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Case Details (Sorted by Age)

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VAERS ID:484290 (history)  Vaccinated:2013-02-12
Age:16.0  Onset:2013-02-12, Days after vaccination: 0
Gender:Female  Submitted:2013-02-12, Days after onset: 0
Location:Louisiana  Entered:2013-02-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4343AA1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Dizziness, Tension headache, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: Ringing in ears, lightheaded "head feels tight" No reports of respiratory distress. Mother called at 2:50 pm pt informed to go to ER if resp distress occurs.

VAERS ID:484372 (history)  Vaccinated:2013-01-30
Age:16.0  Onset:2013-02-03, Days after vaccination: 4
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2013-02-13
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: Autism; Mild mental retardation
Diagnostic Lab Data: See note
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4544EA0UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA120240UNLA
Administered by: Private     Purchased by: Public
Symptoms: Convulsion, Dyskinesia, Hand deformity, Musculoskeletal stiffness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad)
Write-up: He came into mother''s room, sat down on couch. He was flopping his arm, 1 minute his arm got stiff, then his hand became claw. Went to ER. Fainting seizure.

VAERS ID:484548 (history)  Vaccinated:0000-00-00
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-02-14
Location:Unknown  Entered:2013-02-14
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': WAES1302USA006171
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blindness, Headache
SMQs:, Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)
Write-up: This study then seeks to examine how exposure to online blog entries, either supporting or in opposition to HPV vaccine, might influence vaccine-related risk perceptions, attitudes toward HPV vaccination, and intentions to receive the vaccine. Undergraduate studies were invited to complete an online survey in exchange for course credit. The sample was comprised of 341 individuals, including 107 men and 234 women with a mean age of 20 (SD=2.50). Participants first visited a webpage that provided general study information. Informed consent was obtained as participants clicked the "agree to participate" button at the bottom of the informational webpage. The button was also programmed such that participants were randomly directed to three websites corresponding to the three experimental conditions (negative blog, positive blog, and control). Upon entering the study website, participants first responded to a series of preliminary questions, including those about their demographic background, awareness of HPV/HPV vaccines, general beliefs and attitudes toward vaccines/vaccination, and perceived susceptibility to and severity of HPV. Next, participants in the treatment groups (negative blog and positive blog) were told that they were about to see an article posted by an online blogger about the HPV vaccine and were instructed to read the blog carefully (see later description of the blogs). After participants finished reading the blog, the proceeded to complete a postintervention survey that included questions about HPV vaccine-related risk perceptions (i.e., perceived efficacy and safety of the vaccine), attitudes toward HPV vaccination, and intentions to vaccinate. Participants in the control group did not see any blog and proceeded to complete the survey directly. The entire study took approximately 20 minutes to complete for the treatment groups and about 15 minutes for the control group. To enhance external validity, we used existing online blogs about the HPV vaccine as templates. We selected two blogs with clear opposing views about the vaccine. We ensured that each of the selected blogs was a typical exemplar in its respective category, according to the trends uncovered in previous research. That is, the sample blogs were selected to be representative of the sorts of positive and negative content likely to be observed in the blogosphere. Both blogs focused on the effectiveness and safety of the vaccine, with the positive blog indicating that the vaccine is effective and safe and the negative blog suggesting that the vaccine is not effective and is potentially dangerous. We edited the two blogs so they were similar in length and comparable in visual aspects. To increase perceived authenticity of the blogs, we retained the authors'' names, bot proven unfamiliar to our study population in a pretest. We also avoided major editorial changes and left the grammatical errors uncorrected. This report concerned a teenage girl (content of the blogs) aged sixteen. She has been left blind after the HPV vaccine (manufacturer unknown) according to a report shown be the group who reported yesterday that a perfectly healthy girl was left almost totally blind, just 10 days after her second HPV vaccine. The report stated that initially, there was a visual loss reported in the right eye with a left side headache, however, these symptoms worsened over the next 24 hours to include her left eye with a more severe headache. In a controlled experiment (N=341), college students were exposed to either a negative blog post about the HPV vaccine or a positive one. Compared to the control group, participants who had viewed the negative blog perceived the vaccine as less safe, held more negative attitudes toward the vaccine, and had reduced intentions to receive the vaccine. In contrast, exposure to the positive blog did not alter any vaccine-related risk perceptions, attitudes, or intentions. In conclusion, as people are getting more and more information on

VAERS ID:484642 (history)  Vaccinated:2013-02-15
Age:16.0  Onset:2013-02-15, Days after vaccination: 0
Gender:Female  Submitted:2013-02-15, Days after onset: 0
Location:California  Entered:2013-02-15
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: Patient states she is pregnant 3 months
Diagnostic Lab Data: Patient states she is 3 months pregnant.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.HO126430IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4330AB1IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3927AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Maternal exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Student pregnant 3 months. Gave HPV vaccine.

VAERS ID:484697 (history)  Vaccinated:2013-02-09
Age:16.0  Onset:2013-02-14, Days after vaccination: 5
Gender:Female  Submitted:2013-02-17, Days after onset: 3
Location:Illinois  Entered:2013-02-17
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None The following information was obtained through follow-up and/or provided by the government. 2/20/12. Hospital records. NKA.
Diagnostic Lab Data: MRI, EEG The following information was obtained through follow-up and/or provided by the government. 2/20/12. Hospital records. EEG + for epilepsy. 2/20/12. Labs/diagnostics. MRI brain: scattered nonenhancing subcentimeter foci of increased T2 signal seen in subcortical white matter of frontal lobes bilat. WBC 8.3 K/mm3 (N), neuts 72% (H), lymphs 18% (L). CT brain: minimal R periorbital et frontal scalp haematoma. CT maxillofacial area: soft tissue swelling et contusion contiguous c R maxilla, periorbital et R frontal scalp.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.013977 UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Computerised tomogram abnormal, Conjunctival haemorrhage, Convulsion, Corneal abrasion, Electroencephalogram, Electroencephalogram abnormal, Epilepsy, Haematoma, Lymphocyte percentage decreased, Neutrophil percentage increased, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain abnormal, Tongue injury
SMQs:, Haematopoietic leukopenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Corneal disorders (narrow), Conjunctival disorders (narrow), Generalised convulsive seizures following immunisation (narrow)
Write-up: Epileptic seizure, generalized. The following information was obtained through follow-up and/or provided by the government. 2/20/12. Hospital records DOS 2/14-15/2013. DX: new onset seizure. CC: pt woke up c haematoma to R forehead, R cheek, R eye et lower lip; no memory of injury. PE: conjunctival hemorrhage of R eye c small corneal abrasion; tongue laceration. Admitted overnight. DC in stable condition to f/u c PCP et neurology.

VAERS ID:484777 (history)  Vaccinated:2013-02-06
Age:16.0  Onset:2013-02-06, Days after vaccination: 0
Gender:Female  Submitted:2013-02-07, Days after onset: 1
Location:Louisiana  Entered:2013-02-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4585AB UNRA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Allergic reaction - (+) whelps on arms and legs.

VAERS ID:485131 (history)  Vaccinated:2012-10-11
Age:16.0  Onset:2012-10-23, Days after vaccination: 12
Gender:Male  Submitted:2012-10-23, Days after onset: 0
Location:Florida  Entered:2013-02-20, Days after submission: 120
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': 2012SE82153
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2159 IN 
Administered by: Other     Purchased by: Other
Symptoms: Headache, Nasal oedema
SMQs:, Angioedema (broad)
Write-up: A report has been received from a Health Professional concerning a 16 year old, male subject, who had been receiving FLUMIST. FLUMIST started on 11-Oct-2012. The patient experienced HEADACHE and SWELLING IN ONE NOSTRIL which started on 23-Oct-2012. At the time of reporting, the event of HEADACHE and SWELLING IN ONE NOSTRIL was ongoing. The report was considered to be non-serious.

VAERS ID:485139 (history)  Vaccinated:2013-02-05
Age:16.0  Onset:2013-02-05, Days after vaccination: 0
Gender:Male  Submitted:2013-02-20, Days after onset: 15
Location:Iowa  Entered:2013-02-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Patient and mother report vomit daily 1-2 x s since vaccines.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB3613791IMUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0176982IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA1IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting daily since administration (x2 wk).

VAERS ID:485305 (history)  Vaccinated:2012-11-05
Age:16.0  Onset:2012-11-06, Days after vaccination: 1
Gender:Female  Submitted:2012-11-16, Days after onset: 10
Location:Unknown  Entered:2013-02-20, Days after submission: 96
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': 2012SE87396
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Chills, Cough, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Tonsillar hypertrophy
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: A consumer report has been received. The report concerns a 16 year old, Female consumer, who had been receiving FLUMIST. FLUMIST started on an unknown date. The patient experienced chills, cough, fever, sore throat, swollen tonsillitis and congestion which started on 06-Nov-2012. The outcome of the event of chills, cough, fever, sore throat, swollen tonsillitis and congestion is unknown. The report was considered to be non-serious.

