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Found 593491 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:311722 (history)  Vaccinated:2008-04-10
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-04-29
Location:Kansas  Entered:2008-05-06, 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: unknown
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
Administered by: Military     Purchased by: Other
Symptoms: Injection site reaction, Local reaction
SMQs:
Write-up: Localized reaction at injection site R deltoid per pt. mom vaccine was given 4-10-08 & pt. seen by Dr. 4-24-08 with rxn.

VAERS ID:311762 (history)  Vaccinated:2008-04-28
Age:11.0  Onset:2008-04-28, Days after vaccination: 0
Gender:Male  Submitted:2008-05-06, Days after onset: 8
Location:Colorado  Entered:2008-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2604AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2766AA0UNRA
Administered by: Other     Purchased by: Unknown
Symptoms: Nausea, Oedema peripheral, Pain in extremity, Throat irritation, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 3/9/08 told by client that after school he was having a lot of pain in his left arm, it swelled up, he got nauseated and vomited, and his throat felt itchy. His parents took him to the ER. Parents Spanish speaking only. Client reported no treatment.

VAERS ID:311896 (history)  Vaccinated:2008-05-06
Age:11.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 1
Location:Wisconsin  Entered:2008-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Welt at injection site of varicella~Varicella (no brand name)~1~1.00~Sibling
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2541AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2863AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1566U1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red flat "baseball sized" "welt" noted. Painful. Tylenol given. Has been at school today. Inst mom to continue with observation call PCP with increased symptoms. Mother denies wheezing or diffuculty breathing inst to go to urgent care or ER with these symptoms. Inst to call with questions or concerns. Mother verbilizes understanding. RN

VAERS ID:311898 (history)  Vaccinated:2008-05-05
Age:11.0  Onset:2008-05-06, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 2
Location:California  Entered:2008-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SEROQUEL 125mg A.M.;300mg@ 6 p.m. Depakote 750mg BID; Adderall XR 40mg A.M.
Current Illness: NONE
Preexisting Conditions: Bi-Polar; ADD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB377AA5IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2382BA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0782U1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Had variavax vaccine on 5/5/2008 p.m. on right SQ of arm developed sweeling, tenderness and pain at the sire 5x5 sweeling.Saw MD on 5/7/08 p.m.cellulitis , Keflex 250 mg qid for 7 days.

VAERS ID:311914 (history)  Vaccinated:2008-05-05
Age:11.0  Onset:2008-05-06, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 2
Location:Wisconsin  Entered:2008-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: latex-not known at time of vaccination
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B016BA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0086X1SCLA
Administered by: Other     Purchased by: Public
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: (L) arm reddened after 24 hr. Pt saw MD 5/8/08 and was instructed to put a cold pack to area. Mother of pt states he has a latex allergy-no reaction in (R) arm where Tdap was given on the same day.

VAERS ID:311964 (history)  Vaccinated:2008-05-07
Age:11.0  Onset:2008-05-09, Days after vaccination: 2
Gender:Female  Submitted:2008-05-09, Days after onset: 0
Location:Florida  Entered:2008-05-09
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: CBC, WBC 4.0; Hgb 12.8; HCT 39.1
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURC2937AA1UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU2616AA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Full blood count, Haematocrit normal, Haemoglobin normal, Oedema peripheral, Pyrexia, White blood cell count decreased
SMQs:, Cardiac failure (broad), Angioedema (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Right arm Menactra 10x13cm; Left arm TDap x8cm. Fever 104. Very swollen arm.

VAERS ID:311992 (history)  Vaccinated:2008-05-08
Age:11.0  Onset:2008-05-09, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 0
Location:Indiana  Entered:2008-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1967U0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2541AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2775AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Nausea, Pyrexia, Rash macular, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: red splotchy rash, nausea/vomiting, headache, dizziness, fever. OTC Benadryl, topical hydrocortisone cream for rash; continue to follow closely.

VAERS ID:311997 (history)  Vaccinated:2008-05-07
Age:11.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 1
Location:Arkansas  Entered:2008-05-09
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: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU2290AA4IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1797U1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Skin lesion, Swelling, Tenderness
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: Varicella administered in left upper outer arm - resulting in 3x4 cm tender, raised erythematous lesion; Tripedia administered in right deltoid - resulting in 2x2 tender, raised erythematous lesion

VAERS ID:312010 (history)  Vaccinated:2008-05-08
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-09
Location:Illinois  Entered:2008-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: He had a cold without fever
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB233AA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2567AA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient presented vomits, fever and malaise 10 hrs after administration of immunizations for Meningitis, and Hepatits A.

