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Case Details (Sorted by Age)

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VAERS ID:422315 (history)  Vaccinated:2011-05-02
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2011-05-05
Location:Maine  Entered:2011-05-05
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: Child had reaction to shots previously
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Local reaction
SMQs:
Write-up: #1 vaccine Td given on 5-2-2011. #2 vaccine MENACTRA given on 4-25-11.

VAERS ID:422529 (history)  Vaccinated:2010-05-27
Age:11.0  Onset:2010-06-06, Days after vaccination: 10
Gender:Female  Submitted:2010-07-26, Days after onset: 50
Location:Michigan  Entered:2011-05-05, Days after submission: 283
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: The patient has no medical history and was taking no other medications. The patient has no illness at the time of vaccination.
Diagnostic Lab Data: The patient''s Streptococcus test was negative.
CDC Split Type: 201003590
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB362BA  UN
JEV: JAPANESE ENCEPHALITIS (JE-VAX)SANOFI PASTEUREJN234A0SCLA
RAB: RABIES (IMOVAX)SANOFI PASTEURD07920IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3448AA IMUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0996K  UN
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Headache, Lethargy, Nasal congestion, Oropharyngeal pain, Streptococcus test negative, Viral infection
SMQs:, Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Initial report received from a health care professional on 28 June 2010. A 11-year-old female patient, with no medical history, no other medications and no illness at the time of vaccination, received on 27/May/2010 the following vaccines: an intramuscular (IM) injection of ADACEL, lot number C3448AA, an IM injection (dose 1) of IMOVAX, lot number D0792-1, a subcutaneous (SC) injection (dose 1) of JE-VAX, lot number EJN234A, an injection of Hepatitis A vaccine, lot number AHAVB362BA, and an injection of Varicella vaccine, lot number 0996K. On 03 June 2010, the patient received a SC injection (dose 2) to the left arm of JE-VAX, lot number EJN234A, and a IM injection (dose 2) to the right arm of IMOVAX, lot number D0792-1. On 06 Jun 2010, which was 10 days after the first vaccines and 3 days after the second vaccines, the patient developed a temperature of 100-101 (units not provided), headache, sore throat, lethargy, and nasal stuffiness. The patient was seen by the primary care physician (PCP) and was diagnosed with a virus. The patient''s Streptococcus test was negative. The outcome was reported as recovered. Follow-up information received on 07 July 2010 from Biken, the manufacturer of JE-VAX. The only information provided was the manufacturer''s reference number for this case which is F0897. Follow-up information was received 23 July 2010 from a health care professional. The patient was confirmed to have been a female and she had no illness at the time of vaccination. According to the reporter, they reviewed the case information and had no additional information to provide. Documents held by sender: None.

VAERS ID:422339 (history)  Vaccinated:2011-05-02
Age:11.0  Onset:2011-05-02, Days after vaccination: 0
Gender:Female  Submitted:2011-05-05, Days after onset: 3
Location:California  Entered:2011-05-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3874CA4IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Conjunctival hyperaemia, Flushing, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Conjunctival disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: About 12 hrs after injection, fever, chills, HA, flushed, conjunctival infection.

VAERS ID:422407 (history)  Vaccinated:2011-05-03
Age:11.0  Onset:2011-05-04, Days after vaccination: 1
Gender:Female  Submitted:2011-05-06, Days after onset: 2
Location:Michigan  Entered:2011-05-06
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: Past history of asthma; plantar wart; left leg pain
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0181AA0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR03762AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3539AA0UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1499Z1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling of the left arm with progression down the arm, with well demarcated dollar sized erythema on the right.

VAERS ID:422418 (history)  Vaccinated:2011-05-04
Age:11.0  Onset:2011-05-06, Days after vaccination: 2
Gender:Male  Submitted:2011-05-06, Days after onset: 0
Location:Washington  Entered:2011-05-06
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: NKDA; No major medical problems
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1167Z0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3542AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURAC52B048AC0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient was given MENACTRA and Tdap in right deltoid 5/4/11. This morning 5/6 awoke with large amount of swelling and redness in bicep and deltoid.

VAERS ID:422415 (history)  Vaccinated:2011-05-05
Age:11.0  Onset:2011-05-06, Days after vaccination: 1
Gender:Male  Submitted:2011-05-06, Days after onset: 0
Location:Texas  Entered:2011-05-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB462BA0UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3709AA0UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B044CA0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1344Z1SCUN
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reaction to (L) SQ area with redness, fever to touch, raised measured approximately 40mm x 40mm Dr. notified and gave patients'' mother instructions to apply cold compresses and take BENADRYL and ER warning given if any complications.

VAERS ID:422448 (history)  Vaccinated:2011-05-06
Age:11.0  Onset:2011-05-07, Days after vaccination: 1
Gender:Female  Submitted:2011-05-09, Days after onset: 2
Location:Massachusetts  Entered:2011-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1487Z1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: redness and warmth and tenderness around vaccine injection site on left upper arm

VAERS ID:422506 (history)  Vaccinated:2011-05-02
Age:11.0  Onset:2011-05-03, Days after vaccination: 1
Gender:Male  Submitted:2011-05-09, Days after onset: 6
Location:Tennessee  Entered:2011-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB461CA UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B057CA UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1103Z UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: (L) upper arm with 7 cm area of erythema and edema; no other sx.

VAERS ID:422520 (history)  Vaccinated:2011-05-07
Age:11.0  Onset:2011-05-07, Days after vaccination: 0
Gender:Female  Submitted:2011-05-07, Days after onset: 0
Location:Maryland  Entered:2011-05-09, 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:
Current Illness: None
Preexisting Conditions: H/O vasovagal syncope in past
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0672Y0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3463AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3489AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Condition aggravated, Contusion, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Pt fainted, hit head. (+) contusion. Pt observed in office - sent home.

VAERS ID:422544 (history)  Vaccinated:2010-06-16
Age:11.0  Onset:2010-06-16, Days after vaccination: 0
Gender:Male  Submitted:2011-05-04, Days after onset: 322
Location:Unknown  Entered:2011-05-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3088AA IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient received MENACTRA immunization. He laid on the table for approximately 10 minutes then sat up. Patient and mother were informed to stay 15 minutes. It was unclear how long the child sat on the bed before leaving for check out. During checkout the patient fainted. He bumped his head on the wall. Physicians and nurse were with him immediately. Dr. stayed with him until the child was stable.

VAERS ID:422552 (history)  Vaccinated:2011-05-02
Age:11.0  Onset:2011-05-03, Days after vaccination: 1
Gender:Male  Submitted:2011-05-04, Days after onset: 1
Location:Indiana  Entered:2011-05-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0126AA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR03713AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3487AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red area approx. 5 cm in diameter - warm to touch on (R) arm at injection site of MENACTRA. No pain, no fever.

VAERS ID:422665 (history)  Vaccinated:2011-05-10
Age:11.0  Onset:2011-05-10, Days after vaccination: 0
Gender:Female  Submitted:2011-05-10, Days after onset: 0
Location:Florida  Entered:2011-05-11, Days after submission: 1
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: Amoxicillin - Hives
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3338AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1144Z IMRA
Administered by: Public     Purchased by: Private
Symptoms: Allergy to vaccine, Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt came back because allergic reaction to MCV 4, side was red & swollen, pt didn''t have no temp. Pt told to apply ice to area & take Ibuprofen or TYLENOL for pain.

VAERS ID:422685 (history)  Vaccinated:2011-05-03
Age:11.0  Onset:2011-05-05, Days after vaccination: 2
Gender:Male  Submitted:2011-05-05, Days after onset: 0
Location:Minnesota  Entered:2011-05-11, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3779AA0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Large erythematous, warm area below injection site measuring about 10 x 8 cm.

VAERS ID:422765 (history)  Vaccinated:2011-04-26
Age:11.0  Onset:2011-05-02, Days after vaccination: 6
Gender:Female  Submitted:2011-05-12, Days after onset: 10
Location:Vermont  Entered:2011-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1167Z0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3671AA0UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC523048AC0UNLA
Administered by: Private     Purchased by: Other
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5/2/11 Phone call from mom stating "bug bite" looking rash all over body. Not ill. No fever. Probably, per mom, related to old sunscreen.

VAERS ID:422786 (history)  Vaccinated:2011-05-09
Age:11.0  Onset:2011-05-11, Days after vaccination: 2
Gender:Male  Submitted:2011-05-11, Days after onset: 0
Location:Texas  Entered:2011-05-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1606Z1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 10 cm x 5 cm red/warm/welpy area at injection site. Pt seen in office 5-11-11, started on BACTRIM & BENADRYL.