VAERS ID:485118 (history)  Vaccinated:2012-10-22
Age:16.0  Onset:2012-11-13, Days after vaccination: 22
Gender:Male  Submitted:2013-02-14, Days after onset: 93
Location:Michigan  Entered:2013-02-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: OTC
Current Illness: None
Preexisting Conditions: Seasonal allergies; HA & vertigo since 3/2012 The following information was obtained through follow-up and/or provided by the government. 3/12/13. Hospital records. PMH: asthma; hydronephrosis. Allergy: peanuts; tree nuts; fish.
Diagnostic Lab Data: LP; CMP; Drug screen; ANA reflex; TSH; CMV; Brain MRI; MRA; Mono The following information was obtained through follow-up and/or provided by the government. 3/12/13. labs/diagnostics. Infectious disease panel neg. MRI brain: minimal mucosal thickening of R maxillary sinus. MRA brain: neg. MRV brain neg. MRA neck neg. EKG: sinus bradycardia c sinus arrhythmia; nonspecific intraventricular conduction delay.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714AA7IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Angiogram, Antinuclear antibody, Anxiety, Blood thyroid stimulating hormone, Cognitive disorder, Confusional state, Cytomegalovirus test, Depressed level of consciousness, Disturbance in attention, Dizziness, Drug screen, Fatigue, Feeling jittery, Gait disturbance, Headache, Illusion, Irritability, Lumbar puncture, Memory impairment, Metabolic function test, Migraine, Mononucleosis heterophile test, Muscle spasms, Muscular weakness, Neck pain, Nuclear magnetic resonance imaging brain, Paraesthesia, Photophobia, Sensory loss, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Drug abuse and dependence (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Hostility/aggression (broad), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: MENACTRA & FLUZONE vaccines given 10/22/2012 symptoms reported 11/13/2012. C/O fatigue, vertigo, headaches, cognitive and sensory deficits, photophobia. The following information was obtained through follow-up and/or provided by the government. 3/12/13. Hospital records ER visit 11/15/12. DX: Anxiety. CC: jitteriness; episodic confusion; irritability; anxiety; occasional paraesthesias to hands c carpal spasms; dizziness. PE: NAD. Released to f/u c PCP. Hospitalized DOS 12/20-22/2012. DX: HA, improved; asthma, stable; fatigue, improved; cognitive deficits, improved. CC: weak knees, difficulty walking; neck pain; head pressure; head migraine; photophobia; perception difficulties cloudy thinking; memory difficulty; fatigue; jittery; irritability; difficulty concentrating; . Uneventful hospitalization. DC in stable condition to f/u c PCP et specialists. Returned to ER 1/7/13. DX: multiple symptoms of unknown aetiology. CC: persistence of symptoms; requesting EEG. Arrangements made for outpt EEG.

VAERS ID:485329 (history)  Vaccinated:2013-02-18
Age:16.0  Onset:2013-02-21, Days after vaccination: 3
Gender:Male  Submitted:2013-02-22, Days after onset: 1
Location:Oregon  Entered:2013-02-22
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: Allergic rhinitis in 2010
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB536AA1UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURUA350BA0UNLA
Administered by: Public     Purchased by: Public
Symptoms: Rash erythematous, Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Mom called 2/21/13 - RN spoke to 16 y/o male pt who c/o waking up on 2/21/13 morning w/rash all over body. C/O rash being red round raised bumps that itch on face, trunk, arms & legs. Pt denied any wheezing, SOB. now or at any time. Pt denied weakness, rapid or irregular heart beat or dizziness.

VAERS ID:485742 (history)  Vaccinated:2013-02-21
Age:16.0  Onset:2013-02-23, Days after vaccination: 2
Gender:Female  Submitted:2013-02-28, Days after onset: 5
Location:Michigan  Entered:2013-02-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB646BA0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0109151IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4434AA1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Pharyngeal oedema, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Developed itching with throat swelling & vomiting. Resolved with 2 doses BENADRYL.

VAERS ID:485802 (history)  Vaccinated:2013-02-27
Age:16.0  Onset:2013-02-27, Days after vaccination: 0
Gender:Female  Submitted:2013-02-28, Days after onset: 1
Location:New Jersey  Entered:2013-02-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None needed
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0420AE3IMLA
Administered by: Private     Purchased by: Private
Symptoms: Incorrect dose administered
SMQs:
Write-up: 4th dose of HPV given in error.

VAERS ID:485970 (history)  Vaccinated:2013-03-01
Age:16.0  Onset:2013-03-01, Days after vaccination: 0
Gender:Female  Submitted:2013-03-01, Days after onset: 0
Location:California  Entered:2013-03-01
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
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH356AA SCRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient fainted in her chair a few minutes after receiving the yellow fever vaccine. Reported feeling dizzy afterwards.

VAERS ID:486085 (history)  Vaccinated:2013-03-04
Age:16.0  Onset:2013-03-04, Days after vaccination: 0
Gender:Female  Submitted:2013-03-04, Days after onset: 0
Location:California  Entered:2013-03-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA697AA IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB677BA0IMLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.H0156211SCRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4330AB0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: PATIENT SLUMPED OVER WHILE SITTING. WOULD NOT RESPOND. SHE WAS THEN LAID BACK ON EXAM TABLE WHEN SHE HAD A SEIZURE ABOUT 30 SECONDS LONG. THE PROVIDERS WERE THEN CALLED IMMEDIATELY INTO ROOM FOR EVALUATION. PATIENT DID NOT COMPLETELY REGAIN FULL RECOVERY. THE AMBULANCE WAS CALLED TO TRANSPORT PATIENT TO THE ER FOR FURTHER EVALUATION.

VAERS ID:486138 (history)  Vaccinated:2013-02-25
Age:16.0  Onset:2013-02-26, Days after vaccination: 1
Gender:Male  Submitted:2013-02-26, Days after onset: 0
Location:Ohio  Entered:2013-03-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CONCERTA 72 mg QD
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.H0200020UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4374AA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Eyelid oedema, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Face swelling, eyes swollen shut, urticaria on face/neck/arms.

VAERS ID:486237 (history)  Vaccinated:2013-03-02
Age:16.0  Onset:2013-03-03, Days after vaccination: 1
Gender:Male  Submitted:2013-03-03, Days after onset: 0
Location:Washington  Entered:2013-03-05, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Triamcinolone acetonide
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0139770IMUN
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: Pt reported dizziness and blurred vision after shot. Called Nurse to recheck and follow up. See Nurse comments.

VAERS ID:486229 (history)  Vaccinated:2012-10-11
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-01
Location:North Carolina  Entered:2013-03-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Xray of Rt knee - small joint effusion 11/9/12 sed rate 28 ANF & RF & streptozyde (-)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0129730IMRA
Administered by: Private     Purchased by: Private
Symptoms: Antinuclear antibody negative, Arthralgia, Joint effusion, Red blood cell sedimentation rate increased, Rheumatoid factor negative, Streptococcus test negative, X-ray limb abnormal
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Arthritis (broad)
Write-up: Mother of pt report that several days after her shot - she developed pain in her knee generally in Rt knee pain. Also developed ? arthralgia origin undetermined. Has improved. Some occasional pain in joints.

VAERS ID:486286 (history)  Vaccinated:2013-03-05
Age:16.0  Onset:2013-03-05, Days after vaccination: 0
Gender:Female  Submitted:2013-03-06, Days after onset: 1
Location:Texas  Entered:2013-03-06
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: None
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1262AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Fall, Pallor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Client seated next to nurse, HPV #2 given in left arm, IM. After injection, client stated that she thought she was going to faint. While seated, she began to fall back and was caught in arms of nurse giving injection. Mother was told that nurse would ease client to the floor, at which time client sat up and said, "did I go to sleep?". Client was unresponsive from 3-5 seconds. Cool packs applied to back and neck for about 10 minutes. Client very pale and stated she was hungry. She ate an apple and the color returned to her face. Client observed for 15 more minutes.

VAERS ID:486559 (history)  Vaccinated:2008-02-12
Age:16.0  Onset:2008-12-27, Days after vaccination: 319
Gender:Female  Submitted:2013-03-06, Days after onset: 1530
Location:Missouri  Entered:2013-03-11, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None at time
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Test for seizures but no known cause.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1522U2IMLA
Administered by: Private     Purchased by: Other
Symptoms: Grand mal convulsion, Laboratory test normal, Myoclonus
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Started having myoclonic jerk within few months after shots. Reported to physician who said may be stress. Jerks continued then grand mal seizures started. Continue to have myoclonic jerks and grand mal seizures. Have had other hospitalizations due to seizure complications.

VAERS ID:486959 (history)  Vaccinated:2012-11-29
Age:16.0  Onset:2013-02-04, Days after vaccination: 67
Gender:Female  Submitted:2013-03-15, Days after onset: 38
Location:Unknown  Entered:2013-03-15
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': WAES1303USA006519
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Alopecia, Back pain
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: This spontaneous report was received from a registered nurse refers to a 16 year old female patient. Pertinent medical history was unspecified. On 29-NOV-2012, the patient was vaccinated with a dose of GARDASIL (Lot#,route, dose not reported). No concomitant medications were reported. ON 04-FEB-2013, the patient experienced lower back pain and hair loss. It was unspecified if patient received treatment. The outcome of lower back pain and hair loss was unknown. No medical attention was sought by patient. Additional information has been requested.,

VAERS ID:487145 (history)  Vaccinated:2013-03-07
Age:16.0  Onset:2013-03-07, Days after vaccination: 0
Gender:Female  Submitted:2013-03-08, Days after onset: 1
Location:Nebraska  Entered:2013-03-18, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC188BA1IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH134011IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0367AE1SCRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4291AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B093AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0109581SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dyskinesia, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: "Fainted" 1635 unconscious about 1 minute, couple of "jerky" arm movements. 98/64 BP HRR 64. Lowered to floor & elevated legs. 1647 Sitting up, drank water BP 92/68 HRR 60.

VAERS ID:487235 (history)  Vaccinated:2013-03-12
Age:16.0  Onset:2013-03-14, Days after vaccination: 2
Gender:Female  Submitted:2013-03-14, Days after onset: 0
Location:Washington  Entered:2013-03-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hyperinsulinemia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3974AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Tdap administered 3/12/13. Present to office 3/14/13 with c/o swollen arm at site. Red, warm to touch at site. Temp 99.4 (TY).