VAERS ID:312092 (history)  Vaccinated:2008-04-26
Age:11.0  Onset:2008-04-28, Days after vaccination: 2
Gender:Female  Submitted:2008-05-12, Days after onset: 14
Location:New York  Entered:2008-05-12
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2619AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B021BA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Local reaction
SMQs:
Write-up: Lg local reaction LA, no fever. Advised ice/ibuprofen/Benadryl.

VAERS ID:312098 (history)  Vaccinated:2008-04-08
Age:11.0  Onset:2008-04-09, Days after vaccination: 1
Gender:Female  Submitted:2008-04-10, Days after onset: 1
Location:Texas  Entered:2008-05-12, Days after submission: 32
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 no pre-existing medical conditions and no illness at the time of vaccination.
Diagnostic Lab Data:
CDC Split Type: 200801038
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB214AA IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2429A IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Paraesthesia, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial report was received 09 April 2008 from a health care professional. An 11-year-old female patient with no pre-existing medical conditions, had received an intramuscular left arm injection of Menactra, lot number U2429AA and an intramuscular right arm injection of Havrix, lot number AHAVB214AA (manufactured by GSK) on 08 April 2008 and within 24 hours, experienced tingling in both arms, vomiting and a fever of 100 degrees Fahrenheit. The patient had no illness at the time of vaccination. At the time of the report, the patient''s recovery status was unknown.

VAERS ID:312137 (history)  Vaccinated:2008-04-22
Age:11.0  Onset:2008-04-23, Days after vaccination: 1
Gender:Female  Submitted:2008-04-23, Days after onset: 0
Location:North Carolina  Entered:2008-05-12, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Season allergies
Diagnostic Lab Data:
CDC Split Type: NC08057
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB256AA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2540AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1766U1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Back of lt arm, red raised and itching. Site of varicella vaccine give 4/22/08. Instructed by Dr Benadryl PO

VAERS ID:312175 (history)  Vaccinated:2008-05-06
Age:11.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 1
Location:Washington  Entered:2008-05-13, 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: Zyrtec 10mg po QD
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB222AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B019AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1497U1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 days after varicella immuniz. 9x9 cm area of erythema & tenderness.

VAERS ID:312176 (history)  Vaccinated:2008-05-07
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-07
Location:Wisconsin  Entered:2008-05-13, 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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2899AA UNRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated

VAERS ID:312189 (history)  Vaccinated:2008-05-06
Age:11.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-07, Days after onset: 0
Location:New York  Entered:2008-05-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~Varicella (Varivax)~2~10~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: mild intermitted asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2606AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2899AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1503U2SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Child develop 3x3 cm warm, red, square area on L deltoid. Negative sign illness. Child examined 5/7/08. Plan: TYLENOL as needed, BENADRYL 25 mg at bedtime as needed. Recheck 2-3 days if not resolved.

VAERS ID:312192 (history)  Vaccinated:2008-05-06
Age:11.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 1
Location:Maine  Entered:2008-05-13, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1975U1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, 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: Pt had Varivax on 5/6/08 - had a rxn that started on 5/7/08 up to 1 1/2"-2" by 5/18/08. Red & puffy, no itching, no fever.

VAERS ID:312199 (history)  Vaccinated:2008-05-05
Age:11.0  Onset:2008-05-07, Days after vaccination: 2
Gender:Male  Submitted:2008-05-08, Days after onset: 1
Location:Nevada  Entered:2008-05-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: PCN
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC523011CA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: No adverse event
SMQs:
Write-up: Ice pack, MOTRIN, Trinmirholone cream.

VAERS ID:312357 (history)  Vaccinated:2008-05-12
Age:11.0  Onset:2008-05-14, Days after vaccination: 2
Gender:Male  Submitted:2008-05-15, Days after onset: 1
Location:New York  Entered:2008-05-15
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 (MENACTRA)SANOFI PASTEURU2621AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC526024BA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Limb discomfort
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left arm slightly red and discomfort. Advised to use ice and take ADVIL and call in 24 hours if still discomfort.

