National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

Using all 626700 cases in the database

Case Details (Sorted by Vaccination Date)

This is page 2908 out of 6267

Result pages: prev   2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2820 2821 2822 2823 2824 2825 2826 2827 2828 2829 2830 2831 2832 2833 2834 2835 2836 2837 2838 2839 2840 2841 2842 2843 2844 2845 2846 2847 2848 2849 2850 2851 2852 2853 2854 2855 2856 2857 2858 2859 2860 2861 2862 2863 2864 2865 2866 2867 2868 2869 2870 2871 2872 2873 2874 2875 2876 2877 2878 2879 2880 2881 2882 2883 2884 2885 2886 2887 2888 2889 2890 2891 2892 2893 2894 2895 2896 2897 2898 2899 2900 2901 2902 2903 2904 2905 2906 2907 2908 2909 2910 2911 2912 2913 2914 2915 2916 2917 2918 2919 2920 2921 2922 2923 2924 2925 2926 2927 2928 2929 2930 2931 2932 2933 2934 2935 2936 2937 2938 2939 2940 2941 2942 2943 2944 2945 2946 2947 2948 2949 2950 2951 2952 2953 2954 2955 2956 2957 2958 2959 2960 2961 2962 2963 2964 2965 2966 2967 2968 2969 2970 2971 2972 2973 2974 2975 2976 2977 2978 2979 2980 2981 2982 2983 2984 2985 2986 2987 2988 2989 2990 2991 2992 2993 2994 2995 2996 2997 2998 2999 3000 3001 3002 3003 3004 3005 3006 3007   next


VAERS ID: 270227 (history)  
Form: Version 1.0  
Age: 60.0  
Gender: Female  
Location: Michigan  
Vaccinated:2006-12-20
Onset:2006-12-20
   Days after vaccination:0
Submitted: 2007-01-03
   Days after onset:14
Entered: 2007-01-09
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 42254AA / UNK - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium, Actonel, Zocor
Current Illness: Recovering from head cold onset 12/12/06, Finished a 7 day course of Bactrim on 12/17/06 for a UTI onset 12/09/06, finished a 2 day course of Pyridium on 12/16/06 for UTI.
Preexisting Conditions: I had an allergic reaction to Avalox, I am allergic to bee stings, I am not allergic to eggs.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives occurred about 7 1/2 hours after injection. Extreme itching. I took 2 OTC Diphenhydramine Hydrochloride 25 mg tablets and used 1% hydrocortisone cream. Hives went away and itching stopped. However I continued to have out breaks for the next 8 days, which would subside by using the tablets and cream.


VAERS ID: 287454 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Male  
Location: Colorado  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2007-07-30
   Days after onset:220
Entered: 2007-08-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0985F / UNK UN / SC

Administered by: Other       Purchased by: Other
Symptoms: Body temperature increased, Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AUGMENTIN
Current Illness:
Preexisting Conditions: Respiratory tract infection
Allergies:
Diagnostic Lab Data: body temp, 12/21/06, 101
CDC Split Type: WAES0612USA04130

Write-up: Information has been received from a certified medical assistant concerning a 20 year old male with a history of respiratory tract infection who on 20-DEC-2006 was vaccinated SC with a 0.5 mL dose of Pneumovax 23 (Lot# 655291/0985F). Concomitant vaccination on 20-DEC-2006 included a dose of influenza virus vaccine (unspecified) and AUGMENTIN. On 21-DEC-2006 the patient experienced an 8 centimeter area that was red, warm and swollen and had a temperature of 101. It was reported that the patient was recovering. The patient sought unspecified medical attention. Additional information has been requested.


VAERS ID: 287462 (history)  
Form: Version 1.0  
Age: 68.0  
Gender: Male  
Location: New Jersey  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2007-07-30
   Days after onset:220
Entered: 2007-08-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0988F / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Lung disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA00412

Write-up: Information has been received from a medical assistant concerning a 68 year old male with pulmonary problems (not specified) who on 20-DEC-2006 was vaccinated with Pneumovax 23 (Lot # 655499/0988F). It was reported that the patient presented back to the office on 21-DEC-2006 with fever and an injection site reaction which was sore, red, and swollen. At the time injection site reaction which was sore, red, and swollen. At the time of the report, the patient had recovered (date unknown). A lot checked of concern has been requested. The records of testing prior to release of the lot in question have been rechecked and found to be satisfactory. The lot met the requirements and was released by the regulatory agency. Additional information has been requested.


VAERS ID: 287463 (history)  
Form: Version 1.0  
Age: 65.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2007-07-30
   Days after onset:220
Entered: 2007-08-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0988F / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Lung disorder
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0701USA00413

Write-up: Information has been received from a medical assistant concerning a 65 year old female with a history of lung problem unspecified who on 20-DEC-2006 was vaccinated with Pneumovax 23 (lot # 655499/0988F). There was no concomitant medication reported. On 21-DEC-2006, the patient presented back to the office with fever, and an injection site reaction which was sore, red, and swollen. On a unspecified date, the patient recovered from fever and the injection site reaction (sore, red, and swollen). The records of testing prior to release of the lot in question have been rechecked and found to be satisfactory. The lot met the requirements and was released by the regulatory agency. Additional information has been requested.


VAERS ID: 287464 (history)  
Form: Version 1.0  
Age: 45.0  
Gender: Male  
Location: New Jersey  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2007-07-30
   Days after onset:220
Entered: 2007-08-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0988F / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Lung disorder
Allergies:
Diagnostic Lab Data: temperature measurement, 12/21/06, fever
CDC Split Type: WAES0701USA00414

Write-up: Information has been received from a medical assistant concerning a 45 year old male with a history of lung disorder unspecified who on 20-DEC-2006 was vaccinated with Pneumovax 23 (lot # 655499/0988F). No concomitant therapy was reported. On 21-DEC-2006, the patient sought medical attention and presented back to the office with fever and an injection site reaction which was sore, red, and swollen. On an unspecified date, the patient recovered from fever and injection site reaction (sore, red, and swollen). No further information was available at the time of reporting. The records of testing prior to release of the lot in question have been rechecked and found to be satisfactory. The lot met the requirements of the agency and was released by the regulatory agency. Additional information has been requested.


VAERS ID: 287378 (history)  
Form: Version 1.0  
Age: 63.0  
Gender: Female  
Location: Arizona  
Vaccinated:2006-12-20
Onset:2007-03-20
   Days after vaccination:90
Submitted: 2007-07-28
   Days after onset:130
Entered: 2007-08-08
   Days after submission:11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1405F / UNK UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Electromyogram abnormal, Facial palsy, Herpes zoster oticus, Neuropathy
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: EMG confirms neuropathy
CDC Split Type:

Write-up: Patient developed chronic right facial neuropathy from Bell''s Palsy and Ramsay Hunt Syndrome on 3/20/07. 10/22/07-records received for DOS 4/2-10/8/07-seen for right sided facial pain, ear pain, neck spasm, throat irritation and facial droop. Symptoms began on 3/20/07-. Pain lancinating shocks over right side of face and scalp tenderness along with few vesicles around right ear preauricularly. Bells''s Palsy. Visit on 4/3/07-tongue aphthous like ulcer and continues with facial pain. 4/5/07-Geniculate herpes with cluster of lesions in front of right ear. Difficulty keeping eyes shut. Systemic drug reaction due to carbamazepine. Herpes Zoster and facial nerve palsy. Symptoms continue 4/25/07-trigeminal neuralgia. 10/8/07-visit lid lag status post Bell''s palsy with weight and postherpetic neuralgia. Confusion secondary to polypharmacy now improving. Refused influenza vaccine. 1/11/2010 Still has facial weakness and pain. 02/02/2010 Residual eye lid droop, facial droop and pain.


VAERS ID: 287952 (history)  
Form: Version 1.0  
Age: 42.0  
Gender: Male  
Location: Maryland  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2007-08-13
   Days after onset:234
Entered: 2007-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 2 UN / ID
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 2 UN / ID
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 2 UN / ID
TD: TETANUS DIPHTHERIA (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 2 UN / ID

Administered by: Unknown       Purchased by: Private
Symptoms: Back pain, Immediate post-injection reaction, Skin discolouration
SMQs:, Retroperitoneal fibrosis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Visit to doctor offered no options.
CDC Split Type:

Write-up: Nearly immediately following the vaccines dark circle, bags and and what is now a permanent tired line appeared under my eyes and spinal pain. These side affects have worsened and show no indication of lessening. Two additional vacciness not listed on your site that were administered were Menomune and Typhim.


VAERS ID: 288785 (history)  
Form: Version 1.0  
Age:   
Gender: Male  
Location: Maryland  
Vaccinated:2006-12-20
Onset:0000-00-00
Submitted: 2007-08-23
Entered: 2007-08-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER AFLUA203BA / UNK UN / UN
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB109CB / 1 RA / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0306 / UNK UN / UN
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR UE966AA / UNK UN / UN
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR U1880DA / UNK UN / UN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / SANOFI PASTEUR Z0512 / UNK UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Dark circles under eyes, Eye swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valaciclovir hydrochlorid
Current Illness: Unknown
Preexisting Conditions: The subject previously received a flu vaccine, but it was not known if the subject experienced any adverse reactions following vaccination.
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: A0673897A

Write-up: This case was reported by a healthcare professional via a sales representative and described the occurrence of dark circles under eyes in an adult male subject who was vaccinated with Havrix, GlaxoSmithKline for prophylaxis. Concurrent vaccination included Salmonella typhi Vi capsular polysaccharide vaccine (manufacturer unspecified), inactivated poliomyelitis virus vaccine (Sanofi), influenza virus vaccine (manufacturer unspecified), meningococcal polysaccharide groups A, C, W and Y vaccine (Sanofi) and tetanus and diphtheria toxoids adsorbed (Sanofi) given on 20 December 2006. Concurrent medications included Valaciclovir hydrochloride (Valtrex). On 20 December 2006 the subject received 1st dose of Havrix at 1 ml in the right arm. At an unspecified time after vaccination with Havrix, the subject experienced dark circles under eyes, bags under eyes and blemish (described as a permanent tired line) on the face. At the time of reporting the events were unresolved. The healthcare professional stated that in the consumers opinion, the events were considered to be disabling.


VAERS ID: 288866 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Male  
Location: Massachusetts  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2007-08-17
   Days after onset:238
Entered: 2007-08-23
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER U1813AB / 1 RL / IM
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER UF013AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER V1032 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08645M / 1 LL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever after vaccine administration


VAERS ID: 292790 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Kentucky  
Vaccinated:2006-12-20
Onset:2006-12-20
   Days after vaccination:0
Submitted: 2007-09-17
   Days after onset:270
Entered: 2007-09-20
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Burning sensation, Inappropriate schedule of drug administration
SMQs:, Peripheral neuropathy (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA00619

Write-up: Initial and follow up information has been received from a certified medical assistant (CMA), concerning a 16 year old female patient, who on 20-DEC-2006 was vaccinated IM in the arm, with the second dose, 0.5ml, of Gardasil (Lot # not provided). The CMA reported that the patient was "late" with receiving the vaccination, and added that the patient complained that "the medicine burned." At the time of this report, the patient had recovered from the event (date and duration not specified). The patient sought unspecified medical attention. The CMA reported other "young teenaged" patients also experienced the medicine burning when vaccinated with Gardasil (lot # not provided) (WAES #0708USA01332). Additional information is not expected.


VAERS ID: 299458 (history)  
Form: Version 1.0  
Age: 41.0  
Gender: Male  
Location: Maryland  
Vaccinated:2006-12-20
Onset:2006-12-20
   Days after vaccination:0
Submitted: 2007-09-13
   Days after onset:266
Entered: 2007-11-14
   Days after submission:62
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR - / UNK UN / UN
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR - / UNK UN / UN

Administered by: Public       Purchased by: Public
Symptoms: Dark circles under eyes, Drug hypersensitivity, Eye swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valtrex
Current Illness:
Preexisting Conditions: The patient had an allergy to aspirin and "unknown" other medical history. Illness at the time of vaccination was "unknown." Other medications included Valtrex.
Allergies:
Diagnostic Lab Data:
CDC Split Type: 200702906

Write-up: A 41-year-old male patient had received an injection of Decavac, lot number not reported; an injection of IPOL, lot number not reported; an injection of Menommune, lot number not reported; an injection of Typhim VI, lot number not reported; an injection of Fluzone SV 2006-2007, lot number not reported; and an injection of Hepatitis A Vaccine, manufacturer GSK, lot number not reported; on 20 December 2006. Routes and site of administration were not reported. The patient had received the vaccinations for travel to foreign country where he visited for two weeks. Illness at the time of vaccination was unknown. "Almost immediately" post-vaccination, the patient complained of dark circles under his eyes, bags under his eyes, and a permanent tired line in his face. Per a letter from the patient dated 13 Augusut 2007, "These side effects have not improved or diminished to date." At the time of this report, the patient had not recovered. A new version was created for this case on 31 August 2007 to add that the reporter for this case is the same as for case 2007-03017. No relevant medically significant information was added.


