National Vaccine
Information Center

Your Health. Your Family. Your Choice.
MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 593491 cases in entire database

Case Details (Sorted by Vaccination Date)

This is page 2908 out of 5935

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:278054 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-07, Days after onset: 0
Location:Mississippi  Entered:2007-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL 1 1/2 PO (Cherry flavor)
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0175U1 LA
Administered by: Public     Purchased by: Public
Symptoms: Conjunctivitis, Eye infection, Periorbital oedema
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Conjunctival disorders (narrow), Periorbital and eyelid disorders (narrow), Ocular infections (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Within one hour of Varicella vaccine administration patient developed injected eyes and periorbital edema. Presumed to clinic with bilateral conjunctivitis infected, periorbital area puffy. Vital signs WNL. Benadryl 1 tsp PO given.

VAERS ID:278070 (history)  Vaccinated:2007-05-07
Age:5.0  Onset:0000-00-00
Gender:Male  Submitted:2007-05-07
Location:Unknown  Entered:2007-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B070IMLA
Administered by: Public     Purchased by: Public
Symptoms: No adverse effect
SMQs:
Write-up: None as of yet when I contacted the parent

VAERS ID:278148 (history)  Vaccinated:2007-05-07
Age:5.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-08, Days after onset: 1
Location:Tennessee  Entered:2007-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B040CA4IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ04573UNLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.13B7F1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Heat therapy, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: swelling of (R) thigh (moderately to knee) minimal warmth/ no tenderness/ no erythema no mass palpable-full ROM of knee. To apply heat to area and TID/Tylenol prn pain recheck in office if swelling increases or PRN

VAERS ID:278185 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-08, Days after onset: 0
Location:Vermont  Entered:2007-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoride
Current Illness: none
Preexisting Conditions: none, NKQA
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B042BA1IMRA
IPV: POLIO VIRUS, INACT. (POLIOVAX)SANOFI PASTEURZ00180SCRA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.1481F0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased, Erythema, Induration, Pain, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5/7/07: Received vaccines. 5/8/07: Mom calling to report large red raised area, warm to touch and pain temp - 101.0. Mom to apply ice, give Motrin also itch.

VAERS ID:278190 (history)  Vaccinated:2007-05-07
Age:3.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-08, Days after onset: 1
Location:California  Entered:2007-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0248U0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: cheeks and hands red noticed at 7:00 pm. eye redness

VAERS ID:278191 (history)  Vaccinated:2007-05-07
Age:5.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-08, Days after onset: 0
Location:Arizona  Entered:2007-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: records received 7/17/07-CBC normal. Chemistry low bicarb 22.2.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B047AA4UNUN
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB143BA UNLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ03063UNUN
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.13237F SCUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0985F   
Administered by: Private     Purchased by: Private
Symptoms: Cold compress therapy, Erythema, Injection site cellulitis, Injection site swelling, Metabolic acidosis, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling in left arm from injection site to elbow measuring 8" long + 8-9" in cir/dia 8 inches. Tx-Benadryl x 3 qd, ice, Report x 3d to re-check 7/19/07-medical records that document a hospitalization from 9/23-9/24/06. Case status changed to serious. DC DX:Left thigh cellulitis secondary to immunization, mild metabolic acidosis. Swelling and redness of left thigh 24 hours prior to presentation to ED.

VAERS ID:278192 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-08, Days after onset: 0
Location:Texas  Entered:2007-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU198CA  RA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0109U  LA
Administered by: Private     Purchased by: Other
Symptoms: Pain, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: pain, swelling, warm to touch

VAERS ID:278197 (history)  Vaccinated:2007-05-07
Age:5.0  Onset:0000-00-00
Gender:Male  Submitted:2007-05-08
Location:Pennsylvania  Entered:2007-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medication
Current Illness: None
Preexisting Conditions: Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU13870A4IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB162BA IM 
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY10673IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0987F1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1309F1SCRA
Administered by: Private     Purchased by: Other
Symptoms: Expired drug administered, No adverse effect
SMQs:, Medication errors (narrow)
Write-up: Patient was given Dtap that expired 4*13-07, given on 5-7-07. No reaction to vaccine.

VAERS ID:278246 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-07, Days after onset: 0
Location:Virginia  Entered:2007-05-09, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: nasal congestion
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURERC2489AA4IM 
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERZ0013IM 
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0143U1SC 
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: MMRV given in (L) leg. Pt noted scratch leg after bandaid applied. Paper work completed. Checked leg prior to leaving. Pt states no linger itching, area red in arm swelling, ice pack applied. Swelling decreased. Pt denied any other itching.

VAERS ID:278285 (history)  Vaccinated:2007-05-07
Age:7.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-09, Days after onset: 2
Location:North Carolina  Entered:2007-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0125U1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: LEFT ARM WITH LOCAL REACTION- 5 1/2CM X 5 1/2CM AREA OF REDNESS AND INDURATION; WARM TO TOUCH, LOW GRADE FEVER

VAERS ID:278286 (history)  Vaccinated:2007-05-07
Age:0.2  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-09, Days after onset: 1
Location:Iowa  Entered:2007-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: premature, hypoplastic left ventrile and large prinum atrial septal defect, post surgery seizures. Reflux.
Preexisting Conditions: hypoplastic left ventrile and large prinum atrial septal defect
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B066AA0IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1275F0IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08679100IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0940F PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: BI LATERAL LEG SWELLING AND FEVER. TREAT WITH ICE AND TYLENOL AND FOLLOW UP WITH DR. IF SYMPTOMS CONTINUE

VAERS ID:278288 (history)  Vaccinated:2007-05-07
Age:73.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-09, Days after onset: 2
Location:Missouri  Entered:2007-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin 81mg daily
Current Illness: Syncope
Preexisting Conditions: NKDA PMH: PSVT, syncopal episodes, HTN, dyslipidemia, HH
Diagnostic Lab Data: NA LABS: CT of head was WNL. 2-D echocardiogram was essentially WNL. Persantine cardiolite stress test was WNL. Myocardial perfusion was WNL. CT of chest revealed possible pneumonia, non-obstructing renal calculi & thyroid nodule. EEG
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0486U0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood creatine phosphokinase normal, Cardiac stress test, Cerebral disorder, Chest X-ray normal, Chest discomfort, Chest pain, Cold compress therapy, Computerised tomogram abnormal, Computerised tomogram normal, Discomfort, Echocardiogram normal, Electroencephalogram abnormal, Erythema, Full blood count normal, Hypoaesthesia, Laboratory test normal, Loss of consciousness, Nephrolithiasis, Occult blood negative, Pallor, Scan myocardial perfusion, Staring, Swelling, Syncope, Tenderness, Thyroid neoplasm, Troponin
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Non-haematological tumours of unspecified malignancy (narrow)
Write-up: uncomfortable tenderness, swelling, redness, which extended to the axillary area, has been treated with ice packs. 5/11/07 Received medical records from hospital which reveal patient experienced recurrent chest discomfort , pallor, starring & left arm numbness followed by passing out while in church. Admitted 5/6/07- 5/10/07. Vax given 5/7/07 while hospitalized. Patient had hx of extensive cardiac w/u which was neg. Multiple consults done while in hospital. No D/C Summary included. Will call hospital for d/c date. Admit DX: syncopal episode, chest pain, r/o MI, dyslipidemia, hx of tachycardia & HTN FINAL DX: None given. 5/11/07 T/C to med recs. D/C on 5/10/07. No D/C summary dictated. No final dx available.

VAERS ID:278291 (history)  Vaccinated:2007-05-07
Age:18.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-09, Days after onset: 2
Location:Missouri  Entered:2007-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Temperature: 38.6. CSF: Clear Colorless, no cells, Protein 16, Glucose 65, no growth on micro or rapid tests. Chest x-ray normal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR    
Administered by: Public     Purchased by: Public
Symptoms: Body temperature increased, CSF test normal, Chest X-ray normal, Headache, Malaise, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient received vaccine at his high school in preparation for college dorm life. Four hours after vaccine administration headache began. Two hours later, patient had subjective fever and malaise. Took ibuprofen 800mg then slept through the night. Awoke with severe headache, fever (38.6 in ED), muscle stiffness so was brought to emergency department by his mother. Patient stated he did not receive VIS with vaccine administration. In the ED, again had fever as above, headache, and neck stiffness, therefore had lumbar puncture to rule out meningitis (results below). Later discharged from emergency department to home.

VAERS ID:278292 (history)  Vaccinated:2007-05-07
Age:15.0  Onset:2007-05-09, Days after vaccination: 2
Gender:Female  Submitted:2007-05-09, Days after onset: 0
Location:D.C.  Entered:2007-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Augmentin --$g hives, Cefzil--$g hives
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0362U1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 55mm x 55mm area of induration, erythema, and slight warmth, noted 36 hours after varivax dose #2 at site of injection. First dose of Varivax was given on 6/15/1995.

VAERS ID:278300 (history)  Vaccinated:2007-05-07
Age:10.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-09, Days after onset: 1
Location:Colorado  Entered:2007-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.O172U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Booster Varicella given May 7, 2007. One day later developed swelling and erythema, warm to touch. No fevers, no red streaks. Seen in clinic on May 9 afternoon. Swelling was 8cm x 8cm, erythema was 5cm x 5 cm, warm to touch. No evidence of infection. MOC stated that swelling was resolving by May 9.

VAERS ID:278333 (history)  Vaccinated:2007-05-07
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-08
Location:Pennsylvania  Entered:2007-05-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0654F1IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0960F1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:, Medication errors (narrow)
Write-up: pt given Hep A 0.5 ml injection too early from initial injection. Only 2 months apart instead of 6

VAERS ID:278340 (history)  Vaccinated:2007-05-07
Age:23.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-11, Days after onset: 3
Location:California  Entered:2007-05-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oral contraception (Levlen)
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2609AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Headache, Hypoaesthesia, Injection site swelling, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5/10/07 Telephone consult with patient stated nausea and extensive swelling at Tdap site (R) Deltoid. Described (L) sided numbness (L) leg and arm and buttocks, High fever, Headache, and extreme weakness. 48 hours later, most symptoms resolved but patient still c/o (L) shoulder swelling at site.

VAERS ID:278342 (history)  Vaccinated:2007-05-07
Age:65.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-08, Days after onset: 0
Location:Tennessee  Entered:2007-05-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Headache~Influenza (no brand name)~~0~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: H/o Leukemia, Hyperlipidemia, Osteoporosis, Allergic rhinitis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.08888F0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Cold compress therapy, Erythema, Injection site pain, Injection site swelling, Injection site warmth, Nausea, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5/8/07-Pt called c/o pain, warmth, and swelling at injection site. Also c/o fever, chills, nausea, and vomiting. Office appt-pt instructed to ice arm, red, Medrol dosepak, tylenol, and Phenergan

VAERS ID:278353 (history)  Vaccinated:2007-05-07
Age:46.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-09, Days after onset: 2
Location:D.C.  Entered:2007-05-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MVI
Current Illness: None
Preexisting Conditions: Scoliosis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0904F1UNRA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Lightheadedness Weakness Nausea

VAERS ID:278357 (history)  Vaccinated:2007-05-07
Age:59.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-10, Days after onset: 2
Location:New York  Entered:2007-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: History of Breast Cancer with left Mastectomy (many years ago).
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2557AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Induration, Skin nodule, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximatley 12 hours after receiving the vaccination patient developed a hard, swollen red area the size of an apple on her left arm. This area was not at the site of the injection but directly opposite it on the same arm. Upon questioning, patient revealed that she had had a mastectomy many years ago on that side which she did not report to the vaccinator.