VAERS ID:312362 (history)  Vaccinated:2008-05-09
Age:11.0  Onset:2008-05-10, Days after vaccination: 1
Gender:Male  Submitted:2008-05-14, Days after onset: 4
Location:New Hampshire  Entered:2008-05-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Obesity
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1669U1SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1784U1SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Large red rash at vaccine site 5 cm in diameter.

VAERS ID:312399 (history)  Vaccinated:2008-05-01
Age:11.0  Onset:2008-05-01, Days after vaccination: 0
Gender:Female  Submitted:2008-05-15, Days after onset: 14
Location:California  Entered:2008-05-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: cLINDAMYCIN 1% LOTION; ACYCLOVIR PRN
Current Illness: MILD ACNE; LABIAL HSV
Preexisting Conditions: NKDA; ACNE; HSV
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1487U0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2235AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2826AA0IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Expired drug administered
SMQs:, Medication errors (narrow)
Write-up: vACCINE EXPIRED 4/24/08, GIVEN TO PATIENT 5/1/08

VAERS ID:312412 (history)  Vaccinated:2008-05-08
Age:11.0  Onset:2008-05-09, Days after vaccination: 1
Gender:Male  Submitted:2008-05-09, Days after onset: 0
Location:Texas  Entered:2008-05-15, 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: VIGAMOX EYE DROPS, BENADRYL
Current Illness: non ex conjunctivitis
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2551AF0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2842AA0UNRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: Cellulitis of L upper arm. Treated with Bactrim x10 days.

VAERS ID:312482 (history)  Vaccinated:2008-05-13
Age:11.0  Onset:2008-05-15, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 1
Location:Nevada  Entered:2008-05-16
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0063X0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2614AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2936BA0IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: redness, soreness at injestion site Left arm

VAERS ID:312484 (history)  Vaccinated:2008-05-13
Age:11.0  Onset:2008-05-13, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 3
Location:California  Entered:2008-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE NOTED ON SCREENING QUESTIONNAIRE
Current Illness: NO, NOT NOTED ON SCREENING QUESTIONNAIRE
Preexisting Conditions: NONE NOTED ON SCREENING QUESTIONNAIRE
Diagnostic Lab Data: ER PHYSICIAN DIAGNOSED AS "MUSCLE ACHES, PROBABLY RELATED TO IMMUNIZATIONS GIVEN TODAY." ULTRASOUND DONE IN ER SHOWED S/S OF AN OVARIAN CYST,UNLIKELY RELATED TO VACCINES GIVEN.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1758U0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2569AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B020AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1252U1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Hypoaesthesia, Myalgia, Nausea, Ovarian cyst, Paraesthesia, Ultrasound scan abnormal, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: AFTER ~1 HOUR AFTER CHILD WAS IMMUNIZED, MOM CALLED STATING THAT CHILD WAS C/O A SEVERE HA, NAUSEA, AND NUMBNESS AND TINGLING IN HER LOWER EXTREMITIES. I ADVISED HER TO SEEK IMMEDIATE MEDICAL ATTENTION.

VAERS ID:312529 (history)  Vaccinated:2008-05-01
Age:11.0  Onset:2008-05-03, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 13
Location:New Jersey  Entered:2008-05-19, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: SYNTHROID
Current Illness: Hypothyroidism
Preexisting Conditions: PMH: Hypocalcemia. Hypothyroidism
Diagnostic Lab Data: spinal tap 05/03/08 - Partially abnormal. Labs and Diagnostics: CSF cell count 322 with 232 RBCs. CSF Glucose 79. CSF protien 113.7. Repeat 5/13/08 with CSF cell count down to 13, glucose 62, protein 22.4. CSF cx (-). Brain MRI c/w meningoencephalitis. CT brain WNL. Cardiac MR shows an aberrant L subclavian artery. CBC with WBCs 14.7 on 5/4/08. Complement C3 227. C4 50. CRP 5.3. EBV IgG 4.17. 0 Oligoclonal bands. TSH 82.43 and 38.86. Free T4 0.84. CSF viral studies all (-). Vit D 1,25 80. Vit D,25-OH 20. CT brain abnormal.
CDC Split Type: WAES0805USA01353
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Encephalopathy, Lumbar puncture abnormal
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 11 year old female patient with hypothyroidism who on 01-MAY-2008 was vaccinated with a first dose of Gardasil. Concomitant therapy included SYNTHROID. On 03-MAY-2008 the patient experienced encephalopathy after receiving the first injection, was seen at the emergency room (ER). Subsequently she was hospitalized. Laboratory diagnostic test spinal tap was done. No further information was provided. The patient had not recovered. Additional information has been requested. 06/16/2008 MR received from CDC for DOS 5/6-27/2008 with D/C DX: Meningoencephalitis. Hypothyroidism. Hypocalcemia. Pt presented to local ER with c/o pain in the arms and legs, headache and then episodes of shaking of the arms and legs, stool incontinence and unresponsiveness and progressive changes in mental status. In local ER had witnessed episode of eye rolling and shaking of the arms and legs. Transfered to current facility for further w/u. CSF showed WBC pleocytosis. PE (+) for brisk DTRs on the L and difficult to elicit on the R. 10/6/2008 Additional records received from initial ER 5/3/08. Pt presented with disorientation and not feeling well since 5/2/08. Had Gardasil 5/1/08. In ER had several episodes of tremors, clenched teeth, rigid, downward going toes and clenched hands drawn to the chest. Transfered to above facility to r/o meningitis.