VAERS ID:487303 (history)  Vaccinated:2013-03-18
Age:16.0  Onset:2013-03-18, Days after vaccination: 0
Gender:Male  Submitted:2013-03-18, Days after onset: 0
Location:Puerto Rico  Entered:2013-03-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0420AE1UNLA
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: Syncope. Tx lifted his legs.

VAERS ID:487276 (history)  Vaccinated:2013-03-05
Age:16.0  Onset:2013-03-14, Days after vaccination: 9
Gender:Male  Submitted:2013-03-20, Days after onset: 6
Location:Unknown  Entered:2013-03-20
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': WAES1303USA008702
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Computerised tomogram, Pancreatitis
SMQs:, Acute pancreatitis (narrow)
Write-up: This spontaneous report as received from a nurse practitioner via company representative refers to a 16 year old male patient. On 05-MAR-2013 the patient was vaccinated with his first dose of GARDASIL (lot number not provided). The patient was admitted to the hospital on 14-MAR-2013(no hospital details were provided, length of stay undetermined), and was diagnosed with pancreatitis. Lab diagnostics studies about CT and Cats Scan were performed without result provided. The outcome of pancreatitis was unknown. The relatedness for pancreatitis was unknown for GARDASIL. Additional information has been requested.

VAERS ID:487396 (history)  Vaccinated:2012-06-07
Age:16.0  Onset:2012-06-07, Days after vaccination: 0
Gender:Male  Submitted:2012-09-26, Days after onset: 111
Location:California  Entered:2013-03-20, Days after submission: 175
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: STRATTERA; RAPIDUS
Current Illness:
Preexisting Conditions: The patient had no known allergies. Is a known case of ADHD. Concomitant medications were not reported. Follow up information received on 14 September 2012: The patient did not receive any other vaccine within 4 weeks of the MENACTRA. The patient was receiving STRATTERA and RAPIDUS since as unknown date.
Diagnostic Lab Data: Not reported
CDC 'Split Type': 201206219
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4021AA UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Pruritus, Serum sickness-like reaction, Swelling, Tenderness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Initial report received from a healthcare professional on 14 June 2012. A 16-year-old male patient, who had no known allergies or concomitant medication and whose medical history included ADHA, received a dose MENACTRA on 7 June 2012. On 7 June 2012, same day of vaccination, the patient developed urticaria with itchy red swollen hands and soles of the feet, swelling and reddening of palms of hands and soles of feet on an off. It is tender to touch and swelling and redness is progressing up the arms. The patient received ALLEGRA during the day and BENADRYL at night as corrective treatment. The patient was not recovered from the events. List of documents held by sender: none. Follow up information received on 14 September 2012: The patient did not receive any other vaccine within 4 weeks of the MENACTRA. The patient was receiving STRATTERA and RAPIDUS since as unknown date. The patient visited an allergist and was diagnosed was found to have urticaria and serum sickness type reaction (Arthus type reaction) to MENACTRA. He was treated with oral steroids after which the patient was fine.

VAERS ID:487509 (history)  Vaccinated:2013-02-20
Age:16.0  Onset:2013-02-20, Days after vaccination: 0
Gender:Male  Submitted:2013-03-21, Days after onset: 28
Location:Virginia  Entered:2013-03-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Well check up
Preexisting Conditions: None
Diagnostic Lab Data: EKG, blood test
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 1IM 
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IM 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Blood test, Diarrhoea, Diplopia, Dizziness, Electrocardiogram, Migraine, Muscular weakness, Nausea, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Migraines, severe pain in arms and legs, stabbing abdominal pain, diarrhea, double vision, dizziness, nausea, weakness in left arm.

VAERS ID:487822 (history)  Vaccinated:2008-09-18
Age:16.0  Onset:2008-12-03, Days after vaccination: 76
Gender:Female  Submitted:2013-03-26, Days after onset: 1573
Location:Missouri  Entered:2013-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness the date is estimated but can be retrieved from health provider
Preexisting Conditions: No health problems and was not sexually active until two months before receiving shot series and have only had one sex partner
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0SYRGM
Administered by: Public     Purchased by: Other
Symptoms: Anogenital warts
SMQs:
Write-up: Have never had any sexual partners until two months before receiving the three shot series. My self nor my partner was never diagnosed with genital warts until I received the second shot and they shortly appeared and had to receive treatment for them for six month for them to reside and my partner was not effected. So I would like some information because I have found some on the internet stating Gardasil can cause genital warts.

VAERS ID:488194 (history)  Vaccinated:2013-03-28
Age:16.0  Onset:2013-03-28, Days after vaccination: 0
Gender:Male  Submitted:2013-03-29, Days after onset: 1
Location:Pennsylvania  Entered:2013-03-29
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: Non contributory
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB536BA1IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0162381IMLA
Administered by: Private     Purchased by: Public
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient became dizzy and fainted within minutes of vaccine administration. BP 80/44, HR: 48. Patient vital signs monitored for half hour at 5 min interval. Head of.

VAERS ID:488209 (history)  Vaccinated:2013-03-25
Age:16.0  Onset:2013-03-26, Days after vaccination: 1
Gender:Male  Submitted:2013-04-01, Days after onset: 6
Location:Oklahoma  Entered:2013-04-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA
Current Illness: None
Preexisting Conditions: Gastritis; Pharyngitis; Sinusitis; ADHD; Asthma; Constipation
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1885AA1SCLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110471IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0119121SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness at site that evening. Pt went to facility on 3/26/13 at 21:30 with swelling of (R) arm around site and nausea. Pt given BENADRYL and Ranitidine. Pt discharged 3/26/13 at 22:06.

VAERS ID:488253 (history)  Vaccinated:2013-02-19
Age:16.0  Onset:2013-02-19, Days after vaccination: 0
Gender:Female  Submitted:2013-04-01, Days after onset: 40
Location:Florida  Entered:2013-04-01
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.H0200020IMLA
Administered by: Private     Purchased by: Public
Symptoms: Hyperhidrosis, Nausea, Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Mom reports patient felt like throat was closing up, lip was tingling, felt nauseous, broke out in a sweat. Felt better an hour later after a dose of BENADRYL.

VAERS ID:488296 (history)  Vaccinated:2013-03-21
Age:16.0  Onset:2013-03-25, Days after vaccination: 4
Gender:Male  Submitted:2013-04-02, Days after onset: 8
Location:West Virginia  Entered:2013-04-02
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: On 27-MAR-2013, ultrasound was conducted and results were awaited
CDC 'Split Type': WAES1304USA000553
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Neck mass, Ultrasound scan
SMQs:
Write-up: This spontaneous report was received from a father refers to his 16 year old son (who is also the patient). The patient had no pertinent medical history or drug reactions or allergies. On 21-MAR-2013, the patient was vaccinated with a dose of GARDASIL, (lot number, expiry date and route was not reported). On 25-MAR-2013, the patient had lump/mass on the right side of his neck. There was no pain associated with the lump. On 27-MAR-2013, ultrasound was conducted and results were awaited. The outcome of lump/mass on the right side of his neck was reported as not recovered. The patient sought medical attention. Additional information has been requested.

VAERS ID:488312 (history)  Vaccinated:2013-03-25
Age:16.0  Onset:2013-03-27, Days after vaccination: 2
Gender:Male  Submitted:2013-04-02, Days after onset: 6
Location:Kansas  Entered:2013-04-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness: Denies
Preexisting Conditions: Denies
Diagnostic Lab Data: Referral appt made to pediatrician @ medical clinic.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4383AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Feeling abnormal, Insomnia, Malaise, Musculoskeletal stiffness, Pain in jaw, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Started with general malaise on 3/27. Then starting feeling worse and reported to aunt on 3/30 complaining of stiff neck, difficulty sleeping, bumps noted on head, jaw pain and blisters and hives in hair.

VAERS ID:488328 (history)  Vaccinated:2012-02-08
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-02
Location:Tennessee  Entered:2013-04-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives (unspecified)
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Erythrocyte Sedimentation Rate (ESR) (2012): Elevated; C-reactive Protein (CRP) (2012): Elevated; Haemoglobin (Hb) (2012): 8.6
CDC 'Split Type': WAES1304USA000352
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, C-reactive protein increased, Chest pain, Dermatitis bullous, Dyspnoea, Fatigue, Haemoglobin decreased, Myalgia, Pemphigoid, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: This spontaneous report as received from a physician refers to a 16 or 17 year old female patient, with no prior medical history or notable family history. In late 2011 the patient was vaccinated with the first dose of GARDASIL (lot number, expiration date and via not reported), without incident. An a period of time later, on 08-FEB-2012 the patient was vaccinated with the second dose of GARDASIL (lot number, expiration date and via not reported). Concomitant therapies included hormonal contraceptives (unspecified). The reporter stated that subsequent to that second dose, a few days later the patient was hospitalized (also reported by the physician after additional information received as was seen in the emergency room (ER) three times for joint pain, shortness of breath, chest pain, overall fatigue and muscle aches which went away each time over a period of 3 weeks. In approximately 2012, the patient was noted to have an elevated Erythrocyte Sedimentation rate (ESR) and C-reactive Protein (CRP) and a Haemoglobin (Hb) of 8.6. The patient was treated with MEDROL pack with subsequent resolution of her symptoms. The reporter also stated that over the last 8 weeks (also reported as about six weeks), the patient developed bullous lesions on the extensor surfaces of her arms and legs, diagnosed now as bullous pemphigoid. The physician noted that this was very unusual in a young female. The outcomes of joint pain, muscle aches, overall fatigue, chest pain, shortness of breath were reported as recovered/resolved. The outcome of bullous pemphigoid, elevated Erythrocyte Sedimentation rate (ESR), C-reactive Protein (CRP) and a Haemoglobin (Hb) of 8.6 were unknown. Additional information has been requested.