VAERS ID:278359 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-10, Days after onset: 3
Location:California  Entered:2007-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU1891BA4IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY04963SCRA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0344U1SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: PAIN, SWELLING AND REDNESS ON LEFT ARM @ INJECTION SITE. REDNESS AND SWELLING MEASUREMENTS ARE 7CM X 8CM. SITE FEELS WARM TO TOUCH. ADVISED TO APPLY ICE PACK TO THE SITE AND TO CALL BACK IF SYMPTOMS WORSEN.

VAERS ID:278360 (history)  Vaccinated:2007-05-07
Age:62.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-10, Days after onset: 3
Location:Wisconsin  Entered:2007-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: allergies to codeine and bee stings. High blood pressure
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal pain upper, Arthralgia, Chills, Diarrhoea, Dizziness, Fatigue, Headache, Injection site erythema, Injection site swelling, Nausea, Pain, Pallor, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pain, redness, swelling, headache, tiredness, hausea, diarrhea, stomach ache, chills, body aches, sore joints, rash, fever, paleness, dizziness. On set of symtoms approximately 12 hours after injection. Doctor precribed Benydryl for swelling and reddness at site of injection.

VAERS ID:278366 (history)  Vaccinated:2007-05-07
Age:13.0  Onset:2007-05-09, Days after vaccination: 2
Gender:Male  Submitted:2007-05-10, Days after onset: 1
Location:Illinois  Entered:2007-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no illness
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2730AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt was vomiting,fever x1 day.

VAERS ID:278410 (history)  Vaccinated:2007-05-07
Age:63.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-11, Days after onset: 4
Location:Massachusetts  Entered:2007-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0959F SCRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site pain, Injection site reaction, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Large red mark at injection site very sore for 3 days, hot to touch approximately 10cm. Advised: ice and Benadryl.

VAERS ID:278420 (history)  Vaccinated:2007-05-07
Age:0.3  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-08, Days after onset: 1
Location:Illinois  Entered:2007-05-11, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B092BA1IMRL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1436F1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08683P1IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1167F0PO 
Administered by: Public     Purchased by: Public
Symptoms: Rash papular, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Administered all vaccines at 10:00 am, by 3:00 pm, pruritis rash had erupted. Seen in clinic, mild papular-urticarial rash on body. Gave Benadryl. Within 6 hours had resolved. First time Rotateq given.

VAERS ID:278427 (history)  Vaccinated:2007-05-07
Age:7.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-11, Days after onset: 3
Location:Virginia  Entered:2007-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1499F0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Child received Varivax vaccine SQ in right arm on May 7, 2007. Mother states arm became swollen and hot to touch. Brought into HD on Thursday, May 10, 2007 for nurse to evaluate injection site. Injection site was noted to be slightly red, remained swollen and warm to touch. Appearance of arm did not seem out of the normal range for possible reaction. Mother states arm is much less warm than the day before. Mother was asked what comfort measures she had tried (Tylenol, cool cloth, etc.). Stated none, she was "afraid to give Tylenol because she did not have a fever" and the mother feared the possible harm to her daughter''s "kidneys". Also stated the child said her arm did not hurt. Nurse evaluated arm, explained that reaction of redness, swelling, warmth were within the normal range of expected reactions. Instructed mother to apply comfort measure of cool cloth to arm and administer Tylenol per child''s age and package instructions. Also, informed that swelling and warmth in child''s arm should resolve, but if it does not or if mother''s notes increased swelling, redness, and/or pain to take child to physician for evaluation.

VAERS ID:278437 (history)  Vaccinated:2007-05-07
Age:5.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-11, Days after onset: 4
Location:North Carolina  Entered:2007-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: no~ ()~NULL~~In Patient|na~ ()~NULL~~In Sibling1|na~ ()~NULL~~In Sibling2
Other Medications: zyrtec
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: na
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1053R3IMRL
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 5-7-07 noted redness, edema, warm to touch, pain RLL injection site. On 5-9-07 pt. seen in office with worsing s/s (size 2" X 3").

VAERS ID:278514 (history)  Vaccinated:2007-05-07
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-08
Location:Arizona  Entered:2007-05-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0637F IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site pruritus, Injection site pustule
SMQs:
Write-up: Small pimple-like sore at the injection site. Itching at the injection site.

VAERS ID:278537 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-08, Days after onset: 1
Location:California  Entered:2007-05-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Reactive Airway Disease
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B051BA4IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ03063SCLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0298U0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5-8-07 seen in clinic 24 hours after vaccinations L upper arm - deltoid muscle - swollen, red, tender, warm to touch. Tx with Keflex TZD X 10D 2 cellulitis.

VAERS ID:278561 (history)  Vaccinated:2007-05-07
Age:  Onset:0000-00-00
Gender:Female  Submitted:2007-05-11
Location:Georgia  Entered:2007-05-14, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0117U1SCLL
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mild erythema, muscle soreness to leg - do not feel allergic reaction - more muscular.

VAERS ID:278614 (history)  Vaccinated:2007-05-07
Age:6.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-08, Days after onset: 0
Location:North Carolina  Entered:2007-05-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: NC07042
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0111U1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Cold compress therapy, Injection site reaction
SMQs:
Write-up: 50 Cent piece sized area under area where Varivax was given, left deltoid - 5/7/07. May be reaction to circular bandaid - which was removed. This all reported by school nurse via PC today. Denies pain, ice pack applied to area.

VAERS ID:278623 (history)  Vaccinated:2007-05-07
Age:12.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-09, Days after onset: 2
Location:New York  Entered:2007-05-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB620B0 LA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.030741 RA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 3.5cm Erythematous swollen area surrounding injection site right deltoid.

VAERS ID:278628 (history)  Vaccinated:2007-05-07
Age:17.0  Onset:0000-00-00
Gender:Male  Submitted:2007-05-09
Location:Pennsylvania  Entered:2007-05-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Puncture wound/ rusty nail
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2605AA5IMLA
Administered by: Private     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Patient was given Dtap instead of Adacel, doctor ordered Adacel.

VAERS ID:278675 (history)  Vaccinated:2007-05-07
Age:0.4  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-14, Days after onset: 6
Location:Texas  Entered:2007-05-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B084BA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF084AA1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08658E1IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1231F1PO 
Administered by: Public     Purchased by: Public
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Per Dr office the child was vaccinated on 05/07/07. Mother noticed the child developing a rash from head to toe on 05/08/07. Child was evaluated by DR on 05/09/07, no medications were given the patient was put on observation and evaluated again on 05/11/07. Dr indicated child doing well and rash resolving.

VAERS ID:278678 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-13, Days after onset: 5
Location:Illinois  Entered:2007-05-15, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B044AA IMLL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB129AA IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY0535 IMLL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.2727F IMRL
Administered by: Public     Purchased by: Public
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Severe swelling of L thigh down to the knee - resolved in 5 days.

VAERS ID:278886 (history)  Vaccinated:2007-05-07
Age:1.14  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-17, Days after onset: 10
Location:Florida  Entered:2007-05-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Amoxil
Diagnostic Lab Data: Pt''s mother declined, lab work in office visit in a few days after vaccination
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B066AA1IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0054U1IMLL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0300U SCRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHBO8689C1IMRL
Administered by: Public     Purchased by: Unknown
Symptoms: Anorexia, Diarrhoea, Pyrexia, Rash generalised
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: (1) High fever 103.6 x 10 days (on 2 off) (2) Loss of appetite (3) Diarrhea (4) Rashes all over the body

VAERS ID:278900 (history)  Vaccinated:2007-05-07
Age:49.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-16
Location:Tennessee  Entered:2007-05-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Chest pain, Cough, Dysphonia, Headache, Pharyngolaryngeal pain, Rhinorrhoea, Sinus operation, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Headaches, sore throat, hoarse, nasal drainage, sinus drainage, coughing, lots of coughing, chest aches, wheezing

VAERS ID:278988 (history)  Vaccinated:2007-05-07
Age:47.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-18, Days after onset: 11
Location:Louisiana  Entered:2007-05-18
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: A titer drawn on 30 November 2006 showed that the subject was non-responsive following completion of a three dose series of Engerix B. An additional series was then started.
CDC Split Type: A0651681A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB431AA4UNLA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Bedridden, Bursitis, Chest pain, Hypokinesia, Insomnia, Musculoskeletal pain, Pain in extremity, Vaccination failure
SMQs:, Rhabdomyolysis/myopathy (broad), Lack of efficacy/effect (narrow), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of unable to get out of bed in a 46-year-old female subject who was vaccinated with Engerix B for prophylaxis. On 19 September 2006, 13 December 2005 and 31 January 2005 the subject received 3rd dose, 2nd dose and 1st dose of Engerix B at 10 mcg (pediatric dose), two doses given in the right arm for an adult dose total of 20mcg. For the 1st dose, two separate lot numbers of 10 mcg Engerix B were administered to the subject. The numbers were AHBVA06200 with expiration of 14 November 2005 and ENG5506A2 with expiration of 05 February 2005. Following completion of the three dose series of Engerix B, on 30 November 2006, a titer was drawn that revealed that the subject was non-responsive to Engerix B, therefore, an additional series of Engerix B was started. Following a 4th dose of Engerix B given on 19 December 2006, the subject complained of hardly being able to get out of bed and she was experiencing shoulder pain, back pain and chest pain. She was unable to move. The subject''s physician diagnosed her with bursitis in her right shoulder. The 5th dose of Engerix B was administered in the subject''s left shoulder on 07 May 2007. The next morning, on 08 May 2007, the subject reported that she was barely able to sleep the prior evening, her arm hurt and she was experiencing chest pain. The subject was taken to the emergency department and she was admitted to the hospital. The subject was worked up for heart issues and the physician reported that she may have experienced a possible adverse event to the Engerix B. The subject remained hospitalized at the time of reporting. The healthcare professional considered the events were disabling and clinically significant (or requiring intervention). At the time of reporting the events were unresolved.

VAERS ID:279011 (history)  Vaccinated:2007-05-07
Age:3.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-15, Days after onset: 8
Location:South Dakota  Entered:2007-05-18, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1282F0IMRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Blood pressure decreased, Heart rate decreased, Hypersensitivity, Immunisation reaction, Oxygen saturation decreased, Pallor, Somnolence
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Vaccine administered - became pale, week Sats 87%-88%, Heart rate 60-70, BP 82/40. Administered epipen and transported to ER with O2. Fluids given at ER Solumed rol, Solu certef. 06/04/2007 MR received for ER visit for episode of pallor after receiving hep A vaccine. O2 sats 99-100%. Pt. drowsy. Txd with Solumedrol and Solucortef IV. Color improved and child more interactive. D/C home. DX: Allergic reaction to Hep A.

