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Case Details (Sorted by Vaccination Date)

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VAERS ID:311769 (history)  Vaccinated:2008-05-06
Age:0.9  Onset:0000-00-00
Gender:Female  Submitted:2008-05-06
Location:West Virginia  Entered:2008-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURERC2798AA2IMLL
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B156CA2IMLL
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURERUE976AA2IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC547622IMRL
Administered by: Private     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: 2 doses of DTaP.

VAERS ID:311806 (history)  Vaccinated:2008-05-06
Age:56.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-07, Days after onset: 1
Location:California  Entered:2008-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cough and wheezing
Preexisting Conditions: PCN allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0248X1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Induration, Oedema peripheral, Pain, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt states L arm became red and swollen at 6 pm. Soreness and aching later on in evening. Pt applied ice pack and Darvocet, w/some relief. 5/7/08 Redness and induration $g 120mm. Warm to touch with $g redness increasing (per patient). Pt was seen by MD and tx''d w/celedrex 300 mg and pogel and OTC Benadryl.

VAERS ID:311819 (history)  Vaccinated:2008-05-06
Age:0.3  Onset:2008-05-06, Days after vaccination: 0
Gender:Male  Submitted:2008-05-07, Days after onset: 1
Location:Illinois  Entered:2008-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B137AA1IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF230AB1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC575371IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0110X1PO 
Administered by: Public     Purchased by: Public
Symptoms: Hypersensitivity, Injection site erythema, Injection site pain, Injection site swelling, Local reaction
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: About 10:00 PM Father noticed baby''s rt. leg was swollen and red and painful to touch. Mother states upper and lower leg were swollen. Emergency Room report diagnosis was Local Allergic Reaction Right thigh. Was given Benadryl and Motrin at 10:30 PM and discharged home with instructions to return if symptoms increased and to follow up with Physician.

VAERS ID:311820 (history)  Vaccinated:2008-05-06
Age:13.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-07, Days after onset: 1
Location:Michigan  Entered:2008-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB249AA1IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1968U0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Blood pressure, Dizziness, Heart rate, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 6:45 pm Received two injections today. Within 1 minute, complained of feeling dizzy. Had not eaten since morning. Color slightly pale, slightly diaphoretic. Reclined in reclining chair, given a sucker and juice to sip. VS checked at 6:50 and 6:55 pm (BP 108/76 p.92,BP 106/76 p.88). At 6:55 pm color was pink, skin warm and dry, "felt better". Assisted to sitting position. Tolerated well. 7 pm Ambulated to lobby with assistance, tol. well. Discharged with Mom.

VAERS ID:311827 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Male  Submitted:2008-05-07, Days after onset: 1
Location:Nebraska  Entered:2008-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2799AA IM 
IPV: POLIO VIRUS, INACT. (POLIOVAX)SANOFI PASTEURA0342 IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1925U SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0085X SC 
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypersensitivity (narrow)
Write-up: Immunization given in am. Mom called and reported generalized hives and a temp of 102 in the evening.

VAERS ID:311832 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-07, Days after onset: 0
Location:Nevada  Entered:2008-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: MOTHER DENIES
Preexisting Conditions: MOTHER DENIES
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B060AB3IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB428AA3IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB222AA0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURSPA01703IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1671U0SCLA
PNC: PNEUMO (PREVNAR)PFIZER/WYETHWPC451503IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1498U0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Lethargy, Vomiting
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt began vomiting, severe h/a and lethargy less than 24 hours after injection.

VAERS ID:311893 (history)  Vaccinated:2008-05-06
Age:60.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-08, Days after onset: 1
Location:Ohio  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:
Preexisting Conditions:
Diagnostic Lab Data: Pt. had pneumovax -1st dose in 2003 at age 55 for history of asthma, DM and pneumonia
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1225U1IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pneumovax 23 given to pt. on 5/6/08. On 5/7/08 she returned to the clinic for left upper arm (shoulder to elbow area) red and warm to touch.Physician evaluated pt. and gave instructions to use ice to area and Motrin prn.

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:
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)
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:311916 (history)  Vaccinated:2008-05-06
Age:  Onset:2008-05-08, Days after vaccination: 2
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:2008-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2299AA4UNLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01113UNRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.148401SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1589U1SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Pain in extremity, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness/swelling 3x4 cm of size (R) deltoid area painful and hot at palpation.

VAERS ID:311982 (history)  Vaccinated:2008-05-06
Age:5.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 2
Location:Georga  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: Flonase nasal spray
Current Illness: Allergic Rhinitis; Enlarged tonsils; URI
Preexisting Conditions: None
Diagnostic Lab Data: cellulitis R arm
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU2355BA3IMUN
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB242AA1IMUN
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling, hot, redness. Pt had no fever mother stated she did not discover it till 2 days ago, pt was with baby sitter seen by physician, given Keflex antibiotics and instructed to use hot and cold compresses.

VAERS ID:311995 (history)  Vaccinated:2008-05-06
Age:69.0  Onset:2008-05-09, Days after vaccination: 3
Gender:Female  Submitted:2008-05-09, Days after onset: 0
Location:Pennsylvania  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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0158X0SCRA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site induration, Injection site rash, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Patient called today to report injection site reaaction. She reports a red 2 inch raised area (circle) at the site of injection, she does not complain of any pain or itching. She found this when putting on her deoderant today. She said it feels a little hard. Patient was referred to doctor for evaluation.

VAERS ID:312000 (history)  Vaccinated:2008-05-06
Age:5.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 1
Location:Texas  Entered:2008-05-09, 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: NONE
Current Illness: NONE
Preexisting Conditions: HYDROSEPHILUS
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU2290BA4IMRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0039F3IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA0170-24IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0783U SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Pyrexia, Sensation of heaviness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: RIGHT ARM IS SWOLLEN FROM SHOULDER TO ELBOW, RED FEVERISH ON SITE OF INJECTION, HEAVY FOR LIFTING, CHILD HAD FEVER OF 101, ITCHING ON SITE OF INJECTION. PARENT PLACED COLD PAD ON THE INJECTION SITE THE NIGHT OF VACCINATION.

VAERS ID:312009 (history)  Vaccinated:2008-05-06
Age:0.6  Onset:2008-05-09, Days after vaccination: 3
Gender:Male  Submitted:2008-05-09, Days after onset: 0
Location:California  Entered:2008-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B130AA1IMRL
PPV: PNEUMO (PNU-IMUNE)PFIZER/WYETHC458932IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1741U1PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: FEVER @ 103 FOR THE PAST THREE (3) DAY''S PER MOTHER.

VAERS ID:312022 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-05-09, Days after onset: 1
Location:California  Entered:2008-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: healthy
Preexisting Conditions: None
Diagnostic Lab Data: Varicella DFA; culture ordered 5/9/00
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2933AB3IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB2222AA1IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA03013SCLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1672U1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1774U1SCRA
Administered by: Public     Purchased by: Other
Symptoms: Culture, Injection site erythema, Injection site pain, Injection site swelling, Injection site vesicles, Rash vesicular, Varicella
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: (L) arm swollen, erythematous with small blisters somewath tender. Yesterday he had two small, linear vesiculations. Now there are four new linear vesiculation.

VAERS ID:312100 (history)  Vaccinated:2008-05-06
Age:5.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-05-12, Days after onset: 5
Location:Ohio  Entered:2008-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2935AA4IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA08053IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1947U1IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1997U1IMLL
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Joint swelling, Local reaction
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Patient with large local reaction with knee swelling and large swelling with erythema.

VAERS ID:312103 (history)  Vaccinated:2008-05-06
Age:0.3  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-06, Days after onset: 0
Location:Illinois  Entered:2008-05-12, 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: None
Current Illness: None
Preexisting Conditions: 34 wk gestation
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2800AA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF297AA1IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA03011SCLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETH547660IMRL
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 2 mins. after vaccines given Pt''s legs becamer erythematous. No swelling or warmth. Pt. was given Benadryl. Redness diminished. After 1/2 hr.