VAERS ID: 299459 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Maryland  
Vaccinated:2006-12-20
Onset:0000-00-00
Submitted: 2007-09-13
Entered: 2007-11-14
   Days after submission:62
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / UN
MEN: MENINGOCOCCAL (MENOMUNE) / SANOFI PASTEUR - / UNK UN / UN
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR - / UNK UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Alopecia, Dark circles under eyes, Eye swelling, Skin wrinkling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 200703017

Write-up: This case was reported by a health professional on 04 September 2007. A female patient with no reported medical history received injections of Decavac, Fluzone, IPOL, Menomune, Typhim Vi, and hepatitis A (manufacturers and lot numbers not reported) on 20 December 2006. "Almost immediately", the patient reported that she experienced "dark circles under my eyes, bags under my eyes, a permanent tired line on my face, and hair loss". Per the reporter, the events were ongoing. The patient''s husband also reported experiencing dark circles under eyes, bags under eyes, and a permanent tired line in the face after receiving the above vaccines; this information is captured in case number 2007-02806.


VAERS ID: 297791 (history)  
Form: Version 1.0  
Age: 34.0  
Gender: Male  
Location: Maryland  
Vaccinated:2006-12-20
Onset:2006-12-22
   Days after vaccination:2
Submitted: 2007-11-19
   Days after onset:332
Entered: 2007-11-26
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
SMALL: SMALLPOX (DRYVAX) / PFIZER/WYETH 4020072 / 2 LA / OT
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI) / SANOFI PASTEUR Z0425 / 1 RA / IM

Administered by: Military       Purchased by: Military
Symptoms: Chest X-ray normal, Chest pain, Headache
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: None~ ()~~0.00~In Patient
Other Medications: AcipHex daily
Current Illness: None
Preexisting Conditions: History of migraines, seasonal allergies. Allergic to grasses and dust mites. NKDA.
Allergies:
Diagnostic Lab Data: CXR: There are no focal infiltrates or pleural effusions bilaterally. The heart is normal in size. There is no mediastinal shift or pneumothorax. There are no compression fractures in the visualized thoracic spine. Impression: No acute infiltrates or effusions.
CDC Split Type:

Write-up: "Wonder if the smallpox vaccine has anything to do with my chest pain and headaches."


VAERS ID: 320960 (history)  
Form: Version 1.0  
Age: 59.0  
Gender: Female  
Location: Georgia  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2008-07-31
   Days after onset:587
Entered: 2008-07-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1211F / 1 LA / UN

Administered by: Private       Purchased by: Private
Symptoms: Blister, Inappropriate schedule of drug administration, Pain, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: type 2 diabetes, sulpha drugs, penicillin, cipro, other antibiotics, latex
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chicken pox like blisters with itching appearing on mostly face but some isolated on other parts of body with leaving scars w/o any healing interference. Pain to the touch along nerves inside of thighs, along outside of arm, on face with moderate touch.


VAERS ID: 329800 (history)  
Form: Version 1.0  
Age: 1.0  
Gender: Male  
Location: Virginia  
Vaccinated:2006-12-20
Onset:2006-12-21
   Days after vaccination:1
Submitted: 2008-10-23
   Days after onset:671
Entered: 2008-10-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF038AA / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1027F / UNK - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08670H / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abasia, Aphasia, Ataxia, Balance disorder, Childhood disintegrative disorder, Cytogenetic analysis normal, Developmental delay, Electroencephalogram normal, Food allergy, Inappropriate schedule of drug administration, Laboratory test normal, Motor dysfunction, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ACID REFLUX
Preexisting Conditions: PMH: multiple allergies, feeding problems, hyperbilirubinemia
Allergies:
Diagnostic Lab Data: MRI SHOWING ABNORMAL SIGNAL TO WHITE MATTER, EEG NORMAL, LYSOSOMAL STORAGE NEG, VERY LONG CHAIN FATTY ACID NEG, GENETIC TEST (FISH, PRADER WILLI/ANGELMAN SYND) NEG, Labs and Diagnostics: EEG WNL. MRI brain (+) for white matter loss and thin corpus collosum and small pons. Fragile X (-). Endoscopy (+) esophagitis. organic acid and amino acid levels WNL. lactate 22.
CDC Split Type:

Write-up: HAD A FEVER 24 HOURS AFTER THE VACCINE. AFTER A COUPLE OF WEEKS LOST MOTOR/SPEECH SKILLS. MONTHS PROGRESSED AND STARTED TREMORS ALL OVER BODY, AND GLOBAL DEVELOPMENTAL DELAYS. MRI SHOWED ABNORMAL SIGNAL IN WHITE MATTER WITH LOW VOLUME, SECOND MRI 6 MONTHS AFTER SHOW NO CHANGE. CURRENTLY, PATIENT IS ATAXIC, LOSING BALANCE, HAS ABSOLUTELY NO SPEECH, CANNOT WALK UNASSISTED, MULTIPLE FOOD ALLERGIES. ALL GENETIC TESTING(EXETENSIVE) IS NEGATIVE LYSOSOMAL STORAGE, VERY LONG CHAIN FATTY ACID TESTS ALL NEGATIVE. EEG NEGATIVE. PATIENT IS IN THE SAME AGE LEVEL AS WHEN THE VACCINE WAS ADMINISTERED 1/6/09 MR received from multiple specialists dated 6/14/07-9/2008. DX: Congenital Encephalopathy, Cognitive defecits, speech-language disorder, motor dysfunction, hypotonicity and hyperactivity with attention difficulties. Initially seen for low weight gain with dx: failure to thrive. GI consult for eosinophilic esophagitis. Seen 7/11/07 for speech dalay and possible autistic features. PE(+) for small head circumference, drooling, shotty lymphadenopathy, eczematous lesions. Neuro consult reports regression around age 1. Resting tremor noted 4/11/08. Ataxic gait. W/u thus far essentially (-) except for abnormal MRI.


VAERS ID: 354343 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-12-20
Onset:2007-01-15
   Days after vaccination:26
Submitted: 2009-08-14
   Days after onset:941
Entered: 2009-08-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Diarrhoea, Impaired gastric emptying, Vaccine positive rechallenge, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None PMH: wrist surgery, shingles, pertussis rxn./
Allergies:
Diagnostic Lab Data: Unknown Labs and Diagnostics: Gastric Emptying study (+) for decreased bowel transit time. Hepatobiliary scan WNL. CT abdomen (+) for ovarian cyst, fluid in abd, and lower throacic vertebrae end plate irregularity. Abd US unremarkable. ABD X-ray WNL. Stool studies (-). alt 32. Lipase 141. Received vaccine records 10/19/2009, there is no lot # given for Gardisil injection given 10/2006 noted.
CDC Split Type: WAES0908USA00793

Write-up: Information has been received from a consumer concerning her 14 year old daughter with no pertinent medical history and no known drug allergies who in "August/September 2006", was vaccinated with the first 0.5ml dose of GARDASIL (injection, lot# not reported). There was no concomitant medication. The consumer reported that in "mid January 2007", her daughter experienced diarrhea, vomiting and she was unable to keep food in her stomach after getting second dose of GARDASIL in November/December 2006. The patient was hospitalized end of February 2007 and was diagnosed with gastroparesis by physician at the hospital. The patient was discharged on 07-MAR-2007. She received the third dose of GARDASIL in April/May 2007. Lot# was not provided. The patient was recovered but she would get periodic gastroparesis it depended on what she ate. On unspecified day, a stomach emptying scan test and numerous other tests were performed, and the results were unknown. Follow up information has been received via telephone call from a physician indicating that the patient received the first dose of GARDASIL on 20-OCT-2006 (Lot number unavailable to the physician). The patient received the second dose of GARDASIL on 20-DEC-2006 (Lot number unavailable to the physician) and the third dose of GARDASIL on 01-MAY-2007 (Lot number unavailable to the physician). The physician stated that the lot number records for the GARDASIL vaccinations were accidentally discarded. The physician stated that she had changed her Physician Practice and had not seen the patient in over one year. The physician confirmed that the patient was hospitalized sometime at the end of February 2007 and was discharged from the hospital on 07-MAR-2007. The physician confirmed that the patient was diagnosed with Gastroparesis. The health care professional contacted during telephone follow-up could not supply the following information: lot number (if applicable). Additional information has been requested. 9/1/09 MR received for DOS 2/28-/06/2007 with D/C DX: Gastroparesis. Pt presented with c/o RUQ pain, diarrhea, vomiting, palpitations,sweating and H/A x 1 month. Hypertensive with diarrhea and increased HR with abd pain. Worse after eating. PE (+) for abd tenderness, tearful. Referred to outpt GI. 11/12/09 Vaccination records received, same docs as prev. entry 10/19/09, no Lot number provided.


VAERS ID: 563826 (history)  
Form: Version 1.0  
Age: 1.09  
Gender: Male  
Location: Nebraska  
Vaccinated:2006-12-20
Onset:2006-12-20
   Days after vaccination:0
Submitted: 2015-02-05
   Days after onset:2969
Entered: 2015-02-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Private       Purchased by: Other
Symptoms: Asterixis, Autism spectrum disorder, Decreased eye contact, Diarrhoea, Drug hypersensitivity, Dysbacteriosis, Dyskinesia, Dyspraxia, Listless, Rash, Speech disorder, Staring, Stool analysis abnormal
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Dyskinesia (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: He was healthy when we went in for the MMR-Proquad vaccine. It was in the am. Within hours he developed a rash on his chest, started shaking his head in an odd manner, flapping his hands, stopped making eye contact, and diarrhea began from that day forward until we found out how to treat him later. He also ceased talking and looking at us. Doctor told us it was just a reaction that was common and he would be fine.
Preexisting Conditions: No pre-existing conditions. APGAR was 9. He was a very happy and healthy baby pre-shot.
Allergies:
Diagnostic Lab Data: He is diagnosed as ASD-Dyspraxic, being Autistic, on the spectrum and also speech dyspraxia.
CDC Split Type:

Write-up: Patient developed a rash on his chest almost immediately after we got him home. He became listless, started to stare off, stopped looking at us, smiling and ceased talking from that day forward at age 1 and 1 month, until age 7 seven... He began to have diarrhea from that day forward, several times a day. He also started to strangely flap his hands and shake his head intermittentely. His stool sample tested as having NO healthy flora left in it whatsoever. He is also now allergic to Penicillin.


VAERS ID: 269481 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2006-12-21
   Days after onset:0
Entered: 2006-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hives after given HPV.


VAERS ID: 269488 (history)  
Form: Version 1.0  
Age: 0.53  
Gender: Male  
Location: Pennsylvania  
Vaccinated:2006-12-21
Onset:0000-00-00
Submitted: 2006-12-21
Entered: 2006-12-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B034CA / 3 LL / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0651F / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08670A / 3 RL / IM

Administered by: Private       Purchased by: Private
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: A vaccine was given, not ordered by the doctor. Hep A was given at 6 months by mistake.


VAERS ID: 269600 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Male  
Location: Wisconsin  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2006-12-22
   Days after onset:0
Entered: 2006-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2559AA / 1 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain upper, Headache, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: hypospadias--repaired
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: mother called day after vaccination to report child woke in a.m. complaining of headache, stomachache, fever of 101, and achiness


VAERS ID: 269610 (history)  
Form: Version 1.0  
Age: 5.0  
Gender: Female  
Location: North Carolina  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2006-12-23
   Days after onset:1
Entered: 2006-12-24
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER UNKNOWN / 5 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Hypersensitivity, Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: end of a mild cold, only slight cough remained
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Localized pain, itching, redness, heat and swelling at injection site. Gave Benadryl for itching and swelling and possible allergic reaction and Motrin/Tylenol for pain.


VAERS ID: 269696 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2006-12-21
   Days after onset:0
Entered: 2006-12-27
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Immediate after Gardasil given pt developed 4cm bright red area at injection site.


VAERS ID: 269817 (history)  
Form: Version 1.0  
Age: 0.73  
Gender: Male  
Location: Connecticut  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2006-12-27
   Days after onset:5
Entered: 2006-12-28
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dyskinesia, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Involuntary head shaking side to side occuring throughout the day and night; each episode lasting 5-10 seconds. Started the morning after vaccine was given.