VAERS ID:279122 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-14
Location:California  Entered:2007-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, Quar
Current Illness: none
Preexisting Conditions: Asthma
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2490AA4IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0651F1IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY103123SCLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0297U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 5/8/07 17:17 6CM x 6CM induration at L inferior deltoid injection site. No fever, Benadryl 1tsp PO Q6 hrs PRN swelling. Ice Q20 min on/off PRN pain and swelling

VAERS ID:279130 (history)  Vaccinated:2007-05-07
Age:12.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-10, Days after onset: 2
Location:California  Entered:2007-05-21, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2221AA0SCRA
Administered by: Other     Purchased by: Public
Symptoms: Injection site discolouration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen R arm from shoulder to elbow, mildly pink, not warm or tender given Advil and Benadryl

VAERS ID:279159 (history)  Vaccinated:2007-05-07
Age:16.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-21, Days after onset: 13
Location:Florida  Entered:2007-05-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Noticed within 24 hours of injection itchy rash - joints - armpit - elbows - knees - ankles - stomach.

VAERS ID:279261 (history)  Vaccinated:2007-05-07
Age:39.0  Onset:2007-05-10, Days after vaccination: 3
Gender:Female  Submitted:2007-05-16, Days after onset: 6
Location:Arizona  Entered:2007-05-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Leg wound, no other illness
Preexisting Conditions: NKDA, GERD, migraine, HA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2689AA0 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site cellulitis, Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Localized edema and erythema at injection site within 24 hours. NSAID therapy, heat and ABX given. Signs of cellulitis began 7 days after injection. ABX at that time

VAERS ID:279306 (history)  Vaccinated:2007-05-07
Age:14.0  Onset:2007-05-13, Days after vaccination: 6
Gender:Female  Submitted:2007-05-16, Days after onset: 3
Location:Texas  Entered:2007-05-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B012AA0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Dyspnoea, Hypersensitivity
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tdap given 5-7-07 - student states after being out and about on 5-12-07, in th evening she began to have difficulty breathing. Mom took to ER. Dr said was allergic reaction but no specific source diagnosed. Student given steroids by Dr and sent home - Prednisone and Benadryl (went to ER on 5/13/07)

VAERS ID:279366 (history)  Vaccinated:2007-05-07
Age:5.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-10, Days after onset: 2
Location:Washington  Entered:2007-05-22, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC251AA4IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.1280F0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ03243SCRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0539F1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Vaccinated on 5/7/07 right arm from shoulder to elbow swollen and hand starting at 5/8/07 evening. Icing arm still swollen 5/10/07 swelling went down - didn''t take her to the doctor.

VAERS ID:279373 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-07, Days after onset: 0
Location:Alabama  Entered:2007-05-22, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0249U0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1149F1SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Cough, Lacrimation increased, Ocular hyperaemia, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Lacrimal disorders (narrow), Hypersensitivity (broad)
Write-up: Wheezing, coughing, eyes red and tearing

VAERS ID:279384 (history)  Vaccinated:2007-05-07
Age:51.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-05-18, Days after onset: 10
Location:Ohio  Entered:2007-05-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADVAIR, BONIVA, DIOVAN, FLONASE, PROVENTIL
Current Illness: None
Preexisting Conditions: Asthma, Hypertension
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0958F IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Erythema, redness, swelling taken Benadryl

VAERS ID:279313 (history)  Vaccinated:2007-05-07
Age:15.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-16, Days after onset: 9
Location:Missouri  Entered:2007-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccination and had no known pre-existing medical conditions.
Diagnostic Lab Data:
CDC Split Type: 200701717
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2228AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fall, Loss of consciousness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Initial report received on 10 May 2007 from a health care professional. A 15-year-old female patient, with no known past medical history, had received a left deltoid, intramuscular injection of Menactra, lot number U2228AA; and a right deltoid, intramuscular injection of Gardasil, lot number 0389U; on 07 May 2007. On the same day following vaccination, the patient "passed out" and fell to the floor. She was unresponsive for approximately 40 seconds. The patient did not experience any respiratory distress, and the event fully resolved without medical intervention.

VAERS ID:279319 (history)  Vaccinated:2007-05-07
Age:26.0  Onset:2007-05-09, Days after vaccination: 2
Gender:Female  Submitted:2007-05-16, Days after onset: 7
Location:Missouri  Entered:2007-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.038400 RA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Injection site erythema, Injection site induration, 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)
Write-up: Vaccination given 05/07/07. Patient reports dizziness and nausea starting 5/09/07 et continues. 5/14/07 redness et hardness noted at injection site. Injection site s/s worsened 5/15/07. On 5/16/07 site less red with 1.2 cm hardened area noted with slight tenderness.

VAERS ID:279327 (history)  Vaccinated:2007-05-07
Age:4.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-22, Days after onset: 14
Location:Wisconsin  Entered:2007-05-23, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: antimicrobial (unspecified)
Current Illness: Infected toe, allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA02542
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0299U SC 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a health professional concerning a 4 year old male with an infected toe and a OMNICEF /allergy who on 07-MAY-2007was vaccinated SC with a 0.5 ml dose of ProQuad (lot # 657183/0299U). Concomitant therapy included an unspecified antibiotic for a toe infection. On 08-MAY-2007 the patient experienced swelling, redness and warmth at the injection site. Unspecified medical attention was sought in the emergency room on an unspecified date. There were no lab tests performed. The patient was then seen in the office on 10-MAY-2007 and it was noted that the swelling, redness and warmth was getting less. At the time of the report the patient was recovering. There was no product quality complaint involved. No further information was provided. The reporter considered the patient''s events to be other important medical events because the patient was taken to the emergency room. Additional information has been requested.

VAERS ID:279399 (history)  Vaccinated:2007-05-07
Age:11.0  Onset:2007-05-10, Days after vaccination: 3
Gender:Male  Submitted:2007-05-10, Days after onset: 0
Location:Georgia  Entered:2007-05-23, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0336V2SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 3 inches wide - increased redness (1 inch) in center - per doctor - Keflex 500mg 1 BID x 10

VAERS ID:279988 (history)  Vaccinated:2007-05-07
Age:13.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-24, Days after onset: 17
Location:Massachusetts  Entered:2007-05-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB130AA1IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Syncopal episode following Gardasil

VAERS ID:280009 (history)  Vaccinated:2007-05-07
Age:13.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Male  Submitted:2007-05-10, Days after onset: 2
Location:North Carolina  Entered:2007-05-30, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Rhinocort, Singulair
Current Illness: none
Preexisting Conditions: Seasonal allergies; anxiety
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1282F0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2234AA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt developed significant erythema at injection site within 24 hours of injection. Rechecked in office 5/8, 5/9, and 5/10. Began on Keflex to cover for cellulitis though mostly immunization reaction area of erythema is 14cm x 12cm 5/10/07.

VAERS ID:280237 (history)  Vaccinated:2007-05-07
Age:91.0  Onset:0000-00-00
Gender:Male  Submitted:2007-06-01
Location:Connecticut  Entered:2007-06-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin, Proscar, Prinivil
Current Illness: Anaemia; Prostatic nodule; Hypertension; Lactose intolerance
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0705USA04023
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0888F IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Joint range of motion decreased, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a nurse concerning a 91 year old male with anaemia, prostatic nodule, hypertension and lactose intolerance who on 07-MAY-2007 was vaccinated intramuscularly in the left deltoid with Pneumovax 23 (Lot#654977/0888F). Concomitant therapy included finasteride, aspirin and lisinopril. Subsequently, the patient experienced that from his left elbow down to his left hand became grossly swollen. It was reported that the area "was very hot, very erythematous, and very red". The nurse reported that the reaction was described as a "boggy elbow" (mushy) and was the texture of the skin of an orange. It was also reported that it was difficult for the patient to raise his arm. The patient was treated with prednisone (dose not provided) immediately and then prednisone, 20mg daily for two days. The patient was also treated with Benadryl, dose not specified. The nurse reported that the reaction resolved in 3 to 5 days. The nurse considered the events to be disabling and a serious other medical event. Additional information has been requested.

VAERS ID:280268 (history)  Vaccinated:2007-05-07
Age:0.3  Onset:0000-00-00
Gender:Male  Submitted:2007-06-04
Location:Michigan  Entered:2007-06-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALS0C218066AA0 LL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0281F0 RL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08674C0 RL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0410F0PO 
Administered by: Public     Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration, No adverse effect
SMQs:, Medication errors (narrow)
Write-up: 1st Rotavirus given after 12 wks of age. No adverse reaction from vaccine.

VAERS ID:280279 (history)  Vaccinated:2007-05-07
Age:0.33  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-20, Days after onset: 13
Location:Louisiana  Entered:2007-06-04, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocortisone 1% cream
Current Illness: none
Preexisting Conditions: Eczema
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B055AA1IMUN
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0006F1IMUN
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB0869001IMUN
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0022U1PO 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: High Fever 104 and vomiting Resolved after 2 days with symptomatic tx

VAERS ID:281386 (history)  Vaccinated:2007-05-07
Age:15.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-10, Days after onset: 3
Location:Texas  Entered:2007-06-12, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None per mom and Patient
Preexisting Conditions: Denied allergies
Diagnostic Lab Data: per moms description: Blood work to check for infection. Results reported as within normal limits.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1281F0 RA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1424F0 LA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1239AA0 LA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2454AA5 RA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain upper, Blood test normal, Headache, Injected limb mobility decreased, Injection site induration, Injection site swelling, Injection site warmth, Pain
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 5/10/07 0830 in ER with swollen, hot hard rt deltoid with c/o excessive pain and unwillingness to use arm. Pain rated 8 on 1-10. Blood drawn. no infection noted. Warm packs and NSAID. 5/1107 0900 back in ER. "Twice as big" "hard", "head hurts", "stomach hurts", per mother. Augmentin and Hydrazine given. Approx 12" x 8" per mom. 5/14/07 called mom. Went to another ER, was prescribed steroids per mom, all better. Will follow up 5/18

VAERS ID:283169 (history)  Vaccinated:2007-05-07
Age:1.25  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 38
Location:Unknown  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: otitis media
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA01883
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HEPA: HEP A (VAQTA)MERCK & CO. INC.  UNUN
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.  UNUN
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08654H7IM 
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0032U SCUN
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Inappropriate schedule of drug administration, Off label use, Otitis media, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Information has been received from a registered nurse concerning a 15 month old female with no known allergies or medical history who on 07-MAY-2007 was inadvertently vaccinated with a dose of Zostavax (lot# 656608/0032U) instead of a dose of MMRV. Concomitant vaccination on the same day included a dose of DTaP (unspecified) (+) tetanus toxoid, a dose of Vaqta (inactive) (manufacturer unknown), a dose of PedvaxHIB, and a dose of Prevnar. The reporter stated that this was not a product confusion, it was an office staff error. Unspecified medical attention was sought. No diagnostic laboratory tests were performed. A product quality complaint was not involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 6/14/2007. Additional information was received. The patient is a female weighing 35 pounds 1 oz and height of ?? inches tall at the time of the report. The patient had a recent episode of otitis media and "had just finished unspecified antibiotic therapy a few days prior to vaccination. On 07-May-2007 the patient was vaccinated intramuscularly in the right thigh with a dose of OMPC, MSD, a dose of PEDIARIX, lot # AC14B040AA and a dose of PREVNAR, lot # D08684B and intramusculary in the left thigh with a dose of hepatitis A vaccine inactivated (lot # 65433B/0604F). The patient experience no adverse event. No further information is available.

