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Found 500157 cases in entire database

Case Details (Sorted by Vaccination Date)

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VAERS ID:303337 (history)  Vaccinated:2008-01-22
Age:15.0  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-01-23, Days after onset: 1
Location:Kansas  Entered:2008-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2549AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2826AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Headache, Injection site pain, Lethargy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Complaint of injection sites (arms) extremely sore, myalgia, lethargy, headache, dizziness evening of immunizations and next day, not improving with taking Ibuprofen, symptoms not improved day after immunizations.

VAERS ID:303501 (history)  Vaccinated:2008-01-22
Age:7.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Male  Submitted:2008-01-24, Days after onset: 1
Location:Washington  Entered:2008-01-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no present illnesses
Preexisting Conditions: none
Diagnostic Lab Data: Site Reaction (local)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2509AA IM 
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB214AA IM 
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ1069 SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1514U SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Site swelling and redness to the Upper Left Arm (back of arm). Ibuprofen was given to child by his parent along with using cool compresses to injection site. The injection was given at 10:45am.

VAERS ID:303507 (history)  Vaccinated:2008-01-22
Age:9.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Female  Submitted:2008-01-24, Days after onset: 1
Location:Arizona  Entered:2008-01-24
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: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB214AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1175U1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swollen, red, warm to touch. Treated with Keflex, Motrin and warm compresses.

VAERS ID:303526 (history)  Vaccinated:2008-01-22
Age:0.2  Onset:0000-00-00
Gender:Male  Submitted:2008-01-23
Location:Florida  Entered:2008-01-24, 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: NONE
Current Illness: NONE
Preexisting Conditions: Prematurity 29 weeks
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2760AA1IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.0224U1IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA02731SCLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETH847300H1IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0849F0PO 
Administered by: Private     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: The patient was brought in for his 2 month well child visit which usually includes the first set of immunizations. There was no completed immunization record in the patients chart and the physician ordered the following vaccines to be given: DTAP, IPV, HIB/HEP B, PREVNAR and Rotovirus, The vaccines were given as ordered by this writer causing them to be duplicated.;No adverse reaction

VAERS ID:303534 (history)  Vaccinated:2008-01-22
Age:38.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Female  Submitted:2008-01-25, Days after onset: 2
Location:Minnesota  Entered:2008-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: unknown
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2864AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Nausea, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen deltoid muscle with extreme pain to point of immobility lasting almost 2 days. Some nausea.

VAERS ID:303573 (history)  Vaccinated:2008-01-22
Age:66.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Male  Submitted:2008-01-25, Days after onset: 2
Location:Washington  Entered:2008-01-25
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2561AA2IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1380U0SCLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1568U0SCLA
Administered by: Military     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt spouse states extreme redness and swelling at injection site.

VAERS ID:303594 (history)  Vaccinated:2008-01-22
Age:91.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Female  Submitted:2008-01-25, Days after onset: 2
Location:South Dakota  Entered:2008-01-25
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: Hypertension, Hypothyroidism, Vit B12 deficiency, chronic constipation
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0380U1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Pain in extremity, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt received Pneumovax 23 IM in the Lt deltiod on Tuesday, Jan 22. She had a previous dose 10 years ago. She states the arm became sore on Jan 23 with swelling, redness and itching. Swelling and redness became worse on Jan 24 with the swelling and redness going down the arm into the hand. Patient became concerned and came to the clinic for follow up.

VAERS ID:303596 (history)  Vaccinated:2008-01-22
Age:1.3  Onset:2008-01-24, Days after vaccination: 2
Gender:Male  Submitted:2008-01-25, Days after onset: 1
Location:Michigan  Entered:2008-01-25
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: Blood work done at Emergency Department, Tylenol suppository given, Rocephin injection given then patient sent home on amoxicillin.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPH: DTAP + HIB (TRIHIBIT)SANOFI PASTEURU2156CB, UF184A3IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1326F0SCRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB54014D3IMRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1656U0SCLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood test, Convulsion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Had a fever of 101, went to sleep and had a seizure about 20 minutes later. All happened about 52 to 56 hours after immunizations were given.

