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Case Details (Sorted by Age)

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VAERS ID:258103 (history)  Vaccinated:2004-06-09
Age:21.0  Onset:2004-07-01, Days after vaccination: 22
Gender:Unknown  Submitted:2006-06-07, Days after onset: 706
Location:Unknown  Entered:2006-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: hx LBP, seasonal allergies
Diagnostic Lab Data: routine lab/xray per pcp with normal results sees a chiropracter, using naprosyn
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0SC 
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Arthralgia, Back pain, Dizziness, Fatigue, Headache, Injury, Myalgia, Respiratory disorder, Shoulder pain, Sleep disorder, Visual acuity reduced
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Multiple myalgia/arthralgia to back, joint, shoulders, lower back pain, visual problems, dizziness, sleep disorder, knee injury, respiratory problems, headaches, fatigue, and memory loss since June 04 AVA and deployment 2004.

VAERS ID:258174 (history)  Vaccinated:2006-05-18
Age:21.0  Onset:2006-06-01, Days after vaccination: 14
Gender:Female  Submitted:2006-06-06, Days after onset: 5
Location:New York  Entered:2006-06-08, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: 4-5 discrete vesicular lesions scattered on upper body.

VAERS ID:258432 (history)  Vaccinated:2006-06-09
Age:21.0  Onset:2006-06-09, Days after vaccination: 0
Gender:Female  Submitted:2006-06-09, Days after onset: 0
Location:Connecticut  Entered:2006-06-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2491AA  RA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Nausea and vomiting and feeling dizzy began 1 hr after the vaccine.

VAERS ID:258625 (history)  Vaccinated:2006-06-06
Age:21.0  Onset:2006-06-07, Days after vaccination: 1
Gender:Female  Submitted:2006-06-16, Days after onset: 9
Location:New York  Entered:2006-06-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin; Orthonovum
Current Illness: None
Preexisting Conditions: Depression
Diagnostic Lab Data: CBC/CMP - nl results.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVA055AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Seen 6/9/06 at office; rash on legs, trunk and arms. No new exposures but received Hep A 6/6/06. Rash began 6/7/06; no fever, chills.

VAERS ID:258699 (history)  Vaccinated:2006-06-19
Age:21.0  Onset:2006-06-22, Days after vaccination: 3
Gender:Male  Submitted:2006-06-22, Days after onset: 0
Location:Maryland  Entered:2006-06-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: No lab or other test indicated
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB0588A1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Joint range of motion decreased
SMQs:, Arthritis (broad)
Write-up: Patient in for routine vaccination per military guidelines on 19JUN06 and presented to clinic on 22JUN06 c/o limited range of motion and inability to lift arm to shoulder length and overhead.

VAERS ID:258996 (history)  Vaccinated:2006-06-15
Age:21.0  Onset:2006-06-21, Days after vaccination: 6
Gender:Male  Submitted:2006-06-29, Days after onset: 8
Location:Wisconsin  Entered:2006-06-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1070SCRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.AHBVB268AA2IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.AHAVB066AA0IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX08620IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site hypersensitivity, Injection site pain, Injection site reaction, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Presented on 27June06 with reports of rash on back and chest x 6 days following receiving Smallpox vaccination on 15June06. Rash on body nonpruritic, however vaccination site is pruritic and painful. Diffuse rash is noted throughout back and chest measuring as 1x1mm papules. Also present on each hand are 1x1mm papules that appeared 2 days prior to visit. Immunization site notes a 3x3mm scab without redness, warmth or suppuration. Motrin ordered prn, keep site clean and rtc prn.

VAERS ID:259012 (history)  Vaccinated:2006-05-02
Age:21.0  Onset:2006-05-02, Days after vaccination: 0
Gender:Female  Submitted:2006-06-26, Days after onset: 55
Location:Kansas  Entered:2006-06-30, 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: No
Preexisting Conditions: Ceclor, penicillin
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1828AA IM 
TDAP: TDAP (ADACEL)SANOFI PASTEUR(L)C2340AA IM 
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30009173PO 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dyspnoea, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: Influenza, PO Typhoid, Tdap given 5/2/06. She developed weakness and shortness of breath that night which continued until 5/3/06. Also mild tachycardia.

VAERS ID:259024 (history)  Vaccinated:2006-05-19
Age:21.0  Onset:2006-05-19, Days after vaccination: 0
Gender:Male  Submitted:2006-05-25, Days after onset: 6
Location:New Mexico  Entered:2006-06-30, Days after submission: 36
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: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSPAV1071 RA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200721 LA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ0276-21 RA
Administered by: Military     Purchased by: Military
Symptoms: Lymphadenitis
SMQs:
Write-up: left supraclavicular lymphadenitis.

VAERS ID:259109 (history)  Vaccinated:2006-06-13
Age:21.0  Onset:2006-06-15, Days after vaccination: 2
Gender:Female  Submitted:2006-06-16, Days after onset: 1
Location:Montana  Entered:2006-07-03, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vicoprofen
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': MT0602
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0488R1SCLA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1621BA1IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0326R1SCRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: On 06/15/06, the patient experienced dizziness, headaches, chills but no rash. Husband gave her a half of vicoprofen for the headache. Has not seen physician.

VAERS ID:259212 (history)  Vaccinated:2006-07-03
Age:21.0  Onset:2006-07-04, Days after vaccination: 1
Gender:Female  Submitted:2006-07-05, Days after onset: 1
Location:Georga  Entered:2006-07-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 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 BIOLOGICALSAHBVB268CA1IMRA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2384AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Rt upper arm redness, swelling and warm to the touch. Pt reports some itching feelings. Started 7/4/06 evening around the injection site. Reports to clinic 7/5/06 at 08:00 AM for evaluation.

VAERS ID:259429 (history)  Vaccinated:2003-11-20
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2006-01-07
Location:Puerto Rico  Entered:2006-07-12, Days after submission: 185
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020074   
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Balance disorder, Chest pain, Dizziness, Pain, Sexual dysfunction, Vision blurred, Visual disturbance
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: I experienced vision problems (spotted and blurred), sexual problems, chest and arm pain, balance problems and dizziness.

VAERS ID:259526 (history)  Vaccinated:2006-04-01
Age:21.0  Onset:2006-04-01, Days after vaccination: 0
Gender:Female  Submitted:2006-04-13, Days after onset: 11
Location:Pennsylvania  Entered:2006-07-13, Days after submission: 91
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: Augmentin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR204251IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling, redness and soreness at injection site several days later. Palm of both hands itchy.

VAERS ID:259562 (history)  Vaccinated:2006-07-13
Age:21.0  Onset:2006-07-14, Days after vaccination: 1
Gender:Female  Submitted:2006-07-14, Days after onset: 0
Location:California  Entered:2006-07-14
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
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB285AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blister, Headache, Injection site rash, Malaise, Nausea, Vomiting
SMQs:, Severe cutaneous adverse reactions (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: On 7/13/06 pt came in for 2nd of Hep B Series and on 7/14/06 (in the morning) pt. became ill and noticed a few clear bumps around the injection site. Pt received Hep B vaccine around 2pm 7/13 and by 6 pm had a headache, nausea & vomitting. Today pt feels just as bad with constant headache, aches, bumps to L arm at injection site. NAD, A/O x3, GCS 15/15, head NCAT, CNII-XII intact, speech WNL, gait normal, coordination normal, no oropharyngeal edema. No facial edema. Lungs CTAB No wheezes. Heart RRR. Abd NTND BS+ x 4 quads. VSS bP 128/72, pulse 70, rr16, temp 97.2. L deltoid regsion mildly HP, no ecchymosis, no errythema, 3 small surrounding vessicles.

VAERS ID:259658 (history)  Vaccinated:2006-06-30
Age:21.0  Onset:2006-07-07, Days after vaccination: 7
Gender:Male  Submitted:2006-07-07, Days after onset: 0
Location:Idaho  Entered:2006-07-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720 RA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ05720IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Erythema Multiforme

VAERS ID:259796 (history)  Vaccinated:2006-07-17
Age:21.0  Onset:2006-07-19, Days after vaccination: 2
Gender:Female  Submitted:2006-07-20, Days after onset: 1
Location:Indiana  Entered:2006-07-20
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: Splenectomy years ago, allergic to PCN, sulfa, Doxycycline.
Diagnostic Lab Data: Received a Pneumovax 16 months ago which was not known at time of this injection.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)AVENTIS PASTEURUE785AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0089F1SCRA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2384AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Very pronounced local reaction. 4-5 inch diameter red, swollen, painful, hot area at location of injection. Red area expanded to about 5-6 inch diameter today. No improvement.

VAERS ID:259966 (history)  Vaccinated:2006-07-10
Age:21.0  Onset:2006-07-11, Days after vaccination: 1
Gender:Female  Submitted:2006-07-12, Days after onset: 1
Location:Massachusetts  Entered:2006-07-24, Days after submission: 12
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: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.0936P1SCLA
Administered by: Other     Purchased by: Unknown
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Complain of itchy rash, noticed one day after receiving measle, mumps and rubella vaccine, temperature 98.6 "red patches" noted on right arm a few on left upper arm, thighs, ankles, and back at waist band. Nurse Practitioner referred to primary care provider and suggested antihistamine (over counter).

VAERS ID:261183 (history)  Vaccinated:2006-07-15
Age:21.0  Onset:2006-07-26, Days after vaccination: 11
Gender:Female  Submitted:2006-08-07, Days after onset: 12
Location:Wisconsin  Entered:2006-08-07
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: NKDA, depression
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1020SCRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.AHBVB268AA3IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.AHAVB066AA0IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ0452 IMRA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Ear discomfort, Headache, Hypersensitivity, Lymphadenopathy, Nasal congestion, Pharyngolaryngeal pain, Pyrexia, Viral infection
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Presented to the clinic on 7/27/06 with c/o swollen lymph nodes (L axilla and L neck) very sore throat, HA, ear congestion, weakness. Initial temp of 100.3. Reported that she passed out the previous evening. Axilla and Neck palpated and without lymphadenopathy. Nasal mucousa edematous and boggy. Was given Tylenol 325mg 2 tabs and 1 liter IV fluids. Additional medications ordered: Claritin 10mg po daily, Flonase 2 sprays each nostril daily. Quarters times 48 hours. Was diagnosed as smallpox vaccination reaction and seasonal allergies by provider. Following IV fluids temp spiked to 101.8. Patient was transferred to ER for further evaluation. Diagnosed with viral illness by ER Provider and was returned home. Patient was seen for follow up on 7/28/06. Fever broke during the night. Headache and sore throat improved. Temp 98.7 at time of visit. Diagnoses of Febrile Illness vs Smallpox Vaccination Reaction vs Viral Illness.

VAERS ID:261234 (history)  Vaccinated:2006-08-02
Age:21.0  Onset:2006-08-02, Days after vaccination: 0
Gender:Female  Submitted:2006-08-03, Days after onset: 1
Location:Massachusetts  Entered:2006-08-08, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU2116AA0IMLA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2491AA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Respiratory rate increased, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Shaking, breathing fast lasted about 1/2 hour. No rash or hives.

VAERS ID:261465 (history)  Vaccinated:2006-08-03
Age:21.0  Onset:2006-08-04, Days after vaccination: 1
Gender:Female  Submitted:2006-08-10, Days after onset: 6
Location:New Mexico  Entered:2006-08-14, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER4148AA0 RA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER0089F0 RA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Headache, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Local erythema, swelling, headache, Ibuprofen, DECADRON.