VAERS ID:488413 (history)  Vaccinated:2012-07-12
Age:16.0  Onset:2012-07-12, Days after vaccination: 0
Gender:Male  Submitted:2013-04-03, Days after onset: 265
Location:Wisconsin  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': WAES1304USA000724
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0636AA1IMUN
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 16 year old male patient. The patient was vaccinated with the first dose of GARDASIL (lot # reported as 0636AA; expiry date: 11-AUG-2013) on 14-JUN-2012, the second dose (lot # reported as 0636AA; expiry date: 11-AUG-2013) on 12-JUL-2012 and the third dose (lot # reported as 1745AA; expiry date: 13-SEP-2014) on 17-DEC-2012. The patient is not experiencing any known symptoms. Additional information has been requested.

VAERS ID:488468 (history)  Vaccinated:2013-03-28
Age:16.0  Onset:2013-04-01, Days after vaccination: 4
Gender:Female  Submitted:2013-04-03, Days after onset: 2
Location:Texas  Entered:2013-04-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL 500 mg tabs PRN x fever;Pain
Current Illness: Cough (dry)
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0142741SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site cellulitis, Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever, headache started on 4/1/13 at nite. Swelling - erythema to inj site. (L) upper arm. Cellulitis 3 cm diameter upper (L) arm.

VAERS ID:488546 (history)  Vaccinated:2012-12-28
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-04
Location:North Carolina  Entered:2013-04-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Antimicrobial (unspecified); Vitamins (unspecified)
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1304USA001695
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This spontaneous prospective pregnancy report was received from a Nurse Practitioner refers to a approximately 16 year old female patient. No medical history was reported. On 08-AUG-2011, the patient received dose 1 GARDASIL (lot# 1511Z, expiry: 26-APR-2013) 0.5 ml intramuscularly and dose 2 of GARDASIL(lot# 1561AA, expiry: August 2014) 0.5 ml intramuscularly on 20-APR-2012. On 28-DEC-2012, the patient was vaccinated with dose 3 GARDASIL(Lot #, expiry: March 2015) 0.5 ml, intramuscularly. Concomitant therapies included prenatal vitamins (unspecified) and unspecified antibiotics (ANTIMICROBIAL (UNSPECIFIED)) prescribed for the patient 2 weeks ago. The patient became pregnant with LMP of 28-SEP-2012 and EDD of 05-JUL-2013. The pregnancy outcome was outcome pending. The Nurse Practitioner reported that the pregnant patient received GARDASIL. Patient sought medical attention(office visit). Additional information has been requested.

VAERS ID:488588 (history)  Vaccinated:2013-04-04
Age:16.0  Onset:2013-04-04, Days after vaccination: 0
Gender:Male  Submitted:2013-04-04, Days after onset: 0
Location:D.C.  Entered:2013-04-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0162380IMLA
Administered by: Public     Purchased by: Public
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Generalized convulsions for one minute after administration of HPV (GARDASIL).

VAERS ID:488564 (history)  Vaccinated:2013-03-27
Age:16.0  Onset:2013-03-27, Days after vaccination: 0
Gender:Male  Submitted:2013-04-05, Days after onset: 9
Location:Connecticut  Entered:2013-04-05
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: Drug hypersensitivity
Preexisting Conditions: KEFLEX, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': waes1304USA000633
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0106491IMUN
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia, Paraesthesia oral, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This spontaneous report as received from an office manager (healthcare worker) refers to a 12 year old male patient with allergic to KEFLIX and no pertinent medical history. On 05-AUG-2009 the patient was vaccinated with the first 0.5 ml dose of GARDASIL (lot # not reported) intramuscularly. On 27-MAR-2013 the patient was vaccinated with the second 0.5 ml dose of GARDASIL (lot # H010649, EXP date 20-FEB-2015) intramuscularly. There was no concomitant therapy. On 05-AUG-2009 the patient experienced fainted after administration of his first dose of GARDASIL. The patient recovered without requiring medical treatment on an unspecified day. On later of 27-MAR-2013 the patient felt tingling in his arms, legs and tongue and he fainted. He was evaluated in an emergency room and was treated with prednisone and BENADRYL. The patient was seen in the office on 28-MAR-2013 and was found to be fully recovered. Additional information has been requested.

VAERS ID:488862 (history)  Vaccinated:0000-00-00
Age:16.0  Onset:2012-01-01
Gender:Female  Submitted:2013-04-09, Days after onset: 463
Location:California  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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1304USA002564
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1277Y0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Dizziness, Headache, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: This spontaneous report as received from a healthcare worker refers to a 16 year old female patient with none medical history and none drug allergies. On 24-JAN-2012 the patient was vaccinated with GARDASIL (Lot# 1277Y and exp date 29-JUN-2012) 0.5 ml, intramuscular, once. No other co-suspects were reported. No concomitant therapy was reported. The healthcare worker reported that the patient fainted at home after receiving the first dose of GARDASIL, approximately in January 2012. The patient also developed headaches and dizziness few days after vaccination, so the patient could not go to school for 2-3 days. Treatment was not given. Lab tests were not performed. The outcome of the patient fainted at home after receiving the first dose of GARDASIL, the patient also developed headaches and dizziness a few days after the vaccination and the patient also developed headaches and dizziness a few days after the vaccination was reported as recovered/resolved. Additional information is not expected.

VAERS ID:488920 (history)  Vaccinated:2013-03-25
Age:16.0  Onset:2013-03-25, Days after vaccination: 0
Gender:Male  Submitted:2013-04-10, Days after onset: 16
Location:Ohio  Entered:2013-04-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: (R) shoulder pain - suspect rotator cuff tear
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0129730IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0136400SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Musculoskeletal pain, Rotator cuff syndrome
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Patient reports (R) shoulder pain starting on same day as vaccines given. Dr examined - stated not related to vaccines. Refer to ortho for Rotator cuff evaluation.

VAERS ID:489073 (history)  Vaccinated:2013-04-11
Age:16.0  Onset:2013-04-11, Days after vaccination: 0
Gender:Female  Submitted:2013-04-11, Days after onset: 0
Location:Arizona  Entered:2013-04-11
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: PCN allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200021IMLA
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: Syncopal event x approximately 1 minute.

VAERS ID:489146 (history)  Vaccinated:2013-01-10
Age:16.0  Onset:2013-01-10, Days after vaccination: 0
Gender:Female  Submitted:2013-04-12, Days after onset: 91
Location:New Jersey  Entered:2013-04-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No prior adverse events prior to this
Current Illness: None
Preexisting Conditions: Allergic to penicillin
Diagnostic Lab Data: MRI, Arthrogram, Nerve testing EMG
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH721AD   
Administered by: Unknown     Purchased by: Private
Symptoms: Arthrogram, Electromyogram, Mobility decreased, Nerve conduction studies, Neuralgic amyotrophy, Nuclear magnetic resonance imaging
SMQs:, Parkinson-like events (broad)
Write-up: Parsonage Turner syndrome.... Limited movement of right arm.. Currently undergoing rehabilitation for the last month.

VAERS ID:489229 (history)  Vaccinated:2013-03-04
Age:16.0  Onset:2013-03-19, Days after vaccination: 15
Gender:Female  Submitted:2013-03-27, Days after onset: 8
Location:Rhode Island  Entered:2013-04-15, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Check with Dr to see what tests he performed
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4020AA1UNLA
Administered by: Other     Purchased by: Other
Symptoms: Paraesthesia, Vaccination complication
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: No initial reaction --$g 2 weeks after vaccination (3/14/13). Patient had bilateral tingling in hands and feet. Patient wast treated by neurologist, who ruled out Guillain Barre Syndrome but attributed to vaccination.

VAERS ID:489266 (history)  Vaccinated:2013-04-04
Age:16.0  Onset:2013-04-05, Days after vaccination: 1
Gender:Female  Submitted:2013-04-15, Days after onset: 10
Location:Texas  Entered:2013-04-15
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: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4418AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Oedema peripheral, Pruritus, Rash, Rash generalised
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Rash all over body and face starting on Friday, April 5th. Swollen hands, arms and feet. Itchy and burning. Took Benadryl.

VAERS ID:489350 (history)  Vaccinated:2013-04-16
Age:16.0  Onset:2013-04-16, Days after vaccination: 0
Gender:Male  Submitted:2013-04-16, Days after onset: 0
Location:Florida  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:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Blood sugar of 75 taken at 1:25 PM
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AL21560IN 
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200020IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4412BA1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Blood glucose decreased, Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Five minutes after recieving Gardasil, Menactra and Flumist, patient started becoming diaphoretic and very light headed. Patient moved to shot area given 15lt of O2 and evaluated by doctor and given apple juice due to not eating all day.

VAERS ID:489574 (history)  Vaccinated:2013-04-18
Age:16.0  Onset:2013-04-18, Days after vaccination: 0
Gender:Female  Submitted:2013-04-18, Days after onset: 0
Location:Colorado  Entered:2013-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: In last 24 hrs, received Milk of Mag, Docusate, Ibuprofen, Percocet, Ampicillin & Gentamicin
Current Illness: None
Preexisting Conditions: Postpartum; allergy to codeine
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4385AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Eye pruritus, Injection site rash, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash/hives noted to left upper arm and patient c/o her eyes feeling itchy. Denies shortness of breath. Given oral Benadryl.