VAERS ID:312559 (history)  Vaccinated:2008-05-09
Age:11.0  Onset:2008-05-10, Days after vaccination: 1
Gender:Male  Submitted:2008-05-13, Days after onset: 3
Location:Washington  Entered:2008-05-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB222AA1IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B06BA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1799U1SCRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Pruritus, 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, swollen, itchy and warm seen 5-10-08 given KEFLEX.

VAERS ID:312573 (history)  Vaccinated:2008-05-06
Age:11.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-05-13, Days after onset: 6
Location:Connecticut  Entered:2008-05-19, 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: amoxicillin, sulfa allergies
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURAC52B02KB0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSU2405AA UNLA
Administered by: Private     Purchased by: Public
Symptoms: Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Tender swelling L axilla and L chest wall (lateral). No induration or redness (?lymphedema).

VAERS ID:312588 (history)  Vaccinated:2008-05-13
Age:11.0  Onset:2008-05-13, Days after vaccination: 0
Gender:Female  Submitted:2008-05-19, Days after onset: 6
Location:New Jersey  Entered:2008-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: zyrtec
Current Illness: none
Preexisting Conditions: sulfa
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURERUNK0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURUNK0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site haemorrhage, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Child had MENACTRA Vaccine administered in the lower left deltoid area at the same time ADACEL was administered in the upper left deltoid area , ,child developed an approximately 5cm area of eccymosis followed by redness under the eccymotic area with moderate pain to the MENACTRA injection site + bleeding at site after injection reported to pediatrician office no treatment received

VAERS ID:312803 (history)  Vaccinated:2008-03-15
Age:11.0  Onset:2008-03-15, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 60
Location:Unknown  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0804USA00449
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Information has been received from a company representative, as told by the patient''s mother, concerning an 11 year old female who on 15-MAR-2008 was vaccinated with her third dose of GARDASIL (lot# not reported). There was no concomitant medication. On 15-MAR-2008 the patient started sneezing which lasted for 4 days. Subsequently, the patient recovered from sneezing. The mother gave the patient BENADRYL, but it did not help. The patient sought unspecified medical attention. No further information is available.

VAERS ID:312806 (history)  Vaccinated:2007-04-04
Age:11.0  Onset:2007-04-04, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 406
Location:Virginia  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA00470
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1426F0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Dizziness
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)
Write-up: Information has been received from a physician concerning a 12 year old female who was recently IM vaccinated with GARDASIL (lot number 655208/1426F). Subsequently the patient felt woosie. While the patient was in office, she started to have some mild dizziness which she recovered from. However, at home, she complained of increasing dizziness and was unable to get out of bed all evening. The patient recovered on 05-Apr-2007. No other information was available.

VAERS ID:312815 (history)  Vaccinated:2008-03-27
Age:11.0  Onset:2008-03-27, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 48
Location:Michigan  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA01009
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB256AA1IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1967U2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Information has been received from a health professional concerning an 11 year old white female who on 27-MAR-2008 at 14:00 was vaccinated intramuscularly into the left deltoid with the third dose of GARDASIL (Lot # 660387/1967U). Concomitant therapy included a second dose given intramuscularly into the left deltoid of HAVRIX (Lot # AHAVB256AA). On 27-MAR-2008 at 14:00 the patient experienced nausea. On 27-MAR-2008 the patient recovered. No further information is available.

