (strength, formulation, lot#, dose/frequency, route and duration were unspecified). On 20-MAY-2013 the patient was vaccinated with second dose of expired GARDASIL (injection, lot # 668554/0306AA, exp date 10-MAY-2013, 0.5 ml, intramuscular in the left arm). No adverse effects reported. Patient had sought unspecified medical attention. The outcome was unknown. Additional information has been requested.

VAERS ID:492464 (history)  Vaccinated:2013-05-13
Age:13.0  Onset:2013-05-13, Days after vaccination: 0
Gender:Male  Submitted:2013-05-23, Days after onset: 10
Location:Texas  Entered:2013-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Blood pressure, 128/109 not provided
CDC Split Type: WAES1305USA010424
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213460IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Feeling abnormal, Lethargy, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: This spontaneous report as received from a physician refers to a 13 year old male patient. On 13-MAY-2013 the patient was vaccinated with the first dose of GARDASIL lot # H021346, exp. 01-OCT-2015, intramuscular. The physician administered the GARDASIL shot to the male patient, then had the male patient wait 10 minutes prior to leaving the office area to go complete blood work in another area of the facility. Upon completing the routine blood work, which was scheduled during this doctor''s appointment, this male patient experienced lightheadedness and feeling of being dizzy. The laboratory staff then escorted the male patient back to the office area where the office nurse was informed of the patient''s condition. The office nurse had the male patient lie down in the room and vital signs were taken, of which blood pressure reading of 128/109 was obtained. The office nurse continued to monitor the patient''s condition which was not improving much. The patient was very lethargic and had to be shaken 3 times to be aroused along with having to have his father assist him to the bathroom "because of being out of it." After a period of 1 hour, the physician felt as though the patient was stable enough to be sent home. The physician followed up on 15-MAY-2013 with the patient who was still experiencing lightheadedness and being dizzy, "I just don''t feel like myself." The patient was not recovered from the event at reporting time. Therapy with GARDASIL was reported as continued. Additional information has been requested.

VAERS ID:492450 (history)  Vaccinated:2013-05-17
Age:13.0  Onset:2013-05-17, Days after vaccination: 0
Gender:Male  Submitted:2013-05-24, Days after onset: 7
Location:Unknown  Entered:2013-05-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA011940
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a healthcare worker refers to 13 years old male patient. In 2011 the patient was vaccinated with first dose of GARDASIL (dose, route, injection site, lot# and indication not provided). On 17-MAY-2013 (reported as now) the patient was vaccinated with the second dose of GARDASIL (dose, route, injection site, lot# and indication not provided). The reporter stated that the patient was late for his second dose of GARDASIL. No adverse effects reported. The outcome of events was unknown. Additional information is not expected.

VAERS ID:492485 (history)  Vaccinated:2013-05-22
Age:13.0  Onset:2013-05-23, Days after vaccination: 1
Gender:Male  Submitted:2013-05-23, Days after onset: 0
Location:California  Entered:2013-05-24, 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: INH
Current Illness: None
Preexisting Conditions: Latent TB
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0126431IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Localized, indurated, erythema, swelling, 6 x 6 cm in size on (R) lateral upper arm.

VAERS ID:492524 (history)  Vaccinated:2012-10-17
Age:13.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-24
Location:Florida  Entered:2013-05-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA011682
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  IMRA
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.  IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMRA
Administered by: Private     Purchased by: Public
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a patient of unknown demographics. On an unknown date, the patient was vaccinated with a dose of improperly stored GARDASIL (Lot number, expiry date, route and dose were not reported) and Liquid PEDVAXHIB (Lot number, expiry date, route and dose were not reported). Medical assistant reported that both vaccines were exposed to temperature of 26 F (Fahrenheit) for a total of 135 hours. No adverse effects reported. Follow-up received. Medical assistant stated other 104 children received GARDASIL and other 18 children received Liquid PEDVAXHIB vaccine. Follow up information has been received from the medical assistant regarding a 13 years old, male patient with no pertinent medical history reported. On 17-OCT-2012 the patient was vaccinated with GARDASIL (lot number and expiration date not reported) (intramuscular on the right arm, dose not reported). Other suspect therapies included Liquid PEDVAXHIB (lot number and expiration date not reported) (intramuscular on the left arm, dose not reported). Concomitant medications included Hepatitis A vaccine (manufacturer unknown) (lot number and expiration date not reported) (intramuscular on the right arm, dose not reported). It was reported that the patient did not seek medical attention. This is one of the several reports from the same source. Additional information is not expected.

VAERS ID:492525 (history)  Vaccinated:2012-11-15
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-24
Location:Florida  Entered:2013-05-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA011683
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMLA
Administered by: Private     Purchased by: Public
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers a patient of unknown demographics. On an unknown date, the patient was vaccinated with a dose of improperly stored GARDASIL (Lot number, expiry date, route and dose were not reported). The medical assistant reported that the vaccine was exposed to temperature of 26 F for a total of 135 hours. No adverse effects reported. Follow-up received. Medical assistant stated that other 104 children received GARDASIL. Follow up information has been received from the medical assistant regarding a 13 years old, female patient with no pertinent medical history reported. On 15-NOV-2012 the patient was vaccinated with GARDASIL (lot number and expiration date not reported) (intramuscular on the right arm, dose not reported). Concomitant medications included Hepatitis A vaccine (manufacturer unknown) (lot number and expiration date not reported) (intramuscular on the left arm, dose not reported). It was reported that the patient did not seek medical attention. This is one of the several reports from the same source. Additional information is not expected.

VAERS ID:492544 (history)  Vaccinated:0000-00-00
Age:13.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-27
Location:Alabama  Entered:2013-05-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1305USA013473
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Convulsion, Dyskinesia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This spontaneous report as received, via field employee, from a physician refers to a 13 year old female patient. In approximately May 2012, reported as one year ago, the patient was vaccinated with GARDASIL (dose, lot number and expiration date were not reported) dose 1, intramuscular. In approximately May 2012, reported as one year ago, after receiving the first dose of GARDASIL, the patient experienced involuntary hand movements once a day, for an unspecified period of time. On an unspecified date, in approximately 2013, reported as recently at an unspecified timeframe, the patient received a second dose of GARDASIL, (dose, lot number and expiration date were not reported). On an unknown date, in approximately 2013, (72 hours after vaccination with second dose of GARDASIL) the patient experienced seizure. The patient sought medical attention with a neurologist visit (unspecified Health Care Professional (HCP)) and received unspecified treatment. The outcome of involuntary hand movements once a day and seizure was reported as recovering/resolving. Upon internal review the event seizure was considered as medically significant. Additional information has been requested.

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