VAERS ID:283192 (history)  Vaccinated:2007-05-07
Age:53.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-06-14, Days after onset: 38
Location:Michigan  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetes
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA02959
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0290U SCUN
Administered by: Other     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Injection site rash, Off label use, Pain, Pain in extremity, Rash pruritic, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a pharmacist concerning a 53 year old male with diabetes who on 07-MAY-2007 was vaccinated SC with 0.65 ml dose of Zostavax (Lot # 656395/0290U). On 08-MAY-2007 the patient developed local injection site rash and a shingles type rash on feet that reached up to his ankles. It was reported that the rash on his feet was itchy and painful. No diagnostic laboratory tests were undertaken. Unspecified medical attention was sought. At the time of report the patient was recovering. A product quality complaint was not involved. Additional information has been requested. This is in follow-up to report (s) previously on 6/14/2007. The patient recovered "about a week" after onset. A product quality complaint was not involved. No further information is available.

VAERS ID:283792 (history)  Vaccinated:2007-05-07
Age:30.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 38
Location:Tennessee  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA01729
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Nausea, Oedema peripheral, Pharyngeal oedema, Pyrexia, Rash, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health professional concerning a 30 year old female with no pertinent medical history who on 07-MAY-2007 was vaccinated intramuscularly with Gardasil (lot #657736/0389U). Concomitant therapy included ethinyl estradiol (+) etonogestrel (NUVARING). On 07-MAY-2007, five hours after receiving the first dose of the vaccination, the patient experienced a feeling like her throat was swollen and nausea. On 08-MAY-2007 the patient experienced swelling of the face, swelling of both hands, tiny bumps on both hands and low grade fever of 100.9F. The patient was examined by a physician and prescribed oral diphenhydramine hydrochloride (Benadryl). At the time of the report the patient had not recovered. There were no laboratory or diagnostic tests performed. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a health professional concerning a 30 year old female, with no pertinent medical history, who on 07-MAY-2007 at 2:00 pm was vaccinated in the right deltoid with a first dose of GARDASIL (lot # 657736/0389U). Concomitant therapy included NUVARING. On 07-MAY-2007 at 7:00 pm the patient experienced a feeling like her throat was swollen, nausea and swelling of both hands with tiny bumps. On 08-MAY-2007 the patient experienced swelling of the face and low grade fever of 100.9F. The patient was examined by a physician and prescribed oral BENADRYL. There were no laboratory or diagnostic tests performed. On 09-MAY-2007, the patient recovered from a feeling like her throat was swollen, nausea, swelling of the face, swelling of both hands, tiny bumps on both hands and low grade fever of 100.9F. Additional information is not expected.

VAERS ID:283937 (history)  Vaccinated:2007-05-07
Age:21.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-06-14, Days after onset: 37
Location:Hawaii  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NUVARING
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA02227
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U2IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Rash macular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician and follow up information from a health care professional concerning a 21 year old female patient with no drug reactions/allergies who on 07-MAY-2007 was vaccinated IM in the right deltoid with the third dose of Gardasil (Lot #657617/0384U). Concomitant therapy included ethinyl estradiol (+) etonogestrel (NUVARING). On 08-MAY-2007 the patient experienced an injection site reaction of redness, swelling and the area was hot to the touch. There were three red blotches near the injection site including the injection site. No labs were performed. Her outcome was not reported. Additional information is not expected.

VAERS ID:283968 (history)  Vaccinated:2007-05-07
Age:22.0  Onset:2007-05-11, Days after vaccination: 4
Gender:Female  Submitted:2007-06-14, Days after onset: 34
Location:Pennsylvania  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02920
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Enlarged uvula
SMQs:
Write-up: Information has been received from a physician concerning a 22 year old female who on 07-MAY-2007 was vaccinated IM with the first dose of Gardasil (Lot #657617/0384U). On 11-MAY-2007 the patient experienced a swollen uvula. The patient''s outcome was not reported. Medical attention was sought. Additional information has been requested.

VAERS ID:284162 (history)  Vaccinated:2007-05-07
Age:16.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 38
Location:Florida  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Rash
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03848
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a nurse practitioner concerning a 16 year old female who on 07-MAY-2007 was vaccinated with the 2nd dose in the left deltoid with Gardasil (lot # 657617/0384U). There was no concomitant medication. On 07-MAY-2007 the patient experienced rash and itchiness in the joint areas of the armpits, elbows, knees, and ankles which developed after 24 hours of getting the vaccine. The nurse stated that the patient had developed a similar rash when she ate mangos. Patient sought unspecified medical attention. The patient is being treated with steroid cream and has almost recovered. At the time of the report, the patient''s rash and itchiness in the joint areas of the armpits, elbows, knees, and ankles had persisted. Additional information has been requested.

VAERS ID:284168 (history)  Vaccinated:2007-05-07
Age:  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 38
Location:Arkansas  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA03903
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a physician, via a company representative, concerning a female patient, who on approximately 07-MAY-2007 ("about 2 weeks ago"), was vaccinated IM with a dose, 0.5ml, of Gardasil. The physician reported that on 07-MAY-2007, "the patient fainted right after receiving Gardasil," and confirmed that the patient had recovered (date unspecified). The patient sought unspecified medical attention. No further information is available.

VAERS ID:284460 (history)  Vaccinated:2007-05-07
Age:18.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 38
Location:Ohio  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: blood pressure, 05/07/07, stable; body temp, 05/07/07, OK
CDC Split Type: WAES0705USA04103
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1427F1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature, Dizziness, Loss of consciousness, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a physician concerning a female who was vaccinated IM with the second dose of Gardasil. Subsequently the patient passed out within 5-10 minutes after receiving the vaccine. The patient went up to the circulation desk to pay before leaving and made it to the parking lot. The physician reported that the patient began to feel some nausea and dizziness so she came back into the physician''s office. It was unclear as to when and where the patient passed out. The physician reported that they had taken the patient''s blood pressure and let her rest while back in the office and someone came to pick her up . The patient''s outcome was not reported. Medical attention was sought. Additional information has been requested. 10/06/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a physician concerning an 18 year old female with no prior history of drug reactions who was vaccinated intramuscularly into the left deltoid on 07-MAY-2007 at 09:15 AM with the second dose of GARDASIL. Subsequently, the patient passed out within 5-10 minutes after receiving the vaccine. The patient went up to the circulation desk to pay before leaving and made it to the parking lot. The physician reported that the patient began to feel some nausea and dizziness so she came back into the physician''s office. It was unclear as to when and where the patient passed out. The physician reported that they had taken the patient''s blood pressure and let her rest while back in the office and someone came to pick her up. Medical attention was sought. In additional information received on 11-JUL-2007, the attending physician reported that the patient felt dizzy and lightheaded secondary to the vaccine. Her blood pressure was stable and temperature was OK. On 07-MAY-2007, the patient recovered from the nausea, dizziness, syncope, and being lightheaded. No further information is expected.

VAERS ID:282222 (history)  Vaccinated:2007-05-07
Age:6.0  Onset:2007-05-09, Days after vaccination: 2
Gender:Female  Submitted:2007-05-30, Days after onset: 21
Location:Ohio  Entered:2007-06-19, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: "Runny Nose"
Preexisting Conditions: PMH: allergic rhinitis. Surgical removal of an infected eye duct. NKDA.
Diagnostic Lab Data: None in our office. Labs and Diagnostics: CBC unremarkable. Chemistry with Ca+ of 8.9. Blood culture (-).
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2606AA4IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ05483IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1325F1SCRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0123U1SCLL
Administered by: Private     Purchased by: Private
Symptoms: Blood culture negative, Cellulitis, Full blood count, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Laboratory test normal, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt out of town, mom called to report red, hard, swollen warm "saucer-sized" diameter area on (L) leg. no fever, pt. active and alert. R/T pt in another stated, sent to nearest urgent care or ER for eval. Admitted to hosp x 2 days for cellulitis s/p according to mom. 07/02/2007 MR received for o/n hospital stay for L thigh cellulitis. Child presented with swelling and redness and with c/o itching on the L thigh at the site of vax. PE WNL except redness and swelling to L thigh. Asessment: Left thigh cellulitis.

VAERS ID:282256 (history)  Vaccinated:2007-05-07
Age:0.2  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-06-11, Days after onset: 35
Location:Vermont  Entered:2007-06-19, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: DNA
Preexisting Conditions: DNA
Diagnostic Lab Data: DNA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B090AA0IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF021AA0IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08682F0IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1232F0PO 
Administered by: Private     Purchased by: Public
Symptoms: Crying
SMQs:, Depression (excl suicide and self injury) (broad)
Write-up: Cried x 2 1/2 hrs initially straight then 1/2 hr break followed by additional 2 1/2 hrs. Crying then whimpered all night. Fine next morning.

VAERS ID:282257 (history)  Vaccinated:2007-05-07
Age:2.0  Onset:0000-00-00
Gender:Male  Submitted:2007-06-12
Location:Michigan  Entered:2007-06-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1280F IMLL
TDAP: TDAP (ADACEL)SANOFI PASTEURC2688AA IMLL
Administered by: Public     Purchased by: Public
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Administered Tdap to Child under 11yrs

VAERS ID:282259 (history)  Vaccinated:2007-05-07
Age:2.0  Onset:0000-00-00
Gender:Male  Submitted:2007-06-12
Location:Michigan  Entered:2007-06-19, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1280F0IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB0866682IMRL
TDAP: TDAP (ADACEL)SANOFI PASTEURC268AA IMLL
Administered by: Public     Purchased by: Public
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Administered Tdap to child under 11 yrs

VAERS ID:282783 (history)  Vaccinated:2007-05-07
Age:5.0  Onset:2007-05-09, Days after vaccination: 2
Gender:Female  Submitted:2007-05-30, Days after onset: 21
Location:Texas  Entered:2007-06-25, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1491F1SCLL
Administered by: Private     Purchased by: Private
Symptoms: Blister, Rash vesicular
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Varicella-like rash on face and arms, approx. 6 crusted vesicles. No fever. No other symptoms of illness noted.

