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Found 596268 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:277750 (history)  Vaccinated:2007-04-27
Age:14.0  Onset:2007-04-29, Days after vaccination: 2
Gender:Male  Submitted:2007-05-01, Days after onset: 2
Location:Michigan  Entered:2007-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEURU1853BB0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0562R0SCLA
Administered by: Unknown     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus, Injection site warmth, Insomnia, Rash maculo-papular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Administered varicela vaccine 4-27-07. Reports on 4-29-07 small red spot developed at injection site, left upper arm. Redness spread and hot to touch. Unable to sleep. C/O injection site itching. Here 4-30-07, afebrile 4cm x 2cm oval slightly raised macular rash with pinpoint vesicles, about 8 to upper periphery of macula.

VAERS ID:277945 (history)  Vaccinated:2007-04-27
Age:32.0  Onset:2007-04-28, Days after vaccination: 1
Gender:Female  Submitted:2007-05-04, Days after onset: 6
Location:D.C.  Entered:2007-05-04
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: NKDA
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV1064  
Administered by: Military     Purchased by: Military
Symptoms: Condition aggravated, Fatigue, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Pathological fracture, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteoporosis/osteopenia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Felt a little tired on Friday 4/27/07 with a little redness over vaccine site on left triceps area. On Saturday, 4/28/07, woke up feeling fine, but after a couple hours, she felt really tired (like she worked a double shift) and felt feverish (did not check temperature; no sweats or chills). She noted that the back of her left arm was red, swollen, tender, warm and pruritic. This worsened a little on Sunday (redness, warmth, swelling and tenderness extended to left elbow). She also noted 2 days of intense aching at old Right tib-fib fracture site (This normally only occurs with significant weather changes and there were no significant weather changes over the week-end.) No other systemic symptoms. By Monday, the local reaction was improving (area smaller with less pruritus). Takes Mobic q day. By Tuesday, 5/1/07, there was an area of about 1'' in diameter of redness, induration, tenderness and increased warmth. Pruritus reported as minimal.

VAERS ID:278330 (history)  Vaccinated:2007-04-27
Age:30.0  Onset:2007-04-27, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Minnesota  Entered:2007-05-10
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: history abnormal pap smear
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1283F0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2609AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Bone pain, Chills, Fatigue, Headache, Myalgia, Nausea, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Approximately 12 hours after receiving Tdap she had severe (L) arm pain, nausea, chills and fatigue. One day after receiving Tdap she reported (L) shoulder "felt like someone was cutting it off" and every muscle and bone hurt." By 4/30/07 symptoms improving but had headache.

VAERS ID:283151 (history)  Vaccinated:2007-04-27
Age:  Onset:2007-04-29, Days after vaccination: 2
Gender:Female  Submitted:2007-06-14, Days after onset: 46
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA00663
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash, Skin lesion, Varicella
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning a female patient who on 27-APR-2007 was vaccinated with a dose of Zostavax. It was reported that "a couple days after vaccination", the patient experienced a rash similar to chicken pox lesions. The patient did not experience a fever, hives or difficulty in breathing. The nurse reported that patient was not seen by a physician and it was not confirmed whether the rash was chicken pox lesions. Unspecified medical attention was sought. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:283755 (history)  Vaccinated:2007-04-27
Age:  Onset:2007-04-29, Days after vaccination: 2
Gender:Female  Submitted:2007-06-14, Days after onset: 46
Location:Washington  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: WAES0705USA00831
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Asthma
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Information has been received from a health care professional concerning her female co-worker, who on 27-APR-2007 was vaccinated with a dose, 0.5ml, IM of Gardasil. On 29-APR-2007, two days after the vaccination, the patient experienced an asthma attack, and visited the emergency room. The patient was not admitted to the hospital, and treatment was not specified. At the time of this report, it was unknown if the patient had recovered from the asthma attack. Additional information has been requested.

VAERS ID:310322 (history)  Vaccinated:2007-04-27
Age:0.2  Onset:2007-05-31, Days after vaccination: 34
Gender:Male  Submitted:2008-04-14, Days after onset: 319
Location:Pennsylvania  Entered:2008-04-16, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Sulfonamide allergy
Preexisting Conditions: unknown
Diagnostic Lab Data: unknown 4/30/08-records received-WBC 15,900, elevated sed rate 85, platelets 635,000. Cultures negative. Low hemoglobin and albumin. CSF normal. Moderate leukocyte esterase in urine. 5/12/08-records received- Platelets elevated. C. difficile negative. Sed rate elevated 41. Adenovirus negative. Renal ultrasound . VCUG negative for reflux. Urine culture negative. LP negative.
CDC Split Type: WAES0803USA02234
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURC2628AA0IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.1416F0IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ05470SCLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08690C0IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0234U0IN 
Administered by: Private     Purchased by: Private
Symptoms: Blood albumin decreased, Blood product transfusion, CSF culture negative, CSF test normal, Cheilitis, Clostridium difficile toxin test, Conjunctival hyperaemia, Culture negative, Diarrhoea, Haemoglobin decreased, Irritability, Kawasaki's disease, Platelet count increased, Pyrexia, Rash erythematous, Rash maculo-papular, Red blood cell sedimentation rate increased, Ultrasound kidney normal, Urinary tract infection, Urine leukocyte esterase positive, Virus serology test, White blood cell count increased, X-ray with contrast upper gastrointestinal tract
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Vasculitis (narrow), Conjunctival disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from a physician concerning a 4 month old male child whose mother was Caucasian and father was Asian who was vaccinated with rotavirus G1 G2 G3 G4 P1 reassortant vaccine live 2ml PO (human-bovine) at the age of two months. In June 2007, when the patient was 4 months of age he was hospitalized with Kawasaki disease which occurred in June 2007. The physician reported that after the hospitalization the child received the rest of the rotavirus G1 G2 G3 G4 P1 reassortant vaccine live series. The patient fully recovered from Kawasaki disease. 5/12/08-records received for DOS 6/4-6/8/07-DC DX: Kawasaki Disease. HX of fever times 6 days, on bactrim for urinary tract infection. HX of conjunctival injection, red rash, red lips. Treated with IVIG.Watery stools 04/30/08-records received for DOS 6/2-6/04/07-transferred to another facility for treatment of Kawasaki disease. Presented with 3-4 day history of fever as high as 104. Conjunctival injection, maculopapular rash, cracked red lips. Irritability. Further information has been received concerning this male child with an allergy to BACTRIM who on 27-APR-2007 was vaccinated with ROTATEQ ( lot # 656382/0234U) first dose. Other suspect vaccines included COMVAX ( lot #655550/1416F) IM, first dose. Other concomitant vaccine included DTaP (unspecified) + RECOMBIVAX HB + Hib conj vaccine PREVENAR (Lot # B08690C) IM and IPOL (lot # 20547-2) (all first dose). The physician reported that on 01-JUN-2007 the patient developed Kawasaki disease approximately 5 weeks after the two month old vaccination including ROTATEQ). The patient was hospitalized for about four days. The physician reported that the patient recovered. Additional information is not expected.

VAERS ID:388609 (history)  Vaccinated:2007-04-27
Age:4.0  Onset:2009-12-04, Days after vaccination: 952
Gender:Male  Submitted:2010-05-14, Days after onset: 160
Location:New York  Entered:2010-05-18, 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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: body temp, 100.1 F, fever; serum immunoglobulin G, 1.43 ND; serum immunoglobulin M, 1:40:
CDC Split Type: WAES1001USA02065
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Mumps, Pain in jaw, Parotitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Osteonecrosis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 7 year old male who on 03-FEB-2004 was vaccinated with the first dose of MMR II. On 24-APR-2007, was vaccinated with the second dose of MMR II. On 07-DEC-2009 the patient experienced mumps. The patient had a fever of 101.2 F and had a parotitis. On 02-DEC-2009 the patient was diagnosed with mumps. On 02-NOV-2009 the blood work was done and the results indicated IgM was 1:20:00, and IgG was 1.43ND. The outcome of mumps was unknown. Follow up information was received which reported that patient on 04-DEC-2009 developed mumps which was diagnosed at the same date. The patient was afebrile. It was reported that the patient also had lower jaw pain. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.

VAERS ID:545005 (history)  Vaccinated:2007-04-27
Age:10.0  Onset:2007-04-27, Days after vaccination: 0
Gender:Female  Submitted:2014-09-24, Days after onset: 2707
Location:Florida  Entered:2014-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB139BA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0173U1SCLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Pyrexia, Vaccination site swelling
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: Redness and swelling around site of vaccine, and fever. Started on the day of vaccination, and ended 3-4 days later.

VAERS ID:278271 (history)  Vaccinated:2007-04-27
Age:55.0  Onset:2007-04-27, Days after vaccination: 0
Gender:Male  Submitted:2007-05-08, Days after onset: 11
Location:Foreign  Entered:2007-05-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: peginterferon alfa-2b
Current Illness: Melanoma
Preexisting Conditions:
Diagnostic Lab Data: body temp 27Apr07 39 C
CDC Split Type: WAES0705USA00626
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Chills, Diarrhoea, Fall, Injection site inflammation, Injury, Pyrexia, Syncope, Tongue biting, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (broad), Pseudomembranous colitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a 55 year old male patient with melanoma who on 27-APR-2007 at 11:00am was vaccinated intramuscularly in the left arm with a dose of Pneumonia (lot number not reported). Concomitant suspect therapy included peginterferon alfa-2b. On 27-APR-2007, 6 hours post vaccination, the patient experienced fever up to 39C, chills, and injection site inflammation. On 28-APR-2007, the following day, the patient vomited once and suffered from diarrhea. While in the bathroom, he fainted, fell down and hurt himself by biting his tongue. He was admitted to the hospital where he was observed until 01-MAY-2007. The patient reported that the hospital diagnosis was "convulsive syncope" (written hospital report not available). To be noted that the patient was undergoing treatment with peginterferon alfa-2, 50 mcg weekly for one year (last injection 25-APR-2007) as a melanoma after- care treatment. The patient was not sure whether the general symptoms might have also been side effects of this therapy. Other business partner numbers included E2007-02749. Additional information is not expected.

VAERS ID:278381 (history)  Vaccinated:2007-04-27
Age:16.0  Onset:2007-04-27, Days after vaccination: 0
Gender:Female  Submitted:2007-05-10, Days after onset: 13
Location:Foreign  Entered:2007-05-11, 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: Unknown
CDC Split Type: WAES0705USA01162
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0572F IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye rolling, Muscle twitching, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Cardiomyopathy (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a health professional concerning a 16 year old female who on 27-APR-2007 was vaccinated, intramuscularly, in the right deltoid muscle, with Gardasil (Lot number 655376/0572F : Batch number NE 45050). On 27-APR-2007 the patient experienced syncope, eyes rolling and twitches of the right arm. The symptoms lasted for less than one hour. She was admitted to the hospital for monitoring. Further course and diagnostic (not specified) was normal. Subsequently, the patient recovered completely. Additional information has been requested.