VAERS ID:312850 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-14
Location:Unknown  Entered:2008-05-19, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA01484
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: Information has been received from a registered nurse concerning a 11 year old female who on an unspecified date was vaccinated IM with the first dose of GARDASIL. It was reported that the patient developed a headache after being vaccinated. Unknown medical attention was sought. The patient''s outcome was unknown. Additional information has been requested.

VAERS ID:312885 (history)  Vaccinated:2007-06-12
Age:11.0  Onset:2007-06-13, Days after vaccination: 1
Gender:Female  Submitted:2008-05-14, Days after onset: 336
Location:Unknown  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA02275
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0523U UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
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: Information has been received from a physician concerning a 11 year old female with no reported medical history and no drug reactions/allergies who on 12-JUN-2007 was vaccinated with a dose of GARDASIL (lot # 657868/0523U). Concomitant therapy included a dose of Tdap. On 13-JUN-2007 the patient developed a moderately severe injection site reaction. The patient was seen by a physician on 14-JUN-2007. The patient was prescribed an unspecified antibiotic for the treatment of pain, swelling and redness in the left arm. The patient fully recovered on an unspecified date. No other symptoms or treatment reported. Additional information has been requested.

VAERS ID:313067 (history)  Vaccinated:2008-01-01
Age:11.0  Onset:2008-01-01, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 133
Location:Ohio  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA03234
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a physician concerning a 11 year old female who in approximately January or February 2008, was vaccinated with the first dose of GARDASIL. The patient recently (approximately April 2008) came in for her second dose of GARDASIL. The patient experienced excruciating pain at the injection site after the first dose of the vaccine. The patient outcome was recovered. The duration of the pain was not provided. It is unknown whether medical attention was sought. Additional information has been requested.

VAERS ID:313076 (history)  Vaccinated:2007-10-31
Age:11.0  Onset:2008-01-01, Days after vaccination: 62
Gender:Female  Submitted:2008-05-14, Days after onset: 133
Location:Florida  Entered:2008-05-19, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA03287
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Amenorrhoea
SMQs:, Fertility disorders (broad)
Write-up: Information has been received from an office manager at the physician''s office concerning a female consumer who on 31-OCT-2007 was vaccinated with a first dose of GARDASIL (lot # 657736/0389U). It was reported that "after the 1st dose", the patient has her period in November and December; however she did not have it in January, February and March. On 06-MAR-2008 the patient received her second dose of GARDASIL (lot # 659655/1486U). It was reported that the patient was not pregnant. Additional information has been requested.

VAERS ID:313083 (history)  Vaccinated:2008-04-15
Age:11.0  Onset:2008-04-15, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 29
Location:California  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA03577
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Medication errors (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from a physician concerning an 11 year old female who on 15-APR-2008 was vaccinated with her first dose of GARDASIL (lot# not provided). Concomitant therapy included VARIVAX, (duration and dose not reported). Other concomitant therapy included MENACTRA and diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid. On 15-APR-2008 the patient fainted after receiving the first dose of GARDASIL. The patient was recovering from fainting. She sought medical attention in the clinic. Additional information has been requested.

VAERS ID:313086 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-14
Location:Unknown  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA02493
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Medication errors (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from a health professional concerning an 11 year old female who was vaccinated intramuscularly on an unspecified date with her first dose of GARDASIL (lot# not reported). Concomitant therapy included DTAP-IPV and MENACTRA. Subsequently the patient experienced syncope after receiving GARDASIL. She sought unspecified medical attention and her outcome was not reported. No further information is available.

VAERS ID:313241 (history)  Vaccinated:2008-04-21
Age:11.0  Onset:2008-04-22, Days after vaccination: 1
Gender:Female  Submitted:2008-05-14, Days after onset: 22
Location:Florida  Entered:2008-05-19, 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: Unknown
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA04876
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Allodynia, Hyperaesthesia
SMQs:
Write-up: Information has been received from a pharmacist concerning her 11 year old daughter with allergic reaction to AUGMENTIN who on 21-APR-2008 was vaccinated into the arm (which arm not specified) with a dose of GARDASIL. Concomitant suspect therapy included PNEUMOVAX 23 (manufacturer unknown) into the other arm. The reporter reported that on 22-APR-2008, her daughter experienced allodynia or hyperestesia on the left thigh. She sought medical attention from her physician father. The patient had not recovered. No other details available. Additional information has been requested.