VAERS ID:261534 (history)  Vaccinated:2004-12-23
Age:21.0  Onset:2004-12-23, Days after vaccination: 0
Gender:Male  Submitted:2005-11-02, Days after onset: 314
Location:Illinois  Entered:2006-08-14, Days after submission: 284
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Clarinex, Topical prescription
Current Illness:
Preexisting Conditions: The pt has allergies to penicillin, erythromycin, and Ceclor. He has a history of psoriasis and anxiety disorder. His vaccination history includes a first dose of tetanus and diphtheria toxoids on 12Dec93.
Diagnostic Lab Data: No relevant lab data or diagnostic tests were obtained.
CDC 'Split Type': 200500062
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN213A0SCLA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1341AA0IM 
Administered by: Private     Purchased by: Private
Symptoms: Mouth ulceration
SMQs:, Severe cutaneous adverse reactions (broad), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: From initial information received on 05Jan05 from a RN regarding an adverse event occurring it was reported that a 21 yr old male pt received his first dose of JE VAX, lot number EJN213A, administered SC in the left arm and a second dose of TD, lot number U1341AA, administered IM in the right deltoid on 23Dec04. Several hours later, the pt developed several cold sores on his mouth and several canker sores in his mouth. The pt stated that he was afebrile and denied itching, rash, hives, or any other symptoms. The pt recovered from the events.

VAERS ID:261578 (history)  Vaccinated:2006-07-27
Age:21.0  Onset:2006-07-27, Days after vaccination: 0
Gender:Female  Submitted:2006-08-10, Days after onset: 14
Location:Florida  Entered:2006-08-15, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0607USA05775
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0702F0IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a physician and registered nurse concerning a 21 year old female with no medical history of drug allergies who on 27-JUL-2006 was vaccinated intramuscularly in the left deltoid with the first dose of HPV rLI 6 11 16 18 VLP vaccine (yeast) (0.5 ml) (lot#653650/0702F). Concomitant therapy included possible hormonal contraceptives (unspecified). On 27-JUL-2006 the patient experienced extreme pain at the injection site. The onset of the pain was immediate and lasted for 5 to 6 minutes and then resolved. Unspecified medical attention was sought. It was reported that the patient does not wish to continue the series of vaccinations. Additional information has been requested.

VAERS ID:261620 (history)  Vaccinated:2006-07-14
Age:21.0  Onset:2006-07-23, Days after vaccination: 9
Gender:Male  Submitted:2006-08-15, Days after onset: 23
Location:Wisconsin  Entered:2006-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ04250IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Presented on 7/24/06 with c/o n/v, dizziness, fever, achiness x 24 hours. Diagnosed as vaccine reaction vs. acute viral syndrome. Quarters x 24 hours and push fluids. Tylenol prn.

VAERS ID:261731 (history)  Vaccinated:2006-07-13
Age:21.0  Onset:2006-07-13, Days after vaccination: 0
Gender:Male  Submitted:2006-08-17, Days after onset: 35
Location:Wisconsin  Entered:2006-08-17
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: Hepatitis Vaccine
Diagnostic Lab Data: CBC, BMP
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Presented to ER on 7/14/06 with c/o nausea and diarrhea. States that she had received smallpox vaccination the previous day. Started not feeling well one hour after vaccination. Afebrile. Diagnosed as vaccine reaction per ER report. CBC and BMP were done, those results are not available at this time. Was given Imodium, Tylenol 500mg 2 tabs, Phenergan, and Tordol at time of visit. Discharged with orders to push fluids, Compazine 10mg po q 6-8 hours prn nausea, Tylenol 500mg 2 pills every four hours as needed and follow up the next day.

VAERS ID:261804 (history)  Vaccinated:2006-07-20
Age:21.0  Onset:2006-07-29, Days after vaccination: 9
Gender:Male  Submitted:2006-08-18, Days after onset: 20
Location:Wisconsin  Entered:2006-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Acne, Dermatitis, Fatigue, Folliculitis, Pain, Pruritus, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Presented to the Clinic on 7/31/06 with c/o rash on back, fever and fatigue times 2 days. Rash is painful and itchy. Pustular inflammatory eruption on back. Diagnosed as cystic acne vs smallpox vaccine complication vs follucilitis dermatitis. Orders given for Keflex and recheck at SRC shot room in 24-48 hours.

VAERS ID:262633 (history)  Vaccinated:2006-09-05
Age:21.0  Onset:2006-09-05, Days after vaccination: 0
Gender:Male  Submitted:2006-09-06, Days after onset: 1
Location:Georga  Entered:2006-09-06
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: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)SANOFI PASTEUREJN229A2SCLA
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS387011A2IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUE638AA0SCRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 5cm x 4.5cm circular reddened area on left posterior upper arm. Area warm to the touch and slightly raised. Service member c/o mild tenderness at site, denied fever or drainage.

VAERS ID:263115 (history)  Vaccinated:2006-09-13
Age:21.0  Onset:2006-09-13, Days after vaccination: 0
Gender:Female  Submitted:2006-09-13, Days after onset: 0
Location:Arizona  Entered:2006-09-18, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1398AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Fall, Headache, Loss of consciousness, Nausea, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Headache x 5 minutes, nausea x 5 minutes, tingling to lips x 2 minutes. Dizziness x 5 minutes. Donor reported that she thinks 9/13/06 she fell and was unconscious with unknown duration.

VAERS ID:263204 (history)  Vaccinated:2006-07-18
Age:21.0  Onset:2006-07-18, Days after vaccination: 0
Gender:Female  Submitted:2006-09-14, Days after onset: 58
Location:Kentucky  Entered:2006-09-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pap smear abnormal, Dysplasia, Breast Prosthesis user. 7/18/07-records received-HX papular condyloma.
Diagnostic Lab Data: Blood pressure 7/18/06 130/80 records received 7/18/07-Positive yeast vaginal culture. BX on 5/30/07-mild sysplasia/HPV
CDC 'Split Type': WAES0608USA02804
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0640F0 UN
Administered by: Other     Purchased by: Other
Symptoms: Anogenital warts, Biopsy cervix abnormal, Deafness, Dizziness, Dysarthria, Injection site pain, Musculoskeletal pain, Musculoskeletal stiffness, Pallor, Papilloma viral infection, Paraesthesia, Shock, Skin papilloma, Speech disorder, Syncope, Tinnitus, Vaginal candidiasis, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hearing impairment (narrow), Vestibular disorders (broad), Uterine and fallopian tube tumours of unspecified malignancy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Initial and follow up information has been received from a 21 year old female with breast implants and had a history of abnormal pap test and dysplasia and from a nurse practitioner. On 7/18/06 the pt was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653650/0640F). Concomitant therapy included ethinyl estradiol + norgestimate (Ortho Lo). On 7/18/06, immediately following vaccination, the pt experienced slurred speech for approx 3 to 4 minutes and reported that she felt as if her body went into shock. She noted that her fingers curled into a fist and her fingers and hands stiffened up. She reported that the later symptoms lasted for approx 25 to 30 minutes. Also approx two weeks after receiving the vaccination, she began to have some pain and stiffness in her upper left arm and shoulder in the same arm she had received the injection. Unspecified medical attention was sought. At the time of this report, the pain and stiffness in the left arm and shoulder had not resolved. The pt also reported that although she had never had nay type of genital warts in the past, on approx 8/4/06 she noted she had small genital warts which were confirmed by her health care professional. In follow up th nurse practitioner reported conflicting information that what the pt described was not what she and another nurse witnesses. The nurse practitioner stated that following the injection the pt appeared pale and almost fainted. The pt became woozy and could speak clearly. The pt was attended to by both the nurse practitioner and another nurse. The pt was diagnosed with having a near syncopal episode. The pt was treated with a cool compress and she recovered quickly and was noted as fine afterwards. The pts blood pressure was fine noted at 130/80 mmHg. it was reported that the pt did not experience any drop in hart rate, did not loose consciousness, did not seize and did not experience wheezing. The nurse practitioner did not see what she would describe as any adverse reaction to the vaccines and described the pt as being very dramatic. It was further reported that the pt reported seeing genital warts to the nurse practitioner, however, the nurse did not feel these were related to the vaccine. Additional information has been requested. 7/18/07-records received. HX papular condyloma. on 8/21/06-note indicated aftr 1st vaccine had a near syncope episode with no LOC. C/O slurred speech tingling in hands. Outbreak of condyloma. 1/4/10 Lack of concentration, hearing loss, blurred vision-ringing in ears. All of these we are aware of.

VAERS ID:263207 (history)  Vaccinated:2006-08-08
Age:21.0  Onset:2006-08-09, Days after vaccination: 1
Gender:Female  Submitted:2006-09-14, Days after onset: 36
Location:Florida  Entered:2006-09-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0608USA03841
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0702F0UNUN
Administered by: Private     Purchased by: Other
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Information has been received from a nurse practitioner concerning a 20 year old female who on 08-AUG-2006 was vaccinated with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). Following the vaccination, on an unspecified date in August 2006, the patient experienced diarrhea. Unspecified medical attention was sought. At the time of this report, the outcome of the diarrhea was unknown. Additional information has been requested.

VAERS ID:263226 (history)  Vaccinated:2006-07-27
Age:21.0  Onset:2006-08-03, Days after vaccination: 7
Gender:Female  Submitted:2006-09-14, Days after onset: 42
Location:New York  Entered:2006-09-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0608USA06089
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0688F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Influenza, Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Information has been received from a physician concerning a 24 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The patient''s outcome was unknown. Additional information has been requested. 01/05/2007 Follow up information has been received, the physician reported that the patient was recovered from her symptoms and stated "all it was was a one day flu". Additional follow up information has been received from the physician concerning her 24 year old daughter, a student, who on 27-JUL-2006 was vaccinated IM in left arm with her first dose of GARDASIL, lot #653735/0688F. It was reported that on 03-AUG-2006 she developed flu like symptoms. No further information is available.

VAERS ID:263372 (history)  Vaccinated:2006-08-22
Age:21.0  Onset:2006-08-28, Days after vaccination: 6
Gender:Female  Submitted:2006-08-28, Days after onset: 0
Location:Indiana  Entered:2006-09-21, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix, Ortho Tricylen Lo
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU2094AA0IMLA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2455AA IMRA
Administered by: Private     Purchased by: Other
Symptoms: Rash maculo-papular
SMQs:, Hypersensitivity (narrow)
Write-up: Developed maculopapular rash over extremities and abd 7 days after vaccine given TX with Zyrtec 10 mg PO daily.