VAERS ID:489599 (history)  Vaccinated:2013-04-08
Age:16.0  Onset:2013-04-10, Days after vaccination: 2
Gender:Female  Submitted:2013-04-18, Days after onset: 8
Location:California  Entered:2013-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110521UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Localised oedema, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 4/10/13 ER notes 8 cm to 10 cm x 8 cm warm to touch and edematous. No signs of abscess and/or cellulitis. Was given BENADRYL 50mg p.o. helped somewhat of the itching, discharge with BENADRYL prescription.

VAERS ID:489716 (history)  Vaccinated:2013-01-30
Age:16.0  Onset:2013-02-01, Days after vaccination: 2
Gender:Female  Submitted:2013-04-22, Days after onset: 79
Location:Unknown  Entered:2013-04-22
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': WAES1304USA007936
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0131AE0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Rash erythematous, Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a nurse practitioner refers to a 16 year old female patient. The patient had no relevant medical history or drug allergy On 30-JAN-2013 the patient was vaccinated with first dose of GARDASIL (lot # 672834/0131AE, expiry date 26-OCT-2014) intramuscularly. No concomitant therapy reported. On 01-FEB-2013, 2 days after the vaccination, the patient developed red itchy rash over her whole body (head to toe). The patient contacted office for medical attention. She received over the counter antihistamines (manufacturer unspecified) as treatment. No lab tests were performed. On 02-FEB-2013, about 24 hours after starting, the patient recovered from the event. The reporter did not assess causality of the event. Additional information has been requested.

VAERS ID:489807 (history)  Vaccinated:2013-04-09
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-04-22
Location:North Carolina  Entered:2013-04-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline
Current Illness:
Preexisting Conditions: Acne
Diagnostic Lab Data:
CDC 'Split Type': CVAE0192013
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD300032B PO 
Administered by: Other     Purchased by: Other
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Irritated throat after 1st pill. Suspended because also taking doxycycline.

VAERS ID:489827 (history)  Vaccinated:2013-04-18
Age:16.0  Onset:2013-04-18, Days after vaccination: 0
Gender:Male  Submitted:2013-04-18, Days after onset: 0
Location:Wisconsin  Entered:2013-04-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Same as above~Vaccine not specified (no brand name)~UN~0.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: Previous adverse reactions to imms and blood draws
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H016238 IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURM11042 IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B074BA IMRA
Administered by: Private     Purchased by: Public
Symptoms: Asthenia, Blood pressure decreased, Cold sweat, Glassy eyes, Hyperhidrosis, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt. got clammy and instantly started sweating. Blood drained from face and eyes glassed over. Pt. stated he was weak and got very quiet. BP dropped to 65/39.

VAERS ID:489862 (history)  Vaccinated:2013-04-12
Age:16.0  Onset:2013-04-20, Days after vaccination: 8
Gender:Male  Submitted:2013-04-23, Days after onset: 3
Location:Unknown  Entered:2013-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50608 IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM110821IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site mass, Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Developed a 2.5 inch lump on the left arm at the site of meningitis vaccine. Reported muscle twitches for the 2 days prior to the lump developing.

VAERS ID:489900 (history)  Vaccinated:2013-04-10
Age:16.0  Onset:2013-04-10, Days after vaccination: 0
Gender:Female  Submitted:2013-04-23, Days after onset: 13
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': WAES1304USA005371
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0306AA2IMAR
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 via a company representative referred to a 16 year old (age at the time of the report) female patient who on unknown date started therapy with GARDASIL (Lot # 0306AA, exp. 10-MAY-2013). On 06-MAR-2013 was vaccinated with dose No. 2 of GARDASIL and on 10-APR-2013 the patient was vaccinated with dose No. 3 of GARDASIL. No adverse effect was reported. Additional information has been requested.

VAERS ID:489982 (history)  Vaccinated:2013-04-19
Age:16.0  Onset:2013-04-19, Days after vaccination: 0
Gender:Female  Submitted:2013-04-24, Days after onset: 5
Location:Florida  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:
Current Illness: None
Preexisting Conditions: Allergic to pork, pineapple, fish and lobster
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC103AA2IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB646BA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4238AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3976AA0IMRA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3002630PO 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0603AE0SCLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH587AA0SCRA
Administered by: Public     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: The mother of the client called stating that the client broke out in hives after taking the first dose of the oral Typhoid vaccine.

VAERS ID:490159 (history)  Vaccinated:2013-04-25
Age:16.0  Onset:2013-04-25, Days after vaccination: 0
Gender:Female  Submitted:2013-04-25, Days after onset: 0
Location:Michigan  Entered:2013-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL
Current Illness: None
Preexisting Conditions: Allergies: Sulfa; BACTRIM; CEFTIN; ADVIL
Diagnostic Lab Data: BP 110/60; Pulse regular
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB677CA1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4342AA1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Dizziness, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Felt faint/light-headed, diaphoretic. Pt was placed prone on exam table, pulse and BP assessed WNL - Given water to drink per pt. request. Allowed to rest til he felt better.

VAERS ID:490186 (history)  Vaccinated:2013-03-01
Age:16.0  Onset:2013-03-04, Days after vaccination: 3
Gender:Male  Submitted:2013-04-26, Days after onset: 52
Location:Tennessee  Entered:2013-04-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI, lumbar puncture
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.H0101450IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4397AC0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Headache, Lumbar puncture normal, Nuclear magnetic resonance imaging normal, Ophthalmological examination normal
SMQs:
Write-up: Persistent severe headache, started about 4 days after injection and have continued. He has had a negative LP and MRI. Normal ophthalmologic exam.

VAERS ID:490190 (history)  Vaccinated:2013-04-24
Age:16.0  Onset:2013-04-24, Days after vaccination: 0
Gender:Female  Submitted:2013-04-27, Days after onset: 3
Location:Florida  Entered:2013-04-27
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
TDAP: TDAP (ADACEL)SANOFI PASTEURC4344AB IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Electrocardiogram, Injection site erythema, Injection site pruritus, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: The patient was given Tdap vaccination in left deltoid per clinic guidelines. About one minute after the injection the pt states that her arm was itchy. The ARNP imediately retrieved the Epipen and called 911. The pt was place prone on the examination table and feet elevated. Her VS were obtained (HR 65, BP 110/65, SpO2 98%) Pt left arm was red and itchy around injection site. She denied SOB or any difficulty breathing. She denied any chest tightness, difficulty swallowing, itchy chest, nausea, or back pain. Approx. 2-3 minutes after 911 was called the EMS providers arrived. ARNP stayed with pt. After about 15 minutes with EMS. EMS worked on pt in clinic for approx 15-25 minutes. They placed an IV and gave her IV Benadryl. They did an EKG and transported her via stretcher from clinic to ambulance to go to the hospital. PTs father was present for entire encounter. Pt has NKA and has never had a vaccine reaction before.

VAERS ID:490335 (history)  Vaccinated:2013-04-27
Age:16.0  Onset:2013-04-27, Days after vaccination: 0
Gender:Female  Submitted:2013-04-29, Days after onset: 2
Location:Pennsylvania  Entered:2013-04-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: "Fainted"~HPV (no brand name)~2~0.00~Patient
Other Medications: Albuterol MDI
Current Illness:
Preexisting Conditions: No allergies known; only med condition exercise-induced bronchospasm
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB677CA IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4397AC IMRA
Administered by: Private     Purchased by: Public
Symptoms: Breath holding, Loss of consciousness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Within 60 sec of receiving vaccines, pt held breath and lost consciousness for approximately 30 seconds, after which she vomited, HR was in 40''s and returned to baseline of approximately 70 BPM over next 2-3 min. Within 15 min, pt denied any ongoing symptoms.

VAERS ID:490672 (history)  Vaccinated:2013-05-02
Age:16.0  Onset:2013-05-02, Days after vaccination: 0
Gender:Female  Submitted:2013-05-02, Days after onset: 0
Location:Colorado  Entered:2013-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro 10mg; Abilify 5mg
Current Illness: None
Preexisting Conditions: Patient has an irritant cough s/p 4 day intubation secondary to intentional overdose of amitriptyline on 04/08/2013.
Diagnostic Lab Data: Normal head CT. BP = 141/89 [elevated. BP=116/68 at check up, today] Normal CBC and electrolytes.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0126430IMRA
Administered by: Unknown     Purchased by: Public
Symptoms: Blood electrolytes normal, Blood pressure increased, Computerised tomogram head normal, Dizziness, Feeling abnormal, Full blood count normal, Headache, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Patient became dizzy, spacey and tremulous and c/o stabbing headache.

VAERS ID:490739 (history)  Vaccinated:2007-10-08
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-02
Location:Unknown  Entered:2013-05-02
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': WAES1304USA016279
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incomplete course of vaccination, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a female patient of unknown age. On 06-AUG-2007, the patient received the first dose of GARDASIL (lot number, dose and route not reported). On 08-OCT-2007 the patient was vaccinated with the second dose of GARDASIL (lot number, route and dose not reported). It was reported that the patient was concerned because the she wasn''t sure if she had the third dose of GARDASIL or not. No adverse effect reported. Additional information has been requested.

VAERS ID:490836 (history)  Vaccinated:2013-04-16
Age:16.0  Onset:2013-05-03, Days after vaccination: 17
Gender:Male  Submitted:2013-05-06, Days after onset: 3
Location:Indiana  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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC203AB0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4342AA0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B074AA0UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0136390SCRA
Administered by: Public     Purchased by: Public
Symptoms: Varicella
SMQs:
Write-up: Chicken pox diagnosed by ER community hospital on 5/3/13.