VAERS ID: 269865 (history)  
Form: Version 1.0  
Age: 7.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2006-12-21
Onset:0000-00-00
Submitted: 2006-12-22
Entered: 2006-12-29
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2212AA / 2 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Angioneurotic oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Radioallergosorbent test for egg allergy
CDC Split Type:

Write-up: Generalized urticaria and angioedema 8 hours after injection. No respiratory symptoms or decreased lack of consciousness. Resolved with Benadryl. Has no history of egg or other food allergies. Had 1st injection of two about


VAERS ID: 269870 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: California  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2006-12-29
   Days after onset:8
Entered: 2007-01-02
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF) / BERNA BIOTECH, LTD 3001003 / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Erythema, Flushing, Injection site erythema, Oedema, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Rhinocort, Advair, Dexadine
Current Illness: NONE
Preexisting Conditions: Asthma, allergies, depression, ADHD.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Vaccine dispersed 12/11/06. First dose taken 12/21 at 2PM, Pt felt flushed 2 hours after, needle area red, resolved on it''s own. 2nd dose on 12/24 at 2am, woke up at 7am SX included bilateral swollen knees, red as well. Palms itchy, red, arms itchy resolved with Benadryl. No hives appeared. Knee swelling resolved after 3 days Benadryl.


VAERS ID: 270022 (history)  
Form: Version 1.0  
Age: 1.74  
Gender: Male  
Location: New Mexico  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2006-12-22
   Days after onset:0
Entered: 2007-01-04
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B042BA / 4 LL / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2220BB / 1 RL / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1210F / 1 RL / IM

Administered by: Private       Purchased by: Public
Symptoms: Feeling hot, Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Edema, Erythema~DTaP (no brand name)~~0.00~In Patient
Other Medications: NONE
Current Illness: Viral Gastroenteritis
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient developed 10 x 10 cm area of redness, edema and warmth 24 hours after receiving Dtap (INFANRIX) at site of injection. Patient seen 12/22/06 at 5:30 p.m. by MD and was given prescription for Keflex.


VAERS ID: 270056 (history)  
Form: Version 1.0  
Age: 66.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2006-12-22
   Days after onset:1
Entered: 2007-01-04
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0577R / 2 LA / -

Administered by: Other       Purchased by: Unknown
Symptoms: Erythema, Feeling hot, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Zoster, Rheumatoid osteoporis, increased amplase
Allergies:
Diagnostic Lab Data: Ultrasound left arm
CDC Split Type:

Write-up: Left arm with redness, edema, warm to touch.


VAERS ID: 270061 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Florida  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-01-03
   Days after onset:13
Entered: 2007-01-04
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Blindness transient, Dizziness, Headache, Pallor
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Drug hypersensitivity
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0612USA03857

Write-up: information has been received from the mother of a 19 year old female with a drug hypersensitivity to unspecified antibiotics. On 21 Dec 2006, the patient was vaccinated with the first dose of HPV vaccine. There were no concomitant medications reported. On 21 Dec 2006, the patient felt like her head was going to burst, she looked pale and was possibly going to faint. The patient developed temporary blindness that lasted about two minutes. The patient sought unspecified medical attention. On 21 Dec 2006, the patient had recovered from the events, "after a few minutes". Upon internal review, the temporary blindness was considered to be an other important medical event (OMIC). Additional information has been requested.


VAERS ID: 270229 (history)  
Form: Version 1.0  
Age: 1.24  
Gender: Female  
Location: New York  
Vaccinated:2006-12-21
Onset:2006-12-24
   Days after vaccination:3
Submitted: 2007-01-02
   Days after onset:9
Entered: 2007-01-09
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2282AA / 1 RL / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0832T / 1 LL / SC

Administered by: Private       Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Rash papular, Skin discolouration, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Erythema, swelling left lateral thigh at injection site, developed about 3 days after injection increased in size, tenderness over next week. Developed pink papular rash over trunk and proximal extremities over past 24 hours.


VAERS ID: 270274 (history)  
Form: Version 1.0  
Age: 0.51  
Gender: Male  
Location: Ohio  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2007-01-04
   Days after onset:13
Entered: 2007-01-09
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B069AA / 3 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE868AA / 3 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B0867414 / 3 RL / IM

Administered by: Public       Purchased by: Public
Symptoms: Erythema, Feeling hot
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 24 hours after shots knees and elbows were red and hot to touch. No temp. Went to Emergency Room and told was reaction from shots. Next day developed red areas in body and face-went back to ER and advised same. No treatment given.


VAERS ID: 270322 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-12-21
Onset:2007-01-05
   Days after vaccination:15
Submitted: 2007-01-10
   Days after onset:5
Entered: 2007-01-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / UNK LA / -

Administered by: Private       Purchased by: Private
Symptoms: Injection site pain, Joint range of motion decreased
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho tricyclen LO
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Pt seen by doctor on 1/6/07 no swelling or redness good ROM REC NSAIDS and warm compresses. RTO 1-2 weeks
CDC Split Type:

Write-up: 01/05/07 pt called c/p left arm still sore after 2 weeks after receiving vaccine unable to raise arm over head denies redness or swelling.


VAERS ID: 270438 (history)  
Form: Version 1.0  
Age: 6.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2007-01-08
   Days after onset:17
Entered: 2007-01-12
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2308AA / 4 RA / IM

Administered by: Military       Purchased by: Military
Symptoms: Feeling hot, Injection site erythema, Injection site oedema, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received flu shot on 21 Dec 06 mother states next day arm was very red and swollen seen in ER and had local reaction and to TX with Benadryl. SX lasted approx 3 days and resolved. 5 days ago 12 weeks after flu shot, had urticarial rash, red and raised that came and went away with Benadryl, but back with warm, back and since has had sporadic urticaria on back, chest, and arm, no resp SXS.


VAERS ID: 270919 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Male  
Location: Maryland  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2006-12-28
   Days after onset:6
Entered: 2007-01-22
   Days after submission:25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009BA / 1 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0429F / 2 - / SC

Administered by: Private       Purchased by: Public
Symptoms: Skin lesion
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Broke out with lesions the next day after Varicella immunization. No fever. No other symptoms. Benadryl, Calamine lotion, oatmeal bath.


VAERS ID: 271272 (history)  
Form: Version 1.0  
Age: 82.0  
Gender: Female  
Location: Texas  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-01-16
   Days after onset:26
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1406F / UNK UN / SC

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Body temperature, Gait disturbance, Injection site pain, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: acyclovir; FOSAMAX; LIPTOR; insulin; isophane; FIMARA; mehotrexate; prednisone; LYRICA
Current Illness: Breast cancer; Diabetes mellitus insulin-dependent; Immunosupression; Degenerative joint disease; Weakness; Sulfonamide allergy; Pulmonary fibrosis
Preexisting Conditions: Shingles,, breast cancer, diabetes mellitus insulin dependent, immunosuppression, sulfonamide allergy, pulmonary fibrosis.
Allergies:
Diagnostic Lab Data: body temp, 12/11/06
CDC Split Type: WAES0612USA03946

Write-up: Information has been received from a physician concerning an 82 year old female with a sulfa allergy, breast cancer, fibrotic lung disease, insulin dependent diabetes, and a history of shingles who on 21 Dec 2006 was vaccinated SC with a 0.65 ml dose of Zostavax (lot #654604/1406F). Concomitant immunosuppressive therapy included methotrexate and prednisone. Other concomitant therapy included Acyclovir. On 21 Dec 2006, the patient had some mild tenderness and soreness at the injection site. On the morning of 22 Dec 2006, she felt weakness. There were no other symptoms. Unspecified medical attention was sought and no diagnostic laboratory tests were performed. At the time of the report, the patient had not recovered. A product quality complaint was not involved. Additional information has been requested. Additional information has been received from the physician who reported that on 20-DEC-2006 (previously reported as 22-DEC-2006), the patient became weak several hours after the shot. The next morning, on 21-DEC-2006, she had a problem walking due to the weak legs. It was noted that patient was chronically weak form fibrotic lung disease, diabetes, and degenerative joint disease. The patient was anorexic, had mild confusion, had no focal defects, no fever, na no rash. She was considered recovered, feeling back to usual, an continues as pre-event.


VAERS ID: 271276 (history)  
Form: Version 1.0  
Age: 65.0  
Gender: Female  
Location: Florida  
Vaccinated:2006-12-21
Onset:2006-12-27
   Days after vaccination:6
Submitted: 2007-01-16
   Days after onset:20
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1212F / UNK - / SC

Administered by: Other       Purchased by: Other
Symptoms: Back pain, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified) (therapy unspecified) VICODIN FOSAMAX calcium (unspecified) PEPCID MAXALT (RIZATRIPTAN BENZOATE) ZOCOR
Current Illness:
Preexisting Conditions: Coronary artery disease, Crohn''s disease, Osteoporosis, Hyperlipidemia
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA00076

Write-up: Information has been received from a physician concerning a 65 year old female with coronary artery disease, Crohn''s disease, osteoporosis, and hyperlipidemia who on 21-Dec-2006 was vaccinated SC in the left side of the abdomen with a dose of Zostavax vaccine (lot#652947/1212F). Concomitant therapy included calcium (unspecified), famotidine, rizatriptan benzoate, Vicodin, simvastatin, alendronate sodium, "Asapchol", and "Toperol". On 27-Dec-2006, the patient developed radiating arm numbness and back pain. Unspecified medical attention was sought and the patient was being seen a neurologist on 28-Dec-2006. At the time of the report, the patient had not recovered. A product quality complaint was not involved. Additional information has been requested.


VAERS ID: 270996 (history)  
Form: Version 1.0  
Age: 39.0  
Gender: Male  
Location: New York  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-01-18
   Days after onset:28
Entered: 2007-01-24
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2260AA / UNK RA / IM

Administered by: Other       Purchased by: Private
Symptoms: Dyspnoea, Rash, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergic to Zithromax and Clindamycin
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient stated about 3 hours after receiving flu vaccine developed shortness of breath, wheezing and a rash on his abdomen and chest. The above is a physician and he self treated with a nembulizer treatment which improved respiratory symptoms. The rash persisted for 1-2 weeks.


VAERS ID: 271066 (history)  
Form: Version 1.0  
Age: 56.0  
Gender: Male  
Location: Washington  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2007-01-07
   Days after onset:16
Entered: 2007-01-24
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN) / NOVARTIS VACCINES AND DIAGNOSTICS 70739 / UNK LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Influenza like illness, Pain, Pulmonary congestion, Pyrexia, Tremor
SMQs:, Cardiac failure (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Patient describes got reaction like flu symptoms for almost 1 week, chest congestion, fever, body aches, shaking.


VAERS ID: 271078 (history)  
Form: Version 1.0  
Age: 2.0  
Gender: Female  
Location: Montana  
Vaccinated:2006-12-21
Onset:2007-01-13
   Days after vaccination:23
Submitted: 2007-01-24
   Days after onset:11
Entered: 2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2255AA / 2 RL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Coordination abnormal, Culture urine negative, Electromyogram, Electroneurography, Fatigue, Guillain-Barre syndrome, Lumbar puncture, Nasopharyngitis, Pain, Pain in extremity, Rhinorrhoea, Weight bearing difficulty, White blood cell count
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling|none~ ()~~0.00~Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: None Birth HX: c section due to positioning. Uncomplicated.
Allergies:
Diagnostic Lab Data: See #7 LABS: WBC on admit 11.8. Sed rate 8. LP done 1/17 revealed protein 180, glucose 62, WBC 15.. NCS 1/18. Urine & CSF cultures neg 4/10/07 Received CSF protein 180 & glucose 62 from hospital but they do not have EMG study. T/C to neurologist office. No copy in office & office personnel unable to find in hospital records either but is aware that test was done.
CDC Split Type:

Write-up: Received influenza immunizations on 11/10/06 (Lot #U2255 AA given by LPN) and 12/21/06 (administered by RN). She had very mild cold symptoms (slight rhinorrhea) early in January 2007. On 1/13 she developed ataxia, fatigue and leg pain. She had then progressive weakness and pain (legs/arms/back) and then frank refusal to bear weight. She was hospitalized on 1/16/07. She had an LP and nerve conduction velocities done on 1/17. LP with elevated protein and no pleocytosis and EMG revealed prologed nerve conduction velocities. She was diagnosed with Guillain-Barre Syndrome and received 5 days of IVIG. She was discharged on 1/24/07 still with weakness and refusal to bear weight, but her truncal ataxia was improved as was her pain. She was discharged home on Neurontin and with physical therapy. 2/2/07 Received medical records from hospital which reveal patient experienced inability to walk, leg pain, hip pain, back pain, arm pain, malaise & constipation. Patient had significant left hip pain w/touch or movement. Parents reported a couple of weeks prior to onset of s/s patient had mild URI in addition to having flu shot 1 mo prior. Admitted 1/16-1/24/07 for probable toxic synovitis; constipation; & low grad emp. Ortho consult done to r/u septic hip which was ruled out. Neuro exam revealed areflexia by 1/17. Tx w/5 course IVIG w/significant motor improvement. D/C to home w/PT & to f/u w/PCP & neuro. FINAL DX: Guillain Barre Syndrome. No CSF labs or report of NCS included. T/C to medical records. Unable to locate. Request refaxed. Per information received from annual follow up, she has recovered complete motor control. Still does not have reflexes in lower extremities bilaterally. She is still recovering. She is in physical therapy and has residual weakness in her legs.