VAERS ID:279422 (history)  Vaccinated:2007-04-27
Age:23.0  Onset:2007-04-27, Days after vaccination: 0
Gender:Female  Submitted:2007-05-23, Days after onset: 26
Location:Foreign  Entered:2007-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: B0471639A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB078AD IMUN
Administered by: Other     Purchased by: Other
Symptoms: Pallor, 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: This case was reported by a consumer (subject''s mother) and described the occurrence of fainting in a 23-year-old female subject who was vaccinated with Twinrix adult for prophylaxis. A physician or other health care professional has not verified this report. On 27 April 2007 the subject received 1st dose of Twinrix adult (intramuscular, unknown deltoid). The subject did not receive any concomitant vaccine. On 27 April 2007, immediately after vaccination with Twinrix adult, the subject became pale and fainted for about 30 seconds. The event was resolved by changing the sitting position. No other local or systemic reaction was reported. This case was assessed as medically serious by manufacturer. On 27 April 2007, the events were resolved.

VAERS ID:279895 (history)  Vaccinated:2007-04-27
Age:18.0  Onset:2007-05-06, Days after vaccination: 9
Gender:Female  Submitted:2007-05-25, Days after onset: 19
Location:Foreign  Entered:2007-05-29, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705AUS00150
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Convulsion, Epilepsy, Malaise, Spinal fracture
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Osteoporosis/osteopenia (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from media monitors summarising the radio talk-back program. A mother of 18 year old female student contacted the radio talk-back program and informed that on 27-APR-2007 her daughter was vaccinated with Gardasil as part of the regular school-based immunisation program funded by the government. On 06-MAY-2007 the school girl got sick. "The hospital" found that she had had a seizure and fractured two vertebrae and the school girl was diagnosed with juvenile epilepsy. "The hospital" did not believe that "the two events" were connected to Gardasil, but the mother was convinced they are. The interviewee of the program, said that epilepsy could be caused by an number of things. Upon internal review, a seizure is determined to be an other important medical event. Additional information is not expected.

VAERS ID:326667 (history)  Vaccinated:2007-04-27
Age:33.0  Onset:2007-05-28, Days after vaccination: 31
Gender:Female  Submitted:2008-07-17, Days after onset: 416
Location:Foreign  Entered:2008-09-03, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Previous vaccination with Td vaccine was well tolerated in 1990.
Diagnostic Lab Data:
CDC Split Type: E200704470
Vaccination
Manufacturer
Lot
Dose
Route
Site
TBE: TICK-BORNE ENCEPH (NO BRAND NAME)UNKNOWN MANUFACTURER073011A SCUN
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURC2132A SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Vestibular neuronitis
SMQs:, Vestibular disorders (narrow)
Write-up: Case reported by HA (PEI2007006504) through a foreign agency. Case initially received on 09-Jul-07. It was reported that a 33-year-old female patient was vaccinated SC into the upper arm with a booster dose of TD-IMPFSTOff Merieux, lot-no. C2132AA and with a dose of ENCEPUR, lot-no. 073011A, Man. Novartis Behring on 27-Apr-07. 4 weeks later, on 28-May-07, suspicion of vestibular neuronitis was diagnosed. She was admitted to hospital (no dates reported). No information was provided regarding treatment and duration of hosptialisation. She recovered after 4 weeks. FILE CLOSED.

VAERS ID:391800 (history)  Vaccinated:2007-04-27
Age:0.16  Onset:2007-05-01, Days after vaccination: 4
Gender:Male  Submitted:2010-06-30, Days after onset: 1156
Location:Foreign  Entered:2010-06-30
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: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: B0662911A
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41CA198A0PO 
Administered by: Other     Purchased by: Other
Symptoms: Abdominal distension, Haematochezia, Intussusception, Nausea, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)
Write-up: This case was reported by a healthcare professional via another manufacturer (Fiocruz) and described the occurrence of intussusception in a 2-month-old male subject who was vaccinated with ROTARIX (GlaxoSmithKline). On 27 April 2007, the subject received 1st dose of ROTARIX (oral). On 1 May 2007, 4 days after vaccination with ROTARIX, the subject experienced bloody stools, abdominal distension, vomiting and nausea. The subject was hospitalised and intussusception was diagnosed. The subject was treated with surgery and the events resolved. The 2nd dose of ROTARIX was administered on 27 June 2007 and if was unspecified if the events recurred. At the time of reporting, the case was under investigation due to possible acute appendicitis. No further information could be obtained; the case has therefore been closed.

VAERS ID:427348 (history)  Vaccinated:2007-04-27
Age:2.0  Onset:2007-04-27, Days after vaccination: 0
Gender:Female  Submitted:2011-07-14, Days after onset: 1539
Location:Foreign  Entered:2011-07-14
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: at birth st. post reanimationem, displegia spastica, low values of Hgb given concentrated Erc, neonatus praetemporaius, anaemiae, respiratory support,
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
BCG: BCG (NO BRAND NAME)UNKNOWN MANUFACTURER    
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER    
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER    
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Acidosis, Cerebral cyst, Cerebral palsy, Disability, Dyslalia, Gliosis, Incontinence, Periventricular leukomalacia, Psychomotor retardation, Pyrexia, Speech disorder, Status epilepticus
SMQs:, Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Neonatal disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: born healthy, 100% disability, psychomotor retardation, paralysisi cerebralis, dysfunction of brain fron central hypoplastic corpus callosum, periventricular cysts, gliotic postischemic zones, dyslalia, nasal speech, lack of sphincters control, status epilepticus febrilis, oxygen respiratory support, acidosis, periventricular leukomalation,

VAERS ID:277839 (history)  Vaccinated:2007-04-28
Age:  Onset:2007-04-30, Days after vaccination: 2
Gender:Female  Submitted:2007-05-02, Days after onset: 2
Location:New Jersey  Entered:2007-05-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1068SCLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ04432IM 
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER354484IDLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema peripheral, Pain
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: Patient received 9th Anthrax immunization on 4/28/2007 and presented 4/30/07 with a swollen upper arm with redness, pain. Doctor prescribed Motrin and Benadryl, no more Anthrax vaccination.

VAERS ID:277841 (history)  Vaccinated:2007-04-28
Age:37.0  Onset:2007-04-30, Days after vaccination: 2
Gender:Male  Submitted:2007-04-30, Days after onset: 0
Location:New Jersey  Entered:2007-05-03, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1064SCLA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER354482IDLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema peripheral, Pain, Pruritus, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Soldier received 5th Anthrax immunization on 4/28/2007 and presented with a swollen upper arm with redness, itch pain, mild fever on 4/30/2007. Doctor prescribed Benadryl and Motrin.

VAERS ID:278172 (history)  Vaccinated:2007-04-28
Age:18.0  Onset:2007-04-28, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Indiana  Entered:2007-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Teammates with viral illnesses with similar symptoms as patient
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2226AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Headache, Injection site pain, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever: 103 F, dizziness, general achiness, headache x 2 days (+ injection site soreness), feeling better on day #3. Took Ibuprofen for symptoms, no other treatment.

VAERS ID:278652 (history)  Vaccinated:2007-04-28
Age:71.0  Onset:2007-05-01, Days after vaccination: 3
Gender:Female  Submitted:2007-05-15, Days after onset: 14
Location:Florida  Entered:2007-05-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Procrit, Clindamycin, Benadryl
Current Illness: Cat bite
Preexisting Conditions: HX small cell cancer, receiving chemo
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURERU1943AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain, redness, swelling at site of injection

VAERS ID:278689 (history)  Vaccinated:2007-04-28
Age:8.0  Onset:2007-04-29, Days after vaccination: 1
Gender:Male  Submitted:2007-05-15, Days after onset: 16
Location:New York  Entered:2007-05-16, 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: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA00726
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1043F1SCLA
Administered by: Other     Purchased by: Other
Symptoms: Hypokinesia, Injected limb mobility decreased, Injection site erythema, Injection site swelling, Injection site warmth, Local reaction
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a licensed practical nurse concerning an 8 year old male, with no medical history or allergies, was vaccinated with a first and second (0.5 milliliter, subcutaneous in left arm) dose of Varivax on 05-APR-1999 (lot number 627876/1241H) and 28-APR-2007 (lot number 654527/1043F), respectively. There was no concomitant medication. On 29-APR-2007 the patient experienced significant local reaction. The symptoms were described as hot, red, swollen left arm. The patient could not raise his arm. The patient missed school. Ibuprofen and warm soaks were ordered. Adverse event symptoms were reported to be recovered. Unspecified medical attention was sought. No laboratory tests were performed. No product quality complaint was involved. The nurse requested a lot check from the vaccine with lot number 654527/1043F. The reported felt the event was disabling. It was reported that the patient had no reaction after the first vaccination. This is one of several reports from the same source. Additional information has been requested.

VAERS ID:279093 (history)  Vaccinated:2007-04-28
Age:21.0  Onset:2007-05-02, Days after vaccination: 4
Gender:Female  Submitted:2007-05-18, Days after onset: 16
Location:New York  Entered:2007-05-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Haemorrhagic ovarian cyst; Irritable bowel syndrome; Distress gastrointestinal; Anxiety
Diagnostic Lab Data: head computed axial 05/06/07 - normal, magnetic resonance 05/06/07 - normal, complete blood cell 05/06/07 - normal, stool culture 05/06/07 - trace amount of blood
CDC Split Type: WAES0705USA02556
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Computerised tomogram normal, Culture stool, Dizziness, Full blood count normal, Haematochezia, Headache, Nuclear magnetic resonance imaging normal, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a physician concerning a 21 year old female patient with 2.4 centimeter haemorrhagic ovarian cyst, possible irritable bowel syndrome, gastrointestinal symptoms and anxiety. On 28-APR-2007 she was vaccinated IM In the left arm deltoid with a first dose of Gardasil. 3 days post vaccination on 02-MAY-2007 the patient experienced headache, dizziness, blurred vision and "vomiting all the time." On 06-MAY-2007 the patient went to emergency room (ER) and was seen but not hospitalized. On 06-MAY-2007 patient was hospitalized with unknown diagnosis. All types of test were performed; head computed axial tomography (CT scan of the brain), complete blood cell count (CBC), magnetic resonance imaging (MRI) with normal results. Stool culture test was taken and there was a trace amount of blood. She was treated with intravenous (IV) fluids. On 09-MAY-2007 she was released from the hospital. She was still dizzy. The outcome was unknown. Additional information has been requested.

VAERS ID:279274 (history)  Vaccinated:2007-04-28
Age:4.0  Onset:2007-04-29, Days after vaccination: 1
Gender:Male  Submitted:2007-05-17, Days after onset: 18
Location:Colorado  Entered:2007-05-22, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU1969CA4IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ00183IMLL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0296U1SCRL
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness and swelling that extended 10" long and 5" wide with tenderness to preparation in left thigh near vaccination site. Patient was given Zithromax 200mg/5ml for 5 days.