VAERS ID:263462 (history)  Vaccinated:2006-09-19
Age:21.0  Onset:2006-09-19, Days after vaccination: 0
Gender:Female  Submitted:2006-09-22, Days after onset: 3
Location:Colorado  Entered:2006-09-22
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: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2557AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Erythema, Feeling hot, Injection site induration, Injection site swelling, Pain, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: CC: Severe Swelling following vaccination. History: Patient reports about 2 days ago patient presented to the Immunization clinic for vaccination. She was given the Tetanus/Pertussis vaccine. She reports within a couple hours she noticed a lot of pain in the arm. She reports the arm was uncomfortable when trying to sleep. The following morning the lump was a lot bigger. No numbness or tingling in hands. She reports using warm compresses and the took Motrin. The first day it started out being a small painful area but by the second day it covered her whole Deltoid area. She complains of problems working out due to the pain. She was able to sleep but it was mildly uncomfortable. No numbness or tingling. She complains of feeling warm but did not take her temperature. No chills. She reports two bouts of water like stools last night but no blood. Today she awoke with continued swelling and tenderness and she was concerned that she might have an Abscess. No hives or shortness of breath. O: PHYSICAL EXAM: VITALS: Temperture 97.2 degrees GEN: WD, WN in NAD, appears stated age Psy: Interaction normal for age; orientation, mood and affect appear normal Chest: Normal respiratory effort without accessory muscle use; good air movement, CTA bilaterally CV: RRR, nl S1 S2; no murmur heard Skin: 7X7 cm induration with 12X10 erythema of the skin over the right Deltoid. No sharp erythematous border no weeping or oozing

VAERS ID:263597 (history)  Vaccinated:2006-09-19
Age:21.0  Onset:2006-09-21, Days after vaccination: 2
Gender:Male  Submitted:2006-09-26, Days after onset: 5
Location:Virginia  Entered:2006-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)CHIRON CORPORATION387011A2IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain upper, Dizziness, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Approximately 2 minutes after receiving the vaccine (Tuesday, September 19), the client stated he vomited. VIS sheet and package insert were reviewed with him. Was instructed if symptoms worsen to seek medical care. On Friday, September 22, spoke with clients supervisor who stated client had been sent home from work on Thursday, September 21 because of dizziness. Also spoke with client on same day and he stated that on Thursday, September 22, he had vomiting and dizziness. He also stated, he fell at his home and cut his head. By Friday, September 22, he stated he continued to have mild dizziness, but it was improving, he also was having a head ache and stomach ache. As it was three days since the vaccine was administered and was late Friday afternoon when the conversation took place, client was instructed to follow up with a physician for evaluation. While doctor visit may not have been necessary, as a safety measure, he was instructed to follow up with a physician. Unsure if doctor visit was made.

VAERS ID:263930 (history)  Vaccinated:2006-09-28
Age:21.0  Onset:2006-09-28, Days after vaccination: 0
Gender:Female  Submitted:2006-10-03, Days after onset: 5
Location:Rhode Island  Entered:2006-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.08001F0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site warmth, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: FEVER, SITE WARM TO TOUCH, PAIN NOTED WITH MOVEMENT OF EXTREMITY.

VAERS ID:264007 (history)  Vaccinated:2006-10-01
Age:21.0  Onset:2006-10-02, Days after vaccination: 1
Gender:Male  Submitted:2006-10-04, Days after onset: 2
Location:Florida  Entered:2006-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PREDNISONE 5MG
Current Illness: RASH
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
BCG: BCG (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Confusional state, Fatigue, Headache, Heart rate increased, Injury, Loss of consciousness, Muscular weakness
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: FIRST DAY: TIRED, MUSCLES BECOMING WEAK, HEART BEATING FASTER, HEADACHE,ON SECOND DAY: SAME AS FIRST DAY, BUT THEN I BECAME CONFUSED AND BLACKED OUT, I DON''T REMEMBER THE FOLLOWING HAPPENING BUT, I SWUNG AROUND AND HIT MY GIRLFRIEND IN THE ARM BANGED ON THE FRONT WINDOW WHICH I BROKE, CUTTING MY ARM, I WAS AWAKE, BUT I DON''T REMEMBER MUCH OF IT. THE NEXT DAY I WOKE UP IT JAIL AND STILL FELT LIKE I WAS IN A DREAM.

VAERS ID:264025 (history)  Vaccinated:2003-03-02
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2006-08-10
Location:Unknown  Entered:2006-10-05, Days after submission: 56
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Military     Purchased by: Military
Symptoms: Cardiac disorder, Chills, Headache, Hypersensitivity, Hypertension, Liver function test abnormal, Viral infection, Weight increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: Hypertension-Lotrel 5/10mg to maintain my blood pressure, I have a 10% VA compensation; weight gain. I increase dramatically in weight a total of 75 pounds; chills, I suffered of spontaneous chills for an undetermined lapse of time; allergies, I started suffering of allergies and was medicated in the hospital; headaches, I suffer of headaches almost everyday; heart murmur, During various examinations this was dx''d.; liver abnormal, I was dx''d with cytomegalovirus. I received 3 more shots of Anthrax on the following dates: 4/1/03, 5/24/02, 1/23/04. They were all administered by military facilities during my military service. I have a 10% VA compensation.

VAERS ID:264167 (history)  Vaccinated:2006-10-09
Age:21.0  Onset:2006-10-09, Days after vaccination: 0
Gender:Female  Submitted:2006-10-09, Days after onset: 0
Location:Texas  Entered:2006-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1215R0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 10:25 AM Hep B Vaccine administered R deltoid 10:45 AM Reported red rash upper chest, right arm 11:03 AM Reported generalized itching- Medical Staff contacted for evaluation Transported to First Aid Station 11:30 AM Benadryl 50 mg IM- then 25mg by mouth @ 5:30 PM and 11 PM today 11:55 AM Claritin 10 mg by mouth then QD x6 more days

VAERS ID:264303 (history)  Vaccinated:2006-08-24
Age:21.0  Onset:2006-09-03, Days after vaccination: 10
Gender:Male  Submitted:2006-09-12, Days after onset: 9
Location:North Carolina  Entered:2006-10-11, Days after submission: 29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: HIV
CDC 'Split Type':
Vaccination
Manufacturer
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500429P0IN 
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40020720 RA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 21 year old male presented to ER with local reaction to smallpox vaccine, had smallpox shot a wk ago. When going to bed noted area raised and painful with red strip on upper arm with red streak to axilla. Given Toradol 60 mg IM in ER. Wound dressed, sent home, F/U in am.

VAERS ID:264487 (history)  Vaccinated:2006-10-12
Age:21.0  Onset:2006-10-12, Days after vaccination: 0
Gender:Male  Submitted:2006-10-13, Days after onset: 1
Location:Pennsylvania  Entered:2006-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cipro, Zithromax
Current Illness: unknown
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB058BA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye irritation, Eye oedema, Nasal congestion, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (broad), Hypersensitivity (narrow)
Write-up: Mouth and eyes started to itch, then left eye became swollen. Nose was stuffy but no breathing problems. Advised to go to ER. Did not go. Placed warm compress on left eye.

VAERS ID:264703 (history)  Vaccinated:2006-10-11
Age:21.0  Onset:2006-10-12, Days after vaccination: 1
Gender:Female  Submitted:2006-10-12, Days after onset: 0
Location:Massachusetts  Entered:2006-10-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0955F1IMUN
Administered by: Private     Purchased by: Private
Symptoms: Acne, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash/Pimple like on fact and neck. This is in follow-up to report (s) previously submitted on 11/14/2006. Initial and follow-up information has been received from a health professional concerning a 23 year old female with no known allergies who on 11-OCT-2006 at 9:00 was vaccinated with a second dose of GARDASIL (lot # 653978/0955P), intramusculary in the deltoid. Concomitant therapy included ORTHO TRI-CYCLEN. On 12-OCT-2006 at 9:00 AM the patient experienced ''face/neck rash, pimple like stinging.'' It was also received from the FDA through the Freedom of Information Act. There is no additional information. Additional information has been requested.

VAERS ID:264743 (history)  Vaccinated:2006-09-11
Age:21.0  Onset:2006-09-12, Days after vaccination: 1
Gender:Female  Submitted:2006-10-31, Days after onset: 49
Location:Pennsylvania  Entered:2006-10-17, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zithromax, Wellbutrin, Klonopin, Lexapro, Nicomide, Minocycline.
Current Illness:
Preexisting Conditions: Syncope, Anxiety.
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA02502
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0702F0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Feeling abnormal, Headache, Malaise, Mydriasis
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)
Write-up: Information has been received from a registered nurse concerning a 21 year old female with syncope, anxiety and no known allergies reported. On 9/11/06, the pt was vaccinated IM with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653650/0702F). Concomitant therapy included Lexapro, Wellbutrin, Klonopin, Nicomide, and Zithromax. On 9/12/06 when the pt woke up, she complained of her pupils being dilated, a headache, light headed and reported that she feels like something in not quite right. It was reported that it was unknown if the pt had eaten that day. The pt sought unspecified medical attention. At the time of this report, the pt had not recovered from the events. Additional information has been requested.

VAERS ID:265029 (history)  Vaccinated:2006-10-17
Age:21.0  Onset:2006-10-17, Days after vaccination: 0
Gender:Male  Submitted:2006-10-17, Days after onset: 0
Location:Texas  Entered:2006-10-20, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type':
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1398AA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chest pain, Coma, Dyspnoea, Hyperhidrosis, Hypotension, Loss of consciousness, Pallor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Donated 880 CC, consent for tetanus signed approx 6-8 min after injection donor sat in chair and passed out pale, diaphoretic, hypotensive. Asst to floor, no seizure activity. Donor stated prior to passing out his chest hurt, with SOB. Donor only unresponsive approx 15 sec. Donor did not have any incontinence. Donor became responsive and way aware of person, place and date. Donors feet were elevated vital taken, ice packs to back of neck. Blood sugar taken by EMS 118. Donor had no food or liquid since the previous night. Transported by EMS to local Emergency dept. Follow up with Emergency dept no medical treatment done, no lab work, only a food tray given and donor was released home.

VAERS ID:265305 (history)  Vaccinated:2006-10-16
Age:21.0  Onset:2006-10-16, Days after vaccination: 0
Gender:Female  Submitted:2006-10-24, Days after onset: 8
Location:Florida  Entered:2006-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho-tricyclene Low
Current Illness: None.
Preexisting Conditions: None
Diagnostic Lab Data: N/A
CDC 'Split Type':
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HPV4: HPV (GARDASIL)MERCK & CO. INC.UNKNOWN0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Difficulty in walking, Muscle rigidity, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: According to my daughter, the following happened: 1. Shot was given between 1100-1115 am 2. Proceed to wait a few minutes with doctor in room and then went to check out 3. Between 1120-1125 am...she passed out in doctors office. 4. Day 2-4: tightness in muscles especially around lower legs. Also tigtness in arms, but not as bad as legs. 5. Hard time walking after first waking up in morning and gradually loosens up after she starts moving around. 6. I suggested to her to take a Tylenol to help with muscle tightness and to massage calves prior to getting out of bed to help loosen them up.

VAERS ID:265396 (history)  Vaccinated:2006-07-13
Age:21.0  Onset:2006-07-14, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:2006-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to hepatitis vaccine.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Fever, myalgia, nausea, diarrhea, vaccine reaction.

VAERS ID:265398 (history)  Vaccinated:2006-06-30
Age:21.0  Onset:2006-07-03, Days after vaccination: 3
Gender:Male  Submitted:2006-07-19, Days after onset: 16
Location:Wisconsin  Entered:2006-10-26, Days after submission: 99
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
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Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Blister, Erythema, Rash macular, Skin ulcer
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Reaction locally spread to 2 other areas (macular erythematous lesion, small vesicle).

VAERS ID:265414 (history)  Vaccinated:2006-10-16
Age:21.0  Onset:2006-10-16, Days after vaccination: 0
Gender:Male  Submitted:2006-10-26, Days after onset: 10
Location:Virginia  Entered:2006-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500433P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Headache
SMQs:
Write-up: Throbbing Headache that started 7 hours after Flu-mist and and lasted 4 days. Seen in office visit.