VAERS ID: 271202 (history)  
Form: Version 1.0  
Age: 1.03  
Gender: Female  
Location: Texas  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-01-25
   Days after onset:35
Entered: 2007-01-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2191CA / 1 LL / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 1262F / 1 RL / SC

Administered by: Public       Purchased by: Other
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Temp of 104.7F, mom states that she called doctor and was told to give Tylenol and bath. Temp went down but later came back up to 103F. Later when child was at doctor''s office, he told mom that it might have been the vaccine but she didn''t have record with her for him to look at.


VAERS ID: 271836 (history)  
Form: Version 1.0  
Age: 33.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-01-22
   Days after onset:32
Entered: 2007-02-06
   Days after submission:15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM AHBVB300AA / 1 - / -

Administered by: Public       Purchased by: Private
Symptoms: Headache, Myalgia, Pain, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: See box 7
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PCP note reads myalgias, pruritus, general achiness and possibly a fever. Also a headache, resolved within 6 hours of injection.


VAERS ID: 272075 (history)  
Form: Version 1.0  
Age: 0.17  
Gender: Male  
Location: Guam  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2006-12-25
   Days after onset:4
Entered: 2007-02-12
   Days after submission:49
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B033AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UE657AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0306 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08646A / 1 RL / IM

Administered by: Private       Purchased by: Private
Symptoms: Crying, Erythema, Pallor, Skin lesion
SMQs:, Anaphylactic reaction (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 15 minutes after administration of Dtap, Hib, Ipv, Prevnar note of red pinpoint blanching lesions on trunk that spread to arms and legs. No note of hives. No respiratory distress. Observation for $g30 minutes done. No problems noted. Will do phone follow up tomorrow. Parents advised to watch out for hives/respiratory distress. Addendum: on 12/21/06 night time he cried for 3 hours continuously,


VAERS ID: 272191 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-12
   Days after onset:53
Entered: 2007-02-13
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Hypokinesia, Pain in extremity
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA00017

Write-up: Information has been received from a physician concerning a 20 year old female with a penicillin allergy and no other reported health history who on 21-DEC-2006 was vaccinated with a first dose of Gardasil (lot # 654389/0961F) (0.5 ml), intramuscularly. Concomitant therapy included birth control pills. Subsequently, she had experienced severe pain in the arm since the vaccination. She was unable to raise her arm more than a 45 degree angle. She had been seen by her family physician who diagnosed her with "Frozen Arm Syndrome". it was reported that she would be seen by an orthopedic surgeon in a few days. It was noted that the patient is "thin build, weighed 119 pounds and was five feet six inches tall. It was noted that there was no previous injury to area or to arm. Unspecified medical attention was sought. At the time of the report, the patient was considered to be not recovered. The patient''s experiences were considered to be disabling. Additional information has been requested.


VAERS ID: 272327 (history)  
Form: Version 1.0  
Age: 26.0  
Gender: Female  
Location: Florida  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:55
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins (unspecified)
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA01775

Write-up: Information has been received from a licensed practical nurse concerning a female with no pertinent medical history and no known allergies who on 21-DEC-2006 was vaccinated into the right arm with a 0.5 ml first dose of Gardasil (yeast) (lot#654389/0961F). Concomitant therapy included unspecified over the counter vitamin supplements. Subsequently the patient experienced severe deep pain in her right shoulder. Unspecified medical attention was sought and there was no treatment given. At the time of the report, the patient had not recovered. Additional information has been requested.


VAERS ID: 272479 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:55
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 653735/0688F / 2 - / -

Administered by: Private       Purchased by: Private
Symptoms: Blood pressure normal, Dizziness, Flushing, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: blood pressure, 12/21/06, 102/60
CDC Split Type: WAES0701USA03006

Write-up: Information has been received from a health professional concerning a 21 year old white female with no medical history, who on 21-DEC-2006 was vaccinated in the left deltoid with the second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot# 653735/0688F). There were no illnesses at the time of vaccination. On 21-DEC-2006, following vaccination, the patient felt faint and queasy and her face appeared flush. The patient''s blood pressure was 102/60. The patient was given a cold drink of water and a cold compress and remained seated for 10 minutes and subsequently felt fine. The patient stated that "needles make her scared". No further information is expected.


VAERS ID: 272484 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Alabama  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:55
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA03182

Write-up: Information has been received from an office manager concerning a 16 year old female who on 21-DEC-2006 was vaccinated in the arm (unspecified) with the first dose of HPV vaccine (yeast). There was no concomitant medication. On approximately 21-DEC-2006, after receiving the vaccination, the patient developed a "knot" at the injection site. The patient sought unspecified medical attention. The "knot" at the patient''s injection site persisted. Additional information has been requested.


VAERS ID: 273015 (history)  
Form: Version 1.0  
Age: 4.0  
Gender: Male  
Location: Arizona  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-26
   Days after onset:67
Entered: 2007-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / SANOFI PASTEUR 1965CA / 5 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2286AA / 3 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y1030-2 / 4 LA / SC
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0971F / 2 RA / SC

Administered by: Public       Purchased by: Public
Symptoms: Body temperature increased, Erythema, Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type: AZ0701

Write-up: Few hours after receiving vaccines listed below, child''s left upper arm became painful, red, and swollen. Mother reports that child "felt" warm. SHe gave him ibuprofen x ! yesterday. Today (2pm) child''s upper left arm is swollen, warm to touch, red (shoulder to elbow). T-100.2 No enlarged lymph nodes, Less painful today.


VAERS ID: 273112 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Indiana  
Vaccinated:2006-12-21
Onset:2007-02-02
   Days after vaccination:43
Submitted: 2007-02-21
   Days after onset:19
Entered: 2007-02-27
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 - / -

Administered by: Private       Purchased by: Private
Symptoms: Blister, Herpes virus infection, Hordeolum
SMQs:, Severe cutaneous adverse reactions (broad), Ocular infections (narrow), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 2/2/07 Vesicles near eyebrow, sty in eyelid - found to be possible herpes. Treated with Valtrex.


VAERS ID: 273390 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-27
   Days after onset:68
Entered: 2007-03-05
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mom states patient was fine right after shot #1, but felt faint, looked pale on way out of office - came back to exam room and laid down x 20 minutes then was fine. Mom reports this today when returning for shot #2.


VAERS ID: 273451 (history)  
Form: Version 1.0  
Age: 3.0  
Gender: Female  
Location: California  
Vaccinated:2006-12-21
Onset:2007-03-01
   Days after vaccination:70
Submitted: 2007-03-05
   Days after onset:4
Entered: 2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2249AA / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Influenza, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: N/P S was for Influenza A/B Ag: (+) Influenza Type B, (-) Influenza Type A
CDC Split Type:

Write-up: 3/1/07: Fever 103, onset in a.m., sib with documented Influenza Type B by rapid Ag test. Treated with Tamiflu x 5 days.


VAERS ID: 273516 (history)  
Form: Version 1.0  
Age: 59.0  
Gender: Female  
Location: California  
Vaccinated:2006-12-21
Onset:2007-02-06
   Days after vaccination:47
Submitted: 2007-03-06
   Days after onset:28
Entered: 2007-03-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1405F / 1 - / SC

Administered by: Private       Purchased by: Other
Symptoms: Back pain, Rash
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Shingles
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA04619

Write-up: Information has been received from a registered nurse concerning a 59 year old female with a history of shingles (13-JUN-2000) who on 21-DEC-2006 at 09:00 AM was vaccinated SC in the left arm with a first dose of Zostavax (lot #654603/1405F). On 08-FEB-2007, the patient experienced pain in the right middle back. On 09-FEB-2007, the pain continued. On 10-FEB-2007, a rash below the right breast appeared. The same day, the patient was started on VALTREX 1000mg, one every 8 hours for 7 days. It was noted that the patient''s adverse began on 06-FEB-2007. The patient recovered on an unspecified date. The patient''s experienced were considered to be other important medical events by the reporter. No further information is expected.


VAERS ID: 273614 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Female  
Location: Wisconsin  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2007-02-22
   Days after onset:62
Entered: 2007-03-07
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B074AA / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0280F / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08670K / 1 LL / IM

Administered by: Other       Purchased by: Private
Symptoms: Body temperature increased, Injection site pain
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Temp $g 103 for 2 days, some site pain (no swelling or edema).


VAERS ID: 274574 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Texas  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:82
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Drug administered at inappropriate site, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin, Prozac
Current Illness:
Preexisting Conditions: Papanicolaou smear abnormal
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA03916

Write-up: Information has been received from a Registered Nurse (R.N.) concerning a 19 year old female with a history of abnormal papanicolaou smear who on 21-DEC-2006 was vaccinated IM in left deltoid with her first dose of HPV, lot # 653736/0689F. Concomitant therapy included Yasmin and Prozac. She experienced severe pain in the arm with the first dose. This reaction was reported at the time of her second vaccination. On 21-FEB-2006 her second dose of HPV, lot # 655617/1447 was administered via gluteus. No symptoms were reported at that time. The patient was reported as recovered on an unspecified date. Additional information has been requested.


VAERS ID: 275054 (history)  
Form: Version 1.0  
Age: 80.0  
Gender: Female  
Location: Florida  
Vaccinated:2006-12-21
Onset:2007-02-01
   Days after vaccination:42
Submitted: 2007-03-14
   Days after onset:40
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Herpes zoster
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA03726

Write-up: Information has been received from a physician concerning an 80-year-old female who on 21-DEC-2006 was vaccinated with a dose of Zostavax. In early February 2007, the patient developed shingles in the chest region. It was noted that the shingles were in a staggered pattern. The patient has seen a dermatologist and has been prescribed Famvir for treatment. At the time of the report, the patient was recovering. A product quality complaint was not involved. Additional information has been requested.


VAERS ID: 274778 (history)  
Form: Version 1.0  
Age: 42.0  
Gender: Female  
Location: Ohio  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-01-03
   Days after onset:13
Entered: 2007-03-26
   Days after submission:81
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2280AA / 1 - / IM

Administered by: Public       Purchased by: Public
Symptoms: Fatigue, Influenza, Myalgia, Nausea, Pruritus, Urticaria, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Flu symptoms, fatigue, nausea, vomiting, muscle pain, hives, itching. Lasted 7 days.


VAERS ID: 275869 (history)  
Form: Version 1.0  
Age: 65.0  
Gender: Female  
Location: Federated States of Micronesia  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-04-04
   Days after onset:103
Entered: 2007-04-09
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. - / UNK - / SC

Administered by: Other       Purchased by: Other
Symptoms: No adverse effect, Wrong drug administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0612USA03888

Write-up: Information has been received from a registered nurse concerning a female over 60 years old who on 21, Dec 2006 was vaccinated subcutaenously with a 0.5 ml dose of measles virus vaccine (+) mumps virus vaccine (+) rubella virus vaccine live (RA 27/3) (+) varicella virus vaccine live (Oak/Merck upgrade process) instead of varicella-Zoster virus vaccine live (Oka/Merck) (MSD). It was reported that reported that there was no product confusion, but rather that both vaccinations were stored next to each other in the freezer and nurse " grabbed the wrong one". The patient did not experience any known symptoms. Unspecified medical attention was sought. No additional information to report. There was not a product quality complaint involved. Follow-up information was received from a nurse who reiterated that there was no product confusion but human error. The bottles were stored near each other and the administering nurse accidentally pulled out the wrong vaccine.


VAERS ID: 275870 (history)  
Form: Version 1.0  
Age: 65.0  
Gender: Male  
Location: Florida  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-04-04
   Days after onset:103
Entered: 2007-04-09
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. - / UNK - / SC

Administered by: Other       Purchased by: Other
Symptoms: No adverse effect, Wrong drug administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA00325

Write-up: Information has been received from a registered nurse concerning a male over 60 years old who on 21, Dec 2006 was vaccinated subcutaneously with a 0.5 ml dose of Proquad instead of varicella-zoster virus vaccine live (Oka/Merck) (MSD). It was reported that there was no product confusion, but rather that both vaccinations were stored next to each other in the same freezer and a nurse "grabbed the wrong one" The patient did not experience any known symptoms. Unspecified medical attention was sought. No additional information to report. There was not a product quality complaint involved. Follow-up information was received form a nurse who reiterated that there was no product confusion but human error. The bottles were stored near each other and the administering nurse accidentally pulled out the wrong one.