VAERS ID:283899 (history)  Vaccinated:2007-05-07
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2007-07-05
Location:Montana  Entered:2007-07-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52BO13AA1IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient given a second dose of Tdap on 05-07-2007. Initial dose of Tdap given 09-08-2006. Patient experienced a sore left arm with warmth and redness at injection site lasting 48 hours. No further problems following vaccination. No treatment was given.

VAERS ID:284702 (history)  Vaccinated:2007-05-07
Age:84.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-07-09, Days after onset: 62
Location:Oregon  Entered:2007-07-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, Diltiazem, Lisinopril, Folic Acid, Ibuprofen, HCTz, Triamcinolone topical
Current Illness: None
Preexisting Conditions: allergy Bromine-health conditions: HTN, bladder issues many years after colostomy
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUE948AC1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient reported to clinic on 5/14/07 the onset on 5/8-or5/9 of a rash on arms bilaterally without pruitus, fever or respiratory distress. Patient coincidentally had a primary care appointment and reported the rash to her PCP, No treatment was instituted. Rash resolved in 1 week without sequelae.

VAERS ID:285117 (history)  Vaccinated:2007-05-07
Age:0.51  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-08-31, Days after onset: 116
Location:Kansas  Entered:2007-07-18, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: stool culture 05/15/07 - negative; stool for ova and 05/15/07 - negative
CDC Split Type: WAES0706USA03326
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1365F2PO 
Administered by: Private     Purchased by: Private
Symptoms: Culture stool negative, Dermatitis diaper, Diarrhoea, Frequent bowel movements, Gastroenteritis, Parasite stool test negative, Rash erythematous, Rash papular, Weight increased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 6 month old patient who was vaccinated with the third dose of oral Rotateq. Subsequently the patient experienced significant diarrhea. Additional information has been requested. This is in follow-up to report (s) previously submitted on 7/16/2007. Information has been received from a physician concerning a 6-month-old white female who on 06-MAR-2007 (1521) and 07-MAY-2007 (1151) was vaccinated PO with the second and third 2.0 mL doses, respectively, of ROTATEQ (Lot #656191/1365F). Concomitant vaccinations administered on 07-MAY-2007 included the third 0.5 mL, IM dose in the left thigh of PREVNAR (Lot #B08670K), the thrid 0.5 mL IM dose in the right lateral thigh of ACTHIB (Lot #UE923AA) and the third 0.5 mL IM dose in the left lateral thigh of PEDIARIX (Lot #AC218092AA). There was no illness at the time of vaccination. Prior vaccinations administered on 06-MAR-2007 included the second 0.5 mL dose in the right thigh of PREVNAR (Lot #B0B670K) and the second 0.5 mL IM dose in the left lateral thigh of PEDIARIX (Lot #AC21B092AA). On 07-MAY-2007, a few hours after being vaccinated, the patient developed significant diarrhea. On 15-MAY-2007, the patient was seen by the physician. At that time, the patient had no abdominal pain, hematocheria or nausea, fever or vomiting. She was noted to have a stool frequency (diarrhea) of every 1-2 hours. The patient was also noted to have a good appetite and had gained weight. Clear liquids had been tried without improvement. She had no known contact with contaminated food. Bowel sounds were normal. There was no tenderness, organomegaly, masses or hernia. A large erythematous rash on her buttocks was noted characterized by several pinpoint erythematous papules on her entire genitourinary region. A diagnosis of gastroenteritis and diaper dermatitis (suspect yeast component) was made. A stool test for ova and parasitos and culture was negative. It was recommended that A&D ointment with monistat cream be applied to the diaper region. Diet as tolerated. On 16-MAY-2007, the patient recovered. Additional information is not expected.

VAERS ID:285474 (history)  Vaccinated:2007-05-07
Age:17.0  Onset:2007-05-21, Days after vaccination: 14
Gender:Female  Submitted:2007-07-16, Days after onset: 56
Location:New York  Entered:2007-07-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Psoriasis
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA03116
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash macular, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 17 year old female who on 07-MAY-2007 was vaccinated with a 0.5 ml dose of Gardasil. On approximately 21-MAY-2007, two weeks after getting the vaccination, the patient developed a "besicular" rash. The patient was seen by her physician again on 14-JUN-2007 and the rash had continued to spread. The course of treatment for the rash included PREDNISONE and ZYRTEC. The "besicular" rash persisted. Additional information has been requested. This is in follow-up to report(s) previously submitted on 7/16/2007. Initial and follow-up information has been received from a physician concerning a 17 year old female with a history of psoriasis who on 07/MAY/2007 was vaccinated with the first 0.5 ml dose of GARDASIL. On approximately 21-MAY-2007, two weeks after getting the vaccination, the patient developed a rash on her thighs, arms, abdomen and back which was macular in nature and itchy. The patient was seen by her physician on 14-JUN-2007. The course of treatment for the rash included PREDNISONE and ZYRTEC. The rash lasted for more than three weeks after the patient was vaccinated with the first dose of GARDASIL. At the time of the report, the patient had recovered. There were no laboratory or diagnostic tests performed. Additional information is not expected.

VAERS ID:285479 (history)  Vaccinated:2007-05-07
Age:28.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-07-16, Days after onset: 69
Location:Michigan  Entered:2007-07-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown None
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA03153
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0388U0IMUN
Administered by: Private     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial and follow-up information has been received from a physician concerning a 28 year old female who was vaccinated with the first dose of GARDASIL vaccine, on 07-MAY-2007. Two days after receiving the first injection, she experienced swelling in her lymph nodes (under her arm and in her neck). She sought unspecified medical attention. There were no diagnostic or laboratory tests performed. Subsequently the patient recovered. On an unspecified date, the patient was vaccinated with the second dose of GARDASIL vaccine. She did not have any adverse reactions to the second dose. Additional information has been requested. This is in follow-up to report (s) previously submitted on 7/16/2007. Additional information is not expected.

VAERS ID:285679 (history)  Vaccinated:2007-05-07
Age:26.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-07-16, Days after onset: 70
Location:Unknown  Entered:2007-07-18, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA04036
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Bone pain, Diarrhoea, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial and follow-up information has been received from a nurse practitioner concerning an approximately 27 year old female veterinarian technician, who on 07-MAY-2007 was vaccinated intramuscularly with a 0.5 ml first dose of GARDASIL (Lot# 657617/0384U). On 07-MAY-2007 (previously reported as during the next 24 hours), the patient experienced fever, nausea, diarrhea, low back pain, vomiting, her spine ached, and it hurt for her to move. Unspecified medical attention was sought. The patient then recovered within 24 hours from the fever, nausea, diarrhea, low back pain, and vomiting on an unspecified date. Additional information has been requested. Additional information is not expected.

VAERS ID:289920 (history)  Vaccinated:2007-05-07
Age:  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2007-05-18, Days after onset: 11
Location:Pennsylvania  Entered:2007-08-29, Days after submission: 103
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 200701629
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2628AA4UNGM
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ05483UNGM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.1484F1UNGM
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site bruising, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: A male, child (age, date of birth not reported) experienced soreness and bruising at the right and left, gluteal injection sites after he received dose 5 of Daptacel (lot number C2626AA, route of administration not reported) in the left gluteus and dose 4 of IPOL (lot number Z0548-2, route of administration not reported) in the right gluteus on 07 May 2007. The patient also received dose 2 of ProQuad (MMR and Varicella, lot number 1484F, route of administration not reported) in the right gluteus. The parent treated the patient with Tylenol. At the time of the report, the patient was resolving. This case has the same reporter as case 2007-1630.

VAERS ID:292052 (history)  Vaccinated:2007-05-07
Age:21.0  Onset:0000-00-00
Gender:Female  Submitted:2007-09-17
Location:Arizona  Entered:2007-09-20, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0708USA01192
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0319U0IMAR
Administered by: Private     Purchased by: Private
Symptoms: Anogenital warts, Cryotherapy, Vaccine positive rechallenge
SMQs:
Write-up: Information has been received from a physician concerning an approximately 21 year old female who in June 2007, was vaccinated IM with Gardasil. Concomitant therapy included hormonal contraceptives (unspecified). Two days after receiving the first dose of Gardasil, the patient developed groin warts. There is no known history of these warts. The patient came back in about a month later and was given the second dose of Gardasil. A few days after receiving the second dose, the patient had a huge outbreak of warts. The patient was treated with cryotherapy. The patient did not notify the physician of the warts until the second outbreak occurred. Medical attention was sought. The patient''s outcome was not reported. Additional information has been requested. 01/07/2008 This is in follow-up to report(s) previously submitted on 9/17/2007. Initial and follow-up information has been received from a physician concerning a 21 year old female with no pertinent medical history, drug reactions/allergies and no illness at the time of vaccination who on 07-MAY-2007 (also reported as June 2007), was vaccinated IM in the deltoid with a first dose of GARDASIL (lot# 654272/0319U) in the evening. Concomitant therapy included hormonal contraceptives (unspecified). Two days (also reported on an unspecified date in May 2007) after receiving the first dose of GARDASIL, the patient developed groin warts (also reported as vulvar warts). There is no known history of these warts. The patient came back in about a month later (also reported as 09-JUL-2007) was given the second dose of GARDASIL (657868/0523U) IM. A few days after receiving the second dose, the patient had a worse outbreak of warts. The patient was treated with cryotherapy. The patient did not notify the physician of the warts until the second outbreak occurred. Medical attention was sought. The patient''s outcome was not reported. In August 2007, the patient had recovered within 2 weeks post treatment. Additional information is not expected.

VAERS ID:293256 (history)  Vaccinated:2007-05-07
Age:23.0  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-10-16, Days after onset: 161
Location:New York  Entered:2007-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: seasonal allergies
Diagnostic Lab Data: 11/26/07-records received- Hepatitis serology, HIV and CT scan of abdomen all normal. Monospot positive. Lymphoctes elevated.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.AHAVB118AA0IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30011730PO 
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUF045AA0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Chills, Computerised tomogram normal, Convulsion, HIV antibody negative, Hepatitis A antibody negative, Hepatitis B antibody negative, Hepatitis C antibody negative, Liver function test abnormal, Lymphocyte count increased, Mononucleosis heterophile test positive, Pyrexia, Transaminases increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: Chills and felt feverish one day after receiving Hep. A and yellow fever vaccines. One week later, pt. started oral typhoid and was still experiencing chills. No temp. measurement done up to this time. After 3rd oral typhoid, pt. experienced "convulsions." One week later her temp. was measured at 103.9 and she had inc. LFT''s. She was hospitalized for 5 days in Chicago. As of 7/20/2007, LFT''s have returned to normal according to pt. 11/26/07-records received for DOS 5/24-5/27/07- DC DX: fever of unknown origin, abnormal liver transaminases, adenopathy. Seen for acute febrile illness of unknown etiology. Two week HX of fevers chills and rigors.