VAERS ID:422794 (history)  Vaccinated:2011-05-11
Age:11.0  Onset:2011-05-11, Days after vaccination: 0
Gender:Female  Submitted:2011-05-12, Days after onset: 1
Location:California  Entered:2011-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0249Y0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3487AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Crying, Immediate post-injection reaction, Loss of consciousness, Nausea, Pallor
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), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Immediately after Tdap & HPV #1 given. Pt became pale & passed out in chair, recovered & passed out again a second time with nausea, was assisted to the floor & began crying. 911 was called to evaluate by paramedics & was able to go home with mother. Antiemetic given by paramedics.

VAERS ID:422801 (history)  Vaccinated:2011-05-09
Age:11.0  Onset:2011-05-10, Days after vaccination: 1
Gender:Female  Submitted:2011-05-12, Days after onset: 2
Location:Tennessee  Entered:2011-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0768Z0UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3476AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3489AA0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1488Z1SCUN
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema and induration of entire lateral surface of (R) upper arm; tender on palpation of erythematous area.

VAERS ID:422839 (history)  Vaccinated:2011-05-04
Age:11.0  Onset:2011-05-05, Days after vaccination: 1
Gender:Female  Submitted:2011-05-06, Days after onset: 1
Location:New York  Entered:2011-05-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1271Z0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0972Z0SCRA
Administered by: Private     Purchased by: Private
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: About 2 x 4 cm area of swelling, erythema, warmth & tenderness at area of injection ((R) upper arm). Rx - Prednisone 30 mg BID x 4d.

VAERS ID:422844 (history)  Vaccinated:2011-05-10
Age:11.0  Onset:2011-05-10, Days after vaccination: 0
Gender:Female  Submitted:2011-05-13, Days after onset: 3
Location:New Jersey  Entered:2011-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1010Z0UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3507AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3352AA0UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Extreme red, hot and swollen of Rt upper arm all the way to elbow.

VAERS ID:422942 (history)  Vaccinated:2011-05-10
Age:11.0  Onset:2011-05-10, Days after vaccination: 0
Gender:Male  Submitted:2011-05-10, Days after onset: 0
Location:Arizona  Entered:2011-05-16, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3540AA0IMUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B048AC IMUN
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Dyspnoea, Pallor, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Child was very apprehensive. After injection was pale & weak; did not pass out. Smelling salt used. Began to c/o trouble breathing 10-15" after. Wheezing in chest detected, mother & 911 called. Oral BENADRYL 25mg given by school nurse. O2 & Epinephrine administered by paramedics. Taken to ER.

VAERS ID:422944 (history)  Vaccinated:2011-05-06
Age:11.0  Onset:2011-05-14, Days after vaccination: 8
Gender:Female  Submitted:2011-05-16, Days after onset: 2
Location:Missouri  Entered:2011-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB462BA1IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1317Y2IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0641Z1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mother reports 10-15 red flat spots on child''s neck and chest. States child feels fine. No fever. Did not seek medical care.

VAERS ID:422983 (history)  Vaccinated:2011-05-09
Age:11.0  Onset:2011-05-09, Days after vaccination: 0
Gender:Male  Submitted:2011-05-11, Days after onset: 2
Location:Oregon  Entered:2011-05-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS1000261UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left deltoid area red and hot to touch. Swelling, area measured about 115cm. width.

VAERS ID:423021 (history)  Vaccinated:2011-05-16
Age:11.0  Onset:2011-05-16, Days after vaccination: 0
Gender:Male  Submitted:2011-05-16, Days after onset: 0
Location:Wisconsin  Entered:2011-05-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma; allergies; eczema
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3764AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B040BA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Papule, Pruritus, Rash, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt noted wheezing - 15 min after MENACTRA & Tdap. Known asthma. Diffuse wheeze on exam & felt itchy & given Epi & albut neb. Sx cleared & remain clear 2 hour after treatment. Slight rash & fine papules. Allergist felt possible latex rxn.

VAERS ID:423081 (history)  Vaccinated:2011-05-04
Age:11.0  Onset:2011-05-05, Days after vaccination: 1
Gender:Female  Submitted:2011-05-06, Days after onset: 1
Location:California  Entered:2011-05-18, 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:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Clinical exam
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  IJUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site cellulitis, Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Cellulitis at injection site (4.1 x 3.3 x about 0.3 cm). Red and hot without lymphatic streaking or enlarged regional nodes. No fever. Tx: clindamycin.

VAERS ID:423105 (history)  Vaccinated:2008-08-22
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2011-05-12
Location:Michigan  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES1102USA01890
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0430X1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Pain
SMQs:
Write-up: Information has been received from a physician concerning a now 13 year old male with no drug reaction/allergies and no pertinent medical history, who on 01-OCT-1998 was vaccinated with a first dose of VARIVAX (Merck) (dose, route and lot # not reported), a dose of DTP (unspecified) and dose MMR II (MSD). On 22-AUG-2008 the patient was vaccinated with a second dose of VARIVAX (Merck) (dose and route not reported, lot # 660671/0430X). After receiving doses of VARIVAX (Merck), the patient presented with a case of shingles. On 14-FEB-2011 the patient visited the office for this case and was given oral prednisone. No diagnostic laboratory tests were performed. At the time of the report, the patient''s outcome was unknown. According to the reporter the patient''s shingles was considered to be disabling with "a significant pain". Additional information has been requested.

VAERS ID:423145 (history)  Vaccinated:2010-03-17
Age:11.0  Onset:2010-04-14, Days after vaccination: 28
Gender:Female  Submitted:2011-05-12, Days after onset: 393
Location:Michigan  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chickenpox
Diagnostic Lab Data: None
CDC Split Type: WAES1004USA02391
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1227Y UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blister, Secondary transmission, Varicella
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Information has been received from a consumer whose son on 17-MAR-2010 was vaccinated with VARIVAX (Merck) (lot number 665586/1227Y) concerning her 11 year old daughter with a history of chickenpox when she was one year old who on 14-APR-2010 developed chickenpox. Her son did indeed receive VARIVAX (Merck) as well as VAQTA (MSD) (lot number 66030/1397Y) and "MCV4 meningitis vaccine " (other manufacturer). Her son did not develop any rash. The patient had chickenpox again and on the morning of 14-APR-2010, she had blisters on her stomach, back, arms and scalp. The patient felt fine otherwise. It was unknown if medical attention was sought. The outcome was not reported. Follow up information has been received which reported that on 30-AUG-2000 the patient was vaccinated with a dose of VARIVAX (Merck) at another office. She had red small pustular lesions on her limbs and trunk, no vesicles were noted. She went to see the physician and the physician''s impression was questionable chickenpox, but could not diagnose today. At the time of this report, the patient''s outcome was unknown. Follow up information has been received from the physician who reported that the patient did not receive our vaccine and had wild type chickenpox. This is one of several reports from the same source. Additional infection is not expected.

VAERS ID:423152 (history)  Vaccinated:1993-04-01
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-05-12
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic reaction to antibiotics
Diagnostic Lab Data: serum varicella zoster, negative
CDC Split Type: WAES1004USA03445
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Varicella virus test negative
SMQs:
Write-up: Information has been received from a Licensed Practical Nurse concerning a female patient with no pertinent medical history and erythromycin allergy who "17 years ago", in approximately April 1993, at 11 years of age was vaccinated with a dose of VARIVAX (Merck) (route and lot # unknown). Concomitant therapy included prenatal vitamins. The Licensed Practical Nurse reported that currently the patient had negative varicella titers. The patient sought unspecified medical attention. At the time of reporting, the patient''s outcome was unknown. Additional information has been requested.