VAERS ID:490868 (history)  Vaccinated:2013-04-18
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-06
Location:Maryland  Entered:2013-05-06
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': WAES1305USA001370
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216080IMLA
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Disorientation, Lethargy
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: This spontaneous report was received from a father refers to his 16 year old son (who is the patient). The patient had no pertinent medical history, drug reactions or allergies. Approximately on an unknown date in April 2013, the patient was vaccinated with a dose of GARDASIL, (lot number, expiry date and route was not reported). Concomitant medications were not reported. On an unknown date, within a couple of days after the vaccination the patient started feeling extremely disoriented and lethargic to the point he had missed a week of school. There was no laboratory test performed. The patient was prescribed a Z-PAK as a treatment at the doctors office. The outcome of the event was reported as not recovered. The patient sought medical attention (doctor visit). Additional information has been requested.

VAERS ID:490878 (history)  Vaccinated:2013-04-12
Age:16.0  Onset:2013-04-30, Days after vaccination: 18
Gender:Female  Submitted:2013-05-03, Days after onset: 3
Location:Massachusetts  Entered:2013-05-06, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H020020IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Sm red lump at injection site is resolving.

VAERS ID:491162 (history)  Vaccinated:2013-05-01
Age:16.0  Onset:2013-05-01, Days after vaccination: 0
Gender:Male  Submitted:2013-05-07, Days after onset: 6
Location:Pennsylvania  Entered:2013-05-07
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: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1305USA001407
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0146451IMAR
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: This spontaneous report was received from a physician via a company representative concerning a 16 year old male patient with no pertinent medical history and no drug reactions or allergies. On 01-MAY-2013, the patient was vaccinated with the second dose of GARDASIL (lot number and expiry date reported as H014645 and 27-MAR-2015 respectively, dose unspecified), intramuscularly in an unspecified arm. Concomitant therapy included MENACTRA (lot number, expiry date, dose and route unspecified) injected at the same office visit on 01-MAY-2013 with GARDASIL. On 01-MAY-2013, the patient experienced a seizure in the car, five minutes after leaving the office. It was reported by the mother of the patient, ten minutes after having left the office with her two sons. It was unspecified if the patient sought any medical attention. It was unspecified if the patient was treated or if any laboratory tests were performed. The mother of the patient was instructed by an unspecified healthcare worker at the physician office to go to the emergency room of an unspecified hospital. When the physician office later contacted the unspecified hospital to see if the patient had sought treatment, there was no record that the patient had been to the hospital. It was reported that approximately on an unknown date in May 2013, the seizure had ended (duration unspecified). Upon internal review, seizure was considered as medically significant. This is one of the two reports from the same source. Additional information has been requested.

VAERS ID:491220 (history)  Vaccinated:2013-05-06
Age:16.0  Onset:2013-05-07, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Wisconsin  Entered:2013-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 09/25/1997~Measles + Mumps + Rubella (no brand name)~1~1.30~Patient
Other Medications:
Current Illness:
Preexisting Conditions: MMR reaction - rash September 1997
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0420AE2UNRA
Administered by: Private     Purchased by: Private
Symptoms: Confusional state, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad)
Write-up: Marked myalgias lower extremities fatigue and mild confusion onset within 24 hours of #3 HPV. Improved on 5/8/2013. Used ibuprofen.

VAERS ID:491222 (history)  Vaccinated:0000-00-00
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-08
Location:Unknown  Entered:2013-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Blood glucose, 61mg/dL; Blood immunoglobulin G, negative; Blood pressure, 116/65; Body temperature, 98?F; Erythrocyte sedimentation rate, 16; Granulocyte percentage, 89%; Lactate, 1.5mmol/L; Lymphocyte percentage, 9%; Nuclear magnetic resonance ima, normal; Nuclear magnetic resonance ima, see text; Protein, 30mg/dL; Pulse rate, 68bpm; Respiratory rate, 14/min; Serum glucose, 91mg/dL; White blood cells, 6900
CDC 'Split Type': B0889513A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Bacterial test negative, Biopsy brain abnormal, Blindness, Blood glucose normal, Blood immunoglobulin G normal, Blood lactic acid normal, Blood product transfusion, Brain mass, CSF cell count normal, CSF protein normal, CSF test normal, CSF white blood cell count negative, Culture negative, Demyelination, Encephalomyelitis, Fundoscopy abnormal, Fungal test, Granulocyte percentage, Headache, Hemiparesis, Histology abnormal, Laboratory test abnormal, Lymphocyte percentage decreased, Mycobacterium test negative, Nuclear magnetic resonance imaging brain abnormal, Nuclear magnetic resonance imaging spinal normal, Optic atrophy, Optic disc disorder, Parasitic test, Protein total decreased, Pupillary reflex impaired, Red blood cell sedimentation rate, Sensory loss, Toxoplasma serology, Toxoplasma serology negative, Vasogenic cerebral oedema, Viral test negative, Visual acuity reduced, Visual acuity tests abnormal, Visual pathway disorder, White blood cell count normal
SMQs:, Haematopoietic leukopenia (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (narrow), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)
Write-up: This case was reported in a literature article and described the occurrence of bilateral vision loss in a 16-year-old female subject who was vaccinated with HPV vaccine (manufacturer unspecified). No family history of demyelinating disease, collagen-vascular disease or rheumatological disorders. On an unspecified date, the subject received 2nd dose of HPV vaccine (administration site and route unknown, batch number not provided). 8 days after vaccination with HPV vaccine, the subject experienced an acute onset of vision loss. Initially, the visual loss was noted in the right eye accompanied by a left side headache. These symptoms worsened over the next 24 hours. Her examination disclosed a visual acuity of only counting fingers bilaterally with mild left side weakness accompanied by sensory loss to pinprick in the left arm. This case was assessed as medically serious by GSK. There was a left afferent pupillary defect and normal fundoscopic examination. Her visual ability deteriorated further to inconsistently identifying light and movement from the left eye only. She complained of no other symptoms and denied antecedent trauma or prodromal illness. The magnetic resonance imaging brain showed swollen enhancement within the chiasm extending into both retrobulbar optic nerves and a right occipitoparietal lobe mass (later disclosed as tumefactive demyelination) with a large zone of surrounding vasogenic edema. Complete spine magnetic resonance imaging was normal. Biopsy of the hemispheric mass was performed and histology revealed demyelination. Subsequent cultures for aerobic and anaerobic bacteria, fungus, acid fast bacilli and examination for parasites were negative as were serum immunoglobulin G and immunoglobulin M titers for Toxoplasma gondii. The subject was treated with steroid and plasma. 3 months after the onset, the subject still had not regained any visual function, her weakness and sensory deficit recovered completely however. A repeat magnetic resonance imaging of brain revealed resolution of the hemispheric and chiasmal lesions. At 6 months, her fundoscopic examination disclosed bilateral optic disc pallor. A repeat magnetic resonance imaging at this time demonstrated no new lesions and continued resolution of the previously identified chiasmal enhancement and tumefactive lesion. Again complete spine magnetic resonance imaging was normal. Cerebrospinal fluid obtained 6 months after initial symptom onset was negative for malignancy. Additional studies revealed a clear and colorless fluid with 3 white blood cells and 0 red blood cells per microliter. At 18 months after the onset of her symptoms, her examination remained stable with no further neurological complaints, persistent profound visual impairment, inconsistently identifying light and movement from the left eye only. A magnetic resonance imaging of the brain was performed and was unchanged compared with the previous one done at 6 months. An acute demyelinating encephalomyelitis was likely to explain the multifocal deficits. There was no supportive clinical or laboratory evidence for systemic lupus erythematous, Sjogren syndrome or Lyme infection. Other viral studies were unrevealing or negative. The radiological resolution of the chiasmal lesion preceded the occipito-parietal lesion by months. This dissociation of the clinico-radiographic evolution might suggest a clinical feature in favor of acute demyelinating encephalomyelitis. According the authors, it was possible that human papilloma virus was the precipitant for the demyelinating event in the subject. It was tempting to speculate whether there might be a specific immune mechanism initiated with human papilloma virus not yet identified which resulted in not only acute demyelinating encephalomyelitis but also in an unusual clinical course that resulted in persistent visual loss.

VAERS ID:491658 (history)  Vaccinated:2013-05-13
Age:16.0  Onset:2013-05-14, Days after vaccination: 1
Gender:Female  Submitted:2013-05-14, Days after onset: 0
Location:Louisiana  Entered:2013-05-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukast; albuterol; prednisone; fludrocortisone
Current Illness: None
Preexisting Conditions: Congenital adrenal hyperplasia; GU abnormality; asthma
Diagnostic Lab Data: CBC, electrolytes, head CT, EEG pending
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0129731IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4413AA0SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU44313A0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Blood electrolytes normal, Computerised tomogram normal, Full blood count normal, Grand mal convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 12 hrs after Tdap, MCV4, and HPV #2 were given, patient had a generalized tonic clonic seizure at home, lasting less than 5 minutes. Pt. evaluated in ER and found no abnormal labs, normal CT scan of head.

VAERS ID:491862 (history)  Vaccinated:2013-05-13
Age:16.0  Onset:2013-05-13, Days after vaccination: 0
Gender:Female  Submitted:2013-05-16, Days after onset: 3
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': WAES1305USA008505
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200021IMLA
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Overdose
SMQs:, Drug abuse and dependence (broad)
Write-up: This spontaneous report as received from a healthcare worker refers to a 16 year old patient (gender unknown). On 13-MAY-2013 the patient was vaccinated with two doses of GARDASIL (lot # H020002) (dose not reported, intramuscular route in the left arm). Concomitant therapy was not reported. The patient had not demonstrated or reported any adverse effects. Additional information has been requested.