VAERS ID:312116 (history)  Vaccinated:2008-05-06
Age:13.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-12, Days after onset: 6
Location:North Carolina  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: none
Current Illness: none
Preexisting Conditions: Bronchitis 4/15/08
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAV8242AA2IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1487U3IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: Give 3rd dose of Hep A and 4th dose of Gardisil. Last facility in record dated 3/31 showed student due for both. Asked if she had received any "shots"/immunizations anywhere else - replied "no" so I gave both. When I went to facility, discovered she had been given both doses at HD 4/3! Incident report done, patient checked X3. Supervising MD notified 5/6

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)
Write-up: 2 days after varicella immuniz. 9x9 cm area of erythema & tenderness.

VAERS ID:312183 (history)  Vaccinated:2008-05-06
Age:28.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-06, Days after onset: 0
Location:Kentucky  Entered:2008-05-13, 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: Maxsolt, BCP, Allegra, Topomax
Current Illness: None - pre-employment
Preexisting Conditions: seasonal allergies - no drug allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB520AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1715U0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection given at app 0930 this date. Redness & swelling at injection site noted app 1130. Measures 4"x5" at 1300.

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)
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:312221 (history)  Vaccinated:2008-05-06
Age:8.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-08, Days after onset: 1
Location:North Carolina  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: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB256AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1803U1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 4x6 in. area of erythema/induration with central pinpoint water-filled vesicles L deltoid - seen ~48 hours after vaccine given (started at ~24 hours post-vaccine).

VAERS ID:312223 (history)  Vaccinated:2008-05-06
Age:63.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-08, Days after onset: 2
Location:North Carolina  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:
Current Illness: None
Preexisting Conditions: COPD, renal stones, osteopenia
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1541U1IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Local reaction, Pyrexia, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 5.6 cm local rxn with tenderness & swelling. Onset fever 101-102 a few hrs after vaccine admin & persisting x48 hours at time of exam. No other sign or sx of illness.

VAERS ID:312239 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-08, Days after onset: 1
Location:New York  Entered:2008-05-13, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2951AA4IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR04743IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1470F1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.13234U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 4cm x 3.5cm area of redness at site of Varivax vaccine, no treatment required.

VAERS ID:312247 (history)  Vaccinated:2008-05-06
Age:18.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-13, Days after onset: 6
Location:Indiana  Entered:2008-05-13
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
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURERUNSURE1IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Had Hives X 5 days covered body except for face and neck. Hives did come and go with Benadryl.

VAERS ID:312257 (history)  Vaccinated:2008-05-06
Age:60.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-13, Days after onset: 6
Location:Kansas  Entered:2008-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: None known~ ()~NULL~~In Patient|None known~ ()~NULL~~In Sibling1|None known~ ()~NULL~~In Sibling2
Other Medications: Not known
Current Illness: None reported
Preexisting Conditions: Penicillin allergy; sulfa allergy.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0161X0SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt developed a golf ball sized, red welt at injection site, with a smaller, hard knot under the skin, about 24 hours after injection. Area itched for 3-4 days. Today (7 days after injection), skin is still red, but no knot or itching reported by patient.

VAERS ID:312259 (history)  Vaccinated:2008-05-06
Age:12.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-05-13, Days after onset: 5
Location:Pennsylvania  Entered:2008-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1917U1SCLA
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: swollen red pruritic area at the site of vaccine

VAERS ID:312297 (history)  Vaccinated:2008-05-06
Age:18.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 8
Location:Florida  Entered:2008-05-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: 5/19/08-records received-Labs blood urea nitrogen low 6, calcium low 8.3, monocytes elevated 0.8.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB253BA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2408AA0IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUF175AA0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Balance disorder, Blood calcium decreased, Blood urea decreased, Headache, Hypoaesthesia, Injection site oedema, Monocyte count increased, Muscular weakness, Myalgia, Nausea, Neck pain, Pharyngolaryngeal pain, Photophobia, Swelling, Vaccination complication, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad), Chronic kidney disease (broad), Arthritis (broad), Tumour lysis syndrome (broad)
Write-up: Patient had headache, blurred vision, sensitivity to light, loss of balance, back ache, throat ache, right side of body from hip to shoulder and right arm went numb, vomiting, nausea, and weakness of both extremities right side more severe than left. 5/19/08-records received for DOS 5/13-5/14/08-DC DX: Vaccination reaction, probably the yellow fever, although she had a Hepatitis vaccination too. Presented with headache, neck pain, swelling, muscle aches and edema at the site. Intractable vomiting.

VAERS ID:312327 (history)  Vaccinated:2008-05-06
Age:0.1  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-14, Days after onset: 7
Location:Pennsylvania  Entered:2008-05-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSUNKNOWN0IMLL
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN0IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHUNKNOWN0IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.UNKNOWN0PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting after administration of Pediarix, Hib, Prevnar, and Rotateq. Vomiting started 1 day after administration

VAERS ID:312335 (history)  Vaccinated:2008-05-06
Age:33.0  Onset:2008-05-10, Days after vaccination: 4
Gender:Male  Submitted:2008-05-14, Days after onset: 4
Location:California  Entered:2008-05-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2936BA UNLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUF303AA SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Limb discomfort, Musculoskeletal stiffness, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Left arm pain 6 cm fever, erythema, stiffening above the elbow appearing several days after TDaP injection. Also rash upper chest area 4 days after injection.

VAERS ID:312359 (history)  Vaccinated:2008-05-06
Age:54.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Oregon  Entered:2008-05-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PRN Migraine meds
Current Illness:
Preexisting Conditions: Migraine - experienced one 5/8 and 5/10.
Diagnostic Lab Data: None
CDC 'Split Type': OR200808
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2734AA0UNLA
Administered by: Other     Purchased by: Public
Symptoms: Body temperature increased, Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient called and stated that the day after she received Tdap vaccine, she started experiencing 104 F temperature and sore, red, indurated arm where vaccine given - area size of quarter, hard and hot to touch - saw PHP today (5/9) and was given CIPRO 500mg for 10 days for possible infection.

VAERS ID:312462 (history)  Vaccinated:2008-05-06
Age:1.3  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-13, Days after onset: 6
Location:Illinois  Entered:2008-05-16, 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: None
Current Illness: None
Preexisting Conditions: Ptosis - Congestial
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS14B061BB3IMLL
HEP: HEP B (FOREIGN)MERCK & CO. INC.0075U IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC41337 IMRL
Administered by: Private     Purchased by: Private
Symptoms: Eyelid ptosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: High fever during noc - 103.9 ear temperature.

VAERS ID:312463 (history)  Vaccinated:2008-05-06
Age:0.4  Onset:2008-05-06, Days after vaccination: 0
Gender:Male  Submitted:2008-05-13, Days after onset: 7
Location:Illinois  Entered:2008-05-16, 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: albuterol sulfate, DONATUSSIN PEDIATRIC
Current Illness: None
Preexisting Conditions: Question of eczema - question of pyloric stenosis
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B126AA1UNLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF195AB1UNRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC413371UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0770U1PO 
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Red rash on face, legs, arms, trunk, about 3 hours after immunizations. Had increased temp - 101.3 Ax. Fever x 3 days.

VAERS ID:312558 (history)  Vaccinated:2008-05-06
Age:40.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 2
Location:Oregon  Entered:2008-05-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: VICODIN, DEMEROL
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.1022F0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2825AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left deltoid: swelling the size of a tennis ball, erythema, and pain. Site measures 6.5cm by 8.5cm. Pt was seen by her doctor. Pt given ZYRTEC 10mg bid until improved.

VAERS ID:312580 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-05-12, Days after onset: 4
Location:Nevada  Entered:2008-05-19, 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: Mom stated she gave MOTRIN PO prior to E.R. visit.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Not known
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B0560A4IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB222AA1IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURSPA04743IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1746U1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Oedema peripheral, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Received report from child''s mom on 5/12/08 at 9:35 am by phone that child was taken to the emergency room on 5/8/08 - 2 days after shots were given due to redness, swelling of the left arm. She stated that left arm felt hot and child''s fever was 101F. Child was given IV ABT and was checked by the doctor on 5/9/08 and 5/10/08 for follow-up. She stated he has recovered well today.