VAERS ID:423154 (history)  Vaccinated:2010-04-20
Age:11.0  Onset:2010-04-20, Days after vaccination: 0
Gender:Male  Submitted:2011-05-12, Days after onset: 387
Location:Pennsylvania  Entered:2011-05-18, 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:
Preexisting Conditions: None
Diagnostic Lab Data: Blood pressure, 04/20/10, 100/60; temperature measurement, 04/20/10, 98.3; total heartbeat count, 04/20/10, (apical) 88
CDC Split Type: WAES1004USA03467
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
TDAP: TDAP (ADACEL)SANOFI PASTEUR  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1409Y1SCRA
Administered by: Private     Purchased by: Other
Symptoms: Face injury, Hyperhidrosis, Lip haemorrhage, Lip injury, Loss of consciousness, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a registered nurse, concerning a 11 year old male patient, with no medical history or medicines and no allergies, who on 23-JUL-2004, was vaccinated subcutaneously with 0.5 mL dose of VARIVAX (Merck) (lot number not reported). On 20-APR-2010, the patient received intramuscularly the second 0.5 mL dose of VARIVAX (Merck) (lot number 665882/1409Y). Other vaccines administered the same day included ADACEL and MENACTRA. On 20-APR-2010, before leaving the exam room, the patient fainted. The patient recovered right away and with no apparent injury. The patient sought unspecified medical attention. This is one of several reports concerning siblings received from the same source (MSD, WAES# 1004USA04407). Follow-up information has been received from a registered nurse, who reported that on 20-APR-2010, at 09:00 am, the patient received in the right deltoid the second dose of VARIVAX (Merck). The nurse reported that the patient received on the same date a dose of ADACEL as part of his well-child examination. The patient tolerated the injection process and was waiting for his younger brother''s immunization to be completed. When the patient stood to leave, his mother reported that he took several steps forward and leaned over. The mother thought that the patient was tying his shoe when he collapsed, striking his nose on the edge of the examination table footrest. The mother called for help and when the nurse arrived, she found the patient laying face down on the floor of the examination room. The patient was pale and diaphoretic. His pulse was normal but he was unconscious. The nurse rolled the patient onto his side in recover position and monitored him for approximately 45-60 seconds when the patient began to regain consciousness and respond to his name. The patient remained pale but his vital signs were stable. At that moment, the nurse was joined by a licensed practical nurse, who assisted in monitoring the patient. Temperature was 98.3, pulse (apical) was 88 and blood pressure was 100/60. The patient was responsive to questioning. The patient had no recollection of the event. Ice was applied to the contusion/abrasion on his nose. It was noted that he bit the inside of his lower lip which was bleeding slightly. Bleeding was controlled and he remained in the recovery position for approximately 15 minutes with continuous observation until the patient felt well enough to stand. The patient ambulated from the room on his own with an escort. No further information is available.

VAERS ID:423182 (history)  Vaccinated:2010-03-27
Age:11.0  Onset:2010-03-28, Days after vaccination: 1
Gender:Male  Submitted:2011-05-12, Days after onset: 410
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1003USA04567
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR230158A UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURERG3246BA UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1158Y1SCLA
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a Bachelor of Science in Nursing concerning a 12 year old male patient who on 27-MAR-2010 was vaccinated subcutaneously in the left arm with the second dose of VARIVAX (Merck) (lot number 665411/1158Y). The same day the patient was administered in the left arm with a dose of TDap (lot number G3246BA) and MENACTRA (lot number 230158A). It was reported that one day after the patient received VARIVAX (Merck) had fever of 101 degrees for 8 hours and halo effect that was 2 circles, 3 quarter of an inch wide with no open wounds, pink on the inner circle and white on the outer layer. The nurse stated that the swelling was going down and the patient was doing better. The nurse reported that she felt as though the fever was due to the other vaccines the patient received that day because none of the other vaccines were given in the same arm. It was unknown if the patient sought medical attention. Additional information has been requested.

VAERS ID:423285 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:2010-06-11
Gender:Male  Submitted:2011-05-12, Days after onset: 335
Location:Texas  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1006USA01805
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received from a physician concerning an 11 year old male who on unspecified date was vaccinated with a dose of VARIVAX (Merck). On 11-JUN-2010 the patient experienced shingles despite receiving VARIVAX (Merck). No lot number was provided. The patient sought unspecified medical attention. The patient''s shingles persisted. Additional information has been requested.

VAERS ID:423289 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2011-05-12
Location:Maryland  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1006USA02414
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site oedema, Injection site pain, Local reaction, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning an 11 to 12 year old male who on an unspecified date was vaccinated with VARIVAX (Merck) (lot# not reported). Subsequently the patient developed a severe local reaction shortly after receiving vaccination. The injection site had severe edema and redness. The patient was placed on an antibiotic and showed some improvement but the area remained hard and painful, so the antibiotic was switched. The patient also had a fever. At the time of the report, the patient was recovering. Additional information has been requested.

VAERS ID:423294 (history)  Vaccinated:2010-07-20
Age:11.0  Onset:2010-07-20, Days after vaccination: 0
Gender:Male  Submitted:2011-05-12, Days after onset: 296
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1007USA03079
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0224Z UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Local reaction
SMQs:
Write-up: Information has been received from a registered nurse concerning a 11 year old male patient who on 20-JUL-2010 was vaccinated with a 0.5 ml dose of VARIVAX (Merck) (lot# 665967/0224Z). It was unknown if the dose administered was the first or second. Between 20-JUL-2010 and 22-JUL-2010, after receiving VARIVAX (Merck), the patient had a localized reaction which may had been cellulitis. The patient was treated with ZYRTEC OTC, 10 mg, prednisone, 20 mg, BID, and azithromycin. It was unknown if the patient sought medical attention. At the time of the report, the outcome of the patient was unknown. Additional information has been requested.

VAERS ID:423299 (history)  Vaccinated:2010-07-22
Age:11.0  Onset:2010-07-23, Days after vaccination: 1
Gender:Male  Submitted:2011-05-12, Days after onset: 293
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1007USA03080
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0467Z UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site discomfort, Injection site erythema, Injection site swelling, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered nurse concerning a 11 year old male patient who on 22-JUL-2010 was vaccinated with a dose of VARIVAX (Merck) (Lot # 666863/0467Z), 0.5 mL (route of administration not reported). Concomitant therapy included BOOSTRIX. It was reported that on 23-JUL-2010 the patient experienced localized reaction, discomfort, swelling, redness at the injection site after receiving VARIVAX (Merck) (unknown whether this was the first or second dose). At the time of this report, the patient''s outcome was unknown. The patient sought unspecified medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:423300 (history)  Vaccinated:2011-02-01
Age:11.0  Onset:2011-02-01, Days after vaccination: 0
Gender:Female  Submitted:2011-05-12, Days after onset: 99
Location:Nebraska  Entered:2011-05-18, 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:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1102USA00704
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR  UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1187Z1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site oedema, Injection site swelling, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a licensed practical nurse concerning a 11 year old female who for "school and other requirement", on 01-FEB-2011 was vaccinated SC with the second dose of VARIVAX (Merck) (lot # 668473/1187Z). The patient was also given a dose of ADACEL on the same day. The doses were given in different arms. On 01-FEB-2011 the patient experienced an immediate reaction to the VARIVAX (Merck) at the injection site that looked like hives. The patient was given antihistamine and sent home. On 03-FEB-2011, the patient came back with a reaction to both injection sites. The VARIVAX (Merck) injection site was aggravated and the ADACEL injection site was bright red at that time. The patient was given CLARINEX as treatment. The patient was recovering at the time of this report. Follow up information has been received from the licensed practical nurse reporting that the 11 year old female patient with no pre-existing allergies or medical history or illness at the time of vaccination who on 01-FEB-2011 at 10:00 am was vaccinated SC into right arm with the second dose of VARIVAX (Merck) (lot # 668473/1187Z). The patient experienced swelling/edema immediately around the injection site. Redness/edema $g 6 cm persisted one week following. On 11-FEB-2011 the patient recovered from the events. No further information is expected.

VAERS ID:423362 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-05-12
Location:Washington  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1003USA04350
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Local reaction
SMQs:
Write-up: Information has been received from an office nurse concerning her now 11 year old daughter with significant allergies and allergic to antibiotics (names were unspecified) who was vaccinated with the second dose of VARIVAX (Merck) when she was 9 years old. After receiving the second dose of VARIVAX (Merck) the patient had a large local reaction at the injection site that went from the shoulder to the elbow. The nurse did not mention what arm the vaccine was given in. It was unknown if the patient sought medical attention. At the time of the report, the patient''s status was unknown. Additional information has been requested.