VAERS ID:296797 (history)  Vaccinated:2007-05-07
Age:0.4  Onset:2007-05-13, Days after vaccination: 6
Gender:Male  Submitted:2007-11-14, Days after onset: 185
Location:Ohio  Entered:2007-11-15, Days after submission: 1
Life Threatening? No
Died? Yes
   Date died: 2007-05-13
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Left eye drainage
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B090BA2IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF051AA1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08666A1IMRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Infantile spitting up, Irritability, Sudden infant death syndrome
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Neonatal disorders (narrow), Hypoglycaemia (broad)
Write-up: My son went in on May 7th 2007 for his 4 month shots and a check-up. Was found to be a healthy baby boy. He was fussy and spit up but nothing out of the normal. 6 days later on May 13, 2007 died at 12:59pm. 11/16/07 Received autopsy report which reveals COD is sudden infant death syndrome. 11/27/07 Received vax record which confirms report.

VAERS ID:305009 (history)  Vaccinated:2007-05-07
Age:25.0  Onset:2007-05-21, Days after vaccination: 14
Gender:Female  Submitted:2008-02-14, Days after onset: 269
Location:New York  Entered:2008-02-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Penicillin allergy; Sulfonamide allergy
Diagnostic Lab Data: diagnostic laboratory - Normal; ultrasound - Normal
CDC Split Type: WAES0802USA00885
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dyspepsia, Gastritis, Laboratory test normal, Nausea, Ultrasound scan normal, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Information has been received from a 26 year old female dental hygienist with an allergy to penicillin and sulfonamide who on 07-MAY-2007 was vaccinated with the first dose of Gardasil (lot# not reported). There was no concomitant medication. On 21-May-2007 the patient developed vomiting which "lasted for one day". The patient also reported that she experienced nausea, dizziness and heartburn for one week following vomiting. The patient was examined in the emergency room (date not provided) and was diagnosed with gastritis. The patient reported that "blood work and an ultrasound (dates of tests not provided) were performed. The patient was not admitted to the hospital and was released that same day. The patient considered the events to be disabling. The patient reported that she recovered from gastritis and dizziness on 28-May-2007. On 04-Feb-2008 the patient received the second dose of Gardasil (lot# not reported). No additional information is expected.

VAERS ID:307526 (history)  Vaccinated:2007-05-07
Age:33.0  Onset:2007-05-14, Days after vaccination: 7
Gender:Male  Submitted:2008-03-20, Days after onset: 311
Location:Tennessee  Entered:2008-03-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD160 IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY105D IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt. experienced continued soreness. To date he is experiencing muscle weakness and pain. Limited ability to lift weights using this arm.

VAERS ID:309639 (history)  Vaccinated:2007-05-07
Age:0.19  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-03-27, Days after onset: 325
Location:New Hampshire  Entered:2008-04-16, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: premature 6 weeks 4/28/08-records received-PMH: Six week premature c-section birth. Tube fed for 3 weeks due to suck/swallow difficulties. Reflux.
Diagnostic Lab Data: fears dismissed when parent called/call never recorded by nurse
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B044BA0IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF073AA0IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ03240SCLL
Administered by: Private     Purchased by: Private
Symptoms: Autism, Convulsion, Developmental delay, Pyrexia, Screaming, Upper respiratory tract congestion
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: High pitched screaming for 3 days (more than 3 hrs over the course of 3 days), chest congestion, and low grade fever - developmentally delayed. 4/28/08-records received-evaluation 3/31/08 13 months of age- Assessment: not eligible for early intervention services. Per family patient screamed after 2, 4 and 6 month immunizations and experienced convulsions. Follow-up: Diagnosed w/ Autism. Suffering from seizures. Thank you for your hand in poisoning my child.

VAERS ID:315774 (history)  Vaccinated:2007-05-07
Age:9.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Male  Submitted:2008-05-16, Days after onset: 375
Location:California  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: body temp 05/08/2007 - afebrile
CDC Split Type: WAES0705USA02007
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1509F1SC 
Administered by: Private     Purchased by: Private
Symptoms: Body temperature, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered nurse concerning a 9 year old male, with no medical history or allergies who on 07-MAY-2007 at 14:30 PM was vaccinated with a second SC dose of varicella virus vaccine live (Oka/Merck) (lot number 656259/1509F). There was no illness at the time of vaccination. It was report that a few hours after receiving the vaccine injection the patient developed redness, warmth, and swelling at the injection site. No treatment was recommended. The symptoms had persisted and were not resolved as of 9-May-2007. No laboratory studies were performed. Unspecified medical attention was sought. No product quality complaint was involved. Additional information was received from the nurse who reported that in the AM of 08-MAY-07, the patient had a red, swollen, painful arm that was hot to the touch. The patient was afebrile. It was reported that the patient recovered on 10-MAY-07. The patient had no adverse events following prior vaccination. Follow up information was received from the nurse who reported that the reactions were self limiting and went away 72 hours later. No other visits or labs were required. No further information is expected.

VAERS ID:315790 (history)  Vaccinated:2007-05-07
Age:  Onset:2007-05-07, Days after vaccination: 0
Gender:Unknown  Submitted:2008-05-16, Days after onset: 375
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02461
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Information has been received from a registered pharmacist concerning a patient who within the week of 07-MAY-2007 thru 11-MAY-2007 was vaccinated with varicella virus vaccine live (Oka/Merck) 0.5 ml SQ rather than zoster vaccine live (Oka/Merck). The pharmacist reported this was not due to product confusion. No adverse experience related to this event. No further information is available.

VAERS ID:336798 (history)  Vaccinated:2007-05-07
Age:1.18  Onset:2008-10-09, Days after vaccination: 521
Gender:Female  Submitted:2009-01-06, Days after onset: 89
Location:Oregon  Entered:2009-01-08, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Lab culture ordered, but unfortunately an HSV culture was performed rather than VZV culture. The HSV culture was negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.UN0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blister, Erythema, Herpes simplex serology negative, Herpes zoster, Rash papular
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient received VARIVAX on 5/7/07 in the right thigh. She returns to clinic on 10/09/08 with diagnosis of shingles described in medical record as "localized area of reddened vesicular papular rash with areas of coalescence over right side lower abdomen, onto perineum, right labia. Also with more widely scattered vesicles on right buttock and right upper leg".

VAERS ID:348435 (history)  Vaccinated:2007-05-07
Age:34.0  Onset:2008-11-25, Days after vaccination: 568
Gender:Female  Submitted:2009-05-26, Days after onset: 181
Location:Massachusetts  Entered:2009-06-03, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: 6/19/09 PMH records received. PMH: Appy, ankle fx, ovarian cyst, blocked duct, UTI.
Diagnostic Lab Data: 6/15/09 Oncology records received DOS 12/23/08 to 5/5/09. LABS and DIAGNOSTICS: CT Scan - paratracheal, pretracheal and prevascular lymph nodes. Nodules in lungs. MRI Brain - WNL. PET - involvement in mediastinal, pretacheal, and cervical lymph nodes. Mediastinoscopy - pathology consistant with Hodgkin''s Lymphoma. CBC MCHC g/dL 31.9 (L) Neutrophils 73.2% Lymphocytes 19.8 (L). CHEM - WNL. ECHOCARDIOGRAM - WNL Sigmoidoscopy with resection of tubular adenoma. 6/24/09 Medical, vaccine records received. DOS 4/23/07 to 5/17/07. LABS and DIAGNOSTICS: CBC - RBC 3.57 mil/uL (L) Hgb 11.1 g/dL (L) Hct 33% (L). Urine - Chlamydia trachomatis not detected, Neisseria gonorrheae not detected.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0314U0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Adenoma benign, Adverse drug reaction, Anal pruritus, Arthralgia, Bacterial test negative, Chemotherapy multiple agents systemic, Chlamydia identification test negative, Computerised tomogram thorax abnormal, Decreased appetite, Diarrhoea, Echocardiogram normal, Fatigue, Haematocrit decreased, Haemoglobin decreased, Hodgkin's disease, Hypoaesthesia, Laboratory test normal, Lymphadenopathy, Lymphocyte percentage decreased, Mean cell haemoglobin decreased, Mediastinoscopy abnormal, Muscular weakness, Musculoskeletal discomfort, Neutrophil percentage increased, Night sweats, Positron emission tomogram abnormal, Pyrexia, Rectal fissure, Red blood cell count decreased, Sigmoidoscopy abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Malignant lymphomas (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow)
Write-up: Close to 9 months after being given the GARDASIL vaccine. I had a ct scan done, which showed that my lymph nodes were enlarged. A little over a year later. I was diagnosed with Hodgkin''s Lymphoma -HL-. I am now undergoing chemotherapy treatment for this illness. This vaccine needs to be researched properly. I am convinced there is an increased risk for Lymphoma in women who were vaccinated. How many people have to die or get seriously sick for this vaccine to be investigated? I known of several women who became sick with Lymphoma months following vaccination with GARDASIL. I do not believe this is a mere coincidence. Statistical data would prove a connection, I''m certain. No oncologist or other doctor has ever asked me whether I was vaccinated with GARDASIL. 6/15/09 Oncology records received DOS 12/23/08 to 5/5/09. FINAL DIAGNOSIS: Hodgkin''s Disease Lymphocytic Depletion, Unspec Site. Presented with complaints of fever and swollen cervical lymph nodes. Fatigue, pain/discomfort right neck. Night sweats. Decreased appetite. Muscle weakness and soreness in joints. Numbness right hand. Peri-anal itching, diarrhea, rectal fissure pain. Undergoing six cycles of chemotherapy. Has chemotherapy related side effects. ICD-9 Code: 201.70 6/19/09 PMH records received. PMH: Appy, ankle fx, ovarian cyst, blocked duct, UTI. 6/24/09 Medical, vaccine records received. DOS 4/23/07 to 5/17/07. Medical records consist of laboratory studies only.

VAERS ID:403815 (history)  Vaccinated:2007-05-07
Age:15.0  Onset:2008-12-01, Days after vaccination: 574
Gender:Female  Submitted:2010-10-18, Days after onset: 685
Location:Louisiana  Entered:2010-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions: ADD
Diagnostic Lab Data: EEG, EKG, x-rays, CT scans, MRI, sleep study, Tilt test, Holter monitor
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1063U0IJLL
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Blood pressure decreased, Computerised tomogram, Cyanosis, Diplopia, Disorientation, Dizziness, Electrocardiogram, Electrocardiogram ambulatory, Electroencephalogram, Fatigue, Flushing, Headache, Lethargy, Loss of consciousness, Nuclear magnetic resonance imaging, Paraesthesia, Sleep study, Tilt table test, X-ray
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: double vision, lightheaded, feels flush, passes out, lethargic, headaches, tingling in fingers, abdominal pain, drop in blood pressure, disoriented, fatigue, turns blue

VAERS ID:279099 (history)  Vaccinated:2007-05-07
Age:16.0  Onset:2007-05-10, Days after vaccination: 3
Gender:Female  Submitted:2007-05-18, Days after onset: 8
Location:Foreign  Entered:2007-05-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02997
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Muscle spasms, Neck pain, Panic attack, Photophobia, Restless legs syndrome, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dystonia (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a health professional concerning a 16 year old female who on 07-MAY-2007 was vaccinated subcutaneously, into the upper arm, with a second dose of MMR II. On 10-MAY-2007 the patient developed "cramps", initially of the legs, and in the course, of the "whole body", restless legs, panic attacks, headache, neck pain, and blurred vision accompanied by light sensitivity. magnesium orally and FLUSPI, intravenously, were administered. On 11 May 2007 the patient''s symptoms worsened. and she was admitted to the hospital. The patient has been vaccinated previously, in 1992, with MMR Triplovax, which was well tolerated. Other business partner numbers include: E2007-02969. Additional information has been requested.