VAERS ID: 275871 (history)  
Form: Version 1.0  
Age: 1.03  
Gender: Female  
Location: Ohio  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2007-04-04
   Days after onset:102
Entered: 2007-04-09
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 1330F / 1 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B0845A5 / 4 RL / IM

Administered by: Private       Purchased by: Other
Symptoms: Irritability, Skin discolouration
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: unknown
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0701USA00580

Write-up: Information has been received from a physician concerning a 15 month old female with no pre-existing allergies, birth defects, or medical conditions who on 21-DEC-2006 was vaccinated SC in the left thigh with her first 0.5 ml dose of measles virus vaccine (+) mumps virus vaccine (+) rubella virus vaccine (RA 27/3) (+) varicella virus vaccine (Oka/Merck upgrade process) (lot# 655842/1330F). There was no illness at th etime of vaccination. Concomitant therapy that day included a fourth dose of PREVNAR (Batch # B08545A) administered IM in the right thigh. Subsequently, the patient experienced pink and "ray" spots on lower thigh and was irritable for 72 hours after injection, form which she was recovering at the time of this report. Unspecified medical attention was sought. No additional information to report. There was no product quality complaint involved. Additional information has been requested. Follow up information receivved from a registered nurse indicated that on 22-DEC-2006 the patient developed a fever of 102 degrees that lasted 72 hours. She also developed a rash on her lower libs, torso, and face. Some rash was raised and some was flat. The child was also irritable and not sleeping. The patient recovered 4 days after immunization. There were no relevant diagnostic test or laboratory data. No additional information is expected.


VAERS ID: 276248 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:105
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Dizziness, Hot flush, Immediate post-injection reaction, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA04432

Write-up: Information has been received from a registered nurse concerning a 20 year old female student who on 21-DEC-2006, at 2:00PM, was vaccinated IM, into the left deltoid, with a first dose of Gardasil (Lot# 653937/0637F). There was no illness at the time of vaccination. On 21-DEC-2006, after the injection, at 2:00PM, the patient became lightheaded and nauseated, "approximately 15 minutes". The nurse also reported the injection was very painful when vaccine contents injected into muscle and the patient had a hot flash. On 23-FEB-2007, at 3:15PM, the patient was vaccinated IM, into the left deltoid, with a second dose of Gardasil (Lot# 654389/0961F). There was no illness at the time of vaccination. The nurse reported that the patient felt a hot flash immediately post injection . The second injection was also said to be very painful when vaccine contents injected into the muscle (not from needle placement), for "five minutes". No further information is expected.


VAERS ID: 279951 (history)  
Form: Version 1.0  
Age: 49.0  
Gender: Female  
Location: Rhode Island  
Vaccinated:2006-12-21
Onset:2006-12-28
   Days after vaccination:7
Submitted: 2007-05-24
   Days after onset:146
Entered: 2007-05-29
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1025F / UNK LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Injection site pain, Neuralgia, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: MMR 12/21/06 one week later, pain, swelling. Describes - neuralgia with pain radiating distally has residual muscle defect at injection site. No medical intervention.


VAERS ID: 281033 (history)  
Form: Version 1.0  
Age: 1.3  
Gender: Female  
Location: North Carolina  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-06-07
   Days after onset:167
Entered: 2007-06-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH - / UNK UN / UN
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK UN / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / UNK UN / IM
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Abnormal behaviour, Convulsion, Death, Dyskinesia, Irritability, Lethargy, Muscle tightness
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Dyskinesia (narrow), Dystonia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2006-12-24
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Influenza like illness; Pyrexia; Tremor; Viral infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Reported Cause of Death unknown
CDC Split Type: HQWYE488805JUN07

Write-up: Information regarding Prevnar vaccine was received from a consumer, the mother of a 16-month-old female patient who on 21-Dec-2006, received a dose of Prevnar along with a dose of Hib (manufacturer unknown), a dose of Varivax (manufacturer unknown), and a dose of M-M-R II (Merck Sharp & Dome). On the same day, the patient experienced lethargy, possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, the child would not respond and on 24-Dec-2006, the child died. On 21-Dec-2006, the patient with a history of influenza like illness, pyrexia, virus (unspecified) and tremor of hands, was evaluated at the physician''s office for those symptoms and was also administered Prevnar along with Hib, Varivax, and M-M-R II. Later that day, the child was lethargic and experienced a possible seizure, irritability, was not acting normally, had jerky movements and clenched hands. On 22-Dec-2006, child would not respond and was taken to the hospital and placed on life-support for two days. On 24-Dec-2006, the child died. The cause of death was not reported. The reporter stated she "feels that her daughter had an adverse reaction to Prevnar." No additional information was available at the time of this report.


VAERS ID: 288742 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Ohio  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-08-14
   Days after onset:235
Entered: 2007-08-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 2 UN / IM

Administered by: Other       Purchased by: Private
Symptoms: Dermatitis
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0707USA00906

Write-up: Information has been received from a physician concerning a female (age not reported) who on an unspecified date was vaccinated with a first dose of GARDASIL (lot# unknown). In June 2007, the patient was vaccinated with a second dose of GARDASIL. The patient developed "dermatitis all down her arm" right after getting her second dose. Medical attention was sought. At the time of reporting it is unknown if the patient had recovered. No further information was provided. Additional information has been requested. This is in follow-up to report(s) previously submitted on 8/14/2007. Follow-up information was received. On 21-DEC-2006 the patient was vaccinated with a second dose of GARDASIL (lot #653735/0688F). On the same day the patient developed a mild red maculopapular eruption on the injection site arm. On an unspecified date the patient recovered approximately one week after injection. On 25-MAY-2007 the patient was vaccinated with a third dose of GARDASIL (lot# 657737/0522U) IM in the right deltoid. On an unspecified date the patient developed a much worse maculopapular rash on the injected extremity and trunk on that side. On an unspecified date the patient recovered without therapy. Additional information is not expected.


VAERS ID: 309741 (history)  
Form: Version 1.0  
Age: 76.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-12-21
Onset:2007-11-19
   Days after vaccination:333
Submitted: 2008-03-26
   Days after onset:127
Entered: 2008-04-16
   Days after submission:21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK UN / SC

Administered by: Other       Purchased by: Other
Symptoms: Herpes zoster
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0711USA06444

Write-up: Information has been received from a nurse practitioner concerning a 77-year-old female who on 21-DEC-2006 was vaccinated subcutaneous with a single dose of ZOSTAVAX. On 19-NOV-2007 the patient developed a mild case of shingles on one side of her body. On 26-NOV-2007 the patient developed another mild case of shingles on the opposite side of her body. The patient was treated with famciclovir (FAMVIR) antiviral medication. The patient sought unspecified medical attention. At the time of the report the patient''s status was unknown. A product quality complaint was not involved. Additional information has been requested.


VAERS ID: 313876 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: New Mexico  
Vaccinated:2006-12-21
Onset:2007-11-05
   Days after vaccination:319
Submitted: 2008-05-28
   Days after onset:204
Entered: 2008-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Breech delivery, Drug exposure during pregnancy, Foetal disorder, Laboratory test, Pain, Premature baby, Sinusitis
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL WITH CODEINE #3; ZITHROMAX Z-PAK; KEFLEX
Current Illness: Pregnancy NOS (LMP = 2/21/2007); Sulfonamide allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory - "prenatal labs"
CDC Split Type: WAES0704USA04385

Write-up: Information has been received through the Merck pregnancy registry from a health professional and medical records concerning a 26 year old female with sulfonamide allergy who on 06-OCT-2006 was vaccinated with a first dose of GARDASIL. On 21-DEC-2006, the patient was vaccinated with a second dose of GARDASIL. Subsequently the patient became pregnant. Last menstrual period was on 21-FEB-2007 and the estimated date of delivery was 28-NOV-2007. Unspecified medical attention was sought. The patient underwent "prenatal labs" (results not reported). On 05-NOV-2007 a male infant was born (5 pounds 7 ounces, 17 1/2 inches long) (reported as pre-mature birth at 36 weeks). The only complication was the infant was in the breech position. The pregnancy included ZITHROMAX Z-PACK on 08-MAY-2007 for a sinus infection (4 days), KEFLEX on 21-AUG-2007 for a sinus infection (TID x 5 days) and TYLENOL #3 on 04-OCT-2007 for pain. On 05-NOV-2007, the infant''s total serum bilirubin test at 12 hours of life was 7.2. At 24 hours of life it was reported as 7.3. The infant was jaundice but was reported to be recovering. It was reported in the physician''s notes that the infant was at a high risk for rebound hyperbilirubinemia. On 09-NOV-2007, the infant''s total serum bilirubin was 13.1. Instructions were given to the infant''s mom that there would be no more bili checks but to call of the infant''s appetite decreased. On 14-NOV-2007 the infant had newborn screening tests done. They were reported as normal. On 19-NOV-2007, the infant''s parents noticed a lump on the left side of the infant''s neck. The physician noted it was not tender or red. It measured 1 to 2 cm and his range of motion was OK. The physician assessed the lump as torticollis. On 27-NOV-2007, the infant was seen by the physician and it was reported that he had an upper respiratory infection. The mother was instructed to call if the infant had an increase in cough, difficulty breathing, emesis or if he was not eating. On 29-NOV-2007, the infant experienced vomiting. He had vomited phlegm 2 to 5 times and had had been congested for one day. He did not have a cough. The rest of the physician''s assessment was normal. On 05-DEC-2007, the infant was seen by the physician because he spits up phlegm after feeding. This has been occurring for 1 week. His assessment of the infant was a well child. The torticollis was reported to be resolving. On 13-DEC-2007, the infant''s congestion and upper respiratory infection continued. On 09-JAN-2008, the infant was diagnosed with conjunctivitis and was prescribed TOBREX. On this day, the infant was also vaccinated with HIB, PEDIARIX, PREVNAR and Td. On 14-JAN-2008, the infant experienced eye drainage, he was fussy, crying after feedings with a bloated stomach. The physician''s assessment was reported as upper respiratory infection and excessive gas. On 28-JAN-2008, the infant was seen by the physician due to right ear drainage. It was reported that 2 days ago the infant had trouble sleeping. The physician noted moist white drainage from his right ear. He prescribed amoxicillin 250 mg twice a day. His assessment was otitis media. On 02-FEB-2008, the infant experienced a skin rash on his buttock. It was reported that there was breakdown but no infection. The physician''s impression was a diaper rash. He instructed the infant''s mother to continue zinc oxide and to keep the diaper dry. On 27-FEB-2008, the infant experienced nasal congestion, occasional cough and he felt warm. There was no home care except for TYLENOL every 4 hours. On 07-MAR-2008, the infant''s mother had a question about feeding. It was reported that there was a family history of diabetes which was reported to be the center of attention. On this day the infant received HIB, PEDIARIX, PREVNAR and rotavirus. On 25-APR-2008, the patient had a follow up visit from the emergency room visit. The mother had taken the infant to the ER for persistent diarrhea for 3 days. He had been hydrated by mouth and vomited. The physician''s assessment was gastroenteritis. At the time of this report, the infant''s outcome was unknown. Additional information has been requested. All medical records available upon request.


VAERS ID: 320364 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2006-12-21
Onset:2007-03-05
   Days after vaccination:74
Submitted: 2008-07-17
   Days after onset:499
Entered: 2008-07-24
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RAB: RABIES (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Chest pain, Dizziness, Eosinophilia, Extrasystoles, Muscular weakness, Palpitations, Tachycardia, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tachyarrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Eosinophilia, tachycardia
CDC Split Type:

Write-up: Heart palpitations, dropped beats, V-fib, tachycardia, dizziness, muscle weakness and left side chest pain.


VAERS ID: 333079 (history)  
Form: Version 1.0  
Age: 1.3  
Gender: Female  
Location: Nevada  
Vaccinated:2006-12-21
Onset:2006-12-24
   Days after vaccination:3
Submitted: 2008-11-06
   Days after onset:683
Entered: 2008-11-24
   Days after submission:18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR U1857BA / 4 LL / UN

Administered by: Private       Purchased by: Public
Symptoms: Cerumen impaction, Childhood disintegrative disorder, Ear discomfort, Eating disorder, Eye swelling, Hypotonia, Lethargy, Otitis media, Porphyrins urine increased, Pyrexia, Social avoidant behaviour, Speech disorder, Speech disorder developmental, Toe walking, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 99.9 degree temp
Preexisting Conditions: None PMH: recurrent OM & persistent middle ear effusion refractory to antibiotic therapy.
Allergies:
Diagnostic Lab Data: Porphyrin (Urine) test (+) heavy metal burden LABS: lead test 1(N). Fragile X test. MRI brain & brainstem auditory evoked response WNL. Hair tests for metals abnormal.
CDC Split Type:

Write-up: Following days: Fever, swollen eyes, lethargic (12/24/06) seemed to be getting better. 1/3/07: Wheezing, hives, fever. 1/5/07: Hives worse, wheezing. Lost skills after this. (Stopped eating solids, stopped talking, ultimately dx of Austim & Hypotonia). 01/29/2010 Autism dx, speech loss, sensory problems. 1/19/09 Reviewed PCP medical records which reveal patient was in good health on day of vaccination. FINAL DX: mixed language delay; autism spectrum disorder RTC 1/3/07 w/rash all over. Dx w/allergy & hives. Tx w/antihistamine. RTC 1/5/07 w/worsening of hives all over & bronchospasm. Tx w/steroids. RTC 5/14/07 w/fever, runny nose, cough & sneezing. Dx w/URI & treated symptomatically. RTC 6/29/07 w/irritability & pulling at ears. Parent also expressed concern re speech & hearing. Referred for speech delay to early intervention program & tx for bilateral OM & otitis externa. RTC 7/23/07 continuing to pull at ears. Dx w/cerumen impaction. Early intervention evaluation done 7/25/07 revealed patient w/non-purposeful speech, not following directions, picky eater, inconsistent eye contact, toe walking & hand flapping. Referred to ENT for recurrent OM. Recommended BM & T& adenoidectomy.