VAERS ID:303798 (history)  Vaccinated:2008-01-22
Age:22.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Male  Submitted:2008-01-29, Days after onset: 6
Location:Massachusetts  Entered:2008-01-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0989U IMLA
Administered by: Unknown     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: Arm pain, swelling and redness for about 5 days beginning the day after injection in left Deltoid. Responded to ibuprofen and recovered in about 6 -7 days without antibiotic use.

VAERS ID:303898 (history)  Vaccinated:2008-01-22
Age:51.0  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-01-28, Days after onset: 6
Location:Ohio  Entered:2008-01-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB058BA0 LA
Administered by: Other     Purchased by: Other
Symptoms: Feeling hot, Pain, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left deltoid localized pain with swelling, warm to touch, tingling in fingers.

VAERS ID:304044 (history)  Vaccinated:2008-01-22
Age:11.0  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-01-22, Days after onset: 0
Location:Georgia  Entered:2008-01-31, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1355U1SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Mild erythema noted around injection site. Child c/o mild itching. Informed by nurse who administered vaccine to follow-up with their medical doctor if symptoms worsen. Informed of local reactions after vaccines.

VAERS ID:304113 (history)  Vaccinated:2008-01-22
Age:8.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Female  Submitted:2008-01-25, Days after onset: 2
Location:Massachusetts  Entered:2008-02-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Psoriasis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Blister, Cellulitis, Erythema, Oedema peripheral, Tenderness
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Significant arm redness, swelling, exquite tenderness and with a few small coalesced blisters. Total area of erythema covered most of upper arm. Was treated as a cellulitis.

VAERS ID:304337 (history)  Vaccinated:2008-01-22
Age:16.0  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-01-22, Days after onset: 0
Location:Louisiana  Entered:2008-02-05, Days after submission: 14
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: ~DTaP (no brand name)~3~1~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None 2/14/08-records received-HX of psoriasis.
Diagnostic Lab Data: Accu check; CBC; CMP; EEG & EKG 2/14/08-records received-EEG normal awake and drowsy EEG. Labs within normal limits.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1266U0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2323AA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Blood glucose, Convulsion, Dizziness, Dyskinesia, Electrocardiogram, Electroencephalogram normal, Full blood count normal, Gaze palsy, Immediate post-injection reaction, Laboratory test normal, Metabolic function test, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: Seizure like episode lasting approx 10 seconds. 2/14/08-records received for DOS 1/22/08- Became light-headed after vaccination, eye began rolling back, unresponsive to voice. Began jerking movements of right and left arm and head. Post ictal state. 5/27/08-DC Summary received for DOS 1/22-1/23/08-DC DX: Reaction to HPV vaccine. Light headed few seconds after vaccination.

VAERS ID:304393 (history)  Vaccinated:2008-01-22
Age:0.8  Onset:2008-01-22, Days after vaccination: 0
Gender:Male  Submitted:2008-02-06, Days after onset: 15
Location:D.C.  Entered:2008-02-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVH181AA0IMRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: Vaccine administered before 12 months of age.

VAERS ID:304464 (history)  Vaccinated:2008-01-22
Age:1.0  Onset:2008-02-04, Days after vaccination: 13
Gender:Male  Submitted:2008-02-06, Days after onset: 2
Location:Minnesota  Entered:2008-02-06
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
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB517AA2UNRL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB215AA0UNRL
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC. 0UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC351693UNLL
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow)
Write-up: Vaccination 1/22/08; Reaction started 2/9/08 Erythema multiforme on 2/6/08. Rx with orapred.

VAERS ID:304544 (history)  Vaccinated:2008-01-22
Age:84.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Oregon  Entered:2008-02-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vytonn, Cartia, lisinopril, Vagifem, Plavix, splendactomy, actonel
Current Illness: none
Preexisting Conditions: thiazide allergy
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1081U0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: hematoma at site shot - started that evening - progressed over a week to the size of a "plate"; no further following by patient

VAERS ID:307472 (history)  Vaccinated:2008-01-22
Age:17.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Female  Submitted:2008-03-14, Days after onset: 50
Location:Minnesota  Entered:2008-03-17, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0802USA00477
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Influenza like illness, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: Information has been received from a representative concerning a 17 year old female who on 22-JAN-2008 was vaccinated with GARDASIL (lot# not reported). On 23-JAN-2008 the patient experienced severe pains up her back and down her legs that lasted for two days. She also had flu-like symptoms but no fever, congestion, or nausea. Subsequently, the patient recovered from severe pains and flu-like symptoms. No further information was provided. Additional information has been requested.