VAERS ID:265589 (history)  Vaccinated:2006-10-10
Age:21.0  Onset:2006-10-20, Days after vaccination: 10
Gender:Male  Submitted:2006-10-26, Days after onset: 6
Location:D.C.  Entered:2006-10-30, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Punch biopsy results pending
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1072 UN
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720 UN
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site reaction, Pain, Pruritus, Rash erythematous, Rash maculo-papular, Rash pruritic, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt is 21 y/o male, Received AVA (3 right) and primary smallpox vaccine (left) on 10/10/06. Denies significant local reaction at anthrax vaccine site. Smallpox vaccine site with some redness and pruritis, but no streaking or lymphangitis. No tender nodes in left axilla. Has been covering SPV site with dressing and following guidelines regarding site care and hand washing etc. SPV site assessed as take and undergoing normal progression. NO unusual or prolonged systemic symptoms following vaccine receipt, but did experience 2 day history of generalized body aches around post vaccine days 8 and 9. New onset of pruritic lesions around post vaccine day 10 (Oct 20th). Described appearance of about 10 red, slightly raised, pruritic lesions on both arms. By the following day, had generalized rash on arms, trunk, back and legs. Seen in ER on 10/21 and treated with Benadryl. Denies change in character of lesions other than lesions becoming confluent. Came in for follow up evaluation in Dermatology on 10/23 and had punch biopsy done. Continues to experience significant pruritis despite treatment with Benadryl. Denies previous history of any vaccine adverse events. Denies any recent symptoms of viral type illness or infections. No exposure to skin irritants, not using new soap, not new detergents, not new lotions and not recently changed cleansing agents. Allergies: no allergy to foods and no known drug allergies. past medical history denies history of chronic illnesses. Specifically denies history of allergies (aeroallergens), asthma, and eczema. No history of hospitalizations. No surgeries. Previously well, not feeling tired or poorly, no fever, and no chills, no headaches. No mouth sores, no lip sores and no sores on the tongue, Pruritus localized to a skin rash or sores. No blisters. Generalized lesions excluding the palms and soles. No tingling and no burning sensation. Lesions macule, papule, pruritus

VAERS ID:265611 (history)  Vaccinated:2006-09-13
Age:21.0  Onset:2006-09-16, Days after vaccination: 3
Gender:Female  Submitted:2006-10-30, Days after onset: 44
Location:Maryland  Entered:2006-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness at time of vaccination
Preexisting Conditions: NKDA, season allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500436P1IN 
Administered by: Military     Purchased by: Military
Symptoms: Cough, Headache, Lymphadenopathy, Nasal congestion, Nausea, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: After Flumist vaccination, pt developed low grade fever x 3 weeks, swollen lymph nodes x 1 week, developed congestion and cough x 3 weeks and headaches. Patient had nausea and vomiting x 1 week. Pt missed total of about 6 days of work.

VAERS ID:265756 (history)  Vaccinated:2006-08-01
Age:21.0  Onset:2006-08-03, Days after vaccination: 2
Gender:Female  Submitted:2006-11-01, Days after onset: 90
Location:Missouri  Entered:2006-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline,Zoloft,Yasmin
Current Illness: none
Preexisting Conditions: Depression & Anxiety, Migraine Headaches, Acne, Exzema, Seasonal Allergies.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0702F0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Patient complained of Left arm numbness after receiving injection. Lasted less than 48 hours.

VAERS ID:265808 (history)  Vaccinated:2006-10-06
Age:21.0  Onset:2006-10-07, Days after vaccination: 1
Gender:Female  Submitted:2006-10-30, Days after onset: 23
Location:Maryland  Entered:2006-11-01, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrostep
Current Illness: NONE
Preexisting Conditions: allergic to Penicillin.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0800F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Nausea and vomiting, fever 99 degrees F- 100 degrees F, chills for 3 days.

VAERS ID:265886 (history)  Vaccinated:2006-11-01
Age:21.0  Onset:2006-11-02, Days after vaccination: 1
Gender:Female  Submitted:2006-11-02, Days after onset: 0
Location:Massachusetts  Entered:2006-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ibuprofen
Current Illness: none
Preexisting Conditions: mild asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 9IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Pallor, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Paleness, dizziness, feeling of being overheated (did not take temperature, so possibly not a fever), vomiting.

VAERS ID:266325 (history)  Vaccinated:2006-08-30
Age:21.0  Onset:2006-08-30, Days after vaccination: 0
Gender:Female  Submitted:2006-11-01, Days after onset: 63
Location:West Virginia  Entered:2006-11-08, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0696F0 RA
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Complaints of pain in right arm initially after 1st Gardasil injection. States right arm hurt for 1 month after shot was given.

VAERS ID:266538 (history)  Vaccinated:2006-11-07
Age:21.0  Onset:2006-11-08, Days after vaccination: 1
Gender:Female  Submitted:2006-11-09, Days after onset: 1
Location:Wisconsin  Entered:2006-11-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: rash~Hep B (unknown mfr)~2~18~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Has allergy to corn, cinnamon and Blueberries and sulfa drugs.
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION716471 LA
Administered by: Other     Purchased by: Private
Symptoms: Rash pruritic, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Flu vaccine given 11/7/06 approx 3pm, next morning pink rash (with itching) over trunk and extremities.

VAERS ID:266638 (history)  Vaccinated:2006-11-10
Age:21.0  Onset:2006-11-10, Days after vaccination: 0
Gender:Male  Submitted:2006-11-13, Days after onset: 3
Location:California  Entered:2006-11-13
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: laceration-abrasion leg
Preexisting Conditions:
Diagnostic Lab Data: Pulse OX 99%. RA, EKG, Tachycardic incomplete RBBB
CDC 'Split Type':
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TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU1218AB  RA
Administered by: Private     Purchased by: Unknown
Symptoms: Bundle branch block, Face oedema, Hypersensitivity, Injection site reaction, Tachycardia, Tongue oedema, Urticaria, Vaccination complication
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: PT given TD for wound on leg obtained while working in construction. Developed mild wheals near vaccine site. 30 minutes after vaccination, not relieved by Benadryl. Came back to clinic after 1 hour with diffuse wheal trunk, arms and swollen lips and tongue. No dyspnea. Given Benadryl, Zyrtec Epinephrine. Sent to ER. 12/12/06 Received medical records from hospital which reveal patient seen in ER with rash & facial/lip swelling s/p receipt of epi & oral Benadryl at urgent care center. D/C to home same day on tapering prednisone & benadryl. Final Dx: Allergic reaction to dT shot.

VAERS ID:266689 (history)  Vaccinated:2006-10-26
Age:21.0  Onset:2006-11-02, Days after vaccination: 7
Gender:Male  Submitted:2006-11-09, Days after onset: 7
Location:Massachusetts  Entered:2006-11-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Bilateral hearing loss
Diagnostic Lab Data: CBC; LFT; COAGS; Renal function; ESR; CRP
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2238AA IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB109CA0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURZ04215IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURZ01220IMLA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE896AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling cold, Headache, Hot flush, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 7 days after vaccine, developed rash over neck. Progressed to inner arms, lower back, buttocks, inner thighs and back of knees. Hot and cold feelings, headaches. We are checking labs and close observation.

VAERS ID:266788 (history)  Vaccinated:2006-11-13
Age:21.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Female  Submitted:2006-11-14, Days after onset: 1
Location:Oregon  Entered:2006-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair
Current Illness: odd cough & migranes per patient history
Preexisting Conditions:
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0688F0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Fatigue, Panic reaction
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient c/o: dizziness, lightheaded, feels as if she is going to have a panic attack, very fatigued.

VAERS ID:267410 (history)  Vaccinated:2006-07-19
Age:21.0  Onset:2006-07-19, Days after vaccination: 0
Gender:Female  Submitted:2006-11-14, Days after onset: 118
Location:Florida  Entered:2006-11-16, 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: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Papilloma viral infection, Penicillin allergy, Asthma.
Diagnostic Lab Data: Serum Epstein Barr neg
CDC 'Split Type': WAES0610USA01137
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0697F0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Malaise, Mood swings
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (broad)
Write-up: Information has been received from a nurse concerning a 21 year old female with asthma, unspecified drug reaction to Penicillin and Amoxicillin and might have been exposed to papilloma viral infection. On 7/19/06, the pt was vaccinated IM with the first dose of HPV vaccine (lot 653650/0697F). Concomitant therapy included unspecified hormonal contraceptives. Subsequently, the pt experienced fatigue, was sick and had mood swings for two months. It was reported that the pt felt rotten after receiving HPV vaccine. (date unk). The pt sought unspecified medical attention. The pt underwent a test for mononucleosis that came back neg (date unk). It was reported that the pt felt better two weeks before the second dose of HPV was due to be administered (date unk). It was reported that the pt does not want to receive the second and third dose of HPV vaccine. At the time of this report, the pt had recovered from the events (date unk). Additional information has been requested.

VAERS ID:267428 (history)  Vaccinated:2006-09-21
Age:21.0  Onset:2006-09-21, Days after vaccination: 0
Gender:Female  Submitted:2006-11-14, Days after onset: 54
Location:Delaware  Entered:2006-11-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Penicillin allergy; Sulfonamide allergy
Preexisting Conditions: Hypersensitivity reaction
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA08303
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse concerning a 21 year old female with a history of an allergic reaction to penicillin and sulfonamide who on 21-SEP-2006 was vaccinated with HPV. On 21-SEP-2006, following vaccination, the patient broke out in hives all over her upper body particularly in the face, chest, and arms. Unspecified medical attention was sought. Subsequently, the patient recovered on 26- SEP-2006. Additional information has been requested.

VAERS ID:267449 (history)  Vaccinated:2006-09-01
Age:21.0  Onset:2006-09-06, Days after vaccination: 5
Gender:Female  Submitted:2006-11-14, Days after onset: 69
Location:Colorado  Entered:2006-11-16, Days after submission: 2
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: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA12091
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0689F0IMRL
Administered by: Other     Purchased by: Other
Symptoms: Local swelling, Lymphadenitis, Lymphadenopathy, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a physician concerning a 21 year old female who in approximately September 2006 was vaccinated with the first dose of GARDASIL (lot # not provided). On an unspecified date in approximately September the patient developed swelling in her lymph nodes and groin. Unspecified medical attention was sought. At the time of this report it was unknown if the patient had recovered. Additional information has been requested. 01/05/2007: This is in follow-up to report (s) previously submitted on 11/14/2006. Information has been received from a physician concerning a 21 year old female with seasonal asthma and no known drug allergies who on 04-SEP-2006, was vaccinated with an intramuscular injection in the onterolateral right thigh of the first dose of GARDASIL (Lot # 0689F). On 06-SEP-2006 the patient developed swelling in her lymph nodes and groin. The patient was seen in her physicians office and a large (7.3 cm), soft, tender femoral lymph node was noted near the injection site. There was no evidence of cellulitis or drainage. THe patient was diagnosed with lymphadenitis and was given asthma precautions. THe patient was seen in the office on 09-SEP-2006 and the area was still tender and the swelling was noted to have decreased slightly. The patient was seen again in the office on 10-NOV-2006 and the lymphadenitis had not yet fully resolved. The doctor noted that the second vaccination would be delayed until the lymphadenitis had completely resolved. Additional information has been requested.