VAERS ID:313256 (history)  Vaccinated:0000-00-00
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-14
Location:Unknown  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA05121
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1486U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a Nurse concerning a 11 year old female who was vaccinated IM with a 0.5 ml first dose of GARDASIL (lot# 659655/1486U). After the vaccination the patient said she felt anxious and light headed. Unspecified medical attention was sought in the office. The patient sat down for a while and recovered. No product quality complaint was involved. Additional information has been requested.

VAERS ID:313286 (history)  Vaccinated:2007-04-27
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-14
Location:Florida  Entered:2008-05-19, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA05546
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a nurse concerning her 12 year old daughter who on 02-MAR-2007 was vaccinated IM with the first dose of GARDASIL. On 27-APR-2007, the patient was vaccinated IM with the second dose of GARDASIL and on 17-AUG-2007, the patient was vaccinated IM with the third dose of GARDASIL. The patient reported pain in the arm at the injection site for 3 days after the vaccination was given. The pain in the arm included not being able to lift the arm. The nurse also reported that since multiple patients (3 patients) reported pain in their arms, they started giving the vaccination in the buttocks to an unspecified number of patients. Unknown medical attention was sought through contact with the nurse. Patient outcome was unknown. No product quality complaint was involved. This is one of the multiple cases from the same source (WAES # 0805USA01521 and 0805USA01522). Additional information has been requested.

VAERS ID:313314 (history)  Vaccinated:2008-04-28
Age:11.0  Onset:2008-04-28, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 16
Location:Arizona  Entered:2008-05-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0804USA06414
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Loss of consciousness, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from a physician concerning an 11 year old female who on 28-APR-2008 was vaccinated with a first dose of GARDASIL 0.5 ml IM in the arm. Concomitant therapy also given at the same office visit on 28-APR-2008 included MENACTRA, and "PTD" (unspecified). GARDASIL and "PTD" was given in the same arm. On 28-APR-2008, immediately after being vaccinated, the patient experienced syncope, nausea, and passed out. The patient was kept in the office for 30 minutes until her "high pressure went down". On an unspecified date, the patient recovered. Additional information has been requested.

VAERS ID:312665 (history)  Vaccinated:2008-05-05
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2008-05-15
Location:Wisconsin  Entered:2008-05-20, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC528016BA IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0086X SCLA
Administered by: Other     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:, Medication errors (narrow)
Write-up: No adverse event. This is only to report that the child''s parent requested to varicella & that I administered it in school setting. Later, on data entry, notation on data shows that child had chickenpox 1/9/98.

VAERS ID:312674 (history)  Vaccinated:2008-05-15
Age:11.0  Onset:2008-05-16, Days after vaccination: 1
Gender:Male  Submitted:2008-05-19, Days after onset: 3
Location:Connecticut  Entered:2008-05-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB268EA0IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2568AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2938AA0IMUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0084U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Inflammation, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5.5 cm x 6.7 cm area of erythema, inflammation & warmth L deltoid.

VAERS ID:312729 (history)  Vaccinated:2008-05-17
Age:11.0  Onset:2008-05-18, Days after vaccination: 1
Gender:Female  Submitted:2008-05-20, Days after onset: 2
Location:Maryland  Entered:2008-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2730AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 5/18/08, about 24 hours after vaccine patient experienced tingling in face and legs, temp 100, seen at ER, thought to be possible reaction to preservative in the vaccine. Motrin was given. Patient''s symptoms have resolved.

VAERS ID:312904 (history)  Vaccinated:2008-05-12
Age:11.0  Onset:2008-05-13, Days after vaccination: 1
Gender:Female  Submitted:2008-05-15, Days after onset: 2
Location:Wisconsin  Entered:2008-05-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: few chickenpox lesions~Varicella (no brand name)~1~0~In Patient
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 PASTEURU2574AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B016BA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1806U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Local reaction
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness, itching, pain & swelling at site of immuniz. within 24h of injection (R deltoid). Dx-local hypersensitivity reaction. Tx-local ice, BENADRYL, reassurance.