VAERS ID:279982 (history)  Vaccinated:2007-04-28
Age:56.0  Onset:2007-04-30, Days after vaccination: 2
Gender:Female  Submitted:2007-05-16, Days after onset: 16
Location:Florida  Entered:2007-05-30, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2572AA  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Erythema, Headache, Injection site induration, Injection site pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, joint pain, headache, left arm with redness, sore and hard in injection site.

VAERS ID:280864 (history)  Vaccinated:2007-04-28
Age:50.0  Onset:2007-04-29, Days after vaccination: 1
Gender:Male  Submitted:2007-06-07, Days after onset: 39
Location:Unknown  Entered:2007-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1101IMLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Dizziness, Erythema, Fatigue, Hot flush, Injection site mass, Migraine, Oedema, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reactions to first vaccination given on 03 April 2007 (Bioport Corp, Lot#FAV102 Dosage 0.5ml, VIS Ver. 16 Dec 05) were, Migraine lasting for days with no relief, hot/cold flashes, weakness always feeling tired, body and joints aches, dizziness and fatigue lasting for 12 days. Symptoms started within 12 hrs after getting vaccinated. Second vaccination PT had the same symptoms with a large swelling in the left arm from the shoulder to the elbow. The area was bright red in color with a golf ball size knot 9cm in diameter in the area of the vaccination. PT stated edema started around Sunday afternoon with the redness and swelling early Monday morning. Symptoms lasting for 2 to 3 weeks. Treatment warm pack over area for 15 mins., Motrin 800mg 1tablet 3X a day.

VAERS ID:281047 (history)  Vaccinated:2007-04-28
Age:3.0  Onset:2007-05-27, Days after vaccination: 29
Gender:Male  Submitted:2007-06-08, Days after onset: 12
Location:Louisiana  Entered:2007-06-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Unknown
Symptoms: Erythema, Lymph node pain, Pruritus, Pyrexia, Rash papular, Rash pustular, Secondary transmission, Skin lesion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Smallpox vaccine was administered to patient''s mother on April 28, 2007. Mother reports good take with blistering lesions. She kept inoculation site covered as instructed. She developed one satellite lesion about 3 cm from inoculation site. Child developed skin lesion on R forearm approximately 5/27 which developed into multiple pustules; 4-6 days later developed multiple lesions on face, arms and legs. Later lesions were papular, some appeared to be deep pustular lesions but never blistered. The patient had intermittent low grade fever from June 3rd through June 5th. Many of the lesions healed with crusting. On June 4th the primary lesions were becoming scabbed over. On June 6th, the patient was noted to have two posterior auricular lymph nodes on L (same side as facial lesions) which were mildly tender, the skin over one was erythematous. Patient sleeps in bed with mother. Patient has been observed as outpatient; only treatment so far has been Benadryl for itching and calamine lotion.

VAERS ID:284505 (history)  Vaccinated:2007-04-28
Age:17.0  Onset:2007-04-28, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 47
Location:New York  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA05337
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U0IMUN
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: Initial information has been received from a physician and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a dose of Gardasil, it was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however the physician will forward other information including the lot numbers. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a physician, a nurse and a healthcare professional, concerning a 17 year old, female student, with no significant medical history and no known allergies, who was vaccinated IM, on 26-APR-2007 at 1:15pm, with the first dose of GARDASIL (Lot #65617/0384U). There was no illness at the time of vaccination. It was reported that the patient felt lightheaded immediately (at 3:15pm) after receiving the injection and sat, or was laid on the floor. It was confirmed that the patient had recovered on the same day, 26-APR-2007. No further information is expected.

VAERS ID:282426 (history)  Vaccinated:2007-04-28
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2007-06-20
Location:California  Entered:2007-06-20
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: Unknown affect on fetus
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Pregnant female was given MMR, Varicella, DT by above name facility despite informing them that she was pregnant.

VAERS ID:285358 (history)  Vaccinated:2007-04-28
Age:5.0  Onset:2007-05-02, Days after vaccination: 4
Gender:Female  Submitted:2007-05-14, Days after onset: 12
Location:Idaho  Entered:2007-07-20, Days after submission: 67
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: No
Preexisting Conditions: 4 weeks pre-mature. Blueberries and sulfa drug - rash
Diagnostic Lab Data:
CDC Split Type: ID07017
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0249U1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site mass, Injection site pruritus, Injection site warmth, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mom phoned and stated that on the 4th day after child received Hep A #2, left upper arm swollen up, golf-ball size with a lump on it at the injection site, hot to touch, itching, slight fever. Mom took her to the ER (because it''s 9 PM). ER MD told mom to give her Tylenol and Benadryl if it still itch. Mom gave child dose of Tylenol.

VAERS ID:293190 (history)  Vaccinated:2007-04-28
Age:48.0  Onset:2007-04-28, Days after vaccination: 0
Gender:Male  Submitted:2007-10-09, Days after onset: 164
Location:New York  Entered:2007-10-15, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: LFT''s did not change
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0691U0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Influenza like illness, Liver function test normal, Malaise, Rhinorrhoea
SMQs:
Write-up: From nasal discharge c/o flu-like symptoms general non well ness occurring w/ 12 hr after vax. Cont for 1 mo.

VAERS ID:318925 (history)  Vaccinated:2007-04-28
Age:35.0  Onset:0000-00-00
Gender:Male  Submitted:2008-07-09
Location:Delaware  Entered:2008-07-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Neurofibromatosis
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV105 SCUN
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Cognitive disorder, Disturbance in attention
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypoglycaemia (broad)
Write-up: Reports short term memory loss, inattention and concentration deficits after AVA in 2007. Symptoms: Cognitive deficiency.

VAERS ID:351763 (history)  Vaccinated:2007-04-28
Age:75.0  Onset:2009-04-29, Days after vaccination: 732
Gender:Male  Submitted:2009-06-24, Days after onset: 56
Location:Pennsylvania  Entered:2009-07-13, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Prostate cancer
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0905USA01058
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0SCUN
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster, Pain
SMQs:
Write-up: Information has been received from a physician concerning a patient who was vaccinated with a dose of ZOSTAVAX (Merck). The patient developed shingles after receiving the vaccine. The patient sought unspecified medical attention. Follow up information has been received from the physician concerning this 77 year old retired white male with prostate cancer and no history of chickenpox or recent exposure to chickenpox or herpes ZOSTER who on 28-APR-2007 (also reported as 27-APR-2007) was vaccinated SC with a first "0.5" dose of ZOSTAVAX (Merck) (lot # not reported) on the arm. There was no illness at the time of vaccination, or rash at the site of injection or elsewhere within 42 days of vaccination. On 29-APR-2009, the patient developed shingles on his right flank with a pain score of 7 9n a scale of 0 to 10. Direct fluorescent antibody was not performed. There were no photos taken and there were no specimens collected for PCR analysis. Subsequently, the patient recovered on an unspecified date. Additional information is not expected.

VAERS ID:280165 (history)  Vaccinated:2007-04-28
Age:0.42  Onset:2007-04-28, Days after vaccination: 0
Gender:Female  Submitted:2007-05-31, Days after onset: 33
Location:Foreign  Entered:2007-06-01, 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: Dermatitis atopic
Diagnostic Lab Data: Body temperature 28-Apr-2007 Greater than 29 degrees Centigrade
CDC Split Type: HQWYE425030MAY07
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)PFIZER/WYETH 1IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Chapped lips, Erythema, Injection site induration, Lip dry, Oedema peripheral, Palmar erythema, Palmar-plantar erythrodysaesthesia syndrome, Pyrexia, Rash generalised, Stomatitis
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information regarding Prevnar was received from a pediatrician regarding a 5-month-old female patient who received the second dose on 28-Apr-2007 and experienced fever greater than 39 degrees Centigrade, rashes all over body, dry, cracked lips, erythematous buccal mucosa, edema of the palms and soles, erythema of the palms and soles, and 20 mm induration of BCG vaccine injection site on the right deltoid. On 28-Apr-2007, the patient received the second dose of Prevnar. On the same day, the child developed a fever greater than 39 degrees Centigrade. Treatment included paracetamol. On 30-Apr-2007, the patient was hospitalized with rash all over the body. On admission, a 20 mm induration of the BCG vaccine injection site on the right deltoid was noted. The BCG vaccine was administered at 2 weeks of age and had completely healed prior to Prevnar vaccination. On 01-May-2007, the child developed edema of the palms and soles, erythema of the palms and soles, dry, cracked lips and erythematous buccal mucosa. Additional treatment included diphenhydramine, hydrocortisone and Solcoseryl Dental (protein-free calf blood extract/lauromacrogol 400). After three days of diphenhydramine and hydrocortisone treatment, the child recovered from the rash and induration. On an unspecified date, the patient recovered from the pyrexia, oedema peripheral, erythema, lip dry, chapped lips and stomatitis. Body temperature (results: Greater than 39 degrees Centigrade) was done on 28-Apr-2007. No additional information was available at the time of this report.

VAERS ID:299154 (history)  Vaccinated:2007-04-28
Age:60.0  Onset:0000-00-00
Gender:Female  Submitted:2007-12-06
Location:Foreign  Entered:2007-12-10, Days after submission: 4
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: Atenolol, ABLOK
Current Illness:
Preexisting Conditions: Blood pressure disorder and allergy to smoke, dust and construction materials. No history of adverse reaction to vaccine.
Diagnostic Lab Data: hemoglobin: 27/Apr/07: 11.9; 07/Jul/07: 10.0; 08/Sep/07: 8.9; 24/Nov/07: 4.0; 26/Nov/07: 4.7; 27/Nov/07: 5.0; 28/Nov/07: 8.9 The patient''s husband did not specify the performed tests, neither tests units, nor reference values.
CDC Split Type: 200704105
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaemia haemolytic autoimmune, Fatigue, Feeling abnormal, Haemoglobin decreased, Malaise, Pain in extremity
SMQs:, Haemolytic disorders (narrow), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Dementia (broad), Tendinopathies and ligament disorders (broad)
Write-up: A 60-year-old female patient, with medical history of blood pressure disorder and allergy to smoke, dust and construction materials, was diagnosed with an autoimmune hemolytic anemia after receiving the 1st dose of influenza vaccine (from unknown manufacturer) intra-muscularly in the deltoid on 28 April 2007. The physician did not have additional information. The patient''s husband provided with further information. On 27 April 2007, hemoglobin level was 11.9. After the vaccination, on 28 April 2007, the patient started presenting legs pain. On 07 July 2007, patient''s hemoglobin level was 10.0. Due to this fact, other physician recommended treatment with iron for 120 days. On 08 September 2007, a new test showed hemoglobin level of 8.9. The patient stated feeling bad, with tiredness and malaise. On 24 November 2007, she went to hospital and her hemoglobin level was 4.0. She was hospitalized on the same day. Since, she underwent daily tests. She was under treatment with iron and a corticoid medication, reported as "metaprozol". Hemoglobin levels were 4.7, 5.0, 8.9 on 26, 27 and 28 November 2007 respectively. At the time of reporting, the patient was still hospitalized. Outcome, ongoing. In this case, auto-immune hemolytic anemia with first signs occurring about 2/4 months after vaccination is reported. Although no laboratory reference values were provided, the hemoglobin levels before vaccination seem already slightly below normal values. No investigation results were reported to support the diagnosis of auto-immune hemolytic anemia and to rule out other potential causes such as auto-immune disease. Considering the available information and time to onset, no relationship between event and vaccination appears to exist.