VAERS ID:267466 (history)  Vaccinated:2006-08-28
Age:21.0  Onset:2006-09-22, Days after vaccination: 25
Gender:Female  Submitted:2007-04-06, Days after onset: 196
Location:Alabama  Entered:2006-11-16, Days after submission: 140
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: Medical History: Vaginosis bacterial, yeast infection
Diagnostic Lab Data: body temp 101-103F; clinical seriology test, 10/23/06, positive; serum Epstein Barr 10/23/2006 negative, serum herpes simplex 10/23/06 positive; serum herpes simplex negative; WBC count normal; absolute blood atypical, 10/23/06, 13%, 0-6, high; band neutrophil count, 10/23/06, 5.0%, 0-5; eosinophil count, 10/23/06, 1.0%, 0-5; lymphocyte count, 10/23/06, 32.0%, 15-43; monocyte count, 10/23/06, 7.0%, 5-15; neutrophil count, 10/23/06, 42.0%, 43-75, Low; body temp, 101-103F; white blood cell, 10/23/06, moderate smudge cells; serum Epstein-Barr VCA, 10/23/06, positive; serum Epstein-Barr VCA, 10/23/06, - negative; serum EBNA antibody, 10/23/06, - positive; serum herpes simplex, 10/23/06, - positive; serum herpes simplex 10/23/06, 7.41 X1000 4.8
CDC 'Split Type': WAES0610USA14581
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0689F0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Band neutrophil percentage decreased, Body temperature increased, Chills, Eosinophil percentage, Epstein-Barr virus antibody negative, Epstein-Barr virus antigen positive, Epstein-Barr virus test negative, Headache, Herpes simplex, Herpes simplex serology positive, Insomnia, Laboratory test abnormal, Lymphocyte percentage, Lymphocyte percentage decreased, Monocyte percentage, Neutrophil percentage decreased, Pain, Pyrexia, Rhinorrhoea, White blood cell count abnormal
SMQs:, Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Information has been received from a Certified Medical Assistant concerning a 21 year old female patient with a history of bacterial vaginosis and yeast infections who on 28 Aug 2006 was vaccinated IM in left deltoid with her first dose of Gardisil vaccine (yeast) lot #653736/0689F. Concomitant therapy included ethinyl estradiol/norgestimate (Ortho Tri-Cyclen). ON 22 Sep 2006 the patient developed fever, which she reported was "off and on". She described the fever as spiking at night after 6-7pm. Her fevers would reach 101-103 F and they resolved with rest plus the use of acetaminophen (Tylenol). After " a couple days or so", the fevers would reappear. Other symptoms included headache, hot and cold chill, body aches, waking in the night. The CMA stated that the patient reported these symptoms to the physician''s office on 23 Oct 2006. Laboratory tests performed on that date included HSV(herpes simplex virus) IGG type 1 (positive); HSV IGG type 2 (negative); and EBV(Epstein-Barr virus) (negative). It was reported "EBN was positive". Also reported was "sed rate and CBC=white blood cell count was normal". The patient was to be seen the following week to determine whether the fevers continued. Follow up information indicated that when the patient was seen on 30 Oct 2006 she received a second dose of Gardisil. The CMA noted that the patient was fine "so far". Additional information has been requested. This is in follow-up to report (s) previously submitted on 11/14/2006. Information has been received from a Certified Medical Assistant concerning a 21 year old female patient with a history of bacterial vaginosis and yeast infections who on 28-AUG-2006 was vaccinated IM in left deltoid with her first dose of GARDASIL lot #653736/0689F. Concomitant therapy included ORTHO TRI-CYCLEN. On 22-SEP-2006 the patient developed fever, which she reported was "off and on". She described the fever as spiking at night after 6-7 p.m. Her fevers would reach 101-103 F and they resolved with rest plus the use of TYLENOL. After "a couple days or so", the fevers would reappear. Other symptoms included headache, hot and cold chills, body aches, and waking in the night. The CMA stated that the patient also took unspecified allergy and cold medicine for a runny nose during the past month. The patient reported these symptoms to the physician''s office on 23-OCT-2006. Laborary tests performed on that date included HSV (herpes simplex virus) IGG type 1 (positive); HSV IGG type 2 (negative) ; and EBV (Epstein-Barr virus) (negative). It was reported "EBN was positive". Also reported was "sed-rate and CBC = white blood cell count was normal". The patient was to be seen the following week to determine whether the fevers continued. Follow up information indicated that when the patient was seen on 30-OCT-2006 she received a second dose of GARDASIL. The CMA noted that the patient was fine "so far". Additional follow up information has been received from a physician concerning the 21 year old black female student who on 28-AUG-2006 at 11:30 a.m. was vaccinated IM in left arm with her first dose of GARDASIL lot #653736/0689F. The physician reported that the patient made an appointment on 23-OCT-2006 with fever X 2 weeks. Diagnostic laboratory tests were performed, including positive EBNA (Epstein-Barr virus nuclear antigen antibody) and EBV VCA IgG (Epstein-Barr viral capsid antigen immunoglobulin G antibody), which indicated past infection. EBV VCA IgM (Epstein-Barr viral capsid antigen immunoglobulin M antibody) was negative (see laboratory data section for other results). The patient had mononucleosis. The physician indicated she had recovered. Additional information is not expected.

VAERS ID:267478 (history)  Vaccinated:2006-10-30
Age:21.0  Onset:2006-10-30, Days after vaccination: 0
Gender:Female  Submitted:2006-11-14, Days after onset: 15
Location:North Carolina  Entered:2006-11-16, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA00698
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0689F   
Administered by: Other     Purchased by: Other
Symptoms: Syncope vasovagal
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a physician concerning a 21 year old female who on 30 Oct 2006 was vaccinated with 0.5mL of Gardisil (Lot# 653736/0689F). On 30 Oct 2006, the patient developed a vasovagal reaction and passed out within one minute post vaccination. The patient was revived with an ammonia inhalant. No other symptoms were noted. Unspecified medical attention was sought. At the time of this report, the patient had recovered from the events (date unknown). Additional information has been requested.

VAERS ID:267100 (history)  Vaccinated:2006-11-08
Age:21.0  Onset:2006-11-08, Days after vaccination: 0
Gender:Female  Submitted:2006-11-10, Days after onset: 2
Location:Minnesota  Entered:2006-11-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nuvaring, Allegra D, Albuterol, Nasonex
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0688F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt received vaccination early in AM. Called later that afternoon and was itching all over. took Benadryl which helped.

VAERS ID:267106 (history)  Vaccinated:2006-10-10
Age:21.0  Onset:2006-10-10, Days after vaccination: 0
Gender:Female  Submitted:2006-11-09, Days after onset: 30
Location:Utah  Entered:2006-11-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl, birth control, Ibuprofen
Current Illness: NONE
Preexisting Conditions: MD dictation states unremarkable.
Diagnostic Lab Data: WBC 14.9 on 10/11/06; DD QNT 957 10/10/06; K+3.1
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2177AA0IM 
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Dyspnoea, Eye swelling, Hypotension, Ocular hyperaemia, Rash, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Shortness of breath, red and swollen eyes, rash on neck and chest, hypotension, tachycardia, chest pain. Developed in evening after receiving vaccine at approximately 1pm. Treated in ER for possible allergic reaction to flu vaccine. 1st flu shot employee had ever received.

VAERS ID:267524 (history)  Vaccinated:2006-11-01
Age:21.0  Onset:2006-11-01, Days after vaccination: 0
Gender:Female  Submitted:2006-11-02, Days after onset: 1
Location:Pennsylvania  Entered:2006-11-21, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin
Current Illness:
Preexisting Conditions: Von Willebrands, MRSA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0702F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Total body itching

VAERS ID:267605 (history)  Vaccinated:2006-11-08
Age:21.0  Onset:2006-11-18, Days after vaccination: 10
Gender:Male  Submitted:2006-11-21, Days after onset: 3
Location:Hawaii  Entered:2006-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Military     Purchased by: Military
Symptoms: Rash erythematous, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt presented to clinic w/ approx 3-4 d of vesicular rash on erythematous base on chest, abdomen, back, neck and upper arms. Non-pruritic, non-painful. No systemic sx. No specific tx warranted.

VAERS ID:267832 (history)  Vaccinated:2006-11-16
Age:21.0  Onset:2006-11-16, Days after vaccination: 0
Gender:Female  Submitted:2006-11-16, Days after onset: 0
Location:Connecticut  Entered:2006-11-27, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Peptic ulcer
Preexisting Conditions: Peptic ulcer
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA220AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Blood pressure decreased, Dizziness, Haematemesis, Tongue disorder
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad)
Write-up: Pt c/o being light headed, BP 80/50, P 64, RR 16, Color good, lung sounds clear, no stridor feels her tongue is heavy, this is not visibly swollen, denies chest pain/tightness. Pt placed flat/supine, 911 called, arrival of Paramedic transported to medical center. Pt states through an interpreter that she had peptic ulcers and ran out of meds at 2 weeks ago. This past week she had been vomiting blood.

VAERS ID:268048 (history)  Vaccinated:2006-11-29
Age:21.0  Onset:2006-11-29, Days after vaccination: 0
Gender:Male  Submitted:2006-11-30, Days after onset: 1
Location:Michigan  Entered:2006-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2260AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Blood glucose normal, Decreased activity, Dizziness, Feeling hot, Hypersensitivity, Impaired work ability, Insomnia, Nuclear magnetic resonance imaging, Pain, Respiratory depression
SMQs:, Angioedema (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Patient became dizzy and hot on the way home in the car. Pulse 120/Respiration 6. Called 911, EMT stated glucose 88, pulse 80 doing better. At ER was given script for Benadryl. Per 60 day follow up: Approx. 50% of strength recovered in legs; hands? Still in physical therapy 3 x/week. Extreme pain in knees-R$gL instantly with standing -$gwalking -$g movement. Neg evalaution with rheumatologist. MRI March 17, 07 pending appoint with orthopedic, MD. Continues to be on Medical leave from job. On egg free diet due to allergic rex to eggs in hospital, carries EPI-PEN. On daily medication for pain and stomach (ZANTAC) prevention. Multiple MD appts continue, as does pain, imability to sleep through the night, particpate in activities involving physicial movement/action/walking. Especially difficult being without any compensation due to medical leave from work.

VAERS ID:268287 (history)  Vaccinated:2006-09-25
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2006-11-30
Location:Massachusetts  Entered:2006-12-05, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Idiopathic thrombocytopenic purpura.
Diagnostic Lab Data: Head computed axial 9/6 unspecified, spinal tap 9/06 results unspecified. Platelet count 9/06 43000
CDC 'Split Type': WAES0611USA06464
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0688F IMUN
Administered by: Other     Purchased by: Other
Symptoms: Epistaxis, Headache, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad)
Write-up: Information has been received from a physician concerning a 21 year old female with no history of drug reactions/allergies, and a history of idiopathic thrombocytopenic purpura who on 9/25/06 was vaccinated IM with HPV vaccine (Lot 653735/0688F). There was no concomitant medications. In Sept 2006, a few days after vaccination the pt experienced a headache, nose bleed and developed thrombocytopenia. The pts platelet count on an unspecified date was 43,000. The pt was hospitalized and received platelet transfusion. A CT of the head and lumbar puncture were performed, however the results were unspecified. The pt subsequently recovered on an unspecified date. The reporting physician felt that one or more of the events was an other important medical event (OMIC) and life threatening. Additional Information has been requested.

VAERS ID:268445 (history)  Vaccinated:2006-12-05
Age:21.0  Onset:2006-12-05, Days after vaccination: 0
Gender:Female  Submitted:2006-12-06, Days after onset: 1
Location:New York  Entered:2006-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Information received verbally from patient on phone today, unable to verify tests or their results.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1704CA5IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Depressed level of consciousness, Diarrhoea, Dizziness, Fatigue, Injection site pain, Injection site swelling, Malaise, Pyrexia, Stomach discomfort, Syncope, Vision blurred, 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), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow)
Write-up: 21 yo G2 P0010 EDC 4/14/07 at 21 weeks gestation came for routine prenatal care 12/5/06. Pt received Td Vaccine at approximately 1pm. Felt well before and after shot. Started feeling ill about 6pm. Reported feeling feverish with upset stomach. Vomited x 3, felt dizzy, vision blurry, and fainted. Family with her and patient stated family had difficulty arousing her and called EMS, "out x 20 minutes". Taken to hospital and kept for 12 hours. Hit her stomach and kept for fetal evaluation. Stated had fetal sonogram and EKG done there. Had 3-4 episodes of watery diarrhea in the night. Discharged home at 6 am on 12/6/06. Now feeling tired and weak. No fever now. Injection site sore and swollen.