VAERS ID:279455 (history)  Vaccinated:2007-05-07
Age:13.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-05-23, Days after onset: 16
Location:Foreign  Entered:2007-05-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: vital signs 07May07 normal
CDC Split Type: WAES0705AUS00079
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0313U IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Conversion disorder, Hypoaesthesia, Lethargy, Muscular weakness, Physical examination, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Information has been received from the Department of Health as part of a business agreement (manufacturer''s number: GARD 2007 05 16 004). As part of the regular school-based immunisation program funded by the government, several female students was vaccinated with Gardasil vaccine (Lot No. 655743/0313U, Batch No. J1022, Expiry date August 2009). Subsequently the patients experienced fainting (the patient reported as below does not have a record of fainting according to follow-up information) and were taken to hospital. It was stated that most of the cases were not serious. The reporter felt that the reactions were related to therapy with Gardasil (Lot No. 655743/0313U, Batch No. J1022, Expiry date August 2009). Follow-up information was received. At the time of reporting on 08-MAY-2007, it was stated that all girl have recovered, although some were possibly admitted to hospital overnight. None were intubated. The provisional diagnosis appeared to be "hysterical reaction." Follow-up information was received from a physician. The patient was a 13 year old female school girl with no past medical history and no known allergy. After vaccination with Gardasil (Lot No. 655743/0313U, Batch No. J1022, Expiry date August 2009) on 07-MAY-2007, she experienced general weakness. On neurological examination at "approximately 5 - 10 mins" post vaccination, the patient showed right leg numbness (approximately L2 - L5) and right leg weakness (1/5 power whole leg). She was transferred to emergency department. Treatment was reported as "observation". No sequelae were reported. At the time of reporting (date not reported), the patient had not yet recovered (also reported as recovered in follow-up information on 08-MAY-2007). Follow-up information was received via a Surveillance of Adverse Events Following Vaccination in the Community. On 07-MAY-2007, within minutes of vaccination with Gardasil (Lot No. 655743/0313U, Batch No. J1022, Expiry date August 2009), the patient reported right leg weakness of 1/5 power, no sensation to pain

VAERS ID:280242 (history)  Vaccinated:2007-05-07
Age:2.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-01, Days after onset: 25
Location:Foreign  Entered:2007-06-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Laboratory test 00-May-2007 normal results obtained
CDC Split Type: HQWYE325124MAY07
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)PFIZER/WYETH  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Decreased appetite, Dehydration, Dysuria, Laboratory test normal, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Information regarding Prevnar was received from a healthcare professional regarding a 33-month-old female patient who experienced bilious vomiting, dehydration, syncope and decreased appetite. The patient received a dose on 07-May-2007. After receiving Prevnar on 07-May-2007, the patient developed bilious vomiting and was starting to faint. She was hospitalized with dehydration and had not "passed water." According to the child''s mother, during hospitalization "drips" were administered and a "few examinations" were performed that revealed normal results. The child was discharged 3 days later. The mother commented that she was worried about the efficacy of this immunization stating. "I am curious to know if the vaccine was accepted by my daughter''s organism". The physician confirmed that this reaction could be related to the administration of Prevnar, taking into account the temporal relationship. The patient was examined on 16-May-2007 and was found to be healthy, although she was not eating as much as before hospitalization. It was additionally noted that, according to the official vaccination calendar in a foreign country, the child was vaccinated from the beginning, including the first vaccination. No additional information was available at the time of this report.

VAERS ID:280674 (history)  Vaccinated:2007-05-07
Age:13.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-05, Days after onset: 29
Location:Foreign  Entered:2007-06-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705AUS00082
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0313U IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Conversion disorder, Dizziness, Headache, Hemiplegia, Nausea, Tremor, Wheelchair user
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a nurse as part of a business agreement (manufacturer''s case number: GARD 2007 05 11 002). On 07-MAY-2007, as part of the regular school-based immunisation program funded by the government, a female student was vaccinated with Gardasil (Lot No. 655743/0313U, Batch No. J1022, Expiry date August 2009). The patient was observed for 15 minutes after vaccination and return to the classroom. On 07-MAY-2007, on return to the classroom, the student experienced headache, nausea and feeling faint. Subsequently the patient was "fine". The nurse, who gave the patient the vaccine, considered that the events were due to "mass hysteria". In follow-up, the reporting nurse stated that during the 15 minute observation period after the vaccination on 07-MAY-2007, the patient was symptom-free. The patient was not transported to hospital and was sent home complaining of headache, nausea and feeling faint. This is one of several reports received from the same source. Further information was received from media monitors summarising a radio talk-back program, a television evening news and a paper on 22-MAY-2007. The principal of the student''s school stated that "the girl''s reactions were not related to the vaccination itself and it is not uncommon for girls of this age group to react to vaccinations in ways that are not necessarily physical in origin". The hospital, where the other five female students of the school (other than this patient) were taken after fainting, released a statement indicating that they do not believe Gardasil was responsible. Follow-up information was received from the principal of the patient''s school. On 07-MAY-2007 approximately 590 girls were vaccinated with Gardasil by two nurses over a morning beginning at 9:30 am and finishing around 1:00 pm. There was no interruption to the vaccinations after some girls'' adverse events, which occurred through out the morning. Some girls experienced adverse events immediately after vaccination, whilst others only after that had returned t

VAERS ID:283624 (history)  Vaccinated:2007-05-07
Age:0.75  Onset:2007-05-08, Days after vaccination: 1
Gender:Female  Submitted:2007-07-02, Days after onset: 55
Location:Foreign  Entered:2007-07-02
Life Threatening? No
Died? Yes
   Date died: 2007-05-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cardiovascular medication
Current Illness: CONGENITAL HEART DISEASE
Preexisting Conditions:
Diagnostic Lab Data: Body temperature 08May2007 41.1Deg C
CDC Split Type: B0476928A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTPHEP: DTP + HEP B (TRITANRIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
HIBV: HIB (HIBERIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Death, Dyspnoea, Hyperpyrexia, Mechanical ventilation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a physician via a sales representative and described the occurrence of hyperpyrexia in a 9-month-old female subject who was vaccinated with Tritanrix-HB, GlaxoSmithKline, Hiberix for prophylaxis. Concurrent medical conditions included congenital heart disease. Concurrent medications included Cardiovascular medication. The subject was normal, in good condition. On 7 May 2007, the subject received 3rd dose of Tritanrix-HB (unknown route and injection site), unspecified dose of Hiberix (unknown route and injection site). The lot numbers were not provided. The subject was kept under observation after vaccination. She was normal and was sent back home. On 8 May 2007, 12 hours after vaccination with Hiberix and Tritanrix-HB, the subject experienced hyperpyrexia (41.1 Deg C) with gasping respiration. She was brought to hospital. The subject was treated with mechanical ventilation. On 8 May 2006, 16 hours after vaccination, the subject died, cause of death is not specified.

VAERS ID:290684 (history)  Vaccinated:2007-05-07
Age:73.0  Onset:2007-05-11, Days after vaccination: 4
Gender:Male  Submitted:2007-09-17, Days after onset: 129
Location:Foreign  Entered:2007-09-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 64 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: CATARACT SURGERY, HYPERLIPIDEMIA, HYPERTENSION ARTERIAL, LOWER LEG EDEMA
Diagnostic Lab Data: UNK
CDC Split Type: D0053733A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (TD-RIX)GLAXOSMITHKLINE BIOLOGICALSAC12B014GC IMUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Balance disorder, CSF cell count normal, Dysstasia, Electroneurography, Gait disturbance, Guillain-Barre syndrome, Hyperlipidaemia, Hypoaesthesia, Mobility decreased, Muscular weakness, Nerve conduction studies, Oedema peripheral, Polyneuropathy, Sensory disturbance, Somatosensory evoked potentials
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Dyslipidaemia (narrow), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Demyelination (narrow), Vestibular disorders (broad), Lipodystrophy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a regulatory authority and described the occurrence of Guillain Barre Syndrome in a 73-year-old male subject who was vaccinated with Td-RIX for prophylaxis. The last previous vaccination with diphtheria and tetanus toxoids absorbed had been given on 05 May 1997. On 07 May 2007 the subject received a booster dose of Td-RIX (0.5 ml, intramuscular, unknown site). Approximately four days post vaccination with Td-RIX, on 11 May 2007, the subject experience suspected Guillain Barre syndrome. The symptoms of Guillain Barre syndrome were atypical. The subject was hospitalized for an unknown period of time. The symptoms of Guillain Barre syndrome were atypical. Diagnosis of Guillain Barre syndrome was confirmed by electroneurography (ENG) of nerve conduction velocity and somatic evoked potentials (SEP of median and tibial nerves. Cerebrospinal fluid (CSF) examination showed no typical findings. NO signs of paraneoplastic events could be detected. The event had not been experienced previously. No further vaccination with Td-RIX was given. At the time of reporting, on 13 June 2007, the event was unresolved. On 06 September 2007 follow-up information was received including the hospital report from a rehabilitation clinic. The subject was hospitalized at that clinic for rehabilitation post initial hospitalisation at another hospital for 33 days from 11 June 2007 to 13 July 2007. The subject''s medical history included cataract surgery both sides (right in 1994 and left in 1995). The subject''s medical history included no known accidents or injuries. The subject has never experienced epileptic seizures. The subject does not smoke and rarely drinks alcohol. Family anamnesis showed no risk for cardiovascular, neoplastic or neurological diseases. Concurrent medical conditions included severe arterial hypertension causing lower leg edema and hyperlipidemia. The subject has no known allergies. The subject reported no psychological or social stress. Approximately eight days post vaccination with Td-RIX, on 15

VAERS ID:291287 (history)  Vaccinated:2007-05-07
Age:19.0  Onset:2007-09-06, Days after vaccination: 122
Gender:Female  Submitted:2007-09-24, Days after onset: 18
Location:Foreign  Entered:2007-09-25, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy NOS (LMP = Unknown)
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0709USA03288
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1024F0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy, Foetal damage
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)
Write-up: Information has been received from a health professional concerning a 19 year old female who on 07-MAY-2007 was vaccinated intramuscularly into the upper right arm with the first dose of Gardasil (Lot # 655671/1024F). On 02-Jul-2007 the patient was vaccinated intramuscularly into the upper right arm with the second dose of Gardasil (Lot # 655671/1024F). On 06-SEP-2007 the reporting physician received the information about pregnancy (29.+3 gestation week). The physician expressed suspicion of foetal abnormality. The reporting physician considered drug exposure during pregnancy and foetal damage (NOS) to be other important medical events. Other business partners number E2007-06142. No further information is available.