VAERS ID:277780 (history)  Vaccinated:2007-04-29
Age:32.0  Onset:2007-04-30, Days after vaccination: 1
Gender:Female  Submitted:2007-05-02, Days after onset: 2
Location:Texas  Entered:2007-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER30011600PO 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Presented post two doses of oral typhoid. 128/90 76 18 98.7States she has had flushing, intemittent diarrhea, nausea and joint pain. Has not noticed and blood in stool. Instructed to discontinue the rest of the tablets.

VAERS ID:277921 (history)  Vaccinated:2007-04-29
Age:17.0  Onset:2007-04-30, Days after vaccination: 1
Gender:Female  Submitted:2007-05-02, Days after onset: 2
Location:New York  Entered:2007-05-04, 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:
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1426F1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site reaction, Paraesthesia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: c/o rash over cheeks 2 d after vaccination and tingling sensation of upper extremities and lower extremities at the same side of injection.

VAERS ID:304080 (history)  Vaccinated:2007-04-29
Age:25.0  Onset:2007-05-01, Days after vaccination: 2
Gender:Male  Submitted:2007-12-06, Days after onset: 219
Location:New York  Entered:2008-01-19, Days after submission: 44
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: Patient inadvertently given a higher dose (1.0mL instead of 0.5mL).
CDC Split Type: AE0712
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB107AA UNUN
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD166 UNUN
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Incorrect dose administered, Nonspecific reaction
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mild/moderate reaction - redness but no swelling. Within normal limits.

VAERS ID:304079 (history)  Vaccinated:2007-04-29
Age:37.0  Onset:2007-04-30, Days after vaccination: 1
Gender:Male  Submitted:2007-12-06, Days after onset: 220
Location:New York  Entered:2008-01-29, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD test, Aventis, C2192AA, right forearm, unknown doses
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: AE0711
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB346BA UNUN
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB107AA UNUN
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD166 UNUN
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Incorrect dose administered, Infection, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Large area of swelling/redness. Diagnosed as infection and treated with antibiotics. Patient inadvertently given a higher dose (1.0mL instead of 0.5mL).

VAERS ID:304081 (history)  Vaccinated:2007-04-29
Age:25.0  Onset:2007-05-01, Days after vaccination: 2
Gender:Male  Submitted:2007-12-06, Days after onset: 219
Location:New York  Entered:2008-01-29, Days after submission: 54
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type: AE0713
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB346BA UNUN
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB107AA UNUN
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD166 UNUN
Administered by: Other     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: Mild/moderate reaction -- swelling and redness -- within normal limits.

VAERS ID:277656 (history)  Vaccinated:2007-04-30
Age:1.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-04-30, Days after onset: 0
Location:Texas  Entered:2007-04-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB162CB0IMLL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0302U0SCRL
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives within 5 min of vaccine admin. TX with Benadryl PO no wheezing no angio edema.

VAERS ID:277677 (history)  Vaccinated:2007-04-30
Age:21.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:2007-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0384U0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5/1/07 3:30 pm PC from client. States she woke up at noon today with a swollen, red face and "red spots all over both legs. Had received HPV immun on 4/30/07 in the afternoon went to express care at 1:00 pm and was seen by Dr states she was given Benadryl pills and steroid cream.

VAERS ID:277758 (history)  Vaccinated:2007-04-30
Age:5.0  Onset:2007-05-02, Days after vaccination: 2
Gender:Male  Submitted:2007-05-02, Days after onset: 0
Location:Pennsylvania  Entered:2007-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Right ear tube placed 3 weeks ago
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B084BA0IMLL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0232U0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Mother noticed redness and swelling at injection site this morning started treatment today with Cephalexin 250 mg/ 5ml PO suspension 1 tsp. TID x 10 days.

VAERS ID:277777 (history)  Vaccinated:2007-04-30
Age:31.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-02, Days after onset: 2
Location:Kansas  Entered:2007-05-02
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: Type 1 diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema peripheral, Skin warm, Tenderness
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: Patient''s left arm became red, warm and swollen beginning the day of injection in the afternoon. One the second day she felt like the flu. Today she still has an area of erythema and tenderness of about 4cm by 5 cm distal the injection site without swelling, erythema or warmth.

VAERS ID:277789 (history)  Vaccinated:2007-04-30
Age:13.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Male  Submitted:2007-05-02, Days after onset: 1
Location:Michigan  Entered:2007-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metadate CD
Current Illness: None
Preexisting Conditions: Attention Deficit Disorder
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2688AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Night sweats
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: "Sweats thru night of injection "per mother, arm swollen and red deltoid within 24 hours - persisting greater than 48 hours. Using Tylenol/ Motrin - patient declined cold/ hot packs to arm. Positive mobility/normal temp and color of hand and fingers.

VAERS ID:277792 (history)  Vaccinated:2007-04-30
Age:5.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-05-02, Days after onset: 1
Location:Nebraska  Entered:2007-05-02
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: Overweight
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2489AA3IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ04564SCRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1389F0SCLL
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Local reaction
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Local reaction (redness, induration) in both right and left thigh areas that began approximately 24 hours after immunizations were given. Treatment: warm compress, Ibuprofen, hydrocortisone cream.

VAERS ID:277838 (history)  Vaccinated:2007-04-30
Age:2.0  Onset:2007-05-02, Days after vaccination: 2
Gender:Female  Submitted:2007-05-02, Days after onset: 0
Location:Texas  Entered:2007-05-03, 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
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU1751BA3UNRA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pain, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pain, swelling, redness, warm to touch

VAERS ID:277856 (history)  Vaccinated:2007-04-30
Age:4.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Male  Submitted:2007-05-03, Days after onset: 3
Location:Michigan  Entered:2007-05-03
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)AVENTIS PASTEURC2521AA4IMLL
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURZ0001-23IMRL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0497F0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Local 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: Localized redness and slightly raised.

VAERS ID:277857 (history)  Vaccinated:2007-04-30
Age:17.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-03, Days after onset: 3
Location:Maryland  Entered:2007-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Zaditor
Current Illness: Trichamonis vaginosa and allergic rhinitis
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1280F1IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.001240IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)AVENTIS PASTEUR42183AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site irritation, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt noted pruritis at the injection site on the afternoon after administration followed by erythema and a burning sensation also localized to the injections site. She was seen 4 days later when the erythema measured 13 x 7.5 cm. There were no other sx, constitutional or otherwise.

VAERS ID:277863 (history)  Vaccinated:2007-04-30
Age:34.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-05-03, Days after onset: 2
Location:Illinois  Entered:2007-05-03
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
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU1786CA1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Headache, Local reaction, Lymphadenopathy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: High fever(103.5), large local reaction, dizziness, body ache, headache, lymphadenopathy, symptoms lasted for a day and a half

VAERS ID:277873 (history)  Vaccinated:2007-04-30
Age:18.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-05-03, Days after onset: 2
Location:Oregon  Entered:2007-05-03
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: had chickpox at 3 yrs old
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1311F0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site inflammation, Injection site warmth, Varicella
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Large red warm inflamed 6 cm diameter adverse reaction to the varicella

VAERS ID:277884 (history)  Vaccinated:2007-04-30
Age:5.0  Onset:2007-05-02, Days after vaccination: 2
Gender:Female  Submitted:2007-05-03, Days after onset: 1
Location:California  Entered:2007-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl, Ibuprofen
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Clinical observation/Keflex 250 mg/5 ml tsp po 4xd 7
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B051BA4IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.000141IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ00183SCLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0972F0SCRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: LU arm deltoid red/hot swollen 12 cm outline/3 cm below shoulder jt/fever tactile DTaP/IPV given

VAERS ID:277885 (history)  Vaccinated:2007-04-30
Age:17.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-03, Days after onset: 3
Location:California  Entered:2007-05-03
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2230AA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Dizziness, Musculoskeletal discomfort, Rash erythematous, Rash pustular
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: After the injection, she complained of heaviness in neck, dizziness, weakness. We lay her down, BP = 108/80 after 30 mins she was okay. She came back next day 5/2/07 with erythematic rash forehead and erythematic rash - small pustular (L) shoulder by (R) shoulder

VAERS ID:277886 (history)  Vaccinated:2007-04-30
Age:6.0  Onset:2007-05-02, Days after vaccination: 2
Gender:Male  Submitted:2007-05-03, Days after onset: 1
Location:Colorado  Entered:2007-05-03
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB162BA1IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1110R1SCRL
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site rash, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Severe local reaction at injection site within 36 hr. 8cm raised indurated lesion on (R) thigh with vesicles in center more raised area

VAERS ID:277891 (history)  Vaccinated:2007-04-30
Age:1.25  Onset:2007-05-01, Days after vaccination: 1
Gender:Male  Submitted:2007-05-03, Days after onset: 2
Location:Pennsylvania  Entered:2007-05-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: mild jerking, no fever~Measles + Mumps + Rubella + Varicella (ProQuad)~1~1~In Patient
Other Medications:
Current Illness: mild erythema (R) ear infection
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B084CA3IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF026AA3IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETH808655A3IMLL
Administered by: Private     Purchased by: Private
Symptoms: Febrile convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (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 (broad)
Write-up: Fever to 103 24 hours after the immunization febrile seizure lasting 5 minutes at that time and again in 30 minutes. Treated with antipyretics. No current sequelae or symptoms at this time

VAERS ID:277915 (history)  Vaccinated:2007-04-30
Age:4.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-04-30, Days after onset: 0
Location:Georgia  Entered:2007-05-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ08723 RL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0346U0 LL
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B014BA4 LL
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness around eyes, rash

VAERS ID:277919 (history)  Vaccinated:2007-04-30
Age:0.5  Onset:2007-04-30, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:North Carolina  Entered:2007-05-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B101AA2IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08679A2IMRL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0980F2PO 
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever 102.5 1-2 days after vaccination

VAERS ID:277965 (history)  Vaccinated:2007-04-30
Age:5.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-04, Days after onset: 4
Location:Nevada  Entered:2007-05-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (DITANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B033A4IMRL
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURERAHAVB1481IMRA
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURERPMC20326-23IMLL
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER906F1SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye rolling, Hypotonia, Pallor, Skin warm, Tonic clonic movements, Unresponsive to stimuli
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (narrow), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Dtap #5, IPV# 4, Hep A #2 were administered followed by Varicella #2. Immediately following Varicella administration, patient became limp, unreponsive, eyes rolled back, tonic/clonic movements lasting about 30 seconds. Patient recovered and was oriented X3, color was pale and was warm to touch. EMS notified, patient evaluated by first responders. Mother elected to not transport via ambulance. Mother took child to Emergency Room. Discharged with not significant findings. Appointment scheduled with pediatrician in one week.