VAERS ID:268535 (history)  Vaccinated:2006-11-04
Age:21.0  Onset:2006-11-18, Days after vaccination: 14
Gender:Male  Submitted:2006-12-07, Days after onset: 19
Location:Ohio  Entered:2006-12-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none; px was a PRIMARY VACCINEE. I DON''T KNOW HOW MANY PREVIOUS FLU AND TYPHOID VACCINES HE HAS HAD.
Preexisting Conditions: none
Diagnostic Lab Data: Troponin = 1.9; non specific T wave changes CPK=290 MB=1.4 Labs 02/28/07:EKG non diagnostic T wave changes age vs. resolving pericardial inflammation. Echocardiogram: ventricular septal defect. Labs: WNL
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMUN
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0 LA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMUN
Administered by: Military     Purchased by: Military
Symptoms: Adverse drug reaction, Chest pain, Echocardiogram, Myopericarditis, Pericarditis, Ventricular septal defect
SMQs:, Systemic lupus erythematosus (broad), Congenital, familial and genetic disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad)
Write-up: Presented to the ER approximately 14 days after vaccination with chest pain consistent with myopericarditis. 02/28/07-records received from facility for DOS 12/13-2/21/07. DX: acute myopericarditis. adverse effect of drug therapy vaccines small pox. Ventricular septal defect.

VAERS ID:268787 (history)  Vaccinated:2006-12-04
Age:21.0  Onset:2006-12-04, Days after vaccination: 0
Gender:Female  Submitted:2006-12-07, Days after onset: 3
Location:Arizona  Entered:2006-12-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU1398AA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Donor received tetanus shot at 1639 and reports having lightheadness and nausea starting at 1900 and lasting on 12/04/06. Donor states she was going from a sitting to standing position. After 15 minutes symptoms didn''t reoccur.

VAERS ID:269222 (history)  Vaccinated:2006-11-24
Age:21.0  Onset:2006-11-24, Days after vaccination: 0
Gender:Female  Submitted:2007-04-06, Days after onset: 132
Location:Pennsylvania  Entered:2006-12-18, Days after submission: 108
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions: UNK
Diagnostic Lab Data: None
CDC 'Split Type': WAES0611USA07057
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2197AA5IMUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.0961F0IMUN
Administered by: Private     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site oedema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse concerning a female who was vaccinated with a first dose of HPV vaccine. It was reported that immediately upon administration of the vaccine, the patient developed excessive swelling near the injection site. Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. This is in follow-up to report(s) previously submitted on 12/14/2006. Initial and follow-up information has been received from a nurse and a physician concerning a 21 year old white female student with asthma who on 24-NOV-2006, at 12:00 p.m., was vaccinated IM, into the right arm, with a first dose of GARDASIL (lot #654389/0961F) concomitantly with a sixth dose of FLUZONE (lot #U2197AA) IM, into the left arm. On 24-NOV-2006, at 12:01 p.m., the patient developed immediate swelling at the injection site. The patient recovered on the same day. There were no laboratory or diagnostic tests performed. Additional information is not expected.

VAERS ID:269227 (history)  Vaccinated:0000-00-00
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2006-12-14
Location:Unknown  Entered:2006-12-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA07417
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.   UN
Administered by: Other     Purchased by: Other
Symptoms: Malaise
SMQs:
Write-up: Information has been received from the mother of a 21 year old female with penicillin allergy who in 2006 was vaccinated with HPV vaccine. There was no concomitant medication. The patient''s mother stated that following vaccination, her daughter was sick. Unspecified medical attention was sought. At the time of this report, the patient was recovering. No further information is expected.

VAERS ID:269311 (history)  Vaccinated:2004-06-06
Age:21.0  Onset:2005-02-17, Days after vaccination: 256
Gender:Male  Submitted:2006-12-18, Days after onset: 669
Location:Unknown  Entered:2006-12-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: lower back strain obesity
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Arthralgia, Back pain, Dizziness, Dyspnoea, Fatigue, Headache, Night blindness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: I began to have lower back pain in 2003 that worsened following AVA vaccinations during deployment. I''ve also experience joint pain in fingers, knees, shoulders, loss of night vision, dizziness, headaches, shortness of breath, fatigue, and some short term memory loss. Knee problem began after injury twisting knee w/torn MCL, patellofemoral syndrome and chronic hx of lower back pain.

VAERS ID:269346 (history)  Vaccinated:2006-11-22
Age:21.0  Onset:2006-11-26, Days after vaccination: 4
Gender:Female  Submitted:2006-12-19, Days after onset: 23
Location:California  Entered:2006-12-19
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: Allergies-Anox, penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0702F0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Itching of entire body 4-5 days after vaccination on 11/22/06. Has continued on and off since then.

VAERS ID:269674 (history)  Vaccinated:2004-07-19
Age:21.0  Onset:2004-07-19, Days after vaccination: 0
Gender:Male  Submitted:2006-12-26, Days after onset: 890
Location:North Carolina  Entered:2006-12-27, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: mild pancreatitis 2001, resolved. PMH: had been hospitalized 6/06 for ADEM following a 2 month illness of gastroenteritis. S/S at that time were numbness of exts w/mild weakness & electrical sensation shooting down spine w/neck flexion. Tx w/steroids w/complete resolution of all s/s.
Diagnostic Lab Data: LABS: MRI of brain & c spine revealed multiple areas of demyelination in periventricular white matter c/w multiple sclerosis.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Acne, Arthralgia, Asthenia, Back pain, Campylobacter gastroenteritis, Cervicobrachial syndrome, Diarrhoea, Dysarthria, Headache, Hyperglycaemia, Hypoaesthesia, Intensive care, Laboratory test normal, Leukoencephalomyelitis, Multiple sclerosis, Myelopathy, Myofascial pain syndrome, Nausea, Nerve injury, Neuralgia, Nuclear magnetic resonance imaging brain abnormal, Optic neuritis, Paraesthesia, Photophobia, Quadriplegia, Rash, Vomiting, Walking disability
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Corneal disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Ocular infections (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Numbness, tingling legs, feet, hands, diarrhea. Reported in incidence report on same day. All follow up with docs basically dismissed as non-existent until diagnosis MS in 06. 1/4/07 Received medical records from parent/reporter which reveal patient seen 8/30/04 for diarrhea & mild but constant abdominal pain for approx 1 mo. Had just returned from deployment to Iraq on 7/12/04. Tx w/cipro, labs & rest. Returned to clinc 9/16/04 with continued diarrhea. Prior labs were neg. Tx w/lomotil. Returned to clinic for knee pain, ankle pain, back pain. To ER 4/15/06 for N/V/D with abdominal pain for 6 days. On 6/6/06 seen for numbness in arms & legs. EMG/NCS were ordered. Dx w/campylobacter jejuni enteritis & tx w/prednisone. 6/15/06 seen in Neuro clinic for numbness in hand, arm & legs when leans head forward for approx 4 weeks. Dx w/cervical radiculopathy & sent for MRI of brain & c spine. Seen in ER 6/21/06 for LP to r/o MS or ADEM. Return to ER with HA, nausea, dizziness, & photophobia since LP. Tx medically & referred to Neuro clinic. Seen in Neuro clinic 7/14/06 for IV steroid infusion for ADEM treatment & given rx for oral tapering steroids. Returned to Neuro clinic on 9/11/06 & symptoms had resolved. Was OKd for deployment to Kuwait. FINAL DX: ADEM. 1/19/07 Received medical records from 1st hospital which reveal patient admitted 10/28/06-11/6/06. Just prior to deployment to Kuwait 10/06, the numbness started to return & progressed while deployed. Received additional steroids & was transferred to Germany, then back to US. Weakness continued to deteriorate to being unable to ambulate. Had headache, sweats & nausea for approx 5 days. Consult by neuro & dx w/MS & optic neuritis. Tx w/steroids & interferon & transferred to ICU for possible intubation. Gradually improved & was transferred to inpatient rehab facility to continue PT, interferon, prednisone, neurontin & to be followed by neuro. FINAL DX: Multiple sclerosis; hyperglycemia secondary to high dose steroids; & rash probably related to dog tags. 1/25/07 Received medical records from Rehab hospital which reveal patient admitted 11/6-11/10/06 & then transferred back to first hospital prior to transfer to another rehab facility closer to patients family. FINAL DX: tetraplegia, incomplete secondary to MS with myelopathy; MS; neuropathic pain; myofascial pain; acne secondary to long term steroids; & dysarthria. Per information received from annual follow up, patient is in a remitted state (of MS) at this time. He has undergone extensive medical therapy. I have submitted a request by his neurologist to update your records. He still suffers from nerve damage & diarrhea. He is on a monthly infused medicine and interferon. He has made huge progess but everything is tenuous at best and he truelly goes one day at a time because he never knows what his health will be tomorrow.

VAERS ID:269922 (history)  Vaccinated:2006-11-13
Age:21.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Female  Submitted:2006-12-29, Days after onset: 46
Location:Virginia  Entered:2007-01-02, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA02987
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0637F IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Fracture, Injury, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a 21 year old female with no pertinent medical history or drug reactions/allergies, who on 13 Nov 2006 was vaccinated intramuscularly with HPV Vaccine. Concomitant therapy included Zyrtec and Yasmin. On 13 Nov 2006, following vaccination, the patient felt nauseous and dizzy. As she went out of the room to check out, the patient fainted and broke her nose and got a cut under eye. The patient reported that she was on the floor for seven to eight minutes before she woke up. The patient reported that she had to get her nose fixed and received some stitches afterward. At the time of this report, the patient was recovering. Upon internal review, the facial bones fracture which required surgery was felt to be an other important medical event (OMIC). Additional information has been requested.

VAERS ID:270140 (history)  Vaccinated:2007-01-07
Age:21.0  Onset:2007-01-07, Days after vaccination: 0
Gender:Male  Submitted:2007-01-07, Days after onset: 0
Location:Missouri  Entered:2007-01-08, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA243BA IMRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBV360CA IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB109CA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Dyspnoea, Loss of consciousness, Tremor, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Uncontrolled shaking, passed out, shortness of breath, dizziness, vomiting.

VAERS ID:270248 (history)  Vaccinated:2006-12-01
Age:21.0  Onset:2006-12-01, Days after vaccination: 0
Gender:Female  Submitted:2007-01-05, Days after onset: 35
Location:Arizona  Entered:2007-01-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Allergic reaction to antibiotics
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA00467
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0955F IMLA
Administered by: Other     Purchased by: Other
Symptoms: Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: Information has been received from an nurse concerning a 21 year old female with allergic reaction to antibiotics (Septra) who on 01 Dec 2006 was vaccinated intramuscularly in the left deltoid with HPV vaccine. Concomitant therapy included hormonal contraceptives (unspecified). On 01 Dec 2006 about three hours post vaccination the patient developed blurry vision in her left eye. No other symptoms were reported. Unspecified medical attention was sought. At the time of this report the patient had not recovered from the blurry vision. Additional information has been requested.

VAERS ID:270322 (history)  Vaccinated:2006-12-21
Age:21.0  Onset:2007-01-05, Days after vaccination: 15
Gender:Female  Submitted:2007-01-10, Days after onset: 5
Location:Pennsylvania  Entered:2007-01-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho tricyclen LO
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: Pt seen by doctor on 1/6/07 no swelling or redness good ROM REC NSAIDS and warm compresses. RTO 1-2 weeks
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0960F  LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Joint range of motion decreased
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: 01/05/07 pt called c/p left arm still sore after 2 weeks after receiving vaccine unable to raise arm over head denies redness or swelling.