VAERS ID:307369 (history)  Vaccinated:2008-01-22
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:2008-03-07
Location:California  Entered:2008-03-19, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to penicillin
Diagnostic Lab Data: None-$gadvised to see own MD
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30012614PO 
Administered by: Public     Purchased by: Private
Symptoms: Influenza like illness, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Flu like symptoms 5 days after last tablet. Fever x 4 days. Nausea x 2 weeks.

VAERS ID:309849 (history)  Vaccinated:2008-01-22
Age:62.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Female  Submitted:2008-03-26, Days after onset: 62
Location:Unknown  Entered:2008-04-16, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness: Blood pressure; Seasonal allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0802USA05617
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a 62 year old female consumer with a history of seasonal allergies who on 22-JAN-2008 was vaccinated with .65ml ZOSTAVAX (Oka/Merck). Concomitant therapy included "vipalopran" for blood pressure. On 23-JAN-2008 the patient developed a rash on her stomach. Unspecified medical attention was sought. There was no lab studies performed. Subsequently, the patient stated she recovered "about a week or two afterwards." Additional information has been requested.

VAERS ID:310981 (history)  Vaccinated:2008-01-22
Age:13.0  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-04-14, Days after onset: 82
Location:Connecticut  Entered:2008-04-16, 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: Unknown
Current Illness: Allergic reaction to antibiotics; Hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0803USA04213
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1487U0IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a pharmacist concerning a 13 year old female with allergic reaction to AUGMENTIN and cephalosporin (reported as cephlosporin) who on 22-JAN-2008 was vaccinated with a first dose of Gardasil (Lot # 659657/1487U) and was vaccinated with a dose of MENACTRA. With in hours of receiving the first dose of Gardasil, on 22-JAN-2008, the patient developed hives all over her body. No treatment Information was provided. It was reported that after 4 days on 26-JAN-2008, the patient recovered from her hives. It was reported that the patient had not had previous exposure to this or related drug, and the patient is not pregnant. No further information is available.

VAERS ID:314091 (history)  Vaccinated:2008-01-22
Age:  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-05-16, Days after onset: 114
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0802USA02775
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: Information has been received from a physician concerning a female who on 22-JAN-2008, who was supposed to have received zoster vaccine live (Oka/Merck), was inadvertently vaccinated with varicella virus vaccine live (Oka/Merck). The patient was not experiencing any known symptoms. It was indicated that the incident was due to human error. A product quality complaint was not reported. Additional information has been requested.

VAERS ID:315822 (history)  Vaccinated:2008-01-22
Age:78.0  Onset:2008-03-17, Days after vaccination: 55
Gender:Male  Submitted:2008-06-05, Days after onset: 80
Location:California  Entered:2008-06-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: COZAAR, PLEUDIL, naproxen, aspirin
Current Illness: None
Preexisting Conditions: HTN, bronchogenic cyst, osteoarthritis, glaucoma. PMH: Glaucoma, HTN, OA, chest cavity cyst, cataract surgery
Diagnostic Lab Data: EMG/NCVS c/w CIDP, CSF with increased protein. Labs and Diagnostics: MRI lumbar spine shows multilevel DDD. Brain MRI shows moderate, chronic ischemic changes in the white matter of the cerebral hemispheres. Hip X-ray (+) for osteoarthrit
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUS191AA0IMUN
Administered by: Private     Purchased by: Other
Symptoms: Areflexia, Asthenia, Blood glucose increased, Borrelia burgdorferi serology negative, CSF glucose increased, CSF protein increased, Chronic inflammatory demyelinating polyradiculoneuropathy, Constipation, Electromyogram abnormal, Eyelid ptosis, Facial palsy, Gait disturbance, Gram stain negative, Hyporeflexia, Nerve conduction studies abnormal, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain abnormal, Pain in extremity, Paraesthesia, Red blood cells CSF positive, Sleep disorder, Urinary incontinence, X-ray of pelvis and hip abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Periorbital and eyelid disorders (narrow), Osteonecrosis (broad), Ocular motility disorders (narrow)
Write-up: Painful paresthesia down both legs and weakness. 6/30/2008 MR received from Neurologist for DOS 4/3/2008. Seen with c/o onset of heavy aching pain in lower back area which radiates down the lateral aspect of the legs. Sleep disturbed 2'' to pain. Also with one week hx of facial drooping of the R eyelid and R corner of mouth. Recent problems with constipation and dribbling of urine. PE (+) for R sided ptosis, weak eye closure and drooping of R side of lips. Muscle weakness of L hip flexors and extensors. Sensation intact. DTRs absent at knees and ankles and 1+ in the bilateral triceps. Gait high stepping.