VAERS ID:277974 (history)  Vaccinated:2007-04-30
Age:4.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Male  Submitted:2007-05-03, Days after onset: 2
Location:Mississippi  Entered:2007-05-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEUR19854 LL
HEPA: HEP A (VAQTA)MERCK & CO. INC.12130 RL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ02403 RL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.29340 LL
Administered by: Private     Purchased by: Public
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left thigh swollen at the sight where the injection was given.

VAERS ID:277969 (history)  Vaccinated:2007-04-30
Age:1.0  Onset:2007-05-02, Days after vaccination: 2
Gender:Female  Submitted:2007-05-06, Days after onset: 4
Location:North Carolina  Entered:2007-05-06
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: Doctor could not find anything standard wrong. Some fluid in ear, but not infection. Prescribed continued use of motrin.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER   L
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER   L
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER   L
Administered by: Private     Purchased by: Unknown
Symptoms: Anorexia, Insomnia, Irritability, Middle ear effusion, Nasal congestion, Pyrexia, Rhinorrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Fever 2 days later of constant 102 degrees. Lasted for 5 days. Conjestion, runny nose, lost of appetite, vomiting, fussiness, insomnia. Used motrin to control fever.

VAERS ID:278071 (history)  Vaccinated:2007-04-30
Age:1.3  Onset:2007-05-06, Days after vaccination: 6
Gender:Male  Submitted:2007-05-07, Days after onset: 1
Location:Illinois  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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B042BA3IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08681D3IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Injection site erythema, Injection site mass, Rash, Rash generalised
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccines were given on 4/30/2007. Yesterday 05/06/2007, in the morning Mother noticed small slightly raised rash on upper abdominal area. Throughout the day she noted it getting worse and by this morning he had the rash all over his trunk, legs, arms and head. She said she wouldn''t have given the vaccines he received a week ago any thought, but there was a distinct redness and lump aroud the injection site of his right leg. Prior to this rash, he did not seem to have any problems following the vaccinations. Mom took him to an Immediate Care Facility. this morning where the Dr. told her it was an allergic reation but to what is still in question. He advised her to give Benadryl and report the reaction to our facility, although it is doubtful that this episode was due to the vaccination received on the 30th of April.

VAERS ID:278076 (history)  Vaccinated:2007-04-30
Age:4.0  Onset:0000-00-00
Gender:Male  Submitted:2007-05-07
Location:Illinois  Entered:2007-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Preterm, GER
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2650AA4IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY06383IMLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0521F1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Anorexia, Fatigue, Injection site erythema, Injection site pain, Injection site rash, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Local pain at site(R Shoulder), developed several hours later, then fever and fatigue present the next day with loss of appetite. This continued into day 2 post vac at which time developed rash over injection site had nausea and vomited one time. At this time (day 3 post vac) seems better with non-tender erythema over injection site. Now affebrile and otherwise asymptomatic.

VAERS ID:278183 (history)  Vaccinated:2007-04-30
Age:13.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-05-08, Days after onset: 7
Location:Texas  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: Astelin, Zyrtec D
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.1424F0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1504F1SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling of injection site, red and hot to touch, later that evening throat "felt swollen itchy" went to ER prednisolone 10 mg x 5 days.

VAERS ID:278332 (history)  Vaccinated:2007-04-30
Age:4.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Male  Submitted:2007-05-02, Days after onset: 1
Location:Illinois  Entered:2007-05-10, 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: Zyrtec po daily
Current Illness: none
Preexisting Conditions: Murmur 1/6 (11/05)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2406AA4IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURY10503IMRA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.1386F1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Vaccine given 4-30-07. Redness, swelling, hot, tender (R) shoulder to elbow and across pectoral major.

VAERS ID:278347 (history)  Vaccinated:2007-04-30
Age:27.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Male  Submitted:2007-05-04, Days after onset: 4
Location:Washington  Entered:2007-05-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS 0IMUN
Administered by: Other     Purchased by: Private
Symptoms: Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Became very nauseated and pale

VAERS ID:278509 (history)  Vaccinated:2007-04-30
Age:40.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-05-08, Days after onset: 7
Location:South Carolina  Entered:2007-05-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Amoxil, Emitrex, Septra, IVP dye
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2644AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, body aches, Arm red and hard. Tx''d with Claritin, Tylenol, Celestone

VAERS ID:278559 (history)  Vaccinated:2007-04-30
Age:4.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Maryland  Entered:2007-05-14
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
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2489AA4IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ00013IMRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0639P2SCRL
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis
SMQs:
Write-up: Cellulitis of left thigh requiring antibiotics.

VAERS ID:278580 (history)  Vaccinated:2007-04-30
Age:0.4  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-05-08, Days after onset: 7
Location:Virginia  Entered:2007-05-15, Days after submission: 7
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: None PMH congested for 2 weeks with croupy cough and croupy sounds while feeding.
Preexisting Conditions: None
Diagnostic Lab Data: CXR, CBC, Bld cx, UA, UCx records received 5/16/07- Barium enema reflux up to throacic esophagus without fistula or obstruction. WBC 23.8. Blood and urine cultures no growth. CXR normal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2605AA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF100AA1IM 
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ05481SC 
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB08670B1IM 
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1110F1PO 
Administered by: Private     Purchased by: Private
Symptoms: Barium enema, Blood culture, Blood culture negative, Chest X-ray, Chest X-ray normal, Culture urine, Culture urine negative, Decreased appetite, Full blood count, Gastrooesophageal reflux disease, Grunting, Otitis media, Pyrexia, Respiratory distress, Tympanic membrane hyperaemia, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific dysfunction (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Fever to 102.9 the next day 05/16/07-records received from facility for DOS-5/1-5/2/07-DC DX: Fever, GERD. Otitis Media. Fever 101.9 and grunting. Not eating well. In office appeared to be in respiratory distress. PE: right tympanic membrane erythematous and bulging.

VAERS ID:278607 (history)  Vaccinated:2007-04-30
Age:0.3  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-08, Days after onset: 8
Location:North Carolina  Entered:2007-05-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Markedly elevated WBC count. Normal EEG on following day. Labs and Diagnostics: CBC with WBCs of 33.8, H&H 11.3 & 35.2, platelets 546. Differential-64% neutrophils, 21% lymph, 7 monos, 5 bands, and 3 reactive lymphs. Chemistry WNL. W
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU1985CA1IMLL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.1272F1IMLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ032621SCRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB26510F1IMRL
Administered by: Private     Purchased by: Private
Symptoms: Blood culture negative, Chest X-ray normal, Culture stool negative, Electroencephalogram normal, Immunisation reaction, Laboratory test normal, Lethargy, Mental status changes, Pallor, Platelet count increased, Unresponsive to stimuli, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Several hours after receiving vaccine,s patient had a prolonged episode of pallor and diminished response. 06/18/2007 MR received for o/n admission for observation after developing multiple episodes of vomiting followed by pallor and lethargy several hours after vax. Initially appeared quite ill upon arrival in the ER, but became alert, awake and smiling after IV hydration. No further episodes during admission. Impression: Vomiting, altered mental status 2'' immunizations.

VAERS ID:278698 (history)  Vaccinated:2007-04-30
Age:14.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Male  Submitted:2007-05-02, Days after onset: 2
Location:Texas  Entered:2007-05-16, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: No allergies, normal neurological exam
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU21369AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Feeling hot, Head discomfort, Malaise, Photophobia
SMQs:, Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: Not feeling well, his head was "heavy", felling hot and her photo phobia (not tolerate the light).

VAERS ID:278727 (history)  Vaccinated:2007-04-30
Age:0.2  Onset:2007-05-01, Days after vaccination: 1
Gender:Male  Submitted:2007-05-11, Days after onset: 10
Location:Rhode Island  Entered:2007-05-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: WBC NL, BM BX -, LFTs WNL; COAG, Triglyceride NL, no urine protein, antitrypsin -, Rota, HIV, RPR, Parvovirus, EBV -, IgG, A.M.E. WNL. U/S dilated Lt ureter.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSC21B100AA0 RL
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.0062U0 LL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB086980 LL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1166F0PO 
Administered by: Private     Purchased by: Public
Symptoms: Anaemia, Biopsy bone marrow, Blood immunoglobulin A, Blood immunoglobulin E, Blood immunoglobulin G normal, Blood immunoglobulin M, Blood triglycerides normal, Candidiasis, Coagulation test normal, Decreased appetite, Diarrhoea, Epstein-Barr virus antibody negative, HIV test negative, Haematocrit decreased, Haemoglobin decreased, Hepatomegaly, Hypoalbuminaemia, Liver function test normal, Nasal congestion, Parvovirus B19 serology negative, Post-tussive vomiting, Pyrexia, Rash papular, Rotavirus test negative, Skin hypopigmentation, Syphilis test negative, Thrombocytopenia, Transfusion, Ultrasound scan abnormal, Ureteric dilatation, Urine protein/creatinine ratio normal, White blood cell count, Xanthogranuloma
SMQs:, Liver related investigations, signs and symptoms (narrow), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (narrow), Pseudomembranous colitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Diarrhea and fever (102) x 1 week s/p vaccine (2 month imms). -anemia -thrombocytopenia -hypoalbuminemia (severe 1.2) -hepatomegaly, -sm hypopigmented papules on forehead and abd (about 8). 6/8/07 Received medical records from hospital which reveal patient experienced fever, nasal congestion, decreased appetite, diarrhea & post tussive vomiting since receiving vax on 4/30/07. Found to have thrush, congestion, anemia, thrombocytopenia & hepatomegaly in ER. Admitted 5/7-5/19/07. Consults by Heme/onc, Rheumatology, dermatology, ID, GI. Received multiple transfusions of PRBCs & platelets. Improved slowly & d/c to home w/PICC line & home health nursing. LABS: bone marrow biopsy 5/10. Admit H/H 6.0/18.3. Final H/H 7.3/21.6. Parvovirus IgG elevated 1.1. EBNA elevated 1.59 FINAL DX: juvenile xanthogranuloma/ss 6/22/07 Received med recs from provider which included vax rec that confirmed RO lot & dose as reported. Only health problem noted was mild torticollis on day of vax 4/30/07.