VAERS ID:324944 (history)  Vaccinated:2007-05-07
Age:15.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2008-09-11, Days after onset: 493
Location:Foreign  Entered:2008-09-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: echocardiography, normal; Holter monitoring, normal
CDC Split Type: WAES0705AUS00169
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0138U UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactic reaction, Anxiety, Cardiac murmur, Choking sensation, Dyspnoea, Echocardiogram normal, Electrocardiogram ambulatory normal, Feeling cold, Haematemesis, Muscle twitching, Nausea, Oxygen saturation decreased, Stridor, Syncope, Tachypnoea, Throat tightness, Vision blurred, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dyskinesia (broad), Dystonia (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a physician via another company as part of a business agreement (manufacturer control # GARD 2007 05 25001) concerning a 15 year old female who was vaccinated with GARDASIL. On the day of vaccination with GARDASIL the patient "fainted and kept fainting". The physician advised that the patient developed a new heart murmur. Echocardiography and Holter monitoring were done and the results were normal. The physician advised that the patient may be "histrionic". Further Information has been received from the NSW Department of Health, via CSL as part of a business agreement, with follow-up information received on request by the Company via a Line Listing from the NSW Department of Health. As part of the regular school-based immunisation program funded by the government, on 07-MAY-2007, the patient was vaccinated with GARDASIL (Lot No. 655742/0138U, Batch No. J0798, Expiry date 07-AUG-2009). Half an hour after the vaccination the patient fainted. The patient complained of nausea, blurred vision, mild twitching prior to fainting. The patient has continued to faint since. Total 12 times in 13 days. The patient was referred to general physician and cardiologist. Nothing abnormal was detected by a cardiologist. The outcome was reported as ongoing. The reporter considered that repeated syncope was probably related to therapy with GARDASIL. The original reporting source was not provided. Information was also obtained on request by the Company from the agency via a Case Line Listing and a Public Case Detail Form. It was reported that on 07-MAY-2007 after vaccination with GARDASIL the patient developed muscle twitching, nausea and blurred vision which required consultation with a specialist physician. At the time of reporting to the agency on 29-MAY-2007 the patient had not yet recovered from the syncope, muscle twitching, nausea, blurred vision and syncope. The agency considered that syncope, muscle twitching, nausea and blurred vision were probably related to therapy with

VAERS ID:336965 (history)  Vaccinated:2007-05-07
Age:1.0  Onset:2008-05-18, Days after vaccination: 377
Gender:Female  Submitted:2009-01-08, Days after onset: 235
Location:Foreign  Entered:2009-01-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: CHICKENPOX
Diagnostic Lab Data: Acid base balance, May2008, normal; Activated protein C resistance, May2008, 121; Antithrombin III, May2008, 107; Bilirubin, May2008, 12; Blood glucose, May2008, 4.5; C-reactive protein, May2008, 1.4; Cardiolipin immunoglobulin M, May2008,
CDC Split Type: B0551513A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSA20CA262A2UNUN
HIBV: HIB (HIBERIX)GLAXOSMITHKLINE BIOLOGICALSA20CA262A2UNUN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERA20CA262A2UNUN
PNC: PNEUMO (PREVNAR)PFIZER/WYETH 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Acid base balance normal, Activated partial thromboplastin time prolonged, Activated protein C resistance test, Antiphospholipid antibodies, Antithrombin III, Blood bilirubin, Blood creatinine, Blood glucose, Blood potassium normal, Blood sodium normal, C-reactive protein increased, Cardiolipin antibody, Cerebral artery stenosis, Cerebral infarction, Echocardiogram, Haemoglobin normal, Hemiparesis, International normalised ratio normal, Neutrophil count normal, Nuclear magnetic resonance imaging abnormal, Platelet count normal, Protein C decreased, Protein S normal, Red blood cell sedimentation rate increased, Thrombosis, Transient ischaemic attack, Ultrasound Doppler, White blood cell count normal
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Haemorrhage laboratory terms (broad), Ischaemic central nervous system vascular conditions (narrow), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)
Write-up: This case was reported by a regulatory authority (Regulatory Authority #NO-NOMAADVRE-FHI-2008-6951) and described the occurrence of thrombosis in a 2-year-old female subject who was vaccinated with INFANRIX-POLIO-HIB (GlaxoSmithKline), MMR (new strain) and PREVENAR (non-GSK). The subject had a chickenpox infection 6 weeks before. In August 2007, the subject received unspecified dose of PRIORIX (unknown route) Lot number not provided. In May 2008, 9 months after vaccination with PRIORIX, the subject experienced thrombosis and cerebral infarct. This case was assessed as medically serious by GSK. At the time of reporting the outcome of the events was unspecified. Additional information has been requested. Follow up information received on 2 January 2009 from the regulatory authority: Previous and/or concurrent vaccination included PEDIARIX (GlaxoSmithKline) given on 15 August 2006 and 16 October 2006; Polio vaccine (non-GSK manufacturer) given on 15 August 2006 and 16 October 2006). On 7 May 2007, the subject received 3rd dose of INFANRIX-POLIO-HIB (parenteral, unknown injection site), 3rd dose of PREVENAR (parenteral, unknown injection site). On 24 August 2007, the subject received 1st dose of MMR, new strain (parenteral, unknown injection site, lot number not provided). On 18 May 2008, 9 months after vaccination with MMR new strain and 1 year after vaccination with INFANRIX-POLIO-HIB and PREVENAR, the subject experienced thrombosis, cerebral infarct, transient ischemic attack and hemiparesis. The subject was hospitalized. Relevant tests were performed in May 2008 during hospitalization and showed the following results: Transcranial exam: Stenosis of right arteria cerebri media just to partial-site, suspect on dissection. New infarctial changes in nucleus caudatus right side. Doppler scan: MCA stenosis right; MRI brain: MCA stenosis right side and Infarction in caudatus; Doppler echocardiography: Normal heart; INR increased: result pending, protein S: 7; Antithrombin III: 107; Creatinine: 25; Glucose: 4.5, Hemoglob

VAERS ID:341409 (history)  Vaccinated:2007-05-07
Age:0.7  Onset:2007-09-01, Days after vaccination: 117
Gender:Male  Submitted:2009-03-09, Days after onset: 555
Location:Foreign  Entered:2009-03-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concomitant medications were not provided.
Current Illness:
Preexisting Conditions: Relevant medical history was not provided.
Diagnostic Lab Data: Nuclear magnetic resonance imaging (results: unknown) and ultrasound scan (results: unknown) were done in 2007.
CDC Split Type: NLWYEG01150908
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEUR  IMUN
HIBV: HIB (ACTHIB)SANOFI PASTEUR  IMUN
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR  IMUN
PNC: PNEUMO (PREVNAR)PFIZER/WYETH 2IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site discolouration, Injection site infection, Injection site nodule, Nuclear magnetic resonance imaging, Surgery, Ultrasound scan
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Additional information was received from the healthcare professional regarding event details and the patient was hospitalised. Therefore, the case was upgraded to serious. Information regarding PREVENAR was received from a healthcare professional regarding an 8-month-old male patient who experienced blue, purple bump in left leg of 1.5-2 cm on the injection site and injection site infection. The patient received the third dose on 07-May-2007. The patient experienced blue, purple bump in left leg of 1.5-2 cm on the injection site (injection site nodule) (injection site discoloration) in Sep-2007. The bump initially was localised within the skin, but gradually grew to the surface. It was present at the outside of the leg, halfway between the knee and hip, most likely on the injection site. An MRI and echography have been performed, the results are unknown. The bump was surgically removed. It turned out to be containing an infection (injection site infection). The wound was kept open for 14 days and was rinsed twice a day. The child has recovered. No additional information was available at the time of this report.

VAERS ID:448390 (history)  Vaccinated:2007-05-07
Age:16.0  Onset:2007-05-07, Days after vaccination: 0
Gender:Female  Submitted:2012-01-30, Days after onset: 1729
Location:Foreign  Entered:2012-01-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Abdominal pain; Cephalgia; Asthenia; Loss of consciousness; Myalgia
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1201USA03726
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Activities of daily living impaired, Asthenia, Disturbance in attention, Headache, Hot flush, Hypersomnia, Infection, Infectious mononucleosis, Loss of consciousness, Malaise, Migraine, Monoplegia, Muscle spasms, Myalgia, Palpitations
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Case received from the Health Authorities in local country on 24-JAN-2012 under the reference BR20120026. Case not medically confirmed as reported by the patient''s father. A 16 year old female patient received the first, second and third dose of GARDASIL (Lot# and dose not reported), intramuscular route on 07-MAY-2007, 02-NOV-2007 and 07-MAY-2008. Following the first dose, the patient experienced abdominal pain, cephalgia and sever asthenia. Following the second dose, she experienced loss of consciousness, muscular pain and sever asthenia. She experienced infectious mononucleosis, transient paralysis of one hand, cramps, migraine, palpitations and abdominal pain after receiving the third dose. She recovered from all symptoms on unspecified dates. The patient''s father, who reported the case to the Health Authorities, stated that her daughter experienced post-exertional malaise, hot flushes and hypersomnia. She also had impaired concentration leading to difficulties to keep up with school courses or to do sports. She also experienced recurrent ENT and gastrointestinal infections. At the time of reporting, the patient had not recovered. Upon medical review the company judged relevant to code the following adverse event: "recurrent ENT and gastrointestinal infection" which was mentioned by the agency in the narrative but not coded. The Health Authorities assessed the causal relationship between the reported reactions and vaccination as doubtful (C2S1/l) according to the local method of assessment. The adverse events were considered to disabling by the reporter. Other business partner numbers include E-2012-00478. Additional information has been requested.

VAERS ID:283820 (history)  Vaccinated:2007-05-08
Age:39.0  Onset:2007-05-19, Days after vaccination: 11
Gender:Female  Submitted:2007-07-03, Days after onset: 45
Location:Foreign  Entered:2007-07-05, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA05112
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0710R SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Neuralgia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health authority concerning a 39 year old female who was reported to be not immune to chickenpox, who on 08-MAY-2007 was vaccinated with a subcutaneous dose of Varivax (Batch # ND17500, Lot # 651996/0701R). The patient was not receiving any concomitant medications. On 19-MAY-2007, eleven days post vaccination, the patient experienced neuralgia and rash. The patient received treatment with analgesics (unspecified). The patient has not yet recovered. Both the reporter and the IMB considered this to be a serious reaction. No more information was available. This case is closed. The events of neuralgia and rash were considered other important medical events. Other business partner numbers included: E2007-04180 and IMB 037680. Additional information is not expected.

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