VAERS ID:312595 (history)  Vaccinated:2008-05-06
Age:29.0  Onset:2008-05-14, Days after vaccination: 8
Gender:Male  Submitted:2008-05-19, Days after onset: 5
Location:Pennsylvania  Entered:2008-05-19
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: Generalized Vaccinia
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV 1742SCRA
Administered by: Military     Purchased by: Military
Symptoms: Lymphadenopathy, Pyrexia, Rash, Vaccinia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Began with lymphadenopathy and fever, then progressed to a rash under immunized arm with surrounding upper chest, back and both arms.

VAERS ID:312627 (history)  Vaccinated:2008-05-06
Age:51.0  Onset:2008-05-19, Days after vaccination: 13
Gender:Female  Submitted:2008-05-19, Days after onset: 0
Location:California  Entered:2008-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rosacea
Preexisting Conditions: Allergic to Penicillin, (Type 2 Diabetes), HTN, High Cholesterol
Diagnostic Lab Data: Cup meds, Zoloft, Glucominge, Glipizide Lisinopril, Simvastatin
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1169F SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Photophobia, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 5/19/08 awoke this AM with a rash primarily on face to a lesser extent on arms/torso. History Rosacea with 10 min sun exposure past 2y. Also, photophobia, conj. inj. dizziness - type 2 diabetes.

VAERS ID:312699 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-05-13, Days after onset: 5
Location:Indiana  Entered:2008-05-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURERAC14B069AA UNLL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB184BA UNLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA0298 UNLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1669U UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0109U UNRL
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient had redness and swelling in right thigh. Treated with Keflex.

VAERS ID:312705 (history)  Vaccinated:2008-05-06
Age:10.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-08, Days after onset: 2
Location:North Carolina  Entered:2008-05-20, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type': NC08063
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1759U1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 17x16cm erythema surrounding site of vaccine in (L) mid outer forearm. Onset was 1-2 hours after administration of vaccine.

VAERS ID:313135 (history)  Vaccinated:2008-05-06
Age:1.1  Onset:2008-05-16, Days after vaccination: 10
Gender:Male  Submitted:2008-05-16, Days after onset: 0
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: Plumbism
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB200AA0IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0428U0SCRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC451513IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1790U0SCLL
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Pyrexia, Rash maculovesicular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Pt. presents in office 5/16/08 with low grade fever, <15 erythematous maculovesicular lesions on post neck & face. Vaccinated with VARIVAX on 5/6/08. Rx BENADRYL, calamine & AVEENO baths.

VAERS ID:313203 (history)  Vaccinated:2008-05-06
Age:19.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-23, Days after onset: 17
Location:New York  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: no
Preexisting Conditions: NO
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB252AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood pressure, Dizziness, Heart rate normal, Hyperhidrosis, Loss of consciousness, Pallor, Respiratory rate
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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Right after shot patient feeling faint, intructed head to knee position while seated in chair in exam room. Water given. 5 minutes ambulated to traement room when she stated began to "black out". LOC approxiamtely 5 seconds. Diaphoretic .With assiatance from my coworker aided student to the floor. Lying down elevated legs with pillows. Dr. was made aware. P: 60R: 18 cool cloth to forehead.Within 5 minutes: color back to face feeling better. 10 minutes later sitting up , gatorade given and crackers. Amulated without difficulty to infirmary to lie down in bed. P: 60 B/P 100/70 R: 18 Additional 40 minutes rested in infirmary feeling better Before discharge: P: 72 R 18 B/P 100/70 Stable, Alert and oriented.

VAERS ID:313480 (history)  Vaccinated:2008-05-06
Age:22.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Female  Submitted:2008-05-27, Days after onset: 19
Location:New York  Entered:2008-05-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Loestrin
Current Illness: none
Preexisting Conditions: none. PMH:none, no seizure hx
Diagnostic Lab Data: Ct scan - temporal fracture with frontal and bilateral temporal lobe contusions with SA blood. Csf bloody with increased WBC and protein. Repeat CSF was improved. EEG with b/l slowing , repeat:worse, 3RD better but still slow. none showed
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2938AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Blood culture negative, Blood prolactin increased, Brain contusion, CSF neutrophil count increased, CSF protein increased, CSF white blood cell count increased, Cerebral haemorrhage, Computerised tomogram abnormal, Convulsion, Depressed level of consciousness, Electroencephalogram abnormal, Enterovirus serology test negative, Headache, Nausea, Nuclear magnetic resonance imaging brain abnormal, Polymerase chain reaction, Pyrexia, Red blood cells CSF positive, Scan brain, Skull fracture, Skull fractured base, Subarachnoid haemorrhage, Vitamin B12 abnormal, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Haemorrhagic cerebrovascular conditions (narrow), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: 36 hours after receiving a physical exam, which included administration of Adacel vaccine as well as placement of a PPD, patient complained of headache and vomiting. She was taken to an ER where she was found to have a skull fracture and hemorrhagic brain contusions. It was concluded during her hospital stay that she most likely had a seizure. 05/28/2008 MR received for DOS 5/08-16/2008 with D/C DX: Intracerebral hemorrhage. Pt awoke on 5/08/08 with severe L sided headache, nausea and vomiting and intermittant decreased responsiveness. Temporal bone fracture and subarachnoid hemorrhage noted on head CT as well as tomporal and frontal contusions. Pt developed low grade fever that pm. PEs were WNL during hospitalization. Likely pt had seizure in her sleep resulting in fx and SAH. D/C on seizure precautions.

VAERS ID:314083 (history)  Vaccinated:2008-05-06
Age:11.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Female  Submitted:2008-05-22, Days after onset: 14
Location:Wyoming  Entered:2008-05-29, 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: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B012AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: None reported. Previous dose of Tdap given on 8-1-07.

VAERS ID:316239 (history)  Vaccinated:2008-05-06
Age:25.0  Onset:2008-05-14, Days after vaccination: 8
Gender:Male  Submitted:2008-06-13, Days after onset: 30
Location:New York  Entered:2008-06-13
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. Patient''s prior tetanus booster was 6/2/1997 and we were simply updating.
Preexisting Conditions: seasonal/environmental allergies, otherwise in excellent health
Diagnostic Lab Data: Patient had MRI of the brain which was only notable for "There is linear enhancement of the left facial nerve within the apex of the left internal auditory canal, and in all of the segments of the nerve within the fallopian canal. No massli
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2899AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dysgeusia, Eye movement disorder, Facial palsy, Hyperacusis, Movement disorder, Nuclear magnetic resonance imaging brain abnormal
SMQs:, Taste and smell disorders (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (narrow), Ocular motility disorders (narrow)
Write-up: Patient noted to have difficulty closing Left eye and chewing normally while in the shower approximately one week after vaccine administration. Went to local ER where he was diagnosed with a "Bell''s Palsy" and treated empirically with Prednisone and acyclovir. Patient was referred to a neurologist who evaluated him on the 21st - at that time patient was noted to have some facial droop, weakness in closing the eye and changes in taste sensation and hyperacusis consistent with a 7th nerve palsy. Patient came in on 6/13/2008 to report to me this incident. At the time of entry he has regained most of his facial muscle strength and no longer requires the use of artifical tears. 8/5/08 Reviewed ER medical records of 5/14/08. FINAL DX: Bell''s palsy Records reveal patient experienced left facial droop, unable to close left eye or smile on left side w/abrupt beginning few hours prior. Tx w/antiviral, steroids & eye drops. D/C to home w/referral to neurologist as outpatient.

VAERS ID:316847 (history)  Vaccinated:2008-05-06
Age:20.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-06-13, Days after onset: 37
Location:Michigan  Entered:2008-06-16, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0805USA02867
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1978U0IMUN
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a nurse concerning a 20 year old female with pertinent medical history, allergies and concomitant medications reported as none, who on 06-MAY-2008 was vaccinated with the first dose of GARDASIL, 0.5ml, IM, (lot# 659964/1978U). On 07-MAY-2008, one day after receiving GARDASIL, the patient developed red, blotchy areas on both arms. The areas of redness were intermittent, reappearing at night. Unspecified medical attention was sought via the telephone and and resolved completely on 09-MAY-2008 without treatment. Additional information has been requested.