VAERS ID:279673 (history)  Vaccinated:2007-04-30
Age:20.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-14, Days after onset: 14
Location:New Jersey  Entered:2007-05-17, 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: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA00433
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0187U0UNUN
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Immediate post-injection reaction, 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), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from a physician, via a company representative, concerning a 19 year old female patient who on 30-APR-2007 was vaccinated with the first dose of Gardasil. The physician reported that the patient "passed out immediately after receiving first dose of Gardasil; "she added that that patient had not eaten all day prior to receiving the vaccination. The patient recovered on 30-APR-2007, the same day of vaccination. The patient sought unspecified medical attention. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. Initial and follow up information has been received from a physician and a healthcare worker, concerning a 20 year old (previously reported as 19 year old) female patient, with no known drug allergies, who on 30-APR-2007, at 11:45am, was vaccinated with the first dose of GARDASIL (Lot #656049/0187U). There was no illness at the time of vaccination. The physician originally reported that the patient "passed out immediately after receiving first dose of GARDASIL" but the healthcare worker (who administered the vaccination), clarified that at 11:55am, the patient "felt dizzy and complained of nausea, she dropped to the floor, but was conscious". The patient''s blood pressure was reported as normal, and she was helped to a chair, given water, and was then okay. The physician added that the patient had not eaten all day prior to receiving the vaccination. The patient recovered on 30-APR-2007, the same day of vaccination. No further information is expected.

VAERS ID:279018 (history)  Vaccinated:2007-04-30
Age:12.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-05-18, Days after onset: 17
Location:Colorado  Entered:2007-05-18
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 known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0308U1SCLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: received VAR #2 vaacine. Next day had redness, swelling, hot but soft to touch. The following day redness was twice as large and center was firm to touch. Patient was put on Cephalexin 500 mg PO TID x 10 days and recovered.

VAERS ID:279282 (history)  Vaccinated:2007-04-30
Age:18.0  Onset:2007-05-03, Days after vaccination: 3
Gender:Female  Submitted:2007-05-22, Days after onset: 19
Location:Georgia  Entered:2007-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: streptococcal pharyngitis
Preexisting Conditions: Cechlor
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.97224041IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Asthenia, Headache, Hypoaesthesia, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Severe headache, Nausea, Weakness, Numbness in fingers, arms, joint pain, myalgia - symptomatic treatment

VAERS ID:279441 (history)  Vaccinated:2007-04-30
Age:0.2  Onset:2007-05-11, Days after vaccination: 11
Gender:Male  Submitted:2007-05-14, Days after onset: 3
Location:California  Entered:2007-05-23, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B084BA0 LL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF086AA0 LL
Administered by: Other     Purchased by: Public
Symptoms: Injection site nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left thigh has a 1/2cm nodule where the IZ" where administered.

VAERS ID:282564 (history)  Vaccinated:2007-04-30
Age:0.5  Onset:2007-05-02, Days after vaccination: 2
Gender:Unknown  Submitted:2007-06-01, Days after onset: 30
Location:Georgia  Entered:2007-06-18, Days after submission: 17
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: WAES0705USA01000
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC. 2PO 
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Information has been received from a physician concerning a 6 month old patient who on 03-APR-2007 was vaccinated with a 2mL oral third dose of Rotateq. On 02-MAY-2007, two days after vaccination, the patient developed severe diarrhea and vomiting. Unspecified medical attention was sought. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:282573 (history)  Vaccinated:2007-04-30
Age:18.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-14, Days after onset: 14
Location:Ohio  Entered:2007-06-18, Days after submission: 35
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: 200701626
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Neck pain, Pain in extremity
SMQs:, Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Initial report received from a parent (who is also a nurse) in the USA on 09 May 2007. An 18 year old, female patient experienced pain spreading up to neck and down top of arm after she received Adacel (lot number and route of administration not reported) on 30 April 2007. The reporter stated the vaccine appeared to be administered high on the arm, in the shoulder area (in the shoulder joint) and the patient experienced the pain as soon as the vaccine was given. It was reported the pain was becoming progressively worse. At the time of the report, the patient had not recovered.

VAERS ID:283201 (history)  Vaccinated:2007-04-30
Age:82.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 45
Location:Arizona  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: PERCOCET; NORVASC; LIPITOR; calcium (unspecified); citalopram; glipizide; hydrochlorothiazide; PRINIVIL; omeprazole; OXYCONTIN; paclitaxel; LYRICA; HERCEPTIN
Current Illness: Coronary disease; Diabetes; Chronic kidney disease; Hypertension; Breast cancer metastatic; Chemotherapy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA03353
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Rash
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 an 82 year old female with metastatic breast cancer on chemotherapy, coronary disease, diabetes, chronic kidney disease and hypertension who on 30-APR-2007 was vaccinated with a dose of Zostavax. Concomitant therapy included OXYCONTIN, hydrochlorothiazide, glipizide, omeprazole, PERCOCET, lisinopril (manufacturer unknown), NORVASC, LYRICA, LIPITOR, citalopram, calcium (unspecified), HERCEPTIN and paclitaxel. On approximately 04-MAY-2007 the patient developed a rash which was cutaneous eruptions of zoster on her abdomen and perivaginal area. Unspecified medical attention was sought. The patient was treated with famcyclovir and the rash was getting better. There were no laboratory tests performed. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:283778 (history)  Vaccinated:2007-04-30
Age:21.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-06-14, Days after onset: 44
Location:Unknown  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: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA01317
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from an approximately 21 year old female who on 30-APR-2007 was vaccinated with Gardasil. There was no concomitant medication. On 01-MAY-2007 the patient experienced small bumps which spread across her upper torso (not red or itchy) approximately 12 hours after her 1st dose. As of 05-MAY-2007, the patient was not recovered. At the time of this report, the patient had not sought medical attention. No further information is available.

VAERS ID:283985 (history)  Vaccinated:2007-04-30
Age:20.0  Onset:2007-05-04, Days after vaccination: 4
Gender:Female  Submitted:2007-06-14, Days after onset: 41
Location:Illinois  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: WAES0705USA03122
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician, via a company representative, concerning a female patient in her 20''s, who on 30-APR-2007 was vaccinated IM in the deltoid, with a 0.5ml dose of Gardasil. On 04-MAY-2007, "four days post vaccination," the patient developed "red, itchy hives at the injection site." At the time of this report, the patient had not recovered. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:284149 (history)  Vaccinated:2007-04-30
Age:20.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 45
Location:Illinois  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic reaction to antibiotics
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03593
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0244U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Drug hypersensitivity, Dyspnoea, Feeling abnormal, Panic attack
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a mother concerning her 20 year old daughter with a history of allergic reaction to antibiotics (unspecified) who on 30-APR-2007, at 3:00 p.m. was vaccinated intramuscularly with Gardasil (Lot number 656051/0244U). There was no concomitant medication. On 30-APR-2007, after one half hour after receiving the vaccine, the patient experienced an unbalanced feeling "panic attack", pressure on her chest and difficulty breathing. The mother also mentioned that her 2 other daughters experienced the same reactions with two doses of the vaccine but not as severe. The physician reported that the symptoms were not reported to him until 29-MAY-2007 when he called the patient "to find out." No further details were provided. Additional information has been requested.

VAERS ID:284152 (history)  Vaccinated:2007-04-30
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-06-14
Location:Unknown  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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03664
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0244U1IMUN
Administered by: Private     Purchased by: Other
Symptoms: Balance disorder, Chest discomfort, Dyspnoea, Feeling abnormal, Panic attack, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Information has been received from a mother concerning her 16 year old daughter who in February 2007, was vaccinated with Gardasil. In February 2007, the patient experienced difficulty breathing, unbalanced feeling, "panic attack" and pressure on her chest. On 30-APR-2007 the patient received her second dose of the vaccine and again experienced unbalanced feeling, "panic attack", pressure on her chest and difficulty breathing. This is one of three reports received from the mother. These reactions occurred in less severe form than her sister which was reported in WAES #0705USA03593. No further details were provided. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a mother and a physician concerning her 16 year old daughter who in February 2007, was vaccinated with the first dose of GARDASIL. In February 2007, the patient experienced difficulty breathing, unbalanced feeling, "panic attack" and pressure on her chest. On 30-APR-2007 (also reported as 30-MAR-2007), the patient received her second dose of GARDASIL, (lot #656051/0244U), IM. Again the patient experienced unbalanced feeling, "panic attack", pressure on her chest and difficulty breathing. This is one of three reports received from the mother. These reactions occurred in less severe form than her sister which was reported in WAES #0705USA03593. No further details were provided. Additional information is not expected.

VAERS ID:284153 (history)  Vaccinated:2007-04-30
Age:17.0  Onset:0000-00-00
Gender:Female  Submitted:2007-06-14
Location:Unknown  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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03665
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0244U IMUN
Administered by: Private     Purchased by: Other
Symptoms: Chest discomfort, Dyspnoea, Feeling abnormal, Panic attack, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Information has been received from a mother concerning her 16 year old daughter who in February 2007, was vaccinated with Gardasil. In February 2007, the patient experienced difficulty breathing, unbalanced feeling, "panic attack" and pressure on her chest. On 30-APR-2007 the patient received her second dose of the vaccine and again experienced unbalanced feeling, "panic attack" pressure on her chest and difficulty breathing. This is one of three reports received from the mother. These reactions occurred in less severe from than her older sister which was reported in WAES #0705USA03593. No further details were provided. Additional information has been requested. This is in follow-up to report (s) previously sumbitted on 6/14/2007.

VAERS ID:284504 (history)  Vaccinated:2007-04-30
Age:11.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 45
Location:New York  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA05336
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0387U1IMUN
Administered by: Private     Purchased by: Public
Symptoms: Feeling hot, 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 and follow up information has been received from a nurse concerning a female patient between the ages of 11 and 19 who was vaccinated with a first dose of Gardasil. It was reported that the patient sat for a minute (after receiving the injection) and when she got up to leave she fainted in the hallway. Her outcome was not reported. The physician reported that lot numbers were not available, however, the physician will forward other information including the lot numbers. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Follow up information has been received from a health professional concerning the 12 year old female student with no medical history who on 30-APR-2007 received her second IM dose of GARDASIL, lot #657621/0387U. The immunization was followed by a warm sensation all over. The patient laid down for 10 minutes and felt better with no further incident. No treatment was necessary. She was reported as recovered after an unspecified time. Additional information is not expected.

VAERS ID:284561 (history)  Vaccinated:2007-04-30
Age:18.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 45
Location:California  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: Unknown
CDC Split Type: WAES0706USA00049
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a physician concerning an 18 year old female who on approximately 30-APR-2007 was vaccinated with the first dose of Gardasil. It was reported that as the patient was leaving the medical office, she lost consciousness and fainted. The patient regained consciousness and remained in the office for a period of time for observation and was given liquids. The patient recovered and subsequently left the office. Additional information has been requested.

VAERS ID:283503 (history)  Vaccinated:2007-04-30
Age:88.0  Onset:2007-05-15, Days after vaccination: 15
Gender:Male  Submitted:2007-06-29, Days after onset: 45
Location:California  Entered:2007-07-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: aortic stenosis
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA04885
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SC 
Administered by: Other     Purchased by: Other
Symptoms: Bronchitis, Condition aggravated
SMQs:
Write-up: Information has been received from a physician concerning an 88 year old male with a history of aortic stenosis who on 30-APR-2007 was vaccinated with a dose of Zostavax. Concomitant therapy included "a lot of medications" (therapy unspecified). On 15-MAY-2007 the patient experienced exacerbated bronchitis and was admitted to the hospital. The patient''s exacerbated bronchitis persisted. The reporter felt that exacerbated bronchitis was not related to therapy with Zostavax. No product quality complaint. Additional information has been requested.