VAERS ID: 391849 (history)  
Form: Version 1.0  
Age: 60.0  
Gender: Female  
Location: Kansas  
Vaccinated:2006-12-21
Onset:2010-03-26
   Days after vaccination:1191
Submitted: 2010-06-30
   Days after onset:96
Entered: 2010-07-01
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1405F / 1 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Herpes zoster, Skin lesion, Varicella post vaccine
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Hypertension; Osteopenia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1005USA01621

Write-up: Information has been received from a physician concerning a female in her 60''s who about 2 years ago (approximately 2008) was vaccinated with a dose of ZOSTAVAX (Merck). The patient developed shingles after receiving the dose of ZOSTAVAX (Merck). It was also reported that the patient had "a really bad case of shingles and developed post herpetic neuralgia". The patient sought medical attention through an office visit. The patient''s outcome was unknown. Follow up information received from a physician indicated that the patient was a 63 year old real real estate agent, customer service representative, with hypertension, osteopenia, no illness at the time of vaccination and with no significant underlying medical issues. There was no recent exposure to chickenpox or herpes zoster. On 21-DEC-2006 the patient was vaccinated with a first dose of ZOSTAVAX (Merck) (lot # 654603/1405F) into the left arm. On 26-MAR-2010 the patient developed severe herpes zoster in her right V1 distribution; V1 dermatome, the patient developed numerous multiple lesions (nearly contiguous) over her right forehead, upper eyelid and right frontal temporal parietal scalp. The rash did not occur at the site of injection or elsewhere within 42 days of the vaccination. The patient''s pain was quantified as 10. The patient also developed severe neuralgia. No direct fluorescent antibody done; no specimen was collected for PCR. At the time of this report the patient was improving but still ongoing and requiring medications (considered partially recovered). Post herpetic neuralgia and shingles were considered to be disabling. Additional information has been requested.


VAERS ID: 271383 (history)  
Form: Version 1.0  
Age: 0.25  
Gender: Female  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2007-01-26
   Days after onset:35
Entered: 2007-01-29
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (ACTHIB) / SANOFI PASTEUR Z0941 / UNK LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anorexia, Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: not reported
Allergies:
Diagnostic Lab Data:
CDC Split Type: 200700171

Write-up: Case was from a healthcare professional on 22 January 2007 under the local reference number. A 03-month-old female patient with no medical history reported experienced diarrhea and anorexia 1 day after receiving her 1st intramuscular dose of Act-Hib vaccine, batch number Z0941-1 in the right deltoid on 21 December 2006. 1 day post-vaccination presented with diarrhea 4-5 times/day and anorexia. There was neither fever nor cough. She received corrective treatment with an unknown drug, however she did not feel better. On 18 January 2007, the patient''s condition worsened, the frequency of diarrhea/watery stools was gradually increased to more than 10 times/day. The patient was treated in hospital on 19 January 2007. The patient outcome was not reported at the time of the report.


VAERS ID: 271972 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Male  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-08
   Days after onset:49
Entered: 2007-02-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS AHBVB251AJ / UNK LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Concussion, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: D0052167A

Write-up: This case was reported by a physician and described the occurrence of syncope in a 12 year old male subject who was vaccinated with hepatitis B vaccine (Engerix B) for prophylaxis. There were no concurrent medical conditions or risk factors. There was no concomitant medication. On 21 December 2006 the subject received 1st dose of Engerix B (intramuscularly into the left deltoid). Initially it was reported that the subject experienced nausea after vaccination. According to follow up information the subject experienced syncope on 21 December 2006, 5 minutes after vaccination with Engerix B. The subject was monitored in hospital because of commotio. The vaccination course with Engerix B was discontinued. The reporting physician considered syncope as clinically significant because of hospitalisation. At the time of reporting syncope was resolved. The outcome of commotio was unknown. Nausea was not mentioned anymore in follow up information.


VAERS ID: 273047 (history)  
Form: Version 1.0  
Age: 0.27  
Gender: Female  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-26
   Days after vaccination:5
Submitted: 2007-02-14
   Days after onset:50
Entered: 2007-02-26
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0077F / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Haematochezia, Intussusception, Surgery, X-ray abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Diarrhea - no vomiting
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: X-ray shows "Champagne cup"
CDC Split Type:

Write-up: Bloody feces (complete red) like sauce, small intestine intussusception, X ray show sigmoid dilatation. No gas on rectum surgery, Today is ok.


VAERS ID: 275710 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-04-05
   Days after onset:104
Entered: 2007-04-06
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHIB: DTP + HIB (DTP + ACTHIB) / SANOFI PASTEUR - / UNK - / -
MNC: MENINGOCOCCAL (MENINGITEC) / PFIZER/WYETH - / UNK - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 1 - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Periorbital oedema, Rash, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None Provided.
CDC Split Type: GBWYE318903APR07

Write-up: This case was considered medically important. Information regarding Prevnar was received from a healthcare professional via a regulatory authority regarding a female patient who experienced periorbital oedema and itchy rash on face and upper trunk. The patient received the first dose on 21-Dec-2006. The patient experienced periorbital oedema and itchy rash on face and upper trunk on 21-Dec-2006. The reporter considered the event to be mild in severity. At the time of this report the patient is recovering from the event. See related case (s): GBWYE348204APR07 (adverse event, non-expedited). No additional information was available at the time of this report.


VAERS ID: 281910 (history)  
Form: Version 1.0  
Age: 0.58  
Gender: Male  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:174
Entered: 2007-06-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH - / 3 UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Condition aggravated, Myoclonus
SMQs:, Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Myoclonus; Agitation; Crying
Allergies:
Diagnostic Lab Data: None Provided.
CDC Split Type: DEWYE486618APR07

Write-up: Additional information was received regarding event details, date of immunisation and duration and outcome of event. This case was considered medically significant. Information regarding Prevenar was received from a health professional regarding a male patient who experienced myoclonus. The patient received the third dose on 21-Dec-2006. The patient has a past history of crying and agitation (all events after 1st and 2nd vaccination with Prevenar-see related cases). Concomitant medications were not reported. The patient experienced a myoclonus after vaccination. The event lasted for about ten days. The patient recovered. The healthcare professional assessment of relatedness between the adverse events and Prevenar was possibly related. See related case (s): DEWYE489218APR07 (adverse event, expedited) and DEWYE486718APR07 (adverse onset, expedited) of the same patient.


VAERS ID: 282697 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-06-22
   Days after onset:182
Entered: 2007-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Antinuclear antibody increased, Cardiovascular disorder, Cyanosis, Immediate post-injection reaction, Pain in extremity, Vasculitis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Vasculitis (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Antinuclear antibody 2007 1:80 normal 1:40, Antinuclear antibody 2007 1:1:160
CDC Split Type: D0053662A

Write-up: This case was reported by a consumer and described the occurrence of possible vasculitis in an adult female subject who was vaccinated with Twinrix adult for prophylaxis. A physician or other health care professional has not verified this report. Previous vaccination with Twinrix adult on 09 November 2006 was well tolerated. On 21 December 2006 the subject received the 2nd dose of Twinrix adult (unknown route into the left upper arm). Immediately after vaccination with Twinrix adult, the subject experienced pain in the left arm which was resolved approximately after one week. Approximately on 24 December 2006 the subject developed limb pain which was resolved approximately after 2-3 days. On 06 March 2007, two months after vaccination with Twinrix adult, the subject''s left forefinger became blue at the tip. A physician diagnosed a circulation disorder. A laboratory test showed that antinuclear antibodies were increased (1:160). Within 4 weeks antinuclear antibodies decreased to 1:80. Tentative diagnosis was possible vasculitis. This case was assessed as medically serious by GSK. At the time of reporting the outcome of possible vasculitis, antinuclear antibody increased and circulation disorder was unspecified.


VAERS ID: 332154 (history)  
Form: Version 1.0  
Age: 0.1  
Gender: Male  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-22
   Days after vaccination:1
Submitted: 2008-11-12
   Days after onset:691
Entered: 2008-11-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (TRITANRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / IM
HIBV: HIB (HIBERIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK MO / PO
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS AROTA031C / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Irritability, Otitis media acute, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unk
CDC Split Type: B0451804A

Write-up: This male subject was enrolled in the prophylactic double blind study. On 21 December 2006, he received the 1st dose of ROTARIX (HRV) or placebo (po). On 21 December 2006, he also received concomitant oral POLIO SABIN, HIBERIX and TRITANRIX. This subject received ROTARIX. On 22 December 2006, one day after the 1st dose of Blinded vaccine, the seven-week-old subject developed acute otitis media. The subject received the study vaccine on 21 December 2006 at 14:00. Overnight, the subject became irritable and feverish. On 22 December 2006, he was seen by the study investigator. He was referred to a pediatrician and was hospitalized with suspected meningitis. The doctor was telephonically contacted on 27 December 2006. He confirmed that the baby was discharged on 24 December 2006. He said that the septic screen was negative and that the baby was diagnosed and treated for acute otitis media. He assured that he would fax through a discharge summary before going on leave on 29 December 2007. The fax was not received. The doctor went on leave until 18 January 2007. Numerous phone calls as well as attempts to see the paediatrician were made by the investigators, but they were unable to get any written report regarding that admission. They were told that this baby''s records were mislaid and that they were unable to locate them. Up to this date, the records for that admission are lost and therefore no further information on this serious adverse event is available. According to follow-up information received by GSK on 05 March 2007, the final diagnosis was acute otitis media. The baby did not have meningitis. This was confirmed telephonically with the attending paediatrician at the time (27 December 2006). He told the site that it was not meningitis, and that the final diagnosis was acute otitis media. The site was awaiting a discharge summary from him, which they never received. They were unable to attain further information thereafter as the medical records were lost. The mother did not give the site any information regarding this serious adverse event and therefore they did not have the treatment the baby received. The acute otitis media was resolved on 24 December 2006. The investigator considered that there was a reasonable possibility that the acute otitis media may have been caused by investigational product and that the event was possibly due to a possible infection.


VAERS ID: 338788 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Female  
Location: Foreign  
Vaccinated:2006-12-21
Onset:2006-12-26
   Days after vaccination:5
Submitted: 2009-01-30
   Days after onset:766
Entered: 2009-02-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0077F / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Surgery, X-ray abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Diarrhoea
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: X-ray, Sigmoid dilatation, no gas on rectum, "Champagne cup"
CDC Split Type: WAES0901MEX00007

Write-up: Information has been received on request from the FDA under Freedom of Information Act regarding a report from a physician concerning a 3 month old female with diarrhoea who on 21-DEC-2006 was vaccinated with the first dose of ROTATEQ (LOT # 653661/0077F). There was no concomitant medication. ON 26-DEC-2006 the patient experienced bloody feces like sauce, small intestine intussusception and surgery and was hospitalized. The X-Ray showed sigmoid dilation, no gas on rectum and "Champagne cup". Surgery was performed. It was reported that "today" the patient is OK. Bloody feces (complete red), small intestine intussusception and surgery were considered to be immediately life-threatening. Causality was not reported. Copy of the report sent to VAERS by the reporter physician was provided. The VAERS report is 273047-1 Lot check results: A standard lot check investigation was performed. All in process quality checks for the lot number in question were satisfactory. In addition an expanded lot check investigation was performed. The testing performed on the batch prior to release met all release specifications. The lot met the requirements of the center and was released. No further information is available.