VAERS ID:491942 (history)  Vaccinated:2013-04-01
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-16
Location:California  Entered:2013-05-16
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': WAES1305USA004283
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes virus infection, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a physician refers to a 16 year old male patient. Approximately in April 2013 the patient was vaccinated with GARDASIL (Lot # not reported) (dose, route not reported). No other co suspects were reported. No concomitant therapy was reported. The physician reported that the patient developed a per-oral rash within 1 week of administration of GARDASIL on an unspecified date 1 month ago. The rash then spread to the patient''s neck and hands. The patient was initially diagnosed with herpes by unspecified pediatrician and treated with VALTREX. The symptoms did not improve and the patient was referred for evaluation and has been prescribed an unspecified corticosteroid medication. Lab diagnostics were not performed. The outcome of the patient was initially diagnosed with herpes was reported as not recovered/not resolved. Additional information has been requested.

VAERS ID:491894 (history)  Vaccinated:2013-05-09
Age:16.0  Onset:2013-05-09, Days after vaccination: 0
Gender:Male  Submitted:2013-05-17, Days after onset: 8
Location:Michigan  Entered:2013-05-17
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Hx ITP (idiopathic thrombocytopenic purpura 2003, leukopenia 2009, seen by hematologist 2009, and cleared. NKDA
Diagnostic Lab Data: Labs for antibodies pending.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0206920IMRA
Administered by: Private     Purchased by: Private
Symptoms: Antibody test, Contusion, Full blood count abnormal, Immunoglobulin therapy, Platelet count decreased, Rash
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Hypersensitivity (narrow)
Write-up: Pt states he started having small purple spots that evening, that progress the next day, to large bruises, Parents called office 18:00 05/10/13, Pt was seen at a local urgent care and started on po steroids, pt followed up with PCP 05/14/13, CBC shoed platellet count of 2,000, pt was seen in local ER, repeat plt count was less than 5,000. Pt was admitted to the hospital and is currently under the care of a hematologist, he recieved IVIG and po steroids to this point. Pt is currently still hospitalized.

VAERS ID:492045 (history)  Vaccinated:2013-05-16
Age:16.0  Onset:2013-05-17, Days after vaccination: 1
Gender:Female  Submitted:2013-05-20, Days after onset: 3
Location:Indiana  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: None reported
Preexisting Conditions: Cerebral Palsy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30003260PO 
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH596AA0SCRA
Administered by: Public     Purchased by: Private
Symptoms: Feeling abnormal, Headache
SMQs:, Dementia (broad)
Write-up: Headache, puny feeling that comes and goes.

VAERS ID:492289 (history)  Vaccinated:2013-05-16
Age:16.0  Onset:2013-05-22, Days after vaccination: 6
Gender:Female  Submitted:2013-05-22, Days after onset: 0
Location:Florida  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:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH597AA1SCLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: CLIENTS MOTHER CALLED THE HEALTH DEPT CONCERNED ABOUT SWELLING AND REDNESS TO THE LEFT ARM AT THE INJECTION SITE.

VAERS ID:492422 (history)  Vaccinated:2013-05-20
Age:16.0  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? 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': WAES1305USA012683
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1397AA2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a registered nurse refers to a 16 year old female patient. The patient had no medical history, no concomitant medication, and no drug allergy. On 20-NOV-2013, the patient was vaccinated with the first dose of GARDASIL 0.5 ml intramuscularly for vaccination. On 20-MAY-2013 the patient was vaccinated with an expired third dose of GARDASIL lot # 668261/1397AA, exp. date 09-APR-2013, 0.5 ml, intramuscular for vaccination. The patient experienced more burning than usual during the administration on 20-MAY-2013. The nurse reported that the "burning" quickly resolved and the patient "feels better now". Outcome of event was reported as recovered on 20-MAY-2013. No treatment was given. No lab test was done. The patient sought medical attention because the patient was at physician''s office during administration. Additional information is not administration.

VAERS ID:492455 (history)  Vaccinated:2012-11-23
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-23
Location:Florida  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': WAES1305USA011678
Vaccination
Manufacturer
Lot
Dose
Route
Site
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 form 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). The medical assistant reported that the vaccine was 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. Follow up information has been received from the medical assistant regarding a 16 years old, male patient with no pertinent medical history reported. On 23-NOV-2012 the patient was vaccinated with GARDASIL (lot number and expiration date not reported) (intramuscular on the left ar, 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:492510 (history)  Vaccinated:2013-05-13
Age:16.0  Onset:2013-05-13, Days after vaccination: 0
Gender:Female  Submitted:2013-05-20, Days after onset: 7
Location:Virginia  Entered:2013-05-24, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acupuncture after immunization
Current Illness: None
Preexisting Conditions: Migraines; Thoracic Outlet Syndrome
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB703BA1IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B107AA1IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH597AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Acupuncture, Asthenia, Blood test, Dizziness, Fatigue, Nausea, Syncope, Vaccination complication
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt had acupuncture after immunization. Patient developed dizziness, nausea, fatigue, weakness that was prolonged over 4 hrs - enough for patient to go to ER. At ER blood drawn patient fainted. Got IV fluids and ZOFRAN. Dxed by ER at "vaccine reaction".

VAERS ID:492539 (history)  Vaccinated:2012-11-15
Age:16.0  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': WAES1305USA011685
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
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 (Fahrenheit) 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 16 years old, male 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 left arm, dose not reported). Concomitant medications included Hepatitis A Vaccine (manufacturer unknown) (intramuscular in 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. This is an amended report the adverse event codification was updated. Additional information is not expected.

VAERS ID:492562 (history)  Vaccinated:2013-03-18
Age:16.0  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': WAES1305USA011688
Vaccination
Manufacturer
Lot
Dose
Route
Site
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 certified 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. Certified Medical assistant stated other 104 children received GARDASIL and other 18 children received LIQUID PEDVAXHIB. Follow up information has been received from the certified medical assistant regarding a 15 years old, male patient with no pertinent medical history reported. On 27-AUG-2012 the patient was vaccinated with a dose of 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). On 18-MAR-2013 the patient received another dose of GARDASIL (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:492608 (history)  Vaccinated:2013-05-10
Age:16.0  Onset:2013-05-10, Days after vaccination: 0
Gender:Unknown  Submitted:2013-05-27, Days after onset: 17
Location:Virginia  Entered:2013-05-27
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': WAES1305USA007601
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0567AA1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a Medical Assistant refers to a 16 year old patient. On 10-MAY-2013 the patient was vaccinated with an expired dose of M-M-R II (lot # 670618/0567AA, exp date 15-APR-2013) (dose and route was not reported), as the second dose of M-M-R II (date of first dose of M-M-R II was unspecified). No adverse event reported. Additional information has been requested.

VAERS ID:492616 (history)  Vaccinated:2013-05-28
Age:16.0  Onset:2013-05-28, Days after vaccination: 0
Gender:Male  Submitted:2013-05-28, Days after onset: 0
Location:Pennsylvania  Entered:2013-05-28
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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0216080IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4454AC1IMRA
Administered by: Private     Purchased by: Private
Symptoms: 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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Received MENACTRA and GARDASIL. 5 min. later passed out for "10 seconds" per dad.

VAERS ID:492617 (history)  Vaccinated:2013-05-23
Age:16.0  Onset:2013-05-23, Days after vaccination: 0
Gender:Female  Submitted:2013-05-24, Days after onset: 1
Location:Texas  Entered:2013-05-28, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blindness transient, Cold sweat, Dizziness, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Cold/clammy to touch, dizziness, fatigue, difficulty breathing, temporary vision loss. Treatment: Epipen done to right thigh w/in 2 minutes of patient symptoms.

VAERS ID:492893 (history)  Vaccinated:2012-12-31
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-28
Location:Florida  Entered:2013-05-28
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': WAES1305USA011699
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2IMRA
Administered by: Private     Purchased by: Public
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified 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). The certified medical assistant reported that the vaccine was exposed to temperature of 26 F (Fahrenheit) for a total of 135 hours. No adverse effects reports. Follow-up received. Certified medical assistant stated other 104 children received GARDASIL. Follow up information has been received from the certified medical assistant regarding a 16 years old, male patient with no pertinent medical history reported. On 29-AUG-2012 the patient was vaccinated with the first dose of GARDASIL (lot number and expiration date not reported) (intramuscular on the right arm, dose not reported). On 14-NOV-2012 the patient received the second dose of GARDASIL (lot number and expiration date not reported) (intramuscular on the left arm, dose not reported). On 31-DEC-2012 the patient received the third dose of GARDASIL (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:493020 (history)  Vaccinated:2013-05-23
Age:16.0  Onset:2013-05-24, Days after vaccination: 1
Gender:Male  Submitted:2013-05-28, Days after onset: 4
Location:Kansas  Entered:2013-05-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Varicella: medical confirmation of disease
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213460UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM120040UNRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site swelling, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Large, red area on upper (Rt) arm, size of 1 1/2 softball. Area edematous and raised. Red rash on torso. (Rt) arm warm to touch. Took Ibuprofen and BENADRYL. Redness almost gone by 5/26/13 in morning.

VAERS ID:493049 (history)  Vaccinated:2013-02-27
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-28
Location:Florida  Entered:2013-05-28
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': WAES1305USA011700
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified 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). The certified medical assistant reported that the vaccine was exposed to temperature of 26 F (Fahrenheit) for a total of 135 hours. No adverse effects reported. Follow-up received. Certified medical assistant stated that other 104 children received GARDASIL. Follow up information has been received from the certified medical assistant regarding a 16 years old, male patient with no pertinent medical history reported. On 27-FEB-2013 the patient was vaccinated with the first dose of GARDASIL (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:492792 (history)  Vaccinated:2013-05-28
Age:16.0  Onset:2013-05-30, Days after vaccination: 2
Gender:Male  Submitted:2013-05-30, Days after onset: 0
Location:North Dakota  Entered:2013-05-30
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
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM12093 IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0119621SCLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Child woke up this morning with red swollen area the size of a baseball to injection site.