VAERS ID:319700 (history)  Vaccinated:2008-01-22
Age:14.0  Onset:2008-04-15, Days after vaccination: 84
Gender:Female  Submitted:2008-07-18, Days after onset: 94
Location:New York  Entered:2008-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none also note on 10/30/07 dose she did receive fluvaccine Pasteur U2466AA
Preexisting Conditions: asthma-stable
Diagnostic Lab Data: nl mri, nl lp, nl echocardiogram,nl labs
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1060U1IMUN
Administered by: Private     Purchased by: Private
Symptoms: Echocardiogram normal, Laboratory test normal, Lumbar puncture normal, Migraine, Nuclear magnetic resonance imaging normal, Presyncope, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: received HPV 10/30/07, 1/22/08, 5/22/08 Developed epsiodes of near syncope and syncope with migraine headaches beginning 4/15/08 She had MRI LP cardiology eval and felt to have status migranosis

VAERS ID:324197 (history)  Vaccinated:2008-01-22
Age:61.0  Onset:2008-01-22, Days after vaccination: 0
Gender:Female  Submitted:2008-07-30, Days after onset: 189
Location:Illinois  Entered:2008-08-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0801USA04787
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1540U1IMRA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Injection site discolouration, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Initial and follow-up information has been received from a 61 year old female registered nurse with no known drug allergies who on 22-JAN-2008, at 8:00, was vaccinated IM in the right deltoid with a dose of pneumococcal 23v polysaccharide vaccine (lot #659203/1540U). On 22-JAN-2008, four hour post-vaccination, the patient''s arm had signs of edema and became swollen and warm which started at the injection site and extended four inches across and two inches down. The patient had no fever, although, experienced bad chills. On 23-JAN-2008, at 19:00. The area four inches in diameter on the patient''s arm, with the injection site in the center, became red, hot and indurated. The arm was sore to touch and the patient experienced pain with movement. She was seen by a physician at the office where she worked and the physician felt it looked like an allergic reaction. The patient was treated with diphenhydramine HCL (BENADRYL) and ibuprofen (ADVIL). The area was marked, and it was reported that it had not grown any larger, although, had not decreased in size either. It was also reported that the four inch in diameter area around the injection site remained darker in color (gray) "for several weeks." On an unspecified date, the patient recovered from the the injection site erythema, warmth, induration, and discoloration and extremity soreness and pain with movement. The outcome of the allergic reaction with chills, peripheral swelling and edema was not reported. The patient reported that in 1995 she was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine and did not have a reaction. No further information is available.

VAERS ID:326227 (history)  Vaccinated:2008-01-22
Age:5.0  Onset:2008-01-23, Days after vaccination: 1
Gender:Male  Submitted:2008-01-25, Days after onset: 2
Location:New Jersey  Entered:2008-08-26, Days after submission: 213
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: The patient had not been taking any concomitant medications.
Current Illness: The patient was not ill at the time of vaccination.
Preexisting Conditions: The patient had an allergy to peanuts. The patient was not ill at the time of vaccination and had not been taking any concomitant medications.
Diagnostic Lab Data: None
CDC Split Type: 200800250
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEUR 4IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR 4IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Initial report was received from a consumer on 24 January 2008. A five-year-old male child with a history of peanut allergies, had received an intramuscular right deltoid injection of TRIPEDIA (lot number not reported) and an intramuscular left deltoid injection of IPOL (lot number not reported) on 22 January 2008 and 24 hours later, he developed right arm swelling, redness and itching from the shoulder to the elbow. Corrective treatments included TYLENOL. At the time of the report, the patient had been scheduled to follow-up with their pediatrician and had not yet recovered from the event.