VAERS ID:316902 (history)  Vaccinated:2008-05-06
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2008-06-16
Location:New Jersey  Entered:2008-06-23, 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: Claritin
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1850U1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Hypoaesthesia, Pain in extremity, Pallor, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Arm numb x 5 days, pain, tingling, weak and pale.

VAERS ID:316937 (history)  Vaccinated:2008-05-06
Age:55.0  Onset:2008-05-20, Days after vaccination: 14
Gender:Male  Submitted:2008-06-23, Days after onset: 34
Location:Maryland  Entered:2008-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lovastatin 20 mg,Niaspan 2 grams,folic acid, Vitamin E, Ascorbic Acid,glucosamine chondroitin.
Current Illness: Rash on his legs attributed to heat. He experiences this every summer.
Preexisting Conditions: No known allergies. Hyperlipidemia, BMI 31.3
Diagnostic Lab Data: Patient states his doctor drew blood.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2937AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Angioedema, Blood test, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Hives began 5/20/08. Evaluated at Health Unit. Hives began on leg, advanced to torso, extremities, head. Angioedema. He obtained treatment from Dr (Allergy). He is currently taking Prednisone 20 mg, Benadryl, other antihistamines.

VAERS ID:317762 (history)  Vaccinated:2008-05-06
Age:15.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-06-27, Days after onset: 51
Location:New York  Entered:2008-06-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none~ ()~NULL~~In Patient|none~ ()~NULL~~In Sibling1|none~ ()~NULL~~In Sibling2
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: sensitive to pennicillan
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2568AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Chills, Confusional state, Fatigue, Feeling abnormal, Grip strength decreased, Hypotonia, Injection site pain, Injection site swelling, Injection site warmth, Loss of consciousness, Muscular weakness, Musculoskeletal stiffness, Pallor, Pyrexia, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad)
Write-up: Patient was otherwise healthy, had one small cold in over a year. Vaccine was at 3:30pm on 5/6/08. By that night, patient''s vaccine site was swollen, warm and painful. Patient had 100mg. of Ibuprofen and ice on site. When patient woke in morning of 5/7/08 at 5:45am, he complained that he was unusually tired. He seemed a bit spaced out. He went to school. Not recognizing he was not well, he said his legs were really tired through the day, and at Gym class (9:30am)he realized that he kept losing grip of a baseball bat. He ate lunch at 10:30am and still felt a bit tired. By 2:00pm it seems he lost conciousness in the classroom. He said everything turned white and he fainted. At this point he might have hit his head, had symptoms of a concusion. He blacked out a few times in a wheel chair to and at the health office at school. I arrived at the school by 2:30pm. I witnessed his confusion and dazed behavior. He was shaking and had the chills. His temperature was 99, he had a stiff appearence. The most startling event that I witnessed and the EMT said was not typical of a concusion was that his face seemed almost paralyzed. His face was green/greyish and lack of color. He had no muscle tone in his face. One eye was somewhat lower than the other. The EMT checked for signs of a stroke, it was negative. They took him to the Emergency room. He was given glucose and orange juice and by 5:00pm he was more like himself, including color and muscle-tone in his face. His arms and legs were still weak and still had a low fever for another 2 days. The injection site was swollen for another few days. The Doctors denied that this might have been an adverse reaction to the Menactra vaccine. I think it''s just too much of a coincidence for it not to be related. Thankfuly he recovered.

VAERS ID:319488 (history)  Vaccinated:2008-05-06
Age:  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-06-24, Days after onset: 49
Location:Unknown  Entered:2008-07-11, Days after submission: 17
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: Chickenpox
Diagnostic Lab Data: None
CDC 'Split Type': WAES0805USA01728
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blister
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Information has been received from a registered nurse, concerning an adult female "in her forties" with a history of two episodes of severe chickenpox, who on 06-MAY-2008 was vaccinated with zoster vaccine live (Oka/Merck) (lot # dose and route not specified). On 07-MAY-2008 the patient developed "blisters" on her chest, and contacted the physician''s office by telephone. At the time of this report, the outcome of the event was not recovered. No further information was available. Additional information has been requested.

VAERS ID:319489 (history)  Vaccinated:2008-05-06
Age:69.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Female  Submitted:2008-06-24, Days after onset: 48
Location:Michigan  Entered:2008-07-11, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Penicillin allergy; Drug hypersensitivity
Preexisting Conditions: Unknown; Rash
Diagnostic Lab Data: None
CDC 'Split Type': WAES0805USA01659
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0159X0SCUN
Administered by: Other     Purchased by: Private
Symptoms: Burning sensation, Pruritus generalised, Skin lesion
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad)
Write-up: Information has been received from a Registered Pharmacist concerning a 69 year old female with no reactions/allergies who on 06-MAY-2008 was vaccinated with zoster vaccine live (Oka/Merck) 0.65 mL subcutaneously (lot 659760/0159X). On 06-MAY-2008, since the patient was given zoster vaccine live the patient experienced full body itching. No rash or injection site reaction was reported. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/24/2008. Information has been received from a registered pharmacist concerning a 69 year old female patient with allergies to penicillin, CALAN and VICODIN all of which caused a rash and no environmental allergies and no illness at the time of vaccination who on the morning of 06-MAY-2008 was vaccinated subcutaneously in the left arm with a 0.65 mL first dose of ZOSTAVAX (Merck) ( Lot 659760/0159X). On 07-MAY-2008 at 14:00, the patient complained of full body itching including eyes and throat. She stated that the itching was coming from inside and her skin felt like it was burning. The patient had no fever or reaction at the injection site or rash. The patient was treated with BENADRYL for 48 hours. No diagnostic laboratory tests were performed. There was one healing lesion seen in exam on the patient''s back which was located on the right L1 nerve distribution. No product quality complaint was involved. At the time of this report the patient had recovered. Additional information is not expected.

VAERS ID:318844 (history)  Vaccinated:2008-05-06
Age:19.0  Onset:2008-05-17, Days after vaccination: 11
Gender:Male  Submitted:2008-07-09, Days after onset: 53
Location:Texas  Entered:2008-07-14, 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: None
Preexisting Conditions: 07/09/2008 Myocarditis, acute NOS (In remission)
Diagnostic Lab Data: Troponin I high as 15.32 on 18 May 08; 17 May CK 909, CKMB 105, CKMB index 11.6, CRP 52.6; Cardiac MRI 18 May 08; IMPRESSION: Multiple areas of enhancement within the left ventricular lateral wall consistent with history of clinical myocarditis. Echocardiogram (5/21/08) WNL w/ejection fraction 60-70%. CXR WNL
CDC 'Split Type':
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Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  SCUN
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER  IDUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA05222 IMUN
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase MB, Blood creatine phosphokinase increased, C-reactive protein increased, Chest X-ray normal, Chest pain, Dyspnoea, Echocardiogram normal, Ejection fraction, Myocarditis, Nuclear magnetic resonance imaging abnormal, Troponin I increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: 13 ds post SPV developed Myocarditis. Symptoms: Chest Pain. 8/8/08 Reviewed medical records which included cardiology consult of 6/9/08. FINAL DX: acute myocarditis Records reveal patient experienced chest pain & SOB 5/17/08.

VAERS ID:319028 (history)  Vaccinated:2008-05-06
Age:0.2  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-05-21, Days after onset: 13
Location:New York  Entered:2008-07-15, Days after submission: 55
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
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1828U0PO 
Administered by: Private     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:320661 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-07-22, Days after onset: 75
Location:Hawaii  Entered:2008-07-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)SANOFI PASTEURUF211AA3IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURAC2161422IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0417U0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1787U0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Varicella
SMQs:
Write-up: Vaccine administered 5/6/08- Parent reports shot he broke out into chickenpox soon after- Patient doing fine 7/22/08

VAERS ID:324325 (history)  Vaccinated:2008-05-06
Age:4.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-07-30, Days after onset: 83
Location:Unknown  Entered:2008-08-06, 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:
Preexisting Conditions: Undescended testicle
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0805USA01957
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HEPA: HEP A (VAQTA)MERCK & CO. INC.  UNUN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0200U SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Wrong drug administered
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 a 4 year old male with a history of one undescended testicle who on 06-MAY-2008 was vaccinated subcutaneously in the left arm with pneumococcal 23v polysaccharide vaccine (lot# 656233/0200U). Concomitant therapy included measles-mumps-rubella vaccine, for the treatment of prophylaxis (duration and dose not reported) and varicella virus vaccine live, for the treatment of prophylaxis (duration and dose not reported). Other concomitant therapy included poliovirus vaccine, diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid and hepatitis A virus vaccine (unspecified). On 06-MAY-2008, the patient was inadvertently given pneumococcal 23v polysaccharide vaccine. This was a nurse error. He was suppose to receive tuberculin purified protein derivative. The patient experienced a red, raised, painful injection site reaction. The red, raised, painful injection site reaction persisted. The patient was seen in the office. He will not receive the tuberculin purified protein derivative until his arm heals. Additional information has been requested.