VAERS ID:492942 (history)  Vaccinated:2012-11-06
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-05-30
Location:Florida  Entered:2013-05-30
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': WAES1305USA011731
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMLA
Administered by: Private     Purchased by: Public
Symptoms: Incorrect dose administered, Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified 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). The certified medical assistant reported that the vaccine was exposed to temperature 26 F (Fahrenheit) for a total of 135 hours. No adverse effect reported. Follow-up received. Certified Medical assistant stated that other 104 children received GARDASIL. Follow-up information has been received from the medical assistant regarding a 16 years old, male patient with no pertinent medical history reported. On 03-SEP-2012 the patient was vaccinated with the first dose of GARDASIL (lot number and expiration date not reported) (intramuscular on the right arm, dose not reported). Concomitant medication MENACTRA administered on 03-SEP-2012 (intramuscular in the right arm, dose not reported). On 06-NOV-2012 the patient received the second dose of GARDASIL (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:492940 (history)  Vaccinated:2013-02-21
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-30
Location:Florida  Entered:2013-05-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1305USA011729
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  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 certified 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 PEDVAXHIB (Lot number, expiry date, route and dose were not reported. Certified 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. Certified Medical assistant stated other 104 children received GARDASIL and other 18 children received PEDVAXHIB. Follow up information has been received from the certified medical assistant regarding a 16 years old, female patient with no pertinent medical history reported. On 21-FEB-2013 the patient was vaccinated with a dose of GARDASIL (lot number and expiration date not reported) (intramuscular on the arm, dose not reported). Concomitant therapies included MENACTRA (lot number and expiration date not reported) (intramuscular on the right arm, dose not reported) and 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.

VAERS ID:493070 (history)  Vaccinated:2013-06-01
Age:16.0  Onset:2013-06-01, Days after vaccination: 0
Gender:Male  Submitted:2013-06-03, Days after onset: 2
Location:New Jersey  Entered:2013-06-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Dorax, EpiDuo and Vitamin A
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0213461IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Skin swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Severe groin pruritus and swelling of the foreskin.

VAERS ID:493358 (history)  Vaccinated:2013-06-03
Age:16.0  Onset:2013-06-03, Days after vaccination: 0
Gender:Male  Submitted:2013-06-04, Days after onset: 1
Location:New Jersey  Entered:2013-06-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Over the counter allergies medicine
Current Illness: Stuffy nose; Sneezing
Preexisting Conditions: H/O of ADHD off meds for weeks
Diagnostic Lab Data: Negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200021IMRA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Dizziness, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Dizziness - weakness - numbness 5th digit at home for about 10 - 15 mins. Patient treated with Epinephrine SQ.

VAERS ID:493361 (history)  Vaccinated:2013-05-30
Age:16.0  Onset:2013-05-30, Days after vaccination: 0
Gender:Female  Submitted:2013-06-04, Days after onset: 5
Location:Idaho  Entered:2013-06-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Started oral BCP; SPRINTEC
Current Illness: Mild headache
Preexisting Conditions: None
Diagnostic Lab Data: CT scan of brain - negative
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0146450IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Arthralgia, Computerised tomogram head normal, Condition aggravated, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Worsening of a current headache, fever, vomiting, joint pain - ER visit 6/1/13 at midnight.

VAERS ID:493742 (history)  Vaccinated:0000-00-00
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2013-06-07
Location:Unknown  Entered:2013-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Viral titre: "0 titres"; Hepatitis B antibody, Negative
CDC 'Split Type': WAES1306USA003278
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis B antibody negative
SMQs:
Write-up: This spontaneous report as received from a registered nurse via a company representative concerning a female patient two patients were also reported of unknown age who on an unknown date started therapy with [therapy unspecified] (THERAPY UNSPECIFIED) (dose, duration and indication were not reported). The registered nurse stated that on an unknown date the patient had 0 titres. It was reported that was unsure what products or vaccines the patients had received prior to the low titres count. Action taken with suspect therapy was unknown. The outcome of patient had 0 titres was unknown. Follow-up received. This report concerns a high school girl approximately 16-17 years of age. She received a puncture wound in school. She was vaccinated with a dose of Hepatitis B Vaccine (Recombinant) (manufacturer unknown). Patient had no antibodies to Hepatitis B. This patient was being revaccinated with the Hepatitis B Vaccine (Recombinant) (manufacturer unknown). No patient names were provided. The outcome of puncture wound was unknown. This is one of the several reports from the same source. Additional information has been requested.

VAERS ID:493687 (history)  Vaccinated:2013-06-05
Age:16.0  Onset:2013-06-05, Days after vaccination: 0
Gender:Unknown  Submitted:2013-06-07, Days after onset: 2
Location:Unknown  Entered:2013-06-10, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1306USA002816
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 16 year old patient who on 05-JUN-2013, was vaccinated subcutaneously with the first dose of MMR II (dose and lot number not reported). No adverse effects were reported. Additional information has been requested.

VAERS ID:493746 (history)  Vaccinated:2013-05-13
Age:16.0  Onset:2013-05-14, Days after vaccination: 1
Gender:Male  Submitted:2013-05-24, Days after onset: 10
Location:Colorado  Entered:2013-06-10, Days after submission: 17
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: Congenital pulmonary valve anomaly unspec.; Cerebral palsy; Scoliosis NEC; Develop
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B154BA1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Cardiac murmur, Injection site reaction
SMQs:
Write-up: Here for injection site reaction to DTAP shot given Tues. He denies any fever, GI or respiratory sx. He was noted to have murmur on exam and is followed by cardiologist. He is with GM at encounter and few details are known about this.

VAERS ID:493765 (history)  Vaccinated:2013-05-17
Age:16.0  Onset:2013-06-10, Days after vaccination: 24
Gender:Male  Submitted:2013-06-10, Days after onset: 0
Location:New Jersey  Entered:2013-06-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Focalin XR
Current Illness: No
Preexisting Conditions: Ex-34 week premature infant, viral sepsis as neonate
Diagnostic Lab Data: Unknown, patient presented to another facility
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV1: JAPANESE ENCEPHALITIS (IXIARO)INTERCELL AGJEV11201P0IMAR
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURH14820IMAR
Administered by: Private     Purchased by: Private
Symptoms: Disorientation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Disoriented, began on waking the morning of June 10, 2013. No fever.

VAERS ID:494026 (history)  Vaccinated:2013-06-07
Age:16.0  Onset:2013-06-08, Days after vaccination: 1
Gender:Female  Submitted:2013-06-12, Days after onset: 4
Location:Washington  Entered:2013-06-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000420 PO 
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH598AA SCLA
Administered by: Other     Purchased by: Other
Symptoms: Ear pain, Influenza like illness, Lymphadenopathy, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Flu-like symptoms, fever, ear ache, sore throat, swollen glands....still persisting through to 06/12/2013 patients physician is monitoring.

VAERS ID:494184 (history)  Vaccinated:2013-06-12
Age:16.0  Onset:2013-06-12, Days after vaccination: 0
Gender:Male  Submitted:2013-06-13, Days after onset: 1
Location:Maine  Entered:2013-06-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200021IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4290AA1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 5 mins after injection pt became pale sweating did not pass out cool cloth to head elevated legs juice and crackers. Better after 15 mins.

VAERS ID:494227 (history)  Vaccinated:2013-06-12
Age:16.0  Onset:2013-06-12, Days after vaccination: 0
Gender:Female  Submitted:2013-06-14, Days after onset: 2
Location:Iowa  Entered:2013-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Exercise-induced asthma; seasonal outdoor allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Headache, nausea, soreness at injection site, dizziness.

VAERS ID:494306 (history)  Vaccinated:2008-09-01
Age:16.0  Onset:0000-00-00
Gender:Male  Submitted:2013-06-17
Location:Maryland  Entered:2013-06-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Idiopathic thrombocytopenic purpura, Immunoglobulin therapy, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow)
Write-up: Developed ITP, platelets dropped to as low as 5,000. Have had to receive IVIG. No known cure.

VAERS ID:494461 (history)  Vaccinated:2013-06-18
Age:16.0  Onset:2013-06-18, Days after vaccination: 0
Gender:Female  Submitted:2013-06-18, Days after onset: 0
Location:Pennsylvania  Entered:2013-06-18
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: Tuberculin Skin Test- PPD Sanofi C4178AA- Exp.4/16/2015
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH719AB0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Loss of consciousness, Syncope, Tuberculin test
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Initially received Influenza Vaccine, then went and had a PPD administered. Approximately 5 minutes later she became faint and passed out. Administered Ammonia and woke up immediately. Able to drink some juice and ate crackers.

VAERS ID:494472 (history)  Vaccinated:2013-06-04
Age:16.0  Onset:2013-06-17, Days after vaccination: 13
Gender:Female  Submitted:2013-06-19, Days after onset: 2
Location:Missouri  Entered:2013-06-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amoxicillin 500mg bid
Current Illness: None
Preexisting Conditions: Acne
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site nodule, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling, hard knot at injection site.

VAERS ID:494844 (history)  Vaccinated:2013-06-21
Age:16.0  Onset:2013-06-21, Days after vaccination: 0
Gender:Female  Submitted:2013-06-21, Days after onset: 0
Location:Alabama  Entered:2013-06-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Child had had recent episode of infected bug bites and had been on antibiotics
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B090BA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Faint pink rash to inner arms and thighs, itches.

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