VAERS ID:303310 (history)  Vaccinated:2008-01-23
Age:49.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-01-23, Days after onset: 0
Location:Minnesota  Entered:2008-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: Hypothyroidism
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500479P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Expired drug administered
SMQs:
Write-up: Patient given an expired dose of Flumist. Dose expired on 1-10-08. Given on 01-23-08.

VAERS ID:303348 (history)  Vaccinated:2008-01-23
Age:1.8  Onset:2008-01-23, Days after vaccination: 0
Gender:Male  Submitted:2008-01-23, Days after onset: 0
Location:Arizona  Entered:2008-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: chronic rhinitis; allergic rhinitis, bronchitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU2289BA3UNRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2525AA3UNLL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB218BA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria within 10 min of shot

VAERS ID:303351 (history)  Vaccinated:2008-01-23
Age:64.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-01-23, Days after onset: 0
Location:Texas  Entered:2008-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Headache, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Received injection approximately 9:20 A.M. Approximately 5 hrs later felt sleepy. Around 4 P.M. started having a headache (normally do not have headaches). By 5 P.M. the headache was severe (thought I was having a stroke) had chills. Might have had a fever. Went home from work - directly to bed - took 2 Ibuprofen. Slept.

VAERS ID:303597 (history)  Vaccinated:2008-01-23
Age:4.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Female  Submitted:2008-01-25, Days after onset: 0
Location:Pennsylvania  Entered:2008-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: URI
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B132CA2IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB218AA1IMLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0617U1SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Induration, Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: L upper arm with an area of erythema surrounding the vaccine entry point, about 4" X 5 " in size, mild induration noticed today- 1/25/08. Child c/o itching. Benadryl PO prn itching. Cold packs locally.

VAERS ID:303602 (history)  Vaccinated:2008-01-23
Age:11.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-25, Days after onset: 1
Location:Idaho  Entered:2008-01-25
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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1518U1SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 14.5X12 cm redness and 5X5.5 induration at injection site, started one day after vaccine administration.

VAERS ID:303625 (history)  Vaccinated:2008-01-23
Age:1.3  Onset:2008-01-23, Days after vaccination: 0
Gender:Male  Submitted:2008-01-25, Days after onset: 2
Location:New York  Entered:2008-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU2354BA3UNRL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB207BA0UNRL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1305U0UNLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB54015H2UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1592U0UNLL
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site papule, Injection site rash, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt. developed red, papular, urticarial-like lesions to L thigh. Benadryl administered and pt. monitored for 20 mins. - no other adverse effects noted. Left office in NAD.

VAERS ID:303634 (history)  Vaccinated:2008-01-23
Age:37.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-01-25, Days after onset: 2
Location:Missouri  Entered:2008-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2864AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient reported generalized rash to all extremities, torso and facial area approx. 3 hrs. after receiving vaccine. Offered and accepted 50 mg Benadryl. No SOA or hives

VAERS ID:303734 (history)  Vaccinated:2008-01-23
Age:5.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-25, Days after onset: 1
Location:Arizona  Entered:2008-01-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Reactive airway disease
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B062AA4UNLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01693UNRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1326F1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1581U1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Redness 6cm x 5cm in (R) deltoid area. No induration/blisters noted.

VAERS ID:303735 (history)  Vaccinated:2008-01-23
Age:43.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-28, Days after onset: 4
Location:Virginia  Entered:2008-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: None
Preexisting Conditions: Depression tx''d x yrs with Zoloft.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB443BA4IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2766AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Abscess, Axillary pain, Body temperature, Erythema, Injection site erythema, Injection site swelling, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt developed 99 degree temp, malaise, nausea onset next day after vaccines. Also dev. redness and swelling at L arm injection site within 25 min. Well defined sterile abscess with mild overlying erythema observed. 1/2 reported to be less sore than on days prior. Also mild c/o soreness in L axilla without palpable nodes. Temp 98.4 on DOS. To f/u in 7-10 days.

VAERS ID:303751 (history)  Vaccinated:2008-01-23
Age:22.0  Onset:0000-00-00
Gender:Male  Submitted:2008-01-24
Location:Minnesota  Entered:2008-01-28, 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: No
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB443BA1UNUN
TDAP: TDAP (ADACEL)SANOFI PASTEURC2844AA1UNLA
Administered by: Public     Purchased by: Public
Symptoms: Wrong drug administered
SMQs:
Write-up: Tdap given 1-23-08 when Td should have been given. Last Tdap was given 1-22-07. Td #1 8-2-06, Tdap #2 1-22-07.