VAERS ID:270431 (history)  Vaccinated:2006-12-22
Age:21.0  Onset:2007-01-01, Days after vaccination: 10
Gender:Male  Submitted:2007-01-01, Days after onset: 0
Location:Idaho  Entered:2007-01-12, 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:
Preexisting Conditions: Amoxicillin, penicillin
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH402700720 LA
Administered by: Military     Purchased by: Unknown
Symptoms: Rash papular
SMQs:
Write-up: 10 days after Smallpox vaccine left deltoid, developed red papular rash on upper chest.

VAERS ID:270874 (history)  Vaccinated:2007-01-19
Age:21.0  Onset:2007-01-20, Days after vaccination: 1
Gender:Female  Submitted:2007-01-21, Days after onset: 1
Location:South Carolina  Entered:2007-01-21
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) (NO BRAND NAME)UNKNOWN MANUFACTURER?0IDLA
Administered by: Private     Purchased by: Unknown
Symptoms: Feeling cold, Feeling hot, Hyperhidrosis, Listless, Nausea, Tremor, Vision blurred, Visual disturbance
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad)
Write-up: Woke up after feeling very hot, entire body broke out into a sweat then got freezing cold (all within a 10 minute period), felt incredibly nauseous, blurry and darkened vision, hands were extremely shaky, then collapsed back asleep because I felt zapped of energy. Woke up three hours later and felt completely normal.

VAERS ID:270917 (history)  Vaccinated:2006-12-14
Age:21.0  Onset:2006-12-15, Days after vaccination: 1
Gender:Female  Submitted:2006-12-21, Days after onset: 6
Location:Unknown  Entered:2007-01-22, Days after submission: 32
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.0637F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dizziness, Pyrexia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: High fever, shaky, shills, rigors, dizzy.

VAERS ID:271116 (history)  Vaccinated:2006-11-24
Age:21.0  Onset:2006-11-25, Days after vaccination: 1
Gender:Female  Submitted:2007-04-06, Days after onset: 131
Location:New York  Entered:2007-01-22, Days after submission: 73
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper respiratory tract infection
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA02574
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0954F0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Acne
SMQs:
Write-up: Information has been received from a physician concerning a 22 year old female who on an unknown date was vaccinated with a first dose of Gardasil vaccine (yeast). Subsequently, the patient broke out with acne all over her face. Unspecified medical attention was sought. No diagnostic studies were performed. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/16/2007. Information has been received from a physician concerning a 22 year old female student with a recent upper respirtatory infection and no allergies, who on 24-NOV-2006 was vaccinated IM into the left arm with a first dose of GARDASIL (lot # 653938/0954F). On 25-NOV-2006, the patient broke out with acne all over her face. It was noted that the patient and her mother stated that the patient does not usually suffer from acne. Unspecified medical attention was sought. No diagnostic studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information is not expected.

VAERS ID:271162 (history)  Vaccinated:2006-12-05
Age:21.0  Onset:2006-12-05, Days after vaccination: 0
Gender:Female  Submitted:2007-01-16, Days after onset: 42
Location:New Jersey  Entered:2007-01-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0701USA00120
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1162F1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Injection site rash, Injection site warmth, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from an RN concerning a 21 year old female patient who on 23 Oct 2006 was vaccinated IM with her first dose of Gardasil, lot #654540/1162F. On approximately 27 Dec 2006 the patient was vaccinated with her 2nd dose of Gardasil. On 27 Dec 2006 the patient developed a painful injection site after vaccination and also developed a red rash going up and then down her arm and around the injection site. She was given Benadryl and advised to keep an ice pack on it for the rest of the day. As of the report date the patient was recovering. Additional information has been requested. Follow up information has been received concerning the female patient who on 05-DEC-2006 at 1:30 p.m. was vaccinated IM in Left arm with her second dose of GARDASIL, lot # 654540/1162F. On the same day (not 27-DEC-2006 as previously reported), after the vaccination, the patient''s arm became red at the site of injection. Within 5 minutes the redness traveled up her arm and down to her elbow. A rash appeared. The area was warm to touch and painful. BENADRYL 25 mg PO was given. The patient''s arm remained sor for seven days. Additional information is not expected.

VAERS ID:271056 (history)  Vaccinated:2007-01-11
Age:21.0  Onset:2007-01-11, Days after vaccination: 0
Gender:Female  Submitted:2007-01-23, Days after onset: 12
Location:New York  Entered:2007-01-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FOSAMAX, calcium (unspecified)
Current Illness: Osteopenia
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0701USA01725
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1425F IM 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Information has been received from a registered nurse concerning a 21 year old female with osteopenia who on 11-JAN-2007 was vaccinated with Gardasil vaccine (yeast) (lot#655165/1425F), intramuscularly in the left arm. Concomitant therapy included FOSAMAX and calcium (unspecified). Subsequently, on 11-JAN-2007, the patient "passed out", "fainted", was dizzy and nauseated. The patient recovered. There were relevant diagnostic or laboratory tests. It was noted that the patient had eaten before vaccination. Unspecified medical attention was sought. The reporter considered the patient''s experience to be disabling because the patient was incapacitated for a short time. Additional information has been requested.

VAERS ID:271365 (history)  Vaccinated:2006-11-01
Age:21.0  Onset:2006-11-01, Days after vaccination: 0
Gender:Female  Submitted:2007-01-26, Days after onset: 86
Location:Kansas  Entered:2007-01-29, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA02456
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
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: Information has been received from a health professional concerning a 22 year old female patient who on approximately 01-NOV-2006 was vaccinated with a first IM dose of GARDASIL vaccine (yeast). On approximately 01-NOV-2006 the patient experienced seizure. The reporter had no further information. It was noted that patient was 2 weeks late for her second dose of GARDASIL vaccine (yeast) and had not yet received it. Upon internal review, seizure is considered an other important medical event. Additional information has been requested.

VAERS ID:271493 (history)  Vaccinated:2007-01-05
Age:21.0  Onset:2007-01-17, Days after vaccination: 12
Gender:Male  Submitted:2007-01-22, Days after onset: 5
Location:Georga  Entered:2007-01-30, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2559AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1050F0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Enanthema
SMQs:
Write-up: Viral enanthem See attached office notes. Follow up information received March 30, 2007 - Date of vaccination 01/05/2007 at 16:21 - Adverse event onset 01/07/2007 at 09:00.

VAERS ID:271597 (history)  Vaccinated:2006-11-13
Age:21.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Female  Submitted:2007-01-16, Days after onset: 64
Location:Washington  Entered:2007-02-01, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The healthcare professional reported that 4 other subjects experienced injection site reactions following receipt of FluLaval from Lot 2F600311. Please see cases A0628866A, A0628870A, A0628872A, and A062026A.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0628871A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS2F00311  UN
Administered by: Private     Purchased by: Private
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of injection site rash in a 21 year old female subject who was vaccinated with FluLaval for prophylaxis. Medical history included non-smoker and non-drinker. On 13 November 2006 the subject received a dose of FluLaval in an unspecified arm. The healthcare professional noted that at the site of the FluLaval injection, on 13 November 2006, less than one day after vaccination with FluLaval, the subject experienced "a breakout of rash on the arm of the injection site with a black dot in the middle of the injection site." The events resolved on 14 November 2006. The healthcare professional considered the events to possibly be related to vaccination with FluLaval.

VAERS ID:271645 (history)  Vaccinated:2006-05-26
Age:21.0  Onset:2006-05-27, Days after vaccination: 1
Gender:Female  Submitted:2007-01-29, Days after onset: 247
Location:New Jersey  Entered:2007-02-02, 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: ZYRTEC vitamins (unspecified)
Current Illness:
Preexisting Conditions: Heat rash, asthma, Pollen allergy, allergic to cats, Mycotic allergy, allergic to dogs
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0606USA01040
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEA: MEASLES (ATTENUVAX)MERCK & CO. INC.0858R SC 
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site rash, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 21-year-old female with asthma, and allergies to pollen, cats, mold, and dogs, and with a history of heat rash who on 25-May-2006 was vaccinated SC in the left arm with an 0.5 ml dose of measles virus vaccine live (lot#652338/085R). There was no illness at the time of vaccination. Concomitant therapy included vitamins (unspecified) and Zyrtec. On 27-May-2006, the day after vaccination, the patient experienced a transient rash below the injection site of the left arm and patch of redness on other arm and leg. Subsequently, the patient recovered. No treatment was noted. No lab diagnostic studies were performed. There was no product quality complaint. Follow up information received from a physician indicated that a macular rash developed on the left arm below the injection site. The patient recovered on 28-May-2006. Unspecified medical attention was sought. There were no relevant diagnostic tests of laboratory data. No additional information is expected.

VAERS ID:271759 (history)  Vaccinated:2006-06-01
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2007-02-05
Location:Unknown  Entered:2007-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: PMH: none.
Diagnostic Lab Data: 13 Jun 06: Chest PA and Lateral - subtle increased opacity in the RLL is consistent with pneumonia given the history of fever and chest pain. 14 Jun 06: Chest AP portable - normal. Labs: 13 Jun 06 (1900 hrs): CK-806 (25-200); CKMB 48.24 (0-5.0); Troponin 15.53 (0-0.15) 14 Jun (2000hrs), CK-245; CK-MB 7.63, Trop 5.86 15 Jun: CK-133; CK-MB 3.45; Trop 6.93, CRP 3.201; BNP 112. Labs and Diagnostics: CK, CKMB an Troponin were (+). Sed rate 34. ECG with ST elevations and T wave inversions. Echo cardiogram unremarkable. Normal resting LV systolic function. Probable PFO. 7/10/2006: ECG-normal. Exercise stress test without symptoms or ECG changes. Echocardiogram now normal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1070SC 
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.AHBVB268CA0IM 
HEPA: HEP A (VAQTA)MERCK & CO. INC.AHAVB109AA0IM 
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720  
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase MB, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, C-reactive protein increased, Chest X-ray abnormal, Chest pain, Chills, Diagnostic procedure, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram T wave inversion, Electrocardiogram abnormal, Headache, Immunisation reaction, Influenza like illness, Myopericarditis, Pneumonia, Pyrexia, Red blood cell sedimentation rate increased, Tremor, Troponin I increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (broad)
Write-up: 14 Jun 06: Cardiology clinic - vaccinated 1 Jun with onset of headache on 10 Jun he reported increasing headache associated with fever, shakes, chills. On 12 Jun he reported onset of episodic resting sharp chest pains. He was treated with antibiotic and NSAIDS. Subsequent CK, CKMB, and Tnl were positive and patient was instructed to drive to the emergency department. With the exception of a minor headache the patient is now asymptomatic. ECG over the past 2 days demonstrate diffuse 0.5-1 mm ST elevation with T-wave inversions. There are not any appreciable PR depressions. The patinet denies travel or sick contacts. Flu-like symtoms <96 hours Start: 06/11/06 Comment: headache/fever/chills. Chest pain, sub-sternal Start: 06/12/2006. 04/23/2007 MR received for 2 OVs on 6/15/2006 for F/u for c/o 2 day hx of headache, fever chills and new onset of episodic resting sharp chest pain. A/P: Acute Myopericarditis: Temporally related to the vaccinia virus/small pox vaccination. F/U 7/10/2006 Asymptomatic. Per annual follow up: Pt lost to F/U.