VAERS ID:423391 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:2010-08-10
Gender:Female  Submitted:2011-05-12, Days after onset: 275
Location:Illinois  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES1008USA01566
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash, Varicella post vaccine
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a licensed practical nurse concerning an 11 year old female child with no medical history or allergies who on unspecified dates was vaccinated with two doses of VARIVAX (Merck). There was no concomitant medication. On 10-AUG-2010 the patient experienced chicken pox, with more than 50 spots on her head, abdomen, back and legs. There were no laboratory studies performed. The patient sought unspecified medical attention. At the time of report, the patient''s outcome was unknown. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:423404 (history)  Vaccinated:2010-07-20
Age:11.0  Onset:2010-07-21, Days after vaccination: 1
Gender:Male  Submitted:2011-05-12, Days after onset: 295
Location:North Carolina  Entered:2011-05-18, 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:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1008USA01907
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0224Z UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a nurse concerning a 11 year old male patient who on 20-JUL-2010 was vaccinated with a dose of VARIVAX (Merck) (lot 665967/0224Z). On 21-JUL-2010, one day post vaccination, the patient experienced redness and warmth at the injection site. The patient was treated with prednisone "Z-pak". The office followed-up with the patient on 23-JUL-2010 and he was fine. The nurse also reported that the VARIVAX (Merck) was the only vaccine received given at that particular injection site. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:423423 (history)  Vaccinated:2010-08-06
Age:11.0  Onset:2010-08-07, Days after vaccination: 1
Gender:Female  Submitted:2011-05-12, Days after onset: 278
Location:New Jersey  Entered:2011-05-18, 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: Asthma; Rhinitis allergic; Penicillin allergy; Latex allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1008USA01297
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3460BA UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0547Z SCUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Oedema peripheral
SMQs:, Cardiac failure (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 registered nurse (R.N.) concerning an 11 year old female patient with asthma, allergic rhinitis and allergy to amoxicillin and latex who on 06-AUG-2010 was vaccinated subcutaneously with a 0.5mL dose of VARIVAX (Merck) (Lot number 666920/0547Z) (Expiration date: 08-APR-2012). Concomitant therapy included albuterol inhaler, XOPENEX and PULMICORT in nebulizer. The nurse reported that on 07-AUG-2010 the patient called to report that the injection site was reddened 3.5 inches in diameter. On 07-AUG-2010, the patient''s mother called to report that patient''s arm was swollen and had doubled in size. Patient was afebrile at that time. Patient was taken to the emergency room where she was examined by a physician who diagnosed the patient with cellulitis. Patient was hospitalized and put on an antibiotic and sent home. At the time of report, the patient was recovering. Follow-up information has been received from the registered nurse, concerning the 11 year old female patient who on 06-AUG-2010 was vaccinated subcutaneously with a 0.5mL dose of VARIVAX (Merck) (Lot number 666920/0547Z) (Expiration date: 08-APR-2010). Concomitant therapy also included MENACTRA (Lot # U3460BA). The nurse reported on 07-AUG-2010 that the patient''s mother called to report that the patient had a 3.5 centimeter red mark on her left arm. On 08-AUG-2010 the mother called the nurse and took the patient to the emergency room. The patient was diagnosed with cellulitis. Nurse reported that the patient was not admitted to the hospital. Additional information has been requested.

VAERS ID:423470 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-05-12
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1102USA03506
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site cellulitis
SMQs:
Write-up: Information has been received from a nurse practitioner concerning a 11 year old female patient who on an unspecified date was vaccinated with a dose of VARIVAX (Merck) (lot number not provided), at school. Concomitant therapy included Tdap (manufacturer unspecified). The nurse stated that on 25-FEB-2011 the patient came to see her due to an injection site reaction of cellulitis. The patient sought unspecified medical attention. It was unspecified if any treatment was given or any lab diagnostic studies were performed. At the time of the report the patient''s outcome was unknown. Additional information has been requested.

VAERS ID:423496 (history)  Vaccinated:2011-03-07
Age:11.0  Onset:2011-03-08, Days after vaccination: 1
Gender:Female  Submitted:2011-05-12, Days after onset: 64
Location:Kentucky  Entered:2011-05-18, 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: None
Diagnostic Lab Data: None
CDC Split Type: WAES1103USA01587
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1273Z SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 11 year old female with no pertinent medical history or drug reactions/allergies who on 07-MAR-2011 (also reported as 08-MAY-2001) was vaccinated SC with 0.5 ml VARIVAX (Merck) (lot # 668602/1273Z, Exp. September 2012). There was no concomitant medication. On 08-MAR-2011 the patient''s father called the physician''s office to report that the patient had developed a painful, no itchy, "red welt" at the injection site that was the size of a golf ball. The patient was treated with MOTRIN and BENADRYL. On 10-MAR-2011 the patient came to the physician''s office and the injection site was noted to be red and warm to touch. The diameter of the red area was 3-4 centimeters. The registered nurse reported that the patient''s father reported that the diameter of the red area was growing in size, but that the redness was fading and the pain was less. The patient did not recover from these events at the time of this report. No lab diagnostic studies were performed. Additional information has been requested.

VAERS ID:423509 (history)  Vaccinated:2010-07-22
Age:11.0  Onset:2010-07-23, Days after vaccination: 1
Gender:Male  Submitted:2011-05-12, Days after onset: 293
Location:North Carolina  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1008USA01911
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0467Z1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Discomfort, Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning an "11 year old" male patient who on 22-JUL-2010 was vaccinated with the second dose of VARIVAX (Merck) (lot # 666863/0467Z). On 23-JUL-2010 the patient returned to the office with discomfort and redness (unspecified where). At the time of the reporting, the patient''s status was unknown. This is one of two reports from the same source. The patient''s brother''s experience has been captured in WAES 1008USA03167. Additional information has been requested.

VAERS ID:423528 (history)  Vaccinated:2010-07-22
Age:11.0  Onset:2010-07-23, Days after vaccination: 1
Gender:Male  Submitted:2011-05-12, Days after onset: 293
Location:North Carolina  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1008USA03167
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0467Z1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Discomfort, Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning an "11 year old" male patient who on 22-JUL-2010 was vaccinated with the second dose of VARIVAX (Merck) (lot # 666863/0467Z). On 23-JUL-2010 the patient returned to the office with discomfort and redness (unspecified where). At the time of the reporting, the patient''s status was unknown. This is one of two reports from the same source. The patient''s sibling''s experience has been captured in WAES1008USA01911. Additional information has been requested.

VAERS ID:423596 (history)  Vaccinated:2010-06-16
Age:11.0  Onset:2010-06-16, Days after vaccination: 0
Gender:Male  Submitted:2011-05-12, Days after onset: 330
Location:North Carolina  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES1006USA03219
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0994Y1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Urine analysis
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a medical assistant concerning a 11 year old male with no pertinent medical history and no drug allergies who on 25-FEB-2003 was vaccinated with the first 0.5ml dose of VARIVAX (Merck) (lot# 643082/0593M, expiration date unknown) (SC). On 16-JUN-2010, the patient received the second 0.5ml dose of VARIVAX (Merck) (lot# 665034/0994Y, expiration date 13-JUL-2011) (SC). Concomitant therapy included DETROL. On 17-JUN-2010 the patient experienced red and swollen at the injection site of the upper left arm. The patient visited an office. Urine analysis was performed and result was unknown. At the time of the report, the patient had not recovered. Follow up information has been received from the medical assistant and the physician concerning an 11 year old male patient with no illness at time of vaccination and no pre-existing allergies, birth defects, medical conditions who on 16-JUN-2010 was subcutaneously vaccinated with the second dose of VARIVAX (Merck) (665034/0994Y) in his left arm. On 16-JUN-2010 (previously reported as 17-JUN-2010), the patient experienced redness, swelling, pain at injection site of his left upper arm which worsen for 3 days after injection was given. There were no relevant diagnostic tests and laboratory data. On 22-JUN-2010, the patient recovered. No further information is available.

VAERS ID:423610 (history)  Vaccinated:2010-07-22
Age:11.0  Onset:2010-07-23, Days after vaccination: 1
Gender:Unknown  Submitted:2011-05-12, Days after onset: 293
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1008USA03537
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0467Z UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site discomfort, Injection site erythema, Injection site swelling, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered nurse concerning a 11 year old patient who on 22-JUL-2010 was vaccinated with a dose of VARIVAX (Merck) (Lot # 666863/0467Z), 0.5 mL (route of administration not reported). Concomitant therapy included BOOSTRIX. It was reported that on 23-JUL-2010 the patient experienced localized reaction, discomfort, swelling, redness at the injection site after receiving VARIVAX (Merck) (unknown whether this was the first or second dose). At the time of this report, the patient''s outcome was unknown. The patient sought unspecified medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:423614 (history)  Vaccinated:2010-08-23
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2011-05-12
Location:Louisiana  Entered:2011-05-18, 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: Attention deficit/hyperactivity disorder; Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES1008USA03616
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a nurse concerning an 11 year old male with attention deficit/hyperactivity disorder (ADHD) and penicillin allergy who on 23-AUG-2010 was vaccinated with a dose of VARIVAX (Merck) (LOT# not reported). Concomitant therapy included FOCALIN. After receiving the vaccine, the patient experienced redness and swelling of his left arm at the injection site. There were no lab diagnostic studies performed. The patient sought medical attention via visiting to school nurse. The patient''s redness and swelling of his left arm at the injection site persisted. Additional information has been requested.