VAERS ID:322011 (history)  Vaccinated:2008-05-06
Age:5.0  Onset:2008-05-07, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 1
Location:Unknown  Entered:2008-08-13, Days after submission: 97
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B051AA4IMRL
HEPA: HEP A (VAQTA)MERCK & CO. INC.AHAVB182AA0IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01693SCLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1326F1SCRL
Administered by: Military     Purchased by: Military
Symptoms: Gait disturbance, Injection site erythema, Injection site pain, Injection site swelling, Mobility decreased
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received immunizations on 5-6-08/5-7-08 his left leg was swollen, sore & red. He told me it hurt to walk or try to bring his knee up to chest. 5-8-08 worse took to medical center.

VAERS ID:323687 (history)  Vaccinated:2008-05-06
Age:17.0  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-05-20, Days after onset: 14
Location:Georga  Entered:2008-08-29, Days after submission: 101
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None voiced
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type': GA08057
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2766AAVF IMRA
Administered by: Public     Purchased by: Public
Symptoms: Blood pressure decreased, Cold sweat, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient here for TDAP, after injection patient began to have decreasing B/P, clammy skin, and complained of nausea. Continued to have decreasing B/P while sitting or standing only. EMS called patient transported to ER.

VAERS ID:327317 (history)  Vaccinated:2008-05-06
Age:16.0  Onset:2008-07-08, Days after vaccination: 63
Gender:Female  Submitted:2008-09-15, Days after onset: 69
Location:Colorado  Entered:2008-09-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Pregnancy NOS (LMP - 7/8/2008)
Preexisting Conditions:
Diagnostic Lab Data: urine beta-human, 08/26/08, positive;
CDC 'Split Type': WAES0808USA04857
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Nausea, Urine human chorionic gonadotropin positive
SMQs:, Acute pancreatitis (broad), Tumour markers (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received through the pregnancy registry for GARDASIL from a physician concerning a 16 year old female with no pertinent medical history and no history of drug reactions or allergies who no 06-MAY-2008 was vaccinated with the first dose of GARDASIL. On 08-JUL-2008 the patient had her last menstrual period. On 18-AUG-2008 the patient was vaccinated with the second dose of GARDASIL (lot#: ). On 26-AUG-2008 the patient was seen in the physician''s office due to nausea. Urine pregnancy test result was positive. The patient was pregnant at 7 weeks gestation. The estimated delivery date is 15-APR-2009. Additional information has been requested.

VAERS ID:328545 (history)  Vaccinated:2008-05-06
Age:0.5  Onset:0000-00-00
Gender:Male  Submitted:2008-10-06
Location:Michigan  Entered:2008-10-15, Days after submission: 9
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: Atopic Dermatitis; mild plagiocephaly
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPH: DTAP + HIB (TRIHIBIT)SANOFI PASTEURU2070BA0IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR402731IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC413351IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1665U1PO 
Administered by: Public     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: TRIHIBIT given before 15 months of age. no side effects reporter

VAERS ID:328548 (history)  Vaccinated:2008-05-06
Age:0.4  Onset:0000-00-00
Gender:Male  Submitted:2008-10-06
Location:Unknown  Entered:2008-10-15, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPH: DTAP + HIB (TRIHIBIT)SANOFI PASTEURUF105AB0IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURAC2730IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC391860IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.16654 PO 
Administered by: Public     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: D-tap HIB - combo given before 15months of age. No side effects reported

VAERS ID:328847 (history)  Vaccinated:2008-05-06
Age:  Onset:2008-05-06, Days after vaccination: 0
Gender:Female  Submitted:2008-10-08, Days after onset: 155
Location:Unknown  Entered:2008-10-15, 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': WAES0809USA00484
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Information has been received from a consumer concerning her daughter who on approximately 06-MAY-2008 was vaccinated with the first dose of GARDASIL vaccine (yeast). Subsequently the patient experienced diarrhea and vomiting. The outcome of the patient was unknown. The patient did not seek medical attention. Additional information has been requested.

VAERS ID:332382 (history)  Vaccinated:2008-05-06
Age:20.0  Onset:2008-05-10, Days after vaccination: 4
Gender:Female  Submitted:2008-11-07, Days after onset: 181
Location:Washington  Entered:2008-11-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB236AA0UNLA
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Menorrhagia, Menstruation irregular, Papilloma viral infection
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Fertility disorders (broad)
Write-up: States she has GARDASIL (1) dose & 2 days later she had HPV. Her period came early & heavy & lasted 7 days she then stopped & 2 wks later had a regular cycle. She feels it was due to both shots so close.

VAERS ID:340729 (history)  Vaccinated:2008-05-06
Age:16.0  Onset:0000-00-00
Gender:Female  Submitted:2009-02-13
Location:Unknown  Entered:2009-02-18, 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: None
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0901USA00984
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Information has been received from a nurse practitioner concerning a 17 year old female who on 06-MAY-2008 was vaccinated with GARDASIL intramuscularly 0.5 mL. Subsequently the patient developed intermittent "aching" to her hips, knees and right ankle after vaccination. The patient visited the office. At the time of reporting, the patient''s intermittent "aching" to her hips, knees and right ankle after vaccination persisted. No further information was available.

VAERS ID:342094 (history)  Vaccinated:2008-05-06
Age:15.0  Onset:0000-00-00
Gender:Female  Submitted:2009-03-18
Location:Unknown  Entered:2009-03-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy NOS (LMP = 4/23/2008); Attention deficit/hyperactivity disorder; Smoker
Preexisting Conditions:
Diagnostic Lab Data: Beta-human chorionic, 05/27/08, positive
CDC 'Split Type': WAES0806USA01608
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1266U0IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy, Foetal disorder, Pregnancy test positive, Premature baby
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Neonatal disorders (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a registered nurse, for the Pregnancy Registry for GARDASIL concerning a 15 year old female with attention deficit/hyperactivity disorder who denied she was pregnant on 06-MAY-2008 and was vaccinated IM with a first 0.5 mL dose of GARDASIL (lot # 659437/1266U). Concomitant therapy on the same day included a dose of MENACTRA (Sanofi Pasteur). Other medications included "STRAITERA", but has stopped taking this. On 27-MAY-2008 the patient saw her family doctor and a pregnancy test confirmed the pregnancy. On 09-JUN-2008, the patient was seen in the health department office stating she was pregnant and was enrolled in the WIC program. The patient''s LMP was reported to be 23-APR-2008. Follow-up information was received from the registered nurse via a completed pregnancy questionnaire. It was reported that the female patient had no concurrent medical conditions (also reported as unknown) and smoked 3 cigarettes per day when first pregnant. The patient had no previous pregnancy. On 09-JUN-2008 the patient stated that she was taking STRATTERA before pregnancy and did not take during pregnancy. The medication used during this pregnancy was unknown. The patient had some bleeding in early pregnancy. On 08-OCT-2008 a baby girl was delivered prematurely at 26 weeks gestation in a hospital. The baby weighed 1 pound and 11 ounces. The length was 12 inches. The head circumference was 21.5 inches. The baby had congenital heart and breathing problems. It was reported that the complication during labor/delivery, the diagnostic test during pregnancy and the infections or illnesses during pregnancy was unknown. Upon internal review, born prematurely at 26 weeks and birth weight 1 pound and 11 ounces were considered to be other important medical events. Additional information is not expected.