VAERS ID:284808 (history)  Vaccinated:2007-04-30
Age:5.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2007-07-06, Days after onset: 66
Location:Unknown  Entered:2007-07-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA02146
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0298U SCUN
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning a 5 year old female child with no medical history or allergies who on 30-APR-2007 at 4:00 PM was vaccinated SC on left arm with a dose of ProQuad (Lot# 656313/0298U). At the time of vaccination the patient did not have any illness. One day after vaccination, on 01-MAY-2007 the patient developed red, painful, swollen arm that was warm to touch. No medical attention was sought and no diagnostic laboratory tests were undertaken. A product quality complaint was not involved. Additional information has been received from the registered nurse who reconfirmed that the patient experienced a red, painful, swollen arm that was warm to the touch in the AM of 01-MAY-2007. It was reported that the patient recovered on 03-MAY-2007. No further information is expected. This is one of several reports received from same source.

VAERS ID:284810 (history)  Vaccinated:2007-04-30
Age:1.0  Onset:2007-05-07, Days after vaccination: 7
Gender:Male  Submitted:2007-07-06, Days after onset: 60
Location:New Mexico  Entered:2007-07-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: body temp 05/07?/07 101 F - fever
CDC Split Type: WAES0705USA02414
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.1556F SCUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a registered nurse concerning a 12 month old male patient with no medical history or allergies who on 30-APR-2007 was vaccinated SC with 0.5 ml dose of Proquad (Lot # 656642/1556F). There was no concomitant medication. On 07-MAY-2007 the patient started experiencing an "on and off" fever of 100 F for about 1 week. The patient also developed a rash on the left thigh that looks like a group formation of 5 red bumps together. Unspecified medical attention was sought. No diagnostic laboratory procedures were performed. At the time of report, the patient had not recovered. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:284819 (history)  Vaccinated:2007-04-30
Age:1.0  Onset:2007-05-10, Days after vaccination: 10
Gender:Male  Submitted:2007-07-06, Days after onset: 57
Location:Texas  Entered:2007-07-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02919
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0294U SCUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash macular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health professional concerning a 12-month-old male who on 30-APR-2007 was vaccinated SC with 0.5 ml of ProQuad (Lot #657264/0294U). On 10-MAY-2007 the patient experienced fever and rash with macules on the torso and face. Medical attention was sought. The patient''s outcome was not reported. Additional information has been requested.

VAERS ID:293950 (history)  Vaccinated:2007-04-30
Age:11.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-09-24, Days after onset: 147
Location:Ohio  Entered:2007-09-27, 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: ADDERALL XR, 20 mg
Current Illness: Attention deficit/hyperactivity disorder
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA02582
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1968AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2457AA0IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1477F0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Headache, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Information has been received from a health professional concerning a 11 year old female with hyperactivity attention deficit disorder and no known allergies who on 30-APR-2007 at 16:30 was inadvertently vaccinated SC in the right arm with a first dose of Zostavax (Oka/Merck) (lot # 656413/1477F) instead of Varivax (Oka/Merck) (MSD). Concomitant vaccination included a first dose of ADACEL (lot # C2457AA) given IM in the left deltoid and a first dose of MENACTRA (lot # U1968AA) given IM in the right deltoid. Other concomitant therapy included ADDERALL XR 20 mg which was started on 30-APR-2007. Three days after vaccination on 03-MAY-2007, the patient experienced a headache. Unspecified medical attention was sought. There was no product quality complaint involved. Additional information indicated from the registered nurse indicated that she did not know why the patient was vaccinated with Zostavax (Oka/Merck) (lot # 656413/1477F) instead of Varivax (Oka/Merck) (MSD). She stated that Zostavax (Oka/Merck) was kept in the freezer with no other vaccines, they were storing it for the internal medicine department. She was not sure why the individual went to this freezer instead of the going to the correct freezer. That same day the patient was also started on ADDERALL XR 20 mg. The nurse reported that the patient returned to the office on 03-MAY-2007 complaining of a headache and loss of appetite. At the exam, it was determined that the symptoms were side effects from her starting ADDERALL XR 20 mg on 01-MAY-2007 (also reported as 30-APR-2007). The patient subsequently recovered from the headache. She had no other complications. Additional information has been requested.

VAERS ID:292253 (history)  Vaccinated:2007-04-30
Age:17.0  Onset:2007-05-04, Days after vaccination: 4
Gender:Female  Submitted:2007-09-28, Days after onset: 147
Location:New York  Entered:2007-10-05, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 10/7/06 - Virus 11/15/06 - Fever 5/4/07 Bruises
Preexisting Conditions: None
Diagnostic Lab Data: Chronic thrombocytopenia Low platelet count from (3,000) - no medication is causing remission 12/26/07-records received-a positive anti-gliadin antibody, a borderline H. Pylori serum antigen and a normal tissue transglutaminase.platelets fluctuate between 3 and 110.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Contusion, Petechiae, Platelet count decreased, Thrombocytopenia
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pronounced bruising then developed petechiae on ankles shoulders, neck, torso and face. Called Dr. (internist) in June-took blood 6/22/07-Blood work revealed thrombocytopenia at (8000) immediately went to Oncologist Dr. Levels went to (3,000) on (win Ro) Prednisone since 6/25 to present. 10/15/07-records received- office visit 5/4/07-C/O irregular menses. First and second doses of Gardisil no complaints. Note on 6/13/07-C/O easy bruising, dots on skin more on legs than anywhere else. Positive ecchymosis, petcchia. To see hematologist. 12/26/07-records received for DOS 6/25-11/9/07-Receiving WINRHO. Gastroenterology consultation 12/14/07-presented with ITP, No abdominal pain, fever, weight loss, early stiety, anoreixia, nausea, vomiting, melena, hematemesis, rectal bleed. PE: enlarged thyroid. Impression:eradicationof H. pylori may be associated with improvement of ITP. 1/12/2010 According to various health professionals. The Gardasil shots is the primary cause for my daughter''s immune dysfunction. My daughter did not have any prior illness that caused her present condition of (ITP).

VAERS ID:294860 (history)  Vaccinated:2007-04-30
Age:61.0  Onset:2007-05-02, Days after vaccination: 2
Gender:Male  Submitted:2007-10-30, Days after onset: 181
Location:California  Entered:2007-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: see above
Preexisting Conditions: Hemachromatosis
Diagnostic Lab Data: Audiology exam, MRI, lab & ENT consultation
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURERXXX  RA
Administered by: Private     Purchased by: Unknown
Symptoms: Audiogram, Condition aggravated, Laboratory test, Nuclear magnetic resonance imaging, Tinnitus, Vertigo
SMQs:, Hearing impairment (narrow), Vestibular disorders (narrow)
Write-up: Pt had mild tinniuts and vertigo before vaccine which then became disabling; it is slowly resolving 6 months later; his wife had milder, but similar sx after vaccine as well

VAERS ID:303684 (history)  Vaccinated:2007-04-30
Age:18.0  Onset:2007-05-30, Days after vaccination: 30
Gender:Female  Submitted:2008-01-15, Days after onset: 230
Location:Texas  Entered:2008-01-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0712USA06045
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Anogenital warts, Condition aggravated, Inappropriate schedule of drug administration
SMQs:, Medication errors (narrow)
Write-up: Information has been received from a physician concerning an 18 year old female patient who on 30-APR-2007 was vaccinated with a first dose of Gardasil. She received her second dose of Gardasil on 12-DEC-2007. The physician reported that the patient developed a "flare up" of genital warts after receiving the second injection. The patient reported that the non specific increase in amount of genital warts began about one month after the patient received the first dose of Gardasil on 30-APR-2007. The physician stated he did not examine the patient and the symptoms were self reported. Additionally, the patient reported the increase in genital warts to the patient''s gynecologist (unspecified name). No other symptoms and no other information available at the time of this report. The outcome was unknown. Additional information has been requested.

VAERS ID:304090 (history)  Vaccinated:2007-04-30
Age:33.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Male  Submitted:2007-12-07, Days after onset: 220
Location:New York  Entered:2008-01-29, Days after submission: 53
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: AE0719
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD166 UNUN
Administered by: Other     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Mild redness; within normal limits. No swelling.

VAERS ID:309244 (history)  Vaccinated:2007-04-30
Age:33.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2008-04-10, Days after onset: 346
Location:Unknown  Entered:2008-04-10
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: Since 2000, the subject was taking bupropion hydrochloride (for depression), was taking omeprazole since 01 April 2007 (for gastroesophageal reflux disease), and used baclofen and Vicodin for chronic pain control.
Current Illness:
Preexisting Conditions: The subject has a medical history of tension headaches, anxiety-depressionbipolar disorder, reflux esophagitis and gastroeseophageal reflux disease. In 2005, she was diagnosed with chronic lower back pain associated with disc disease. In November 2006, the subject developed migrainous headache for which a CAT scan of the head without contrast was unremarkable on 01 March 2007.
Diagnostic Lab Data: A MRI of the brain performed the same day was suspicious for an early demyelinating process. The cervical spine MRI was within normal limits, as were the visual evoked potentials and the brainstem evoked potentials. On 01 May 2007, the MR
CDC Split Type: B0470726A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Brain stem auditory evoked response normal, Demyelination, Intervertebral disc disorder, Migraine, Nuclear magnetic resonance imaging brain abnormal, Nuclear magnetic resonance imaging normal, Spinal X-ray normal, Vision blurred, Visual evoked potentials normal
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)
Write-up: This 33-year old female subject was enrolled in the prophylactic observer blind study 108933 (HPV-010) which compares GSK''s Human Papillomavirus type 16 and 18 vaccine to Merck''s GARDASIL. She received three doses of blinded vaccine on 21 February 2007, 28 March 2007 and 30 April 2007. The subject has a medical history of tension headaches, anxiety-depression bipolar disorder, reflux esophagitis and gastrooesophageal reflux disease. In 2005, she was diagnosed with chronic lower back pain associated with a disc disease. In November 2006, the subject developed migrainous headache for which a CAT scan of the head without contrast was unremarkable on 01 March 2007. Since 2000, the subject was taking bupropion hydrochloride (for depression), was taking Omeprazole since 01 April 2007 (for gastrooesophageal reflux disease), and used baclofen and vicodin for chronic pain control. On 30 April 2007, 33 days after the second of vaccine and on the same day as the third dose of vaccine, the subject went to the emergency room because of blurred vision. A MRI of the brain performed the same day was suspicious for an early demyelinating process. The cervical spine MRI was within normal limits, as were the visual evoked potentials and brainstem evoked potentials. She was treated with sodium chloride, prednisone and methylpredisolone sodium succinate for treatment of multiple sclerosis. Following this treatment, the double vision resolved. On 01 May 2007, the MRI of the cervical spine with and without contrast was negative. She was discharged from the hospital on 02 May 2007. At the time of reporting, the event was unresolved. The subject is being followed by a neurologist. The investigator considered there was no reasonable possibility that the multiple sclerosis may have been caused by the administration of the investigational product. Expert review: A blinded review of the case by an independent expert did not support the diagnosis of multiple sclerosis as this diagnosis required a dissemination of lesions in space and time. Th