VAERS ID: 422960 (history)  
Form: Version 1.0  
Age: 6.0  
Gender: Female  
Location: Foreign  
Vaccinated:2006-12-21
Onset:0000-00-00
Submitted: 2011-05-16
Entered: 2011-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS AHABB0644C / 2 LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Aphthous stomatitis, Fatigue, Hallucination, Headache, Hypoacusis, Pain in extremity, Somnambulism, Tinnitus
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: D0071232A

Write-up: This case was reported by a physician and described the occurrence of sleepwalk in an approximately 6-year-old female subject who was vaccinated with TWINRIX PEDIATRIC (GlaxoSmithKline). On an unspecified date the subject received 2nd dose of TWINRIX PEDIATRIC (unknown route and application site). At an unspecified time after vaccination with TWINRIX PEDIATRIC, the subject experienced sleepwalk, tiredness, fatigue, abdominal pain, headache and sound in ears. Follow-up was received from the physician on 13 May 2011, including a questionnaire. There was no concurrent medical condition or any other risk factors. Previous vaccination with TWINRIX PEDIATRIC was well tolerated. On 21 December 2006 the subject received 2nd dose of TWINRIX PEDIATRIC (intramuscular, left arm). At an unspecified time after vaccination with TWINRIX PEDIATRIC, the subject experienced hallucination, sleepwalk, severe fatigue over 2 days, aphtha at mouth, abdominal pain, headache, limb pain, sound in ears and bad hearing. There was no treatment. This case was assessed as medically serious by GSK. At the time of reporting the events were resolved. The vaccination course with TWINRIX PEDIATRIC was discontinued.


VAERS ID: 269608 (history)  
Form: Version 1.0  
Age: 53.0  
Gender: Male  
Location: Minnesota  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2006-12-23
   Days after onset:1
Entered: 2006-12-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Diarrhoea, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac, Klonopin, Omeprazole, Zocor, Ambien, Low-dose asprin
Current Illness:
Preexisting Conditions: Recurrent Depression, Panic Disorder, Essential Tremor, GERD, High Cholesterol
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: About 11 hrs after receiving vaccine, suddenly began to experience severe abdominal cramps, nausea, diarrhea, and body aches. Reaction lasted for about 6 hours.


VAERS ID: 269613 (history)  
Form: Version 1.0  
Age: 71.0  
Gender: Male  
Location: Indiana  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2006-12-26
   Days after onset:4
Entered: 2006-12-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2245AA / 1 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Soreness in arm~Pneumo (no brand name)~~0.00~In Patient
Other Medications: Only takes Chemotherapy
Current Illness: None
Preexisting Conditions: Did not give info as to why taking Chemo
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: On 12/22/2006, about 2 hours post injection, patient noticed Left upper arm began to ache. No redness or bruising noted. 24 hours post injection, patient noticed swelling in Left arm extending from Left upper arm through Left forearm. Slight residual edema noticed in Left arm yet today on 12/26/2006. No redness noticed. No longer has pain in arm.


VAERS ID: 269731 (history)  
Form: Version 1.0  
Age: 64.0  
Gender: Female  
Location: Georgia  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2006-12-27
   Days after onset:5
Entered: 2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2248AA / UNK LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0485F / UNK RA / IM

Administered by: Public       Purchased by: Private
Symptoms: Erythema, Injection site warmth, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Penicillin, Novocaine, Codeine
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states she received pneumonia shot on 12/22/06 at 1:45 pm. She noticed her right arm began to swell and was red around 5:00 pm. She states the area around the site was red, swollen and warm to touch.


VAERS ID: 269764 (history)  
Form: Version 1.0  
Age: 0.51  
Gender: Male  
Location: Arizona  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2006-12-27
   Days after onset:5
Entered: 2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B042BA / 3 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08689D / 3 RL / IM

Administered by: Private       Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Fever 103F 3 hours after injection given. Went away with bath and Tylenol.


VAERS ID: 269821 (history)  
Form: Version 1.0  
Age: 32.0  
Gender: Female  
Location: California  
Vaccinated:2006-12-22
Onset:2006-12-24
   Days after vaccination:2
Submitted: 2006-12-28
   Days after onset:4
Entered: 2006-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dysphonia, Dyspnoea, Heart rate increased, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1. Pyradium
Current Illness: n/a
Preexisting Conditions: nkda
Allergies:
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Pt''s Symptoms were hoarsness, difficulty breathing, rapid heart beat, and throat was closing up. The treatment by the PCP was an Epinephrine injection and pt. was given a Benadryl 50mg- 1 po q4-6 hrs Rx.


VAERS ID: 269831 (history)  
Form: Version 1.0  
Age: 0.34  
Gender: Male  
Location: Utah  
Vaccinated:2006-12-22
Onset:2006-12-25
   Days after vaccination:3
Submitted: 2006-12-28
   Days after onset:3
Entered: 2006-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B079BA / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0406F / 2 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B58845D / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1110F / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Blood sodium increased, Dehydration, Diarrhoea, Hyperthermia, Viral infection
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Accidents and injuries (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Sodium 156 LABS: Initial Na 156; discharge Na 146. Initial K 5.9; discharge K 4.1. Initial BUN 50; discharge BUN 11. Initial creatinine 0.6; discharge creatinine 0.3.
CDC Split Type:

Write-up: Rotavirus Diarrhea, admitted overnight at hospital for dehydration and hyperthermia, Cousin did have diarrhea. 2/12/07 Received medical records from hospital which reveal patient experienced multiple episodes of nonbloody vomiting & diarrhea since 12/25 w/decreased oral intake. He had lost 2 lbs. On exam, patient was tachycardic & very tired appearing w/sunken eyes & dry mucous membranes. Tx w/IV hydration w/improvement & admitted overnight for continued hydration & monitoring. FINAL DX: hypernatremic dehydration likely due to viral gastroenteritis.


VAERS ID: 270165 (history)  
Form: Version 1.0  
Age: 0.41  
Gender: Male  
Location: Nevada  
Vaccinated:2006-12-22
Onset:2006-12-23
   Days after vaccination:1
Submitted: 2007-01-08
   Days after onset:16
Entered: 2007-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B0740A / 2 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0085F / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 57556B / 2 LL / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms:
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2006-12-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: born with imperforate anus, had colostomy in place
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Unexplained death within 24 hours of 4 month vaccines in the office. 3/26/07 Received Autopsy Report which reveals COD as SIDS. Patient had colostomy in place s/p surgical formation of rectum at birth & site was considered unremarkable. Child had been examined by PCP on 12/22/06 & received vax. Found to be well at that time.


VAERS ID: 270281 (history)  
Form: Version 1.0  
Age: 6.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-01-04
   Days after onset:13
Entered: 2007-01-09
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS B285AA / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: mild upper respiratory symptoms
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Will pursue Hep B Ab status with allergist.
CDC Split Type:

Write-up: Phone call from patients mother 1-2-07 reports child had hives on face and chest/abdomen 1 hour after Hep B #2. Tolerated Hep B #1 without problem. Was seen at urgent care and given Benadryl with good results and no further hives. Had mild upper respiratory symptoms then.


VAERS ID: 270540 (history)  
Form: Version 1.0  
Age: 1.0  
Gender: Female  
Location: Indiana  
Vaccinated:2006-12-22
Onset:2006-12-28
   Days after vaccination:6
Submitted: 2007-01-15
   Days after onset:18
Entered: 2007-01-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0654F / 1 LL / UN
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0813P / 1 LL / UN

Administered by: Private       Purchased by: Public
Symptoms: Varicella
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Had chicken pox. Per follow up: Broke out with chicken pox type lesion 1 wk prior to shot.


VAERS ID: 270580 (history)  
Form: Version 1.0  
Age: 1.0  
Gender: Male  
Location: Virginia  
Vaccinated:2006-12-22
Onset:2007-01-15
   Days after vaccination:24
Submitted: 2007-01-16
   Days after onset:1
Entered: 2007-01-17
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 1027F / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0653F / 1 RL / SC

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Red, macular, papular rash over head, face, truck, upper arms. Noticed on 1-15 (24 days after receiving MMR vaccine). Per follow-up: Not life threatening illness per reporter. None - Pt recovered and having no symptoms.


VAERS ID: 270769 (history)  
Form: Version 1.0  
Age: 2.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-12-22
Onset:2007-01-10
   Days after vaccination:19
Submitted: 2007-01-11
   Days after onset:1
Entered: 2007-01-18
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2292AA / 1 RL / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1209F / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08666H / 4 LL / IM

Administered by: Private       Purchased by: Private
Symptoms: Computerised tomogram, Coordination abnormal, Hordeolum, Vaccination complication
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular infections (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Hordolum interum
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Work-up for ataxia so far has included negative head CT, toxicology pending, consultation peds neurology.
CDC Split Type:

Write-up: Patient was inoculated 12-22-06 child developed ataxia 1-10-07 seen at hospital ER and admitted for work-up. 03/01/07-records received from PCP for DOS 12/21/06-02/06/07 Hospitalized 01/10-01/12/07-DC DX:Lack of coordination. Late effects of vrial encephalitis. PCP note 2/6/07-all diagnostic tests negative, and conclusion was post viral cerebellitis. On visit 2/6/07-alter, no ataxia. Stye on left eye. Well visit 12/21/06-WNL No one ever suspected that her condition was caused by vaccination, event was reported due to occuring within 45 days of a vaccination. Followup 3/30/2010 We never thought the vaccine caused her problem but we made the report because they symptoms presented within 45 days of immunization. She is ok and did get a 2nd flu shot without incident.


VAERS ID: 270775 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Male  
Location: Alabama  
Vaccinated:2006-12-22
Onset:2006-12-23
   Days after vaccination:1
Submitted: 2006-12-26
   Days after onset:3
Entered: 2007-01-18
   Days after submission:23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 500442 / 1 NS / IN
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR C2631A / 1 LA / -

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: Runny Nose, cough (allergies)
Preexisting Conditions: NKDA, allergic rhinitis.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12/23 to 12/25/06 had golf ball size swelling at injection site, redness, let deltoid x 72 hours, low grade fever x 24 hrs. Mom reported to nurse on 12/26/06.


VAERS ID: 270784 (history)  
Form: Version 1.0  
Age: 13.5  
Gender: Female  
Location: Oregon  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-01-08
   Days after onset:17
Entered: 2007-01-18
   Days after submission:10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Erythema, Pallor, Palpitations, Pyrexia, Rash, Rash macular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: History of Dysplasia (hips)
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 5 hours after receiving HPV pt had low grade fever (99), felt dizzy, pale, had a blotchy red rash on both arms (upper) onto back. No rash elevation, no hives. Pt went to bed, rash was gone by am without further side effects. During episode heart was also pounding.


VAERS ID: 271450 (history)  
Form: Version 1.0  
Age: 1.1  
Gender: Female  
Location: Missouri  
Vaccinated:2006-12-22
Onset:2007-01-01
   Days after vaccination:10
Submitted: 2007-01-30
   Days after onset:29
Entered: 2007-01-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 LL / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 RL / IM

Administered by: Private       Purchased by: Public
Symptoms: Erythema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None done.
CDC Split Type:

Write-up: woke up with face, neck, covered with bright red spots that did not itch or ooze. Spots gradually continued down upper torso, the lower torso the next 3 days. Spots a pinhead size and could be felt. Each one (raised). In three days they started to slowly fade and disappeared. No fever or discomfort appeared.


VAERS ID: 272295 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-22
Onset:2006-12-29
   Days after vaccination:7
Submitted: 2007-02-14
   Days after onset:47
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA00778

Write-up: Information has been received from a physician concerning a female (age not reported) with a sulfonamide allergy and no other pertinent medical history reported. On 22-DEC-2006, the patient was vaccinated with 0.5ml of Gardasil ( Lot #655165/1425F). There were no concomitant medications reported. On 29-DEC-2006, one week after the injection, the patient developed a rash on her arms, legs and abdomen. The patient sought unspecified medical attention. It was reported that the rash had since cleared up but the date was unknown. At the time of this report, the patient had recovered from the event. Additional information has been requested. 5/14/10 Follow up: The patient took Benadryl for 24 hours and itching resolved. No diagnostic laboratory tests were performed. On 12-JAN-2007, the patient had recovered completely. Additional information is not expected.


VAERS ID: 272306 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:54
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Feeling abnormal, Malaise, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho Tri Cyclen
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA01016

Write-up: Information has been received from a physician concerning a 19 year old female with a penicillin allergy and no other pertinent medical history reported. On 22-DEC-2006, the patient was vaccinated intramuscularly with one dose of Gardasil (Lot #654885/1424F). Concomitant therapy included Ortho Tri Cyclen. On 22-DEC-2006, the patient felt nauseous shortly after administration. The patient then fainted for approximately 10 seconds while she was at the office. The patient remained in the office until she felt "normal" again. The patient then went home where later she felt sick again. The patient went to the emergency room and was then released. It was reported that there were no laboratory diagnostics performed at the physician''s office and it was unknown it any were performed in the emergency room. At the time of this report, the patient had recovered from the events (date unknown). Additional information has been requested.