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)
Write-up: Right arm Menactra 10x13cm; Left arm TDap x8cm. Fever 104. Very swollen arm.

VAERS ID:311979 (history)  Vaccinated:2008-05-07
Age:35.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 1
Location:South Carolina  Entered:2008-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none stated~Tdap (no brand name)~UN~17~In Patient
Other Medications: Wellbutrin, Nexium, vitamin D & B12
Current Illness: none
Preexisting Conditions: fire ant bite allergy & lamb food allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2644AA2IMLA
Administered by: Public     Purchased by: Private
Symptoms: Influenza like illness, Neck pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Fever of 100 degrees or above (even with Motrin). Body aches, severe. Neck pain. Flu-like symptoms for 2-3 days.

VAERS ID:311991 (history)  Vaccinated:2008-05-07
Age:4.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 1
Location:Texas  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: Cefzil allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2950AA4IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA0342-24IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1671U1SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0090X1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: On 5/8/08, the patient was seen for left lateral thigh with 10 1/2cm x9 1/2cm area that was red, indurated, slightly warm and painful. Possibly early cellulitis. Treatment included Clindamycin x7 days and Motrin for pain.

VAERS ID:311994 (history)  Vaccinated:2008-05-07
Age:25.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Female  Submitted:2008-05-09, Days after onset: 2
Location:New York  Entered:2008-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site rash, Malaise, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: intense pain at injection site. Large bump and redness. Pain up and down arm. General body pain and general feeling of illness

VAERS ID:312017 (history)  Vaccinated:2008-05-07
Age:17.0  Onset:2008-05-09, Days after vaccination: 2
Gender:Female  Submitted:2008-05-09, Days after onset: 0
Location:Michigan  Entered:2008-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl for "cold or sinus inf"
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.14460U2IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Nausea, Pruritus, Rash erythematous, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: After receiving HPV #3, child got navel pierced. The next day she had nausea, vomiting, light-headedness, dizziness. Stayed home from school. Today (5/9/08) noticed a few white spots on her feet-turned to red, spread to legs, hands & arms. Took Benadryl 5/8/08 for "cold or sinus infection". Reports itching with rash. Advised to see a doctor - clinic info given.

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:312181 (history)  Vaccinated:2008-05-07
Age:53.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-12, Days after onset: 4
Location:Minnesota  Entered:2008-05-13, 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: OTC - Ranitidine
Current Illness: None
Preexisting Conditions: GERD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSU2514AA IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB525BA0IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB172AA0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA04460IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUF302AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 5/12/08 phone call from patient complaining of tenderness and swelling to left axillary - (no temperature) swelling approximately 7.5cm, referred to MD.

VAERS ID:312265 (history)  Vaccinated:2008-05-07
Age:0.2  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-13, Days after onset: 6
Location:Arizona  Entered:2008-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEUR 0IMRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abnormal behaviour, Choking, Decreased appetite, Diet refusal, Disturbance in attention, Hypersomnia, Somnolence
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad)
Write-up: Since the vaccine, patient has been sleeping about 50% more of the time or is drowsy, his appetite has decreased about 30%, he is much less alert, chokes while he is eating, eye contact has decreased significantly, he no longer want to take a bottle at all, he has moments where it seems he isn''t there (spaced out), and he has for the most part stopped coo''ing. These symptoms started the evening after the vaccine and have persisted to now.

VAERS ID:312278 (history)  Vaccinated:2008-05-07
Age:0.3  Onset:2008-05-08, Days after vaccination: 1
Gender:Male  Submitted:2008-05-08, Days after onset: 0
Location:North Carolina  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: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B141AA1IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0260U1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC659321IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0144X1PO 
Administered by: Private     Purchased by: Public
Symptoms: Crying, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (broad)
Write-up: Cried for 4 hours, fever of 102 degrees.

VAERS ID:312444 (history)  Vaccinated:2008-05-07
Age:13.0  Onset:2008-05-09, Days after vaccination: 2
Gender:Female  Submitted:2008-05-09, Days after onset: 0
Location:Washington  Entered:2008-05-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0928U0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2560AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0086X1SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Swelling, Throat tightness, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt. started having redness of the left deltoid this morning. She had swelling of the legs deltoid for several hours. She complained of tightness in her throat and hives on her face and neck. She has 5x6 cm tenderness on her left deltoid.

VAERS ID:312448 (history)  Vaccinated:2008-05-07
Age:16.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 1
Location:California  Entered:2008-05-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: No labs ordered.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0063X IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1807U SCLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: May 9, 2008, pt came to clinic with complaint of increased redness and warmth on left arm (injection site of Varicella vaccine received 5/7/2008). MD notes described left arm with 4x4cm redness with central induration on left area inferior to injection site of varicella.

VAERS ID:312457 (history)  Vaccinated:2008-05-07
Age:9.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-12, Days after onset: 4
Location:Delaware  Entered:2008-05-16, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB264BA1UNLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0523U1UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1800U2UNLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Induration, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: L arm was swollen, red, hard, warm.

VAERS ID:312491 (history)  Vaccinated:2008-05-07
Age:4.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-16, Days after onset: 8
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:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B067AA IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA0125 IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0040X SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1384U SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Child received immunizations on 7 May 2008 at about 1600 and returned to the clinic on 8 May 2008 for 1500 appointment due to left arm swollen, red, warm, and tender to touch. Treated with augmentin.

VAERS ID:312508 (history)  Vaccinated:2008-05-07
Age:54.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Kansas  Entered:2008-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol; Diovan
Current Illness: None
Preexisting Conditions: PCN, Ceclor
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2889AA IMRA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Headache, Injection site erythema, Injection site induration, Injection site pain, Injection site pruritus, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Fever highest 103.7, body joint aches, headache, itchy and painful injection site, injection site red, swollen hard 10" x 6" area.

VAERS ID:312517 (history)  Vaccinated:2008-05-07
Age:1.5  Onset:2008-05-07, Days after vaccination: 0
Gender:Female  Submitted:2008-05-12, Days after onset: 5
Location:Kansas  Entered:2008-05-16, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B061AA3UNRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0700F0UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC499163UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1781U0UNLL
Administered by: Private     Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Immediate hive reaction at site between where MMR & VARIVAX were given on left thigh. Called 5/12/08 at 4:30pm reaction diminished by night time.

VAERS ID:312518 (history)  Vaccinated:2008-05-07
Age:9.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-16, Days after onset: 8
Location:Alabama  Entered:2008-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote; Carbatrol
Current Illness: None
Preexisting Conditions: Seizure disorder
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1361U1SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Around injection site, red, swollen area on (R) arm; diameter 7 inches long, 10 1/4 inches, warm to touch.

VAERS ID:312575 (history)  Vaccinated:2008-05-07
Age:28.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Female  Submitted:2008-05-09, Days after onset: 1
Location:Minnesota  Entered:2008-05-19, Days after submission: 10
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
RAB: RABIES (IMOVAX)SANOFI PASTEURA0257-23IMRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Donor came to center on 5-9-08 to donate. Donor had red rash on right arm and some swelling which donor states believes is from Rabies immunization on 5-7-08.

VAERS ID:313371 (history)  Vaccinated:2008-05-07
Age:  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-23, Days after onset: 16
Location:Virginia  Entered:2008-05-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: [therapy unspecified]; VENTOLIN (ALBUTEROL); TENORMIN; DIAZEPAM; NEXIUM; ZETIA; ADVAIR; HYDRODIURIL; prednisone
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0805USA03538
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0380U IMRA
Administered by: Other     Purchased by: Other
Symptoms: Anxiety, Injection site cellulitis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a medical assistant (MA) concerning a male patient with asthma who on 07-MAY-2008 was vaccinated IM into the right deltoid with a dose of PNEUMOVAX 23 (lot #657143/0380U). Concomitant therapy included hydrochlorothiazide (manufacturer unknown), TENORMIN, ezetimibe (MSD), unspecified therapy ("CELZONE"), NEXIUM, ADVAIR, VENTOLIN, DIAZEPAN, prednisone and unspecified therapy ("HYOSEYMINE"). The MA reported that the patient contacted the office on 09-MAY-2008 and reported that he was experiencing anxiety. On 10-MAY-2008 he visited the emergency room and he was admitted to the hospital. He was discharged on 11-MAY-2008. He had developed cellulitis at the site of the deltoid-bicep area and the "underneath area" of the right arm. He was given an unspecified antibiotic. On 14-MAY-2008, he was seen by his physician in the office. The patient complained of swelling. There was no redness or signs of cellulitis. No further information was available. The patient was recovering. Additional information has been requested.