VAERS ID:312345 (history)  Vaccinated:2007-04-30
Age:17.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2008-05-14, Days after onset: 380
Location:Illinois  Entered:2008-05-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: vitamins (unspecified)
Current Illness: Pregnancy NOS (LMP = 6/1/2007)
Preexisting Conditions:
Diagnostic Lab Data: ultrasound 08/16/07 - 7 weeks pregnancy, EDC 3/4/08; diagnostic laboratory - biophysical profile; diagnostic test - Amniotic fluid index (AFI); fetal nonstress test 12/27/07 - Weekly starting 27-DEC-2007 then twice weekly till 28-JAN-2008;
CDC Split Type: WAES0707USA01072
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0387U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Amniotic fluid index, Blood urea increased, Diagnostic procedure, Drug exposure during pregnancy, Echocardiogram normal, Nausea, Pityriasis, Threatened labour, Ultrasound scan abnormal
SMQs:, Acute renal failure (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial and follow up information has been received from a Registered Nurse (R.N.) concerning a 17 year old female who on 30-APR-2007 was vaccinated IM with a first dose of Gardasil lot # 657621/0387U. Concomitant therapy included prenatal vitamins (unspecified). The nurse reported that the patient became pregnant sometime after her first injection. Patient was positive over the counter pregnancy test. In follow up it was reported that on 16-AUG-2007 ultrasound showed 7 weeks pregnancy and the expected date 04-MAR-2008. The patient''s outcome was unknown. In follow up information from doctor''s office it was reported that patient was treated with prenatal vitamins starting from 15-AUG-2007 for pregnancy. On 16-AUG-2007 she was diagnosed pityriasis. On 05-SEP-2007 patient was treated with 10 mg REGLAN for nausea every 6 hour as needed. Fetal arrhythmia was detected at 20 weeks of her pregnancy. She saw maternal Fetal Medicine (MFM) doctor and her fetal cardiac ultrasound was normal. It was reported that she had threatened preterm labor and on 08-NOV-2008, she was treated with magnesium sulfate intravenous (IV) in the hospital for it. After she was off magnesium sulfate she was treated with PROCARDIA 20 mg every 6 hour for preterm labor. On 08-NOV-2008 she was noted to be positive ureaplasma of the vagina/cervix. Other laboratory tests included biophysical profile, Amniotic fluid index (AFI), Non stress test (NST) was done weekly starting 27-DEC-2007 and then twice weekly till 28-JAN-2008. It was reported that patient had a normal female baby on 12-MAR-2008, 41 weeks from her last menstrual period. The baby weighed 8lb 1oz and her Apgar score was 8/9. There were no abnormalities reported. Additional information has been requested.

VAERS ID:315741 (history)  Vaccinated:2007-04-30
Age:14.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2008-05-16, Days after onset: 381
Location:California  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA00747
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0363U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered nurse concerning a 14 year old female with no medical history and no allergies who on 30-APR-2007 was vaccinated with a second 0.5mL subcutaneous dose of varicella virus vaccine live (Oka/Merck) (Lot# 657193/0363U)in the left arm. There were no concomitant medications. There was no illness at the time of vaccination. On 01-MAY-2007, in the morning, the patient experienced a baseball sized red, hot, swollen and painful area of the arm at the injection site that was warm to touch. No treatment was required. There were no laboratory or diagnostic tests performed. The patient recovered on 03-MAY-2007. No additional information was available. No product quality complaint was involved. This is one of several reports received from the same source. Follow-up information received from a registered nurse stated that the patient''s symptoms were self-limiting and went away in approximately 72 hours. There was no treatment necessary. There were no other visits nor was any follow-up needed. No further information is expected.

VAERS ID:315748 (history)  Vaccinated:2007-04-30
Age:1.0  Onset:2007-05-01, Days after vaccination: 1
Gender:Female  Submitted:2008-05-16, Days after onset: 381
Location:Texas  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA00833
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1009F0IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1026F0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1503F0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Varicella post vaccine
SMQs:
Write-up: Information has been received from a health professional concerning a 12 month old female, with no medical conditions or pre existing allergies, who on 30-APR-2007, at 14:30, was vaccinated subcutaneously into the left arm with a first dose of varicella virus vaccine live (Oka/Merck) (Lot # 656279/1503F). Concomitant therapy, that same day, included a first dose of Vaqta administered intramuscularly into the left thigh (Lot# 655320/1009F) and a first dose of M-M-R II administered subcutaneously into the right arm. There was no illness at the time of vaccination. On 01-MAY-2007, at 19:00, the patient developed a breakthrough of chickenpox, consisting of approximately 14-16 lesions, including one in the oral cavity. Unknown medical attention was sought. There was no product quality complaint. There were no lab diagnostic studies performed. At the time of reporting the patient''s status was unknown. Additional information is not expected.

VAERS ID:314740 (history)  Vaccinated:2007-04-30
Age:34.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:North Dakota  Entered:2008-06-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2730AA UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site atrophy, Injection site discolouration
SMQs:
Write-up: Indention in right arm where shot was given - left indention and round purple mark

VAERS ID:315849 (history)  Vaccinated:2007-04-30
Age:20.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2008-06-09, Days after onset: 406
Location:Utah  Entered:2008-06-10, 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: ALDARA
Current Illness: Pregnancy NOS (LMP = 4/10/2007)
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0705USA02699
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0210U0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Caesarean section, Drug exposure during pregnancy, Foetal malposition
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a physician and a 20 year old female consumer through a Merck pregnancy registry with no allergies and a history of 1 pregnancy and 1 live birth who on 30-APR-2007 was vaccinated with the first dose of GARDASIL (lot #0210U), 0.5 ml. Concomitant therapy included ALDARA. In approximately April 2007, it was determined that the patient was pregnant. The date of last menstrual period was 10-APR-2007 and estimated delivery date was reported as 15-JAN-2008. It was reported that the patient has had no ill effects. On 15-JAN-2008, the patient reported that she delivered a healthy baby girl weighing 7 lbs. 13 oz. via primary cesarean due to fetal malposition (baby was transverse). At the time of reporting, it was noted that mother and baby are both well, "without any problems." No further information is available.

VAERS ID:334826 (history)  Vaccinated:2007-04-30
Age:12.0  Onset:2007-08-01, Days after vaccination: 93
Gender:Female  Submitted:2010-06-08, Days after onset: 1042
Location:Unknown  Entered:2008-11-17, Days after submission: 567
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Diagnostic laboratory, normal; Ultrasound, normal; Computed axial, normal.
CDC Split Type: WAES0810USA04517
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Computerised tomogram normal, Inappropriate schedule of drug administration, Laboratory test normal, Ultrasound scan normal
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)
Write-up: Information has been received from a female consumer, concerning her 13 year old daughter with no medical history or allergies who on 12-FEB-2007 was vaccinated with the first dose of GARDASIL, the second dose on 30-APR-2007 and the third dose on 07-AUG-2007. There was no concomitant medication. The consumer reported that, in August 2007, "not too long after receiving the third dose of GARDASIL", the patient started to have severe stomach pain on her upper left side. The reporter stated that her daughter''s pain level on a scale of 1 to 10 was a 7. The consumer reported that the patient had blood work, ultra sounds and CAT scans done and they all came back normal. The reporter stated that the next time the patient saw the physician they may have to "put a scope in her to check out her stomach area". The patient was not recovered at the time of this report. The patient sought medical attention with a physician. No further information is available. This is in follow-up to report (s) previously submitted on 11/14/2008. Information has been received from a female consumer, concerning her 13 year old daughter with no medical history or allergies who on 12-FEB-2007 was vaccinated with the first dose of GARDASIL, the second dose on 30-APR-2007 and the third dose on 07-AUG-2007. There was no concomitant medication. The consumer reported that, in August 2007, "not too long after receiving the third dose of GARDASIL", the patient started to have severe stomach pain on her upper left side. The reporter stated that her daughter''s pain level on a scale of 1 to 10 was a 7. The consumer reported that the patient had blood work, ultra sounds and CAT scans done and they all came back normal. The reporter stated that the next time the patient saw the physician they may have to "put a scope in her to check out her stomach area". The patient was not recovered at the time of this report. The patient sought medical attention with a physician. This is an amended report. The vaccination date of the third dose of GARDASIL now reads 07-AUG-2007 instead of 07-AUG-2008. No further information is available.

VAERS ID:365427 (history)  Vaccinated:2007-04-30
Age:15.0  Onset:2007-08-30, Days after vaccination: 122
Gender:Female  Submitted:2009-11-05, Days after onset: 798
Location:California  Entered:2009-11-05
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: asthma Allergies: NKDA
Diagnostic Lab Data: CAT Scan, EEG, MRI, Blood work ups Diag/Labs: CT(-), UA(-), tox screen(-), MRI(-), EEG abnormal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1447F0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Aggression, Amnesia, Asthma, Blood test, Computerised tomogram, Computerised tomogram normal, Convulsion, Disorientation, Dizziness, Electroencephalogram, Electroencephalogram abnormal, Fatigue, Flat affect, Incoherent, Incontinence, Lacrimation increased, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging normal, Toxicologic test normal, Unresponsive to stimuli
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Started passing out at school, incoherent and did not recognize people. Was taken to hospital emergency complete blood work including drug testing done, all came back negative. CAT scan done came back negative. Unable to recognize family member that came to hospital and friends. While in hospital she had what we now know 3 seizures. She becomes completely quiet, tears running down face and does not respond to any one. They released her saying it was a reaction to her asthma inhaler. Went to pediatrician next day who thought it may be drugs but drug panel at hospital was negative. Her personality completely changed went from outgoing and friendly, to quiet and tired. On Wednesday September 5 she returned to the pediatrician who suggested she see a specialist she suspected patient was having seizures and her memory had still not returned. Started seeing Dr. on Sept. 6 and he confirmed seizures put on meds. After seizures she becomes very aggravated and mean then take a nap that can last anywhere from a couple hours to all day. There were 2 occasions she lost control of her bodily functions. In October she started have short term memory loss and would ask the same question over and over again. She was taken out of school and put on hospital/home studies for the remainder of her sophmore year. She was taken off all med in the spring of 2008 and her last seizure was in Nov of 2008. 12/16/09 Medical records received for dates 9/16/07 to 3/14/08. DX: seizures. Multiple f/u appts for seizure monitoring. Pt w/ active seizure disorder. 12/17/09 ER records received for date 8/30/07. DX not documented. SX: c/o asthma attack, parents states pt not acting right since the asthma attack. Assessment: flat affect, disoriented. 1/4/2010 Ed note for 9/20/2007, patient with c/o''s dizziness, no tx noted,

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