VAERS ID:423621 (history)  Vaccinated:2010-08-09
Age:11.0  Onset:2010-08-31, Days after vaccination: 22
Gender:Female  Submitted:2011-05-12, Days after onset: 254
Location:Illinois  Entered:2011-05-18, 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: Diabetes
Preexisting Conditions:
Diagnostic Lab Data: Blood glucose, 08/31/10, was in the 400s; Blood glucose, 09/01/10, was in the 400s; Urinalysis, 08/31/10, positive for ketonuria; Urinalysis, 09/01/10, positive for ketonuria
CDC Split Type: WAES1009USA00168
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0216Y IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNRA
Administered by: Public     Purchased by: Other
Symptoms: Blood glucose increased, Ketonuria, Nasal congestion, Urine analysis abnormal, Urine ketone body present
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)
Write-up: Information has been received from a Registered Nurse concerning an 11 year old female patient with diabetes and no drug reactions or allergies who last week on approximately 24-AUG-2010 was vaccinated by an unspecified route with an unspecified dose of VARIVAX (Merck) (Lot# unknown). Concomitant therapy included insulin. The school nurse reported that the patient on 31-AUG-2010, presented with an elevated blood glucose level, ketonuria and a stuffy nose. The school nurse reported that the blood glucose levels on 31-AUG-2010 and 01-SEP-2010, where both in the 400s, and that the patient tested positive for ketonuria on both days. No specific values were available. The school nurse stated that she conferred with the patient''s parents and physician and reported that the patient''s physician ordered an increase in the quantity of insulin. At the time of the report, the patient was recovering. The patient sought medical attention by seeing school nurse. Follow up information has been received from a Registered Nurse who indicated that the patient was a student who on 09-AUG-2010, was vaccinated with a dose of VARIVAX (Merck) into her right arm. Secondary suspect vaccination included a dose of GARDASIL (Lot# 663451/0216Y) given IM into her left deltoid. It was reported that on 31-AUG-2010, the patient''s blood sugar ran high for several weeks. Illness at the time of vaccination included increased blood sugar and body spilling out ketones in urine. According to the reporting nurse, the physician thought that it might be an insulin per mal function and the patient had improved with using insulin syringes again. Additional information is not expected.

VAERS ID:423631 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Unknown  Submitted:2011-05-12
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1009USA00534
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received concerning that an 11 year old patient who was on an unspecified date vaccinated with the first dose of VARIVAX (Merck) (Lot # not reported). Subsequently, the patient presented with mild case of the chickenpox. It was unknown if the patient sought medical attention. At the time of reporting, the patient''s outcome was unknown. The patient''s sibling also presented with a mild case of the chickenpox after received the first dose of VARIVAX (Merck) (WAES#1009USA00399). No further information is available.

VAERS ID:423638 (history)  Vaccinated:2010-08-25
Age:11.0  Onset:2010-08-25, Days after vaccination: 0
Gender:Male  Submitted:2011-05-12, Days after onset: 260
Location:New York  Entered:2011-05-18, 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: Syncope; Anxiety
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1009USA00986
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a physician concerning an approximately 8 year old (8 or 9) year old male patient who on approximately 25-AUG-2010 (within the last two weeks), was vaccinated with a dose of VARIVAX (Merck) (Lot # not provided). Concomitant therapies included vaccination with a dose of meningococcal vaccine (unspecified) (manufacturer unspecified) (Lot # not provided) and a dose of TDAP (manufacturer unspecified) (Lot # not provided). The physician reported that the patient after receiving a dose of VARIVAX (Merck) experienced syncope in the office and was observed in office for an hour. Patient recovered in office. Follow-up information was received from a medical assistant who clarify that the patient was 11 year old. The medical assistant also stated that the patient never received VARIVAX (Merck) and the physician diagnosed the syncopal episode as being related to anxiety over an injection. Additional information is not expected.

VAERS ID:423655 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Unknown  Submitted:2011-05-12
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1009USA04066
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a nurse concerning a 11 year old patient who on an unspecified date was vaccinated with at least one dose of VARIVAX (Merck) (Lot # and route no reported). The nurse reported that the patient on an unspecified date came down with chickenpox. At the time of the report, the patient outcome was unknown. The patient sought unspecified medical attention. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:423672 (history)  Vaccinated:2010-08-31
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-05-12
Location:Iowa  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Irritable bowel syndrome
Preexisting Conditions:
Diagnostic Lab Data: Serum varicella zoster, Negative
CDC Split Type: WAES1009USA05537
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1385X1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Crohn's disease, Varicella virus test negative
SMQs:, Gastrointestinal premalignant disorders (narrow), Ischaemic colitis (broad)
Write-up: Information has been received from a licensed practical nurse concerning an approximately 11 year old female patient with irritable bowel syndrome and no drug reactions or allergies who on 06-MAY-2004, was vaccinated with the first dose of VARIVAX (Merck) (Lot# not reported, expire date 27-OCT-2010)). On 31-AUG-2010, the patient was vaccinated with the second dose of VARIVAX (Merck) (Lot# not reported). On an unspecified date, the patient was diagnosed with Crohn''s disease after receiving VARIVAX (Merck). There was not concomitant medication. It was also reported that the patient''s varicella titer was found to be negative. At the time of the report, the patient had not recovered. The patient sought unspecified medical attention. On follow up information received on 22-NOV-2010, the medical assistant reported that the patient''s Crohn''s Disease was unrelated to the dose of VARIVAX (Merck). Follow up information has been received from the medical assistant concerning the female patient who on 06-MAY-2004, was vaccinated with the first dose of VARIVAX (Merck) (Lot# 647259/1137N). On 31-AUG-2010, the patient was vaccinated with the second dose of VARIVAX (Merck) (Lot# 662450/1385X). It was reported that there was no adverse reaction. The GI doctor wanted to know if having Crohn''s disease was going to effect the VARIVAX (Merck) from working. Patient had Crohn''s had nothing to do with VARIVAX (Merck). GI doctor did not feel Crohn''s was from the VARIVAX (Merck). No further information is available.

VAERS ID:423712 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2011-05-12
Location:Illinois  Entered:2011-05-18, 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:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1010USA02315
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Local reaction
SMQs:
Write-up: Information has been received from a nurse concerning a male patient between the age of 11-13 who on an unspecified date was vaccinated with a dose of VARIVAX (Merck) (Lot# unknown). It was reported that the patient also received a dose of influenza virus vaccine (unspecified) (Lot# unknown) (manufactured unknown). The nurse reported that the patient experienced a localized reaction after receiving the dose of VARIVAX (Merck). The nurse stated that the patient had called the physician to report the events. On 19-OCT-2010, the patient had recovered. The patient sought unspecified medical attention. The health care professional contacted during telephone follow up could not supply the following information: patient name, date of birth, dates of vaccination, lot number. This is one of several reports from the same source. No further information is available.

VAERS ID:423728 (history)  Vaccinated:2010-10-20
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-05-12
Location:Kentucky  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES1011USA00502
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0969Z1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a healthcare worker concerning an approximately 11 year old female patient with no pertinent medical history and no drug reactions/allergies, who on 19-NOV-1999 was vaccinated with a first dose of VARIVAX (Merck) (Lot # not reported) and a second dose on 20-OCT-2010 (Lot # 668533/0969Z) SQ. Patient also received on 20-OCT-2010, a dose of GARDASIL and influenza virus vaccine (unspecified). Patient''s mother called the physician and stated that on an unspecified date the patient had developed chicken pox marks on her body. There were no Lab diagnosis/studies performed. At the time of the report the patient had not recovered. The patient sought unspecified medical attention. No further information is available.

VAERS ID:423779 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-05-12
Location:Unknown  Entered:2011-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chickenpox
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1012USA01937
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure to communicable disease, Hypersomnia, Polydipsia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)
Write-up: This report was received from Novartis (manufacturer report number S2010US32233) concerning an 11 year old female patient with a history of 2 cases of chickenpox even after receiving VARIVAX (Merck), who on an unspecified date was vaccinated with a dose of VARIVAX (Merck) (Lot # and route not reported). It was reported that the patient increased in sleep patterns, drinking like there is no tomorrow and exposed to chickenpox. At the time of the report, the outcome of the patient was not reported. This was originally reported by a consumer. Additional information has been requested.