VAERS ID:312992 (history)  Vaccinated:2008-05-16
Age:11.0  Onset:2008-05-16, Days after vaccination: 0
Gender:Female  Submitted:2008-05-19, Days after onset: 3
Location:Pennsylvania  Entered:2008-05-22, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1484U1SCRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2407AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B016BA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1364U1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Client waited 15 minutes in waiting room after receiving her shots & exited via the elevator. T.C. returned from security in the lobby that the client passed out as exiting the elevator.

VAERS ID:313009 (history)  Vaccinated:2008-05-14
Age:11.0  Onset:2008-05-15, Days after vaccination: 1
Gender:Female  Submitted:2008-05-19, Days after onset: 4
Location:Virginia  Entered:2008-05-22, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: redness~Td Adsorbed (no brand name)~UN~14~In Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2771AA5IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, 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: Began swelling & erythema, present the next morning at approx 8AM. Used cold pack & problem resolved. Erythema approx 50 mm. No fever.

VAERS ID:313038 (history)  Vaccinated:2008-05-20
Age:11.0  Onset:2008-05-21, Days after vaccination: 1
Gender:Female  Submitted:2008-05-22, Days after onset: 1
Location:Pennsylvania  Entered:2008-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, Celiac disease
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.   UN
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
Administered by: Private     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Erythema, Headache, Oedema peripheral, Pain in extremity, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: She received four vaccines on Tuesday, May 20. She received the Chickenpox vaccine booster,meningococcal vaccine, HPV first vaccine, and tDAP. On Wednesday morning she had fever, headache, and two hot, three-inch diameter red swellings- one on each arm. We gave her Motrin and kept her home from school. By Thursday morning, the fever was gone. Her arms were still very sore and one site on each arm was red, swollen and hot to the touch.

VAERS ID:313124 (history)  Vaccinated:2008-05-12
Age:11.0  Onset:2008-05-12, Days after vaccination: 0
Gender:Male  Submitted:2008-05-15, Days after onset: 3
Location:Michigan  Entered:2008-05-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SINGULAIR, FLONASE, MUCINEX, amox., CLARITIN
Current Illness: Sinusitis/allergic rhinitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2937BA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1658U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth, Pain, 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: Fever x3d, pain x3d, erythema x2d, swelling x2d, warm at site x2d, 45mm x 80mm erythema & edema.

VAERS ID:313127 (history)  Vaccinated:2008-05-07
Age:11.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-20, Days after onset: 12
Location:Arizona  Entered:2008-05-23, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2572AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2842AA0UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.184941SCUN
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis
SMQs:
Write-up: Cellulitis. AUGMENTIN 400mg BID x10d.

VAERS ID:313159 (history)  Vaccinated:2008-05-19
Age:11.0  Onset:2008-05-19, Days after vaccination: 0
Gender:Male  Submitted:2008-05-19, Days after onset: 0
Location:Minnesota  Entered:2008-05-23, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2078BA0UNUN
Administered by: Other     Purchased by: Public
Symptoms: Fall, Mydriasis, Skin warm, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: fell to ground, didn''t respond for short time pupils dilated- in Doc Rm felt warm, O2 given

VAERS ID:313196 (history)  Vaccinated:2008-05-20
Age:11.0  Onset:2008-05-21, Days after vaccination: 1
Gender:Female  Submitted:2008-05-23, Days after onset: 2
Location:Michigan  Entered:2008-05-23
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: Allergies to Nuts, Dairy, and Eggs PMH: Asthma, Sickle Cell Trait, CF Gene Carrier
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2613AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B021AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed itchy rash and minimal fever.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