VAERS ID: 272356 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Louisiana  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:54
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / UNK RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Pain, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA02455

Write-up: This is in follow-up to report(s) previously submitted on 2/14/2007; 4/6/2007. Information has been received from a physician concerning a female patient with NKDA or preexisting medical conditions who on 22-DEC-2006, at 1:15 PM, the patient was vaccinated in the right arm with a 0.5 ml dose of GARDASIL (lot # 654389/0961F). Subsequently, several hours after the vaccination, she experienced localized right arm pain, developed a rash which was described as hives or her chin. Subsequently, on an unspecified date, the patient recovered from the events without treatment. The patient sought unspecified medical attention. Additional information is not expected. Additional information has been requested


VAERS ID: 272485 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Michigan  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:54
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2141AA / 1 UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Blood pressure normal, Dizziness, Feeling hot, Visual acuity reduced
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Otitis; Sore throat; Nasal congestion; Runny nose; Penicillin allergy; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: blood pressure, 12/22/06, 98/60, normal
CDC Split Type: WAES0701USA03195

Write-up: Information has been received from a registered nurse concerning a 14 year old female with no fever, otitis (diagnosed on 22-DEC-2006), mild sore throat, congestion, runny nose, amoxicillin and erythromycin allergy who on 22-DEC-2006 was vaccinated with the first dose of GARDASIL (lot # 653938/0954F), IM. Concomitant therapy included the first dose of MENACTRA (lot # U2141AA), IM. On 22-DEC-2006 after the vaccine while at the check out window, the patient stated that she felt hot, felt her vision was fading and felt faint. The registered nurse held her arm and walked with her back to an exam room where she had her lay down and elevated her legs on two pillows for 15 minutes. The patient''s feeling passed. When the patient first returned to the exam room the physician checked her and then checked her when she felt better. After 15 minutes of lying down, the patient then sat up for 5 minutes. Her blood pressure was taken and was normal 98/60. Subsequently, the patient recovered from the events that same day. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 2/14/2007. It was reported that there was no diagnostic work-up performed, the patient was not hospitalized nor was an outpatient and the patient fully recovered before she left the physician''s office. On 21-FEB2007, the patient was vaccinated with the second dose of GARDASIL and had no side effects. Additional information is not expected.


VAERS ID: 272684 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-02-13
   Days after onset:53
Entered: 2007-02-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0701USA00299

Write-up: Information has been received from a female consumer who on 22-DEC-2006 was vaccinated IM with one 0.65 ml dose of varicella-zoster virus vaccine. On 22-DEC-2005 the patient developed a rash at the injection site which lasted "about 24-36 hours." The patient recovered. There was no product quality complaint involved. No further information was available. Additional information has been requested.


VAERS ID: 272885 (history)  
Form: Version 1.0  
Age: 62.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2006-12-22
Onset:2006-12-23
   Days after vaccination:1
Submitted: 2007-02-16
   Days after onset:55
Entered: 2007-02-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0577R / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Cellulitis, Inflammation, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, Lisinopril, Atenolol, Boniva
Current Illness: NONE
Preexisting Conditions: NKDA, HTN, osteopenia, asthma, disc
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 12/26/06 left upper arm cellulitis, hot, inflamed, swollen-3 1/2 x 5" -following pneumoshot on 12/22/06 treated with Augmentin 875 mg BID x 10 days, warm compress


VAERS ID: 272940 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Florida  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-02-22
   Days after onset:62
Entered: 2007-02-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Insomnia, Medical device complication, Musculoskeletal pain, Pain, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: X-ray 02/12?/07 - No bony abnormalities
CDC Split Type: WAES0702USA03448

Write-up: Information has been received from a physician and an office manager concerning a 17 year old female with asthma who on 22-DEC-2006 was vaccinated IM, into the left arm, with a 0.5 ml first dose of Gardasil (lot#654540/0800P). It was reported that at the end of the administration the "safety spring plunger snapped back and caused the patient pain." The office manager explained that this incident was due to human error, the physician was unfamiliar with safety mechanism. On 22-DEC-2006, the patient experienced left shoulder pain and difficulty sleeping on her left arm. On approximately 12-FEB-2007, the patient saw an orthopedic surgeon. The patient underwent an X-ray which revealed no bony abnormality. The orthopedic surgeon recommended that the patient go to physical therapy. At the time of the report, the patient had not recovered. The physician considered the left shoulder pain and difficulty sleeping on her left arm to be disabling events. Additional information has been requested.


VAERS ID: 274118 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: California  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:81
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0454F / 1 UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Blood glucose normal, Dizziness, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Postpartum state; Shellfish allergy
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK; vital sign, 12/22/06, normal; blood sugar, 12/22/06, 110
CDC Split Type: WAES0702USA00572

Write-up: Information has been received from a nurse practitioner, via a company representative, concerning an approximately 22 year old female who was 6 weeks post partum and had completed a pelvic exam followed by the vaccination of the first dose (dose unspecified) of Gardasil. The nurse reported that 45 minutes after the appointment, the patient began to experience dizziness. The sensation of movement/dizziness" made it difficult for the patient to walk and persisted for about four hours, then abruptly resolved with no lingering effects. The patient sought unspecified medical treatment. Additional information has been requested. This is in follow-up to report(s) previously submitted on 3/14/2007. Initial and follow up information has been received from a nurse practitioner, concerning a 21 year old female patient, with a shellfish allergy who was 6 weeks post partum who on 23-DEC-2006 had completed a pelvic exam at the visit, who was then vaccinated, IM at 3:30pm, with the first dose of GARDASIL (Lot # 653938/0954F). The nurse reported that at 4:00 pm (previously reported as 45 minutes after the appointment), the patient began to experienced dizziness. The patient was observed in the nurse''s clinic and was then sent to the same day clinic for observation. The patient''s vital signs were reported to be normal, and a random blood sugar was 110 (units not specified). The sensation of movement/dizziness" made it difficult for the patient to walk and persisted for about four hours, then abruptly resolved with no lingering effects. No further information was expected.


VAERS ID: 275026 (history)  
Form: Version 1.0  
Age: 82.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-12-22
Onset:2006-12-22
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:81
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARZOS: ZOSTER (ZOSTAVAX) / MERCK & CO. INC. 1212F / 1 LA / SC

Administered by: Private       Purchased by: Private
Symptoms: Injection site pustule, Injection site rash, Injection site vesicles
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sulfonamide allergy; Allergic reaction to antibiotics; Drug hypersensitivity
Preexisting Conditions: Bronchiectasis; Post herpetic neuralgia
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA00961

Write-up: Information has been received from a physician concerning an "at least 60 year old" patient who on an unspecified date was vaccinated SC with a single first dose of Zostavax. Subsequently the patient developed a rash at the injection site that looked like "little pox with pustules." Unspecified medical attention was sought. The patient recovered on 05-FEB-2007. There was no product quality complaint involved. No further information was provided. Additional information has been requested. 06/22/07 This is in follow-up to report(s) previously submitted on 3/14/2007. Initial and follow-up information has been received from a physician concerning an 82 year old female with allergies to sulfa, KEFLEX, MEPERGAN, MACRODANTIN and horse serum, who on 22-DEC-2006 was vaccinated SC in the left arm with a single first dose of ZOSTAVAX (Oka/Merck) (lot # 652947/1212F). The patient had bronchiectasis and post herpetic neuralgia at the time of vaccination. On the same day the patient developed a vesicular eruption rash at the injection site which was 2.5 cm in diameter and looked like "little pox with pustules." The pustules had some weeping. Unspecified medical attention was sought. The patient recovered "over 2 weeks time" on approximately 06-JAN-2007 (previously reported as 05-FEB-2007). There was no product quality complaint involved. No further information was provided. Additional information is not expected.


VAERS ID: 273385 (history)  
Form: Version 1.0  
Age: 73.0  
Gender: Male  
Location: Foreign  
Vaccinated:2006-12-22
Onset:2007-01-10
   Days after vaccination:19
Submitted: 2007-03-02
   Days after onset:51
Entered: 2007-03-05
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0294F / UNK - / SC

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Gait disturbance, Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BIOFERMIN R 10Oct06 - 15Feb07, EXCELASE 10OCT06 - 15Feb07
Current Illness: Colitis ulcerative; Interstitial lung disease; Gastrointestinal disorder
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA01040

Write-up: Information has been received from a physician concerning a 73 year old male outpatient with ulcerative colitis (since 1989), interstitial pneumonia (since 2000), dyspepsia and no allergy history who on 22-DEC-2006 was vaccinated subcutaneously with a 0.5 ml of Pneumovax 23 (Lot 9MG01R). Concomitant suspect therapy included from 17-OCT-2006 berberine chloride one tablet three times a day for vomiting and from 10-OCT-2006 unspecified therapy ("SAIREI-TO") 3 g three times a day for diarrhea. Other concomitant therapy included digestive enzymes (+) Excelase and Lactobacillus, Biofermin. On approximately 10-JAN-2007, the patient experienced loss of strength of the lower extremities and had slight difficulty in walking. On 19-JAN-2007, the patient complained of numbness in the feet and weakness (especially in the left foot) during the visit to the reporting physician''s clinic. At the time of the visit, the patient could walk somehow and could drive a car. There was neither Barre sign nor hemiplegia. He felt that the left lost strength and was slightly constricted. The reporting physician recommended the patient present to the department of neurosurgery by way of precaution. However, the patient hoped to be just followed up for a while. On 06-FEB-2007, the patient''s family visited the reporting physician''s clinic to report that the patient could not walk by himself and had a growing difficulty in driving a car. On 15-FEB-2007, therapy with berberine chloride and SAIREI-TO were discontinued. Subsequent clinical course was unknown. The reporting physician felt that suspected Guillain-Barre syndrome (lower extremity weakness) was definitely related to therapy with Pneumovax 23. The physician considered that the event was serious as disabling. Additional information has been requested


VAERS ID: 299858 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Foreign  
Vaccinated:2006-12-22
Onset:2007-04-01
   Days after vaccination:100
Submitted: 2007-12-14
   Days after onset:257
Entered: 2007-11-15
   Days after submission:29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS - / 1 LA / IM

Administered by: Other       Purchased by: Other
Symptoms: Arthralgia, Rheumatoid arthritis
SMQs:, Arthritis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mesalazine
Current Illness: Ulcerative Colitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: B0498915A

Write-up: This case was reported by the subject''s father and described the occurrence of rheumatoid arthritis in a female subject of unspecified age who was vaccinated with Twinrix adult for prophylaxis. Concurrent medical conditions included ulcerative colitis since 2.5 years. Patient is treated for this condition with Mesalazine (colitofalk). On 22 December 2006 and 25 January 2007 the subject received 1st dose and booster dose of Twinrix adult (unknown). In April 2007, 3 months after vaccination with the booster dose of Twinrix adult, 4 months after vaccination with the 1st dose of Twinrix adult, the subject experienced pain on right hip then on left hip then right ankle then right knee and left knee and right wrist. Since April 2007 patient experienced regularly a recurrence of symptoms and each recurrence lasted approximately 3 days; patient experienced also pain in the night. Investigation was done in May 2007 and a diagnose of rheumatoid arthritis was established. This case was assessed as medically serious. At the time of reporting the outcome of the events was unspecified. The subject''s father intend for a claim. Further information has been requested.


Result pages: prev   2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2820 2821 2822 2823 2824 2825 2826 2827 2828 2829 2830 2831 2832 2833 2834 2835 2836 2837 2838 2839 2840 2841 2842 2843 2844 2845 2846 2847 2848 2849 2850 2851 2852 2853 2854 2855 2856 2857 2858 2859 2860 2861 2862 2863 2864 2865 2866 2867 2868 2869 2870 2871 2872 2873 2874 2875 2876 2877 2878 2879 2880 2881 2882 2883 2884 2885 2886 2887 2888 2889 2890 2891 2892 2893 2894 2895 2896 2897 2898 2899 2900 2901 2902 2903 2904 2905 2906 2907 2908 2909 2910 2911 2912 2913 2914 2915 2916 2917 2918 2919 2920 2921 2922 2923 2924 2925 2926 2927 2928 2929 2930 2931 2932 2933 2934 2935 2936 2937 2938 2939 2940 2941 2942 2943 2944 2945 2946 2947 2948 2949 2950 2951 2952 2953 2954 2955 2956 2957 2958 2959 2960 2961 2962 2963 2964 2965 2966 2967 2968 2969 2970 2971 2972 2973 2974 2975 2976 2977 2978 2979 2980 2981 2982 2983 2984 2985 2986 2987 2988 2989 2990 2991 2992 2993 2994 2995 2996 2997 2998 2999 3000 3001 3002 3003 3004 3005 3006 3007   next

New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?EVENTS=ON&PAGENO=2908&PERPAGE=100&ESORT=VAX-DATE


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166