VAERS ID:423790 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2011-05-12
Location:Illinois  Entered:2011-05-18, 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:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1012USA03051
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Local reaction
SMQs:
Write-up: Information has been received from a nurse concerning a male patient between the age of 11-13 who on an unspecified date was vaccinated with a dose of VARIVAX (Merck) (Lot# unknown). It was reported that the patient also received a dose of influenza virus vaccine (unspecified) (Lot# unknown) (manufactured unknown). The nurse reported that the patient experienced a localized reaction after receiving the dose of VARIVAX (Merck). The nurse stated that the patient had called the physician to report the events. On 19-OCT-2010, the patient had recovered. The patient sought unspecified medical attention. The health care professional contacted during telephone follow up could not supply the following information: patient name, date of birth, dates of vaccination, lot number. This is one of several reports from the same source. No further information is available.

VAERS ID:423211 (history)  Vaccinated:2011-05-16
Age:11.0  Onset:2011-05-16, Days after vaccination: 0
Gender:Male  Submitted:2011-05-19, Days after onset: 3
Location:Virginia  Entered:2011-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Limb discomfort, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Severe swelling and redness at site of injection. Arm warm and uncomfortably swollen from shoulder area down to elbow.

VAERS ID:423233 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:2011-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rash on face
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB469AA1IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3360AA UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3052CA UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1274Z1SCLA
Administered by: Private     Purchased by: Other
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling to (L) arm. Do cold compress. Ibuprofen given.

VAERS ID:423324 (history)  Vaccinated:2011-05-18
Age:11.0  Onset:2011-05-18, Days after vaccination: 0
Gender:Female  Submitted:2011-05-19, Days after onset: 1
Location:Michigan  Entered:2011-05-19
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
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 0 AR
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0 AR
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 6 AR
Administered by: Public     Purchased by: Public
Symptoms: Headache
SMQs:
Write-up: Severe headache. Took ibuprofen. Symptoms were gone within an hour and did not return.

VAERS ID:423334 (history)  Vaccinated:2011-05-18
Age:11.0  Onset:2011-05-18, Days after vaccination: 0
Gender:Female  Submitted:2011-05-19, Days after onset: 1
Location:California  Entered:2011-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU38781AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3874AA IMLA
Administered by: Private     Purchased by: Private
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: Approx. 1 hr. after vaccines were administered in Pt.''s (L) delt. pain & redness started per Pt. mom. Pt. returned (on 5/19/11) to office with redness, warm to touch & slightly swollen (L) delt. area measuring 110mm x 100mm. Tx: cool compresses, TYLENOL & monitor area.

VAERS ID:423337 (history)  Vaccinated:2011-05-18
Age:11.0  Onset:2011-05-18, Days after vaccination: 0
Gender:Female  Submitted:2011-05-19, Days after onset: 1
Location:California  Entered:2011-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Heart rate: 230 on digital PO monitor
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1778Y UNRL
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3509AA UNRL
TDAP: TDAP (ADACEL)SANOFI PASTEURU3554CA UNLL
Administered by: Private     Purchased by: Public
Symptoms: Heart rate decreased, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad)
Write-up: Patient for 11 yo physical, received Tdap, MENACTRA, HPV #1, and 05 minutes presents tachycardia up to 230 BPM on digital PO2 monitor, several valsalva maneuvers applied, heart rate decreased 140, paramedics called to E.D.

VAERS ID:423469 (history)  Vaccinated:2011-05-09
Age:11.0  Onset:2011-05-10, Days after vaccination: 1
Gender:Male  Submitted:2011-05-13, Days after onset: 3
Location:Ohio  Entered:2011-05-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B048AC IJLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling and pain at injection site of BOOSTRIX. Induration 5 cm diameter.

VAERS ID:423589 (history)  Vaccinated:2011-05-10
Age:11.0  Onset:2011-05-10, Days after vaccination: 0
Gender:Male  Submitted:2011-05-20, Days after onset: 10
Location:Texas  Entered:2011-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3540AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness & swelling 3in around injection site.

VAERS ID:423581 (history)  Vaccinated:2011-05-10
Age:11.0  Onset:2011-05-13, Days after vaccination: 3
Gender:Female  Submitted:2011-05-22, Days after onset: 9
Location:Illinois  Entered:2011-05-23, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER54330IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: (L) arm had raised, warm, reddened area, 9 cm in diameter, pt was given Rx for KEFLEX 500mg 2 PO BID x 10 days.

VAERS ID:423745 (history)  Vaccinated:2011-05-20
Age:11.0  Onset:2011-05-21, Days after vaccination: 1
Gender:Female  Submitted:2011-05-23, Days after onset: 2
Location:Massachusetts  Entered:2011-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0337Z0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3539AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3490AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Feeling hot, Flatulence, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Nausea and cellulitis onset next day, warmth & fluctuance 2 days later, warmth & nausea persisted.

VAERS ID:423860 (history)  Vaccinated:2011-05-13
Age:11.0  Onset:2011-05-14, Days after vaccination: 1
Gender:Male  Submitted:2011-05-17, Days after onset: 3
Location:Florida  Entered:2011-05-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: (1) Allergic rhinitis; (2) Reactive Airway Disease
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3671AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3111CA0UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Local swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Local swelling & redness noted 5/14/11 better by 5/17/11 only minimal itching used BENADRYL orally & oral MOTRIN .

VAERS ID:423952 (history)  Vaccinated:2011-05-17
Age:11.0  Onset:2011-05-19, Days after vaccination: 2
Gender:Male  Submitted:2011-05-19, Days after onset: 0
Location:Georgia  Entered:2011-05-25, 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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0126AA0IMRL
TDAP: TDAP (ADACEL)SANOFI PASTEURU3491DA0IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1280Z1SCLL
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Positive for large (15cm) in diameter redness, with some swelling & tenderness in the middle (3 cm diameter) on left anterior thigh with needle puncture spot in center. Treatment - Ibuprofen prn, cool compresses, BENADRYL 25-50mg every 4-6 hour prn - observation.

VAERS ID:423956 (history)  Vaccinated:2011-05-17
Age:11.0  Onset:2011-05-18, Days after vaccination: 1
Gender:Male  Submitted:2011-05-19, Days after onset: 1
Location:Kentucky  Entered:2011-05-25, 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: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB498AA IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3437AA IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B069BB IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1488Z SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site reaction, Injection site warmth, Skin lesion
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 x 3 inch red warm lesion at injection site.

VAERS ID:423964 (history)  Vaccinated:2011-05-17
Age:11.0  Onset:2011-05-18, Days after vaccination: 1
Gender:Male  Submitted:2011-05-19, Days after onset: 1
Location:Utah  Entered:2011-05-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3753AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSDTPA614C90IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient was seen at clinic on 5-18-11. Clinic MD diagnosed him with swelling and redness below the Tdap and is warm to the touch. He also was diagnosed with cellulitis.

VAERS ID:424163 (history)  Vaccinated:2011-05-26
Age:11.0  Onset:2011-05-26, Days after vaccination: 0
Gender:Female  Submitted:2011-05-26, Days after onset: 0
Location:New York  Entered:2011-05-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1570Z0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3779AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Administered vaccines in box # 13, after administered pt experienced syncopal episode. Pt was in sitting position at the time & laid down, supine position, with legs elevated. Pt symptoms fully resolved after 10 min. After 15 min pt assisted to standing position. Pt left fine. After pt was assisted to standing position, left office in good condition.

VAERS ID:424199 (history)  Vaccinated:2011-05-26
Age:11.0  Onset:2011-05-26, Days after vaccination: 0
Gender:Male  Submitted:2011-05-26, Days after onset: 0
Location:Pennsylvania  Entered:2011-05-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B067GA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0835Z SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pruritus, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Child received Tdap and Varicella in (L) arm at approximately 09:30. At about 1140 am pt return to vaccine area LDT area itchy, (+) hives and warm to touch. No resp. symptoms. 25 mg of BENADRYL adm. IM LOQ per standing orders.

VAERS ID:424200 (history)  Vaccinated:2011-05-23
Age:11.0  Onset:2011-05-24, Days after vaccination: 1
Gender:Female  Submitted:2011-05-26, Days after onset: 2
Location:Pennsylvania  Entered:2011-05-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3779AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3819BA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Had syncopal episode while on field trip on 5/24/11 - in museum. Possible episode of tachycardia evening of 5/23 - not well documented.

VAERS ID:424257 (history)  Vaccinated:2011-05-23
Age:11.0  Onset:2011-05-23, Days after vaccination: 0
Gender:Male  Submitted:2011-05-27, Days after onset: 4
Location:Texas  Entered:2011-05-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: Takes med for ADHD
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3464AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B048AC IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1097Z1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Activities of daily living impaired, Cold sweat, Fall, Feeling hot, Head injury, Hyperhidrosis, Skin warm, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Child went to mother''s classroom after receiving shots. Fainted - fell backwards on head. Had only strawberry milk for breakfast. Just finished P.E. class - was hot sweaty. Mom stated was "out" about minute. Was awake, warm, clammy when I reached room. Mom took to M.D. later that day. Missed next day. School nurse reported child vomited - thought maybe virus rather than from head injury.