VAERS ID:315891 (history)  Vaccinated:2008-05-07
Age:4.0  Onset:0000-00-00
Gender:Female  Submitted:2008-06-02
Location:California  Entered:2008-06-10, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B054BA4IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA03423IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1672U1SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1502U1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 40 mm soft indefined lump at (L) deltoid-tender only today pressure- (not red) - bad redness and DTaP given-swelling has remained.

VAERS ID:316198 (history)  Vaccinated:2008-05-07
Age:13.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-07, Days after onset: 0
Location:Illinois  Entered:2008-06-13, Days after submission: 37
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 PASTEURU261AA0IMRA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Public
Symptoms: Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Complained of headache, nausea, and vomiting. Denied eating breakfast. Refused orange juice and doughnut

VAERS ID:316199 (history)  Vaccinated:2008-05-07
Age:14.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-07, Days after onset: 0
Location:Illinois  Entered:2008-06-13, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2616AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Complained of dizziness with beginning headache.

VAERS ID:316200 (history)  Vaccinated:2008-05-07
Age:13.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-07, Days after onset: 0
Location:Illinois  Entered:2008-06-13, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Feeling tired
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2616AA0 LA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Dry skin, Fatigue, Skin warm
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Pt c/o of feeling tired, no pain, slight dizziness, no headache, no SOB. Pain score is 0. Pt is alert and oriented x3. Skin warm and dry. Walks with steady gait.

VAERS ID:316201 (history)  Vaccinated:2008-05-07
Age:14.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-07, Days after onset: 0
Location:Illinois  Entered:2008-06-13, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2616AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Headache
SMQs:
Write-up: Complained of headache (frontal). Ate doughnut, apple before shot

VAERS ID:316838 (history)  Vaccinated:2008-05-07
Age:19.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Female  Submitted:2008-06-13, Days after onset: 37
Location:North Carolina  Entered:2008-06-16, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: YASMIN
Current Illness: Drug hypersensitivity; Drug hypersensitivity; Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: brachial artery, within normal limits
CDC 'Split Type': WAES0805USA02271
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1968U2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Brachial pulse normal, Incorrect route of drug administration, Injection site erythema, Injection site irritation
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a health professional concerning a 19 year old female with an allergy to DEMEROL, morphine and penicillin who on 11-OCT-2007 was vaccinated with her first dose of GARDASIL (lot# 658563/1063U). On 03-JAN-2008 the patient was vaccinated with her second dose of GARDASIL (lot# 659439/1267U). On 07-MAY-2008 the patient was vaccinated with her third dose of GARDASIL (lot# 660389/1968U). The third dose may have been administered subcutaneously. Concomitant therapy included YASMIN. On 07-MAY-2008, within 15 minutes of the dose, the patient experienced burning and redness at the injection site. The patient was being treated with BENADRYL, antibiotics and cool compresses applied to the injection site. The patient was seen in the office and her outcome was unknown. Additional information has been requested.

VAERS ID:317092 (history)  Vaccinated:2008-05-07
Age:0.6  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-06-13, Days after onset: 37
Location:Unknown  Entered:2008-06-16, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0805USA01315
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0020X0PO 
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: Information has been received from a registered nurse concerning a 6-month-old male who on 07-MAY-2008 was vaccinated orally with a first dose of ROTATEQ (lot # 659773/0020X). No adverse effects reported. The patient did not seek medical attention. A product complaint was not involved. Additional information has been requested.

VAERS ID:317210 (history)  Vaccinated:2008-05-07
Age:0.3  Onset:0000-00-00
Gender:Male  Submitted:2008-06-13
Location:Washington  Entered:2008-06-24, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B130AA UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETH0886F UNRL
Administered by: Private     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:318620 (history)  Vaccinated:2008-05-07
Age:0.3  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-07-09, Days after onset: 63
Location:Virginia  Entered:2008-07-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2951AA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF353AA1IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA03011IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC631101IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0019X1PO 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site urticaria, Injection site warmth, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Low grade fever (101.0), red raised welt from knee to hip on both legs, warm to touch, went to ER, no meds were given, was better 9 hrs after immunizations given.

VAERS ID:319595 (history)  Vaccinated:2008-05-07
Age:62.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-06-24, Days after onset: 48
Location:Unknown  Entered:2008-07-11, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified); (therapy unspecified)
Current Illness: Cholesterol high; Blood pressure high
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0805USA03389
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: Information has been received from a consumer concerning her 62-year-old husband with high cholesterol and high blood pressure who on 07-MAY-2008 was vaccinated with a dose of zoster vaccine live (Oka/Merck). Concomitant therapy included unspecified cholesterol and blood pressure medications. On 07-MAY-2008, the patient experienced severe headache. The patient did not seek medical attention. At the time of the report the patient''s status was not recovered. A product quality complaint was not involved. No further information is available.

VAERS ID:320388 (history)  Vaccinated:2008-05-07
Age:17.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Female  Submitted:2008-07-15, Days after onset: 69
Location:Wisconsin  Entered:2008-07-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1740U0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1797U1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site cellulitis, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received HPV IM in left deltoid on 5-7-08. Developed redness, swelling, hot to touch & pain at site and surrounding area. Within a week of administration sought medical treatment for cellulitis at injection site. Treated with antibiotic. Condition resolved. Urgent care treatment was 5/09/08.

VAERS ID:320669 (history)  Vaccinated:2008-05-07
Age:18.0  Onset:2008-05-20, Days after vaccination: 13
Gender:Male  Submitted:2008-07-01, Days after onset: 42
Location:Georga  Entered:2008-07-28, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO
Current Illness: None
Preexisting Conditions: "Allergies" "Has trouble staying focused without med"
Diagnostic Lab Data:
CDC 'Split Type': GA08038
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0608F1IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB217BA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Deafness, Temporomandibular joint syndrome
SMQs:, Hearing impairment (narrow), Arthritis (narrow)
Write-up: Mother states that in mid-May pt''s girlfriend noticed "he was not hearing her" - took pt to Dr., ENT, on 06-30-08. Mother states hearing test showed severe hearing loss - was also dx with TMJ - has return appt 07-30-08. Mother states she was told by a friend that hearing loss could be a side effect of vaccines.

VAERS ID:320714 (history)  Vaccinated:2008-05-07
Age:5.0  Onset:2008-06-11, Days after vaccination: 35
Gender:Male  Submitted:2008-07-29, Days after onset: 48
Location:Indiana  Entered:2008-07-29
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI spine non-enhancing ant. column; hypersensitivity of cord at T2. 9/18/08-records received-CT head unremarkable. MRI showed cervical spinal cord which appeared demyelinated and consistent with acute transverse myelitis. PPD negative. Lumbar puncture normal glucose and protein. All cultures and serologies were negative for Bartonella, Lyme disease, Mycoplasma, CMV and general virus cultures. Bronchoscopy with smears and cultures negative. Visual evoked response test normal.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B067BA4IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01253IMLL
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Balance disorder, Bronchoscopy, CSF glucose normal, CSF protein normal, Computerised tomogram normal, Culture negative, Demyelination, Endotracheal intubation, Gastrointestinal tube insertion, Grip strength decreased, Hyperglycaemia, Intensive care, Lumbar puncture normal, Mechanical ventilation, Mobility decreased, Muscle twitching, Muscular weakness, Myelitis transverse, Neurogenic bladder, Nuclear magnetic resonance imaging abnormal, Physiotherapy, Pneumonia aspiration, Pyrexia, Rehabilitation therapy, Respiratory distress, Respiratory failure, Terminal dribbling, Tracheostomy, Tremor, Tuberculin test negative, Visual evoked potentials normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Demyelination (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: On 6-12-08, pt developed back pain, fever, and acute onset of weakness. He was initially admitted to floor but developed resp. distress and was transferred to Ped ICU and intubated. He was subsequently diagnosed with transverse myelitis.9/18/08-records received for DOS 6/13-7/22/08-DC/Transfer Summary DX: Acute transverse myelitis. Respiratory failure. Presented to ED on 6/11/08 with acute onset of upper back pain and weakness in upper extremities and lower extremities with upper worse than lower. Developed problems with balance. Unable to squeeze parent''s finger, and developed upper body twitching and shaking. Fever 103. In ED unable to raise arms. Developed respiratory distress and was intubated and placed on mechanical ventilation. Hyperglycemia due to high-dose Solu-Medrol. Aspiration pneumonia. Nasograstric tube feedings. Continued with low grade fevers. Transferred to rehabilitation facility. 2/27/09-records received-rehabiliation facility with subsequent decannulation after venitaltor dependency. Neurogenic bladder. Postvoid residual. 1/25/2010 Follow-up: patient had an active transverse myelitis and continues to have physical limitation he continues to received physical therapy services.