VAERS ID:271762 (history)  Vaccinated:2004-09-25
Age:21.0  Onset:0000-00-00
Gender:Male  Submitted:2007-02-05
Location:Unknown  Entered:2007-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: denies
Diagnostic Lab Data: 22 Feb 06: L-Spine series- Questionable sclerotic and erosive changes of the right sacroiliac joint. Recommend dedicated images of the SI joints. 2. Minimal levo curvature and slight loss of the normal lumbar lordosis. 27 Feb 06: SI Joints - Limited examination with radiographic findings suggestive of right sacroiliac with stable radiographic findings as seen on the prior examination. Mar 06: ANA <180, HLA-B27 present, RF Negative, ESR 18 (0-15), AUG 05: G.C Negative, Chlamydia - positive
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0862  
Administered by: Military     Purchased by: Military
Symptoms: Ankylosing spondylitis, Back pain, Blood test abnormal, Chlamydia serology positive, Gait disturbance, Musculoskeletal stiffness, Nuclear magnetic resonance imaging abnormal, Pain, Physiotherapy, Red blood cell sedimentation rate increased, Rheumatoid factor negative, Spinal X-ray abnormal, Spinal deformity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Osteoporosis/osteopenia (broad), Arthritis (narrow)
Write-up: Patient is a 21 year old male who received Anthrax vaccine #1 16 Aug 04, #2 Sep 04, and #3 on 25 Sep 04. He reported no problems with these vaccinations. Between shots #2 and #3 he began to notice lower back discomfort with radiation down his right leg. He denied any history of injury and never had pain like this before. No other associated symptoms and he did not seek medical attention. He did not notice any immediate worsening of this pain with Anthrax #3. From Sep 05-Jan 06, He noticed a gradual increase in his back pain. He stated the pain was across his lower back and he noticed a decrease during the day as his movements increased. He did not seek medical attention for this pain until the spring of 05. He was told it was muscle strain and was given anti-inflammatories and muscle relaxants. He reported no relief with these measures. In Jun/Jul 05 he went to a chiropractor and he experienced only slight relief and the pain eventually returned. He went back to his provider and was given anti-inflammatories and muscle relaxants. During New Year 06 he stated his pain became so bad that he could hardly move or even walk, especially during the am. His pain continued to ease during the day. He went back to his provider and had x-rays and physical therapy. He reported that his x-rays showed something so they were repeated along with the blood work. His blood work revealed a + HLA B27 gene and he was referred to rheumatology, had an MRI and was diagnosed with Ankylosing Spondylitis (A.S.) this past spring. He was started on Enbrel and is reporting relief, however, he is noticing upper back pain. He stated that the pain was always there but that he did not notice before because of the severe lower back pain. He reported this pain to his rheumatologist who thinks that it is related to the A.S. or scoliosis. Even though he realizes he has the gene for A.S. he thinks the anthrax vaccine triggered it to become active. Pain 09/2004 low back with morning stiffness.

VAERS ID:271894 (history)  Vaccinated:2007-01-26
Age:21.0  Onset:2007-01-26, Days after vaccination: 0
Gender:Female  Submitted:2007-01-26, Days after onset: 0
Location:Arizona  Entered:2007-02-06, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: yes~Hep B (unknown mfr)~1~20~In Patient
Other Medications: Amitriptyline, Lexapro
Current Illness: NONE
Preexisting Conditions: Codeine-dx IBS, anxiety, bi-polar
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB257BA0IM 
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Headache, Hyperhidrosis, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: c/o lightheadedness/dizzy with diarphoresis and near syncope-noted head pain to occipital reg. Dull non-radiating 2/10 in severity w/o visual disturbances (onset) 1 hr after injection.

VAERS ID:272065 (history)  Vaccinated:2007-02-07
Age:21.0  Onset:2007-02-07, Days after vaccination: 0
Gender:Female  Submitted:2007-02-09, Days after onset: 2
Location:Texas  Entered:2007-02-09
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 per patient
Preexisting Conditions: ASTHMA
Diagnostic Lab Data: blood glucose 86 mg/dl, temperature 97.1, pulse 88 and regular, BP 110/76 SpO2 99%
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0012U0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blood glucose normal, Body temperature decreased, Dizziness, Dyspnoea, Headache, Heart rate increased, Oxygen saturation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Headachem dizziness, increased heart rate, light-headness, shortness of breath. Symptoms began approximately 40 minutes after vaccination.

VAERS ID:272166 (history)  Vaccinated:2007-01-03
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2007-01-31
Location:California  Entered:2007-02-13, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1424F0IM 
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760  
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR2057220IM 
Administered by: Military     Purchased by: Unknown
Symptoms: Pregnancy test negative, Pregnancy test positive
SMQs:, Normal pregnancy conditions and outcomes (narrow)
Write-up: Pt had negative pregnancy test 1/3/07, given smallpox vaccine and HPV. Had positive pregnancy test 1/27/07.

VAERS ID:272210 (history)  Vaccinated:2007-01-30
Age:21.0  Onset:2007-02-06, Days after vaccination: 7
Gender:Female  Submitted:2007-02-13, Days after onset: 7
Location:North Carolina  Entered:2007-02-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Chest X ray negative for airspace disease, All labs done on 2/8/2007, Troponin < 0.010, CPK 71 I/U, CBC normal, chemistry normal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0  
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH 0  
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Blood creatine phosphokinase normal, Chest X-ray, Erythema, Full blood count normal, Heart rate increased, Joint swelling, Laboratory test, Laboratory test normal, Musculoskeletal pain, Myalgia, Nausea, Palpitations, Pyrexia, Tachycardia, Tenderness, Troponin, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Patient develops nausea, vomiting, fever, muscle aches, and a swollen and red shoulder and arm several days after AVA and SPV vaccinations. Joint pain isolated start 02/06/2007 pain in left shoulder inability to lift the left arm for several. Erythema start 02/06/2007 end 02/10/2007 patient reported redness over the entire left shoulder and down to the middle left bicep as well as into the axilla and the upper outer left pectoral. Fever start 02/06/2007 end 02/09/2007 initially as high as 101F but has been declining since her last ED visit. Nausea w/vomiting start 02/07/2007 end 02/10/2007 the vomiting was recurrent and caused the patient to present to the emergency department on 2/7 and 2/9/2007. Tenderness start 02/06/2007 noted in the left axilla. The pain was previously more intense but has declined over the weekend. Tachycardia started 02/07/2007 end 02/09/2007 patient reported a racing and pounding heartbeat after several episodes vomiting. Resolved since ED treatment with IV fluids on 2/9/07.

VAERS ID:272227 (history)  Vaccinated:2006-07-07
Age:21.0  Onset:2006-08-01, Days after vaccination: 25
Gender:Male  Submitted:2007-02-14, Days after onset: 197
Location:Unknown  Entered:2007-02-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none, no other vaccinations known.
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER  IDLA
Administered by: Military     Purchased by: Military
Symptoms: Guttate psoriasis
SMQs:
Write-up: Patient received Smallpox vaccination on 7July2005. And 3 weeks later started developing Guttate psoriasis. Has had guttate psoriasis for 7 months as of now.

VAERS ID:272290 (history)  Vaccinated:2006-09-06
Age:21.0  Onset:2006-09-06, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 161
Location:Unknown  Entered:2007-02-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Allergic reaction to antibiotics.
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA00697
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a registered nurse concerning a 21 year old female with pertinent medical history reported as none and allergic reaction to some antibiotics who on 06-SEP-2006 was vaccinated with the first dose of Gardasil. Concomitant medication was reported as none. On approximately 06-SEP-2006, the patient developed injection site pain that lasted 3 days following vaccination with Gardasil. On an unspecified date, the patient sought unspecified medical attention. On approximately 08-SEP-2006, the patient recovered from injection site pain. The patient had not received her second dose of Gardasil. Additional information has been requested.

VAERS ID:272337 (history)  Vaccinated:2006-11-16
Age:21.0  Onset:2006-11-16, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 90
Location:Unknown  Entered:2007-02-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Anemia
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA02079
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0954F0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Discomfort, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Information has been received from a health professional concerning a 21 year old female patient with a history of anemia who on 16-NOV-2006 was vaccinated SC with a first 0.5 ml dose of Gardasil (yeast) (lot#653938/0954F). The patient reported feeling lightheaded and uncomfortable after the first dose was given. No further information was provided. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 2/14/2007. Information has been received from a health professional concerning a 21 year old female patient with a history of anemia who on 16-NOV-2006 was vaccinated SC with a first 0.5 ml dose of GARDASIL (lot # 653938/0954F). Follow up information reported that the vaccination was administered by the IM route. The initial report of being vaccinated SC was charted incorrectly. The patient''s chart was corrected by the nurse who gave the injection. The patient reported feeling lightheaded and uncomfortable after the first dose was given. No further information was provided. No further information was available.

VAERS ID:272479 (history)  Vaccinated:2006-12-21
Age:21.0  Onset:2006-12-21, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 55
Location:New York  Entered:2007-02-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: blood pressure, 12/21/06, 102/60
CDC 'Split Type': WAES0701USA03006
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.653735/0688F1  
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure normal, Dizziness, Flushing, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Information has been received from a health professional concerning a 21 year old white female with no medical history, who on 21-DEC-2006 was vaccinated in the left deltoid with the second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot# 653735/0688F). There were no illnesses at the time of vaccination. On 21-DEC-2006, following vaccination, the patient felt faint and queasy and her face appeared flush. The patient''s blood pressure was 102/60. The patient was given a cold drink of water and a cold compress and remained seated for 10 minutes and subsequently felt fine. The patient stated that "needles make her scared". No further information is expected.

VAERS ID:272480 (history)  Vaccinated:2006-11-08
Age:21.0  Onset:2006-11-08, Days after vaccination: 0
Gender:Female  Submitted:2007-02-14, Days after onset: 98
Location:Virginia  Entered:2007-02-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Acne
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0701USA03029
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0955F0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site discolouration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a registered nurse concerning a 21 year old female with no past medical history and no drug allergies who on 08-NOV-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot# 653978/0955F) (0.5 ml), intramuscularly in the left deltoid. Concomitant therapy included minocycline HCl (MINOCIN). On 08-NOV-2006 the patient experienced skin discoloration around injection site. The discoloration was slightly lighter than her skin color and was shaped like a "C" to the other side was 20 mm. The area was not raised or sore. She mentioned that she had some mild soreness at the injection site for one to two days after the vaccine was initially administered. The patient had no other symptoms. There were no relevant diagnostic tests performed. Unspecified medical attention was sought. Additional information has been requested. This is in follow-up to report(s) previously submitted on 2/14/2007. Information has been received from a registered nurse concerning a 21 year old female with acne and no drug allergies who on 08-NOV-2006 at 1:20 PM was vaccinated with a first dose of GARDASIL (lot # 653978/0955F) (0.5 ml), intramuscularly in the left deltoid. Concomitant therapy included MINOCIN. On 08-NOV-2006 the patient experienced skin discoloration around left deltoid (injection site). The discoloration was slightly lighter than her skin color and was shaped like a "C" to the other side was 20 mm. The area was not raised or sore. She mentioned that she had some mild soreness at the injection site for one to two days after the vaccine was initially administered. The patient had no other symptoms. The area was still noticed approximately 8 weeks after vaccination, and denied other adverse reactions. Subsequently on 26-JAN-2007, the area was inspected. C shape was now a complete circle with center the same color as surrounding skin. After close inspection, the area was the same size and shape by Band aide used to cover injection site with lightened area corresponding to the adhesive on the Band aide. The patient received a second dose of GARDASIL on 26-JAN-2007. There were no noticeable skin changes at the time of the report. There were no relevant diagnostic tests performed. it was reported to be unknown if the patient recovered. Additional information has been requested.

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