VAERS ID:424491 (history)  Vaccinated:2010-03-01
Age:11.0  Onset:2010-03-01, Days after vaccination: 0
Gender:Female  Submitted:2011-05-24, Days after onset: 448
Location:Unknown  Entered:2011-05-27, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1005USA00861
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1684Y1UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event
SMQs:
Write-up: Information has been received from a registered nurse concerning an 11 year old female patient who "one or two months ago" approximately in March 2010, received a second adult dose of VAQTA (Lot # 666802/1684Y). The child''s mother noted that on a computer generated record it said that the child received a dose of GARDASIL (Lot # 662304/1013Y) but on the hand written medical legal record it was recorded as VAQTA (Lot # not recorded on the chart). No adverse reaction was noted. The first dose of VAQTA was given on 02-SEP-2005. The patient sought unspecified medical attention. Follow up information has been received from the registered nurse who reported that the medical assistant was 95% sure she gave the patient a dose of pediatric VAQTA and that there was a clerical error in which HPV vaccine printed out on the record. It was reported that the parent wanted to be 100 percent sure her child did not receive GARDASIL but there were no commercially available test for this. Also since this would have been the second dose of VAQTA it would be pointless to run hepatitis A antibody testing. There was no adverse reaction in this case. No further information is available.

VAERS ID:424294 (history)  Vaccinated:2011-04-02
Age:11.0  Onset:2011-04-02, Days after vaccination: 0
Gender:Female  Submitted:2011-05-31, Days after onset: 59
Location:Arizona  Entered:2011-05-31
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: short stature, underweight
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3439AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B058AA0IMRA
Administered by: Unknown     Purchased by: Public
Symptoms: Dizziness, Immediate post-injection reaction, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow), Hypersensitivity (narrow)
Write-up: Pt says she felt dizzy and that things were spinning immediately after the shots were injected. She says this feeling lasted about 1 week after the shots.

VAERS ID:424308 (history)  Vaccinated:2011-04-27
Age:11.0  Onset:2011-04-27, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2011-05-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Anemia; Menorrhagia
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3872AA UNLA
Administered by: Private     Purchased by: Private
Symptoms: CSF test, Dizziness, Hypoaesthesia, Nausea, Nuclear magnetic resonance imaging brain, Optic neuritis, Pain in extremity, Paraesthesia, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular infections (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: 30 min to few hrs after Tdap, pt c/o numbness and tingling in fingers & hand. 3 days later c/o leg pains. Approximately 10-12 days later c/o nausea, emesis, dizziness, and blurred vision. Dx''d = optic neuritis. Required brain MRI, MRA. ER visit for CSF, LP done, then hospitalized.

VAERS ID:424350 (history)  Vaccinated:2011-05-04
Age:11.0  Onset:2011-05-05, Days after vaccination: 1
Gender:Male  Submitted:2011-05-31, Days after onset: 26
Location:California  Entered:2011-05-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: HTN MORBID OBESITY
Preexisting Conditions: NO
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3781AA0 LA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B058BA0 LA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Feeling hot, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: REDNESS, HEAT, SWELLING AND PRURITUS TREATED WITH BENADRYL

VAERS ID:424373 (history)  Vaccinated:2011-05-25
Age:11.0  Onset:2011-05-26, Days after vaccination: 1
Gender:Female  Submitted:2011-05-31, Days after onset: 5
Location:Michigan  Entered:2011-05-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prior pharyngitis non strep
Preexisting Conditions: None.
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3779AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3958AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1701Z1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Induration, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling, induration, fever right arm.

VAERS ID:424435 (history)  Vaccinated:2011-05-31
Age:11.0  Onset:2011-06-01, Days after vaccination: 1
Gender:Male  Submitted:2011-06-01, Days after onset: 0
Location:North Carolina  Entered:2011-06-01
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: Strep test negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1016Z1IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS1000230IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Pyrexia, Streptococcus test negative
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: High fever 103.7 oral and dizziness started morning after injections.

VAERS ID:424816 (history)  Vaccinated:2011-05-26
Age:11.0  Onset:2011-05-27, Days after vaccination: 1
Gender:Male  Submitted:2011-05-31, Days after onset: 4
Location:New York  Entered:2011-06-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: SEPTRA - rash
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3832A0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC37190IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt noted redness and induration of (L) deltoid area 4 x 4 cm. Warm but not tender.

VAERS ID:424889 (history)  Vaccinated:2011-06-01
Age:11.0  Onset:2011-06-02, Days after vaccination: 1
Gender:Male  Submitted:2011-06-06, Days after onset: 4
Location:Indiana  Entered:2011-06-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3486CA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site streaking, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness & swelling with streaks below injection site within 48 hours of administration. Cold compress applied, BENADRYL given. Swelling & tenderness by the 4th day.

VAERS ID:424921 (history)  Vaccinated:2011-05-12
Age:11.0  Onset:2011-05-12, Days after vaccination: 0
Gender:Female  Submitted:2011-06-07, Days after onset: 26
Location:Texas  Entered:2011-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TX20110023PU
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B048AC0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURH3540AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.174641SCRA
Administered by: Other     Purchased by: Public
Symptoms: Abdominal pain upper, Dizziness, Flushing, Headache, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: FACE FLUSHED DIZZY, SPOTS BEFORE EYES, HEADACHE, STOMACH ACHE. LAID CLIENT DOWN TO MONITOR BLOOD PRESSURE. BP 124/86 142/88 112/74. HR 105 INITIALLY AND THEN RETURNED TO 78 AFTER 15 MINUTES. FOLLOW UP PHONE CALL TO MOM 6:58 PM 5/12/11 DOING WELL.

VAERS ID:424953 (history)  Vaccinated:2011-06-07
Age:11.0  Onset:2011-06-07, Days after vaccination: 0
Gender:Male  Submitted:2011-06-07, Days after onset: 0
Location:Texas  Entered:2011-06-07
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: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3753AA UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3554CA UNLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Hypoaesthesia, Neurological examination normal, Pain in extremity, Tenderness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt. c/o leg pain/numbness/headaches. As PE WNL except tenderness on calf. Neuro intact. Care discussed with parent by MD 6/7/1011.

VAERS ID:424980 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-05-18
Location:Texas  Entered:2011-06-08, Days after submission: 21
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
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS460011A IMLA
Administered by: Private     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: Pt bitten by dog in (L) hand Sunday 5/15/11.

VAERS ID:425033 (history)  Vaccinated:2011-06-07
Age:11.0  Onset:2011-06-07, Days after vaccination: 0
Gender:Male  Submitted:2011-06-07, Days after onset: 0
Location:Arizona  Entered:2011-06-08, Days after submission: 1
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: Prior history of vasovagal syncope
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB461CA IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS1000220IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B051AB0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Muscle rigidity, Pallor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Vaccines given at 9:10. Pt did great. As he & parent were driving out of parking lot he became pale, rigid & unresponsive for 10-20 seconds. Pt monitored for 90 minutes then sent home in stable condition.

VAERS ID:425068 (history)  Vaccinated:2011-06-07
Age:11.0  Onset:2011-06-07, Days after vaccination: 0
Gender:Male  Submitted:2011-06-09, Days after onset: 2
Location:Maryland  Entered:2011-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: ALLERGIC TO AMOXICILLIN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA100320IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Local reaction, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: VERY LARGE LOCAL REACTION + ERYTHEMA, WARMTH AND MINIMAL INDURATION FROM DELTOID TO ELBOW- NONTENDER

VAERS ID:425092 (history)  Vaccinated:2011-05-23
Age:11.0  Onset:2011-05-24, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Oregon  Entered:2011-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Indurated area 6 cm around injection site.

VAERS ID:425102 (history)  Vaccinated:2011-06-07
Age:11.0  Onset:2011-06-07, Days after vaccination: 0
Gender:Male  Submitted:2011-06-09, Days after onset: 2
Location:Michigan  Entered:2011-06-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS1000220IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: (L) deltoid red & itchy (5 1/4" x 5 1/2" area) warm to touch. The night of the vaccine date, the area was smaller. It continued to get larger and showed up today for us to look at it (6/9/11).