VAERS ID:313985 (history)  Vaccinated:2007-09-04
Age:11.0  Onset:2007-09-06, Days after vaccination: 2
Gender:Female  Submitted:2008-05-16, Days after onset: 253
Location:Tennessee  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0710USA02678
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB186AA0IMLL
HPV4: HPV (GARDASIL)MERCK & CO. INC.658558/1061U0IMLL
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR1061U0IMRL
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B024AA5IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.658422/1030U SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning a 11 year old female with no pertinent medical history, with an allergy to amoxicillin (+) clavulanate potassium (AUGMENTIN) who on 04-SEP-2007 was vaccinated subcutaneously into the left arm with a second dose varicella virus vaccine live (Oka/Merck) (Lot # 658422/1030U). Concomitant vaccine therapy that same day included a first dose of human papillomavirus vaccine, for the treatment of prophylaxis, administered intramuscularly into the left thigh (Lot # 658558/1061U), a first dose of hepatitis A vaccine (inactive) (HAVRIX) administered intramuscularly into the left thigh (Lot# AHAVB196AA), a fifth dose of diphtheria toxoid (+) pertussis acellular 3-component vaccine (+) tetanus toxoid (BOOSTRIX) administered intramuscularly into the right arm (Lot# AC52B024AA) and a first dose of meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA) administered intramuscularly into the right thigh (Lot # 1061U). On 06-SEP-2007 the patient developed a red, hard, welt "about the size of a silver dollar", which was warm to touch. There was no illness at the time of vaccination. There were no diagnostic tests performed. The patient had no prior history of adverse events following prior vaccinations. The patient recovered on an unspecified date. No further information is expected.

VAERS ID:314006 (history)  Vaccinated:2007-08-01
Age:11.0  Onset:2007-08-02, Days after vaccination: 1
Gender:Male  Submitted:2008-05-16, Days after onset: 288
Location:Illinois  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0801USA04016
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0815U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pruritus, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), 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 who on 01-AUG-2007 was vaccinated SC on right arm with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657649/0815U). There was no illness at the time of vaccination. On 02-AUG-2007 at 14:50 PM, the patient experienced injection site "puffy" and swelling of 2-3". The patient''s body temperature was slightly elevated at 100.1. The patient had itchiness at injection site. On 05-AUG-2007, the patient recovered. No diagnostic laboratory tests were undertaken. Additional information has been requested. This is one of several reports received from the same source.

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

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

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

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

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

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

VAERS ID:314381 (history)  Vaccinated:2007-06-25
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Kentucky  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA05040
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC269CAA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0715U1SCRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health professional concerning an 11 year old female with no allergies who on 25-JUN-2007 was vaccinated SC on right arm with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657403/0715U). Concomitant therapy included IM sixth dose on left arm of Adacel (Lot # C269CAA). At the time of vaccination there was no illness. It was reported that the patient developed redness, swelling and pain after vaccination. No medical attention was sought. At the time of report the patient had recovered. Additional information has been requested. This is one of several reports from the same source.

VAERS ID:314382 (history)  Vaccinated:2007-06-19
Age:11.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Kentucky  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA05041
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2331AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC261CAA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.657404/0592U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Pruritus, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health professional concerning a 11 year old white female with no allergies who on 19-JUN-2007 was vaccinated SC on left arm with a second dose of varicella virus vaccine live (Oka/Merck) (Lot # 657404/0592U). Concomitant therapy included a IM first dose on right arm of meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA) (Lot # U2331AA) and an IM sixth dose on left arm of diphtheria toxoid (+) pertussis acellular 5-component vaccine (+) tetanus toxoid (ADACEL) (Lot # C261CAA). There was no illness at the time of vaccination. It was reported that the patient developed a red hard knot that was itchy, warm to touch and slightly tender after vaccination. No medical attention was sought. At the time of report the patient had recovered. Additional information has been requested. This is one of the several reports received from the same source.

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

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

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

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

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

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

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

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

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

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

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

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

VAERS ID:314929 (history)  Vaccinated:2007-08-24
Age:11.0  Onset:2007-08-25, Days after vaccination: 1
Gender:Female  Submitted:2008-05-16, Days after onset: 265
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA05099
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.10294 IMUN
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a physician concerning an 11 year old female with drug hypersensitivity who on 24-AUG-2007 was vaccinated with varicella virus vaccine live (Oka/Merck) (Lot number "10294"). On 25-AUG-2007, the patient experience significant swelling, warmth and redness at the injection site. Subsequently, the patient recovered from significant swelling, warmth and redness at the injection site. No further information is available.

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

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

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

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

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

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

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

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

VAERS ID:315368 (history)  Vaccinated:2007-07-23
Age:11.0  Onset:2007-07-23, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 298
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA03859
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a registered nurse concerning an 11 year old male who on 23-JUL-2007 was vaccinated with a dose of varicella virus vaccine live (Oka/Merck). Subsequently, the patient fainted. Unspecified medical attention was sought. At an unspecified time the patient recovered. No other information was provided. There was no product quality complaint involved. Additional information received indicated that no additional information is available.

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

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