VAERS ID:320765 (history)  Vaccinated:2008-05-07
Age:0.4  Onset:2008-05-07, Days after vaccination: 0
Gender:Female  Submitted:2008-07-23, Days after onset: 77
Location:Maine  Entered:2008-07-29, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2651AA1UNLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0254U1UNRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ05481UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB47442C1UNRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1888U1PO 
Administered by: Private     Purchased by: Public
Symptoms: Crying
SMQs:, Depression (excl suicide and self injury) (broad)
Write-up: Patient received vaccinations on 5/7/08. Mom states that patient was crying and was inconsolable for 3-4 hours after administration.

VAERS ID:326076 (history)  Vaccinated:2008-05-07
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2008-08-14
Location:Texas  Entered:2008-08-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0807USA02188
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1522U0UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Information has been received from a physician concerning an 18 year old female who on 07-MAY-2008 was vaccinated with the first dose of GARDASIL vaccine (yeast) (lot # 659055/1522U) and also with varicella virus vaccine live (Oka/Merck) in her arm. Concomitant therapy included meningococcal ACYW conj vaccine (dip toxoid) (MENACTRA). The physician reported that the patient experienced pain and weakness in her arm after receiving GARDASIL vaccine (yeast) (Lot # 659055/1522U) and varicella virus vaccine live (Oka/Merck). The vaccines were administered in the same arm on the same day and the symptoms are being experienced in the same arm that the vaccines were administered. The patient''s pain and weakness in her arm persisted. No further information was provided. The patient sought medical attention, seen by the physician. Additional information has been requested.

VAERS ID:326477 (history)  Vaccinated:2008-05-07
Age:21.0  Onset:2008-05-07, Days after vaccination: 0
Gender:Female  Submitted:2008-08-14, Days after onset: 99
Location:Tennessee  Entered:2008-08-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0807USA05749
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1757U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Nausea, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Information has been received from a registered nurse concerning a 21 year old female patient who on 07-MAY-2008 was vaccinated with the first dose of GARDASIL vaccine (yeast) (lot # 659182/1757U) 0.5ml intramuscularly. On 14-JUL-2008, the patient was vaccinated with the second dose of GARDASIL vaccine (yeast) (lot # 660389/1968U) 0.5ml intramuscularly. Concomitant therapy included YAZ. The nurse reported that the patient developed dizziness, nausea, some shortness of breath and heaviness in her chest after the first two doses of HPV vaccine. The nurse reported that the symptoms were worse after the second dose. The patient was observed in the office for 20 minutes after the vaccination and then was discharged home when all symptoms resolved. At the time of the report, the patient had recovered. The patient sought medical attention. Additional information has been requested. This is in follow-up to report (s) perviously submitted on 8/14/2008. No futher information is available.

VAERS ID:327089 (history)  Vaccinated:2008-05-07
Age:19.0  Onset:2008-05-21, Days after vaccination: 14
Gender:Female  Submitted:2008-09-15, Days after onset: 117
Location:Maryland  Entered:2008-09-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Urinary tract infection
Preexisting Conditions: Urinary tract infection
Diagnostic Lab Data: None
CDC 'Split Type': WAES0808USA02809
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Skin papilloma
SMQs:
Write-up: Information has been received from a physician concerning a 19 year old female with a history of urinary tract infection who on 07-MAY-2008, was vaccinated with the third dose of GARDASIL. The dates of administration for the first and second dose was not known. There was no concomitant medication. The physician reported that on 21-MAY-2008, after the administration of all three doses of GARDASIL, the patient developed about 25 facial common flat warts and 15 warts on the back of her hands. The patient was initially examined by a dermatologist who prescribed acne cream the first visit. The dermatologist began treatment for warts after the second examination. At the time of the report, the patient was recovering. The patient sought medical attention at the physician''s office. There was no product quality complaint. Additional information has been requested.

VAERS ID:345754 (history)  Vaccinated:2008-05-07
Age:81.0  Onset:2009-04-29, Days after vaccination: 357
Gender:Female  Submitted:2009-05-05, Days after onset: 6
Location:Illinois  Entered:2009-05-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Osteoporosis, Dyslipidema ; cut b diffciency; DJO.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Herpes zoster
SMQs:
Write-up: Patient had been diagnosed with shingles on 04/29/2009

VAERS ID:348529 (history)  Vaccinated:2008-05-07
Age:5.0  Onset:2008-05-08, Days after vaccination: 1
Gender:Male  Submitted:2009-05-01, Days after onset: 358
Location:California  Entered:2009-06-05, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject was born at 39 weeks gestation. The newborn was taken to the NICU for possible sepsis, RA sats in the 80''s, with a dusky spell. Echo showed PDA the next day. Resolved on it''s own. Blood cultures were negative. PCXR was negative. The subject has a milk allergy. It causes allergic rhinitis. There is no history of adverse events previous vaccinations.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0729267A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B073AA4IMUN
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA03013IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1314U1UNLA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURERC2812AA1UNUN
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Incorrect dose administered, Lymph node pain, Lymphadenopathy, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of swollen axillary nodes in a 5-year-old male subject who was vaccinated with INFANRIX, MMR II (Merck). Concurrent vaccination included IPOL and unspecified vaccine PPD both given on 7 May 2008. On 7 May 2008 at 09:45 the subject received 5th booster dose of INFANRIX at 0.5 ml, intramuscularly in the left arm and 2nd dose of MMR II vaccine at 0.5 ml subcutaneously in the right tricep. Approximately 12 to 24 hours later, on 8 May 2008, the subject experienced swollen axillary nodes, erythema, swelling and itching. Also reported was pain in axillary node and a warm axillary node. Erythema, swelling and itching resolved at an unspecified time. Swelling of the axillary node was unresolved. The outcome of the axillary node tenderness and warm axillary node was not specified. While being seen for these events in the physician''s office, it was noted that the subject received a 4th dose of INFANRIX intramuscularly in the left deltoid on 30 March 2007. According to the reporter, this dose of INFANRIX was not needed. This was considered to be an extra dose administered. The healthcare professional considered the events of swollen axillary node, erythema, swelling and itching to be probably related to vaccination with INFANRIX and MMR II vaccine. Follow-up information received on 16 June 2008 indicated that the events were unresolved and possibly related to treatment with INFANRIX. The subject''s mother reportedly called the reporter on 23 May 2008 and stated that her daughter''s axillary node was still enlarged. She also mentioned that it was not tender. Swollen axillary gland was documented in follow-up.

VAERS ID:349931 (history)  Vaccinated:2008-05-07
Age:  Onset:2008-05-20, Days after vaccination: 13
Gender:Male  Submitted:2009-05-29, Days after onset: 374
Location:Unknown  Entered:2009-06-17, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins (unspecified)
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0805USA04742
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Rash erythematous, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a NP concerning a male with no known medical history or allergies who on 07-MAY-2008 was vaccinated sc with a 0.5 ml dose of MMR II. Concomitant therapy included multivitamins. It was reported on 20-MAY-2008 the patient experienced a red blotchy rash that extended from the upper middle back to the waistline. Patient was seen by the NP. No laboratory test were performed. The patient''s outcome was not reported. Additional information has been requested.

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