VAERS ID:425143 (history)  Vaccinated:2011-05-17
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2011-06-09
Location:Illinois  Entered:2011-06-10, 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: Not reported.
Diagnostic Lab Data:
CDC Split Type: 201103230
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3779AA UNUN
TDAP: TDAP (ADACEL)SANOFI PASTEURC3518AA UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Finger deformity, Muscle spasms, Muscle tightness
SMQs:, Dystonia (broad)
Write-up: Initial case received from a pediatrician on 04 June 2011. An 11-year-old female patient, with no reported history, received the following vaccines on 17 May 2011: ADACEL (lot number C3518AA, MENACTRA (lot number U3779AA), hepatitis B (manufacturer and lot not reported), and VARIVAX (lot not reported). Within 2 weeks of vaccination, the patient developed a swan finger deformity, with muscle spasms and tightness. She was evaluated by orthopedic specialists, and per the reporter no cause had been established. No additional information was reported.

VAERS ID:425194 (history)  Vaccinated:2011-06-09
Age:11.0  Onset:2011-06-09, Days after vaccination: 0
Gender:Female  Submitted:2011-06-10, Days after onset: 1
Location:Oklahoma  Entered:2011-06-10
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: not resolved yet, no tests run
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS1000230IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B060CA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Tingling, numbness on side of injection, in left hand

VAERS ID:425218 (history)  Vaccinated:2011-06-06
Age:11.0  Onset:2011-06-07, Days after vaccination: 1
Gender:Female  Submitted:2011-06-10, Days after onset: 3
Location:Kentucky  Entered:2011-06-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1569Z0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3765AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3837BA0UNLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1697Z1UNUN
Administered by: Private     Purchased by: Private
Symptoms: 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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient received vaccines on 06-06-11. The next day pt presented with a swollen, tender (L) arm (at the site where the varicella vaccine was given). 5 x 5cm area mild erythema. Apply cool compress, TYLENOL PRN - call with changes, fever or increased swelling.

VAERS ID:425313 (history)  Vaccinated:2009-08-10
Age:11.0  Onset:2009-08-10, Days after vaccination: 0
Gender:Female  Submitted:2011-06-10, Days after onset: 669
Location:Unknown  Entered:2011-06-14, 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: The patient had a history of asthma, and milk allergy demonstrated by vomiting after milk-based formula as an infant; angioedema of hands after contact with spilled milk at one year of age.
Diagnostic Lab Data:
CDC Split Type: 201103279
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURUF551AA5IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactic reaction, Respiratory distress, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial report was received via a search of the scientific literature on 03 June 2011. The patient captured in this case was one of eight patients noted in the reference who experienced anaphylaxis after receiving a diphtheria, tetanus and acellular pertussis containing vaccine (manufacturer unknown). These patients tolerated their initial vaccinations but reacted to booster doses. A 11-year-old female patient had received an injection of Tdap vaccine (manufacturer unknown, lot number, route, site and date of administration not reported) and while driving home from the pediatricians, she developed anaphylaxis with symptoms of throat tightness, wheezing and respiratory distress. Corrective treatments consisted of epinephrine. The patient had a history of asthma, and milk allergy demonstrated by vomiting after milk-based formula as an infant and angioedema of hands after contact with spilled milk at one year of age. Laboratory testing showed the patient had increased IgE levels (96.1) within two years of vaccination. Outcome was not reported. This patient had previously been referenced in case number 2011-01614. The other seven patients have been captured in case numbers 2011-03272, -03275, -03276, -03277, -03278, -03280 and -03281. Documents held by sender: None.

VAERS ID:425320 (history)  Vaccinated:2011-06-06
Age:11.0  Onset:2011-06-07, Days after vaccination: 1
Gender:Male  Submitted:2011-06-09, Days after onset: 2
Location:Georgia  Entered:2011-06-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3780AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3828AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Urticaria & hives.

VAERS ID:425321 (history)  Vaccinated:2009-12-30
Age:11.0  Onset:2009-12-31, Days after vaccination: 1
Gender:Female  Submitted:2011-06-06, Days after onset: 521
Location:New York  Entered:2011-06-14, Days after submission: 8
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 60 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0312Y2IMAR
Administered by: Private     Purchased by: Unknown
Symptoms: Acute lymphocytic leukaemia
SMQs:, Malignant tumours (narrow)
Write-up: Diagnosed with Acute Lymphoblastic Leukemia (ALL) on 12/31/2009.

VAERS ID:425349 (history)  Vaccinated:2011-06-06
Age:11.0  Onset:2011-06-07, Days after vaccination: 1
Gender:Female  Submitted:2011-06-08, Days after onset: 1
Location:Washington  Entered:2011-06-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER492810IMUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER581600IMUN
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER00061SCUN
Administered by: Private     Purchased by: Unknown
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Varicella like rash.

VAERS ID:425364 (history)  Vaccinated:2011-05-31
Age:11.0  Onset:2011-06-01, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2011-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0306AA0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3840AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3553AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: S/E From Tdap & MENACTRA given both at LD - red, swollen, warm to touch, area about 2" x 3". Mom call advice nurse. Applied warm compress, gave Ibuprofen. Pt was relieved. No itchiness. Seen MD. Ordered to apply cold packs within 48 not relieved, SEPTRA ABX.

VAERS ID:425372 (history)  Vaccinated:2011-06-01
Age:11.0  Onset:2011-06-01, Days after vaccination: 0
Gender:Male  Submitted:2011-06-03, Days after onset: 2
Location:Texas  Entered:2011-06-14, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3357BA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2727AA UNRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site dryness, Injection site erythema, Injection site pain, Injection site papule, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: (R) upper arm (Tdap site) with 5 x 8 cm dry itchy papular red tender reaction. (L) upper arm (MENACTRA site) with 14 x 14 cm dry red itchy tender papular reaction. Both sites better after BENADRYL 50 mg.

VAERS ID:425401 (history)  Vaccinated:2011-06-14
Age:11.0  Onset:2011-06-14, Days after vaccination: 0
Gender:Male  Submitted:2011-06-14, Days after onset: 0
Location:Unknown  Entered:2011-06-14
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: Surgery to correct connected toes from birth to 9 months of age. Had pneumonia @ 5.5 years of age with fluid removal.
Diagnostic Lab Data: Unsure what was done at hospital
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH100AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Dizziness, Rash, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Patient received SQ Yellow Fever vaccination in his left upper arm @ ~ 0915 & had a syncopal episode ~ 5 minutes later lasting 5 minutes. Patient kept supine and apparently recovered completely within 15 minutes. Mother given instructions to take patient home with no physical activity for the rest of the morning. Received a phone call @ ~ 10:10 AM from the patient''s mother reporting that the patient had become lightheaded again and vomited food from breakfast. She also indicated that the patient had a fine yellow, non-pruritic rash on his abdomen and had briefly c/o a tightness in his chest, although he was presently not SOB and was speaking in full sentences without difficulty. His mother was given instructions to take the child to the nearest emergency department. She agreed to do so. Approximately 1 hour later I again called the patient''s mother to check on his progress. She stated he had been taken back to a treatment room, had been given Benadryl and was now experiencing a decreasing rash with no other symptoms.

VAERS ID:425446 (history)  Vaccinated:2011-06-14
Age:11.0  Onset:2011-06-14, Days after vaccination: 0
Gender:Male  Submitted:2011-06-15, Days after onset: 1
Location:Florida  Entered:2011-06-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA100490IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3577AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1310Z1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Hard, red and warm induration at injection site; mom states patient very uncomfortable d/t pain

VAERS ID:425482 (history)  Vaccinated:2011-06-13
Age:11.0  Onset:2011-06-14, Days after vaccination: 1
Gender:Male  Submitted:2011-06-15, Days after onset: 1
Location:Florida  Entered:2011-06-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3538BA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3111CA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1497Z1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Local reaction, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red, warm to touch with swelling 10mm x 10mm. No resp distress, local reaction.

VAERS ID:425488 (history)  Vaccinated:2011-06-15
Age:11.0  Onset:2011-06-15, Days after vaccination: 0
Gender:Male  Submitted:2011-06-15, Days after onset: 0
Location:Arizona  Entered:2011-06-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0180AA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3676AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B069BB0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Fall, Neurological examination normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Pt fainted falling forward off the exam table after receiving vaccines. Examined by physician vital signs and neuro check done, within normal limits.

VAERS ID:425496 (history)  Vaccinated:2011-06-13
Age:11.0  Onset:2011-06-13, Days after vaccination: 0
Gender:Female  Submitted:2011-06-15, Days after onset: 2
Location:North Carolina  Entered:2011-06-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Injection site nodule, Injection site oedema, Injection site pain, Injection site rash, Injection site urticaria, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pain at injection site, numbness and tingling in fingers, edema at injection site with golf ball size knot, hive like rash appearing around area of injection site. Symptoms not improved after ibuprofen and ice packs 72 hours later symptoms continue.

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