VAERS ID:303763 (history)  Vaccinated:2008-01-23
Age:65.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-01-28, Days after onset: 4
Location:Washington  Entered:2008-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: end of cough
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Night sweats, Tenderness
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: Flu and pneumonia shots 4pm Wednesday 23rd January. 7pm Thursday 24th temperature of 102.9, rash? and tenderness. Treated with Theraflu and ginger tea. Major night sweat - fine in morning.

VAERS ID:303764 (history)  Vaccinated:2008-01-23
Age:68.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-28, Days after onset: 4
Location:Colorado  Entered:2008-01-28
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
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN1IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.UNKNOWN0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Influenza like illness, Local swelling, Myalgia, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Shingles Vaccine administered 1/23/08 approx 2pm no reaction until 1/24/08 around 7pm when local swelling reached a 3" x 4" wheal severe itching 1/25 am flu like symptoms all muscles ached (no headache) very tired feeling swelling 5" x 8" and hanging down noticeably this continued until 1/27 am when swelling was much better muscles not so achy and not as tired. By 1/28 am all symptoms are gone. Took Benadryl for itching. Used Benadryl gel topically.

VAERS ID:303766 (history)  Vaccinated:2008-01-23
Age:2.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-28, Days after onset: 4
Location:California  Entered:2008-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none known
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU1965AB3IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHBVB213AA1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Hypersensitivity, Injection site erythema, Injection site swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This 2 yo female received a DTaP and HAV immunization 01/23/08 in the right arm. On 01/24/2008 redness and swelling developed in the right upper arm 11cm x 12cm. Physician diagnosed cellulitis with differential diagnosis of allergic reaction to vaccine. No fever. RX for Keflex 250mg/5ml dosage: 6ml TID x 10 days.

VAERS ID:303767 (history)  Vaccinated:2008-01-23
Age:0.2  Onset:2008-01-26, Days after vaccination: 3
Gender:Male  Submitted:2008-01-28, Days after onset: 2
Location:Hawaii  Entered:2008-01-28
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none 2/11/08-records received-HX of looser stools which have not improved with changes to formula. HX of projectile vomiting with large volumes of feeding possibly due to overfeeding. PMH: umbilical hernia, perinatal complications including mother positive culture for beta strep vaginally.
Diagnostic Lab Data: Rotavirus Elisa POSITIVE at Hospital. severe acidosis with initial bicarbonate of 14 and pH following resuscitation of 7.22. Repeat Elisa NEGATIVE. Stool specimen from 1/26/08 at Hospital Lab. 2/11/08-records received-Abdominal US negative. Upper GI series normal. Blood cultures negative. CXR normal. Abdominal series prominent bowel gas dilated loops of bowel. O2 sats on room air 90%. White count 21,000, platelet 681 elevated. Stool positive for rotavirus and blood.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B130AA0IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB54013H0IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1621U0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal distension, Blood bicarbonate decreased, Blood culture negative, Blood gases abnormal, Blood pH decreased, Chest X-ray normal, Culture stool, Diarrhoea, Fontanelle depressed, Hypotension, Immunology test, Intubation, Irritability, Mechanical ventilation, Metabolic acidosis, Pallor, Respiratory failure, Rotavirus test positive, Shock, Tachycardia, Ultrasound abdomen normal, Vomiting, White blood cell count increased, X-ray with contrast upper gastrointestinal tract
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad)
Write-up: Developed pallor and profuse diarrhea on 1/26/08. Seen at Hospital. 1/26/08 at 23:31. Pale, hypotensive, and in shock with massive non-bloody diarrhea. Intubated and fluid resuscitation performed. Stabilized and transferred to Medical Center pediatric intensive care unit 1/27/08 AM. Still there as of 01/28/08 9am HST. 1/29/08-records received for DOS 12/13/07 well baby visit. URI, acute. Visit 1/26/08-ED note C/O diarrhea. Dry cough, copious diarrhea, pale. Eating well. Fussy, stool yellow watering. Tachypneic and dusky, decreased bowel sound, abdomen firm. Intubated. 2/11/08-records received for DOS 1/27-2/1/08-DC DX: Shock with Respiratory Failure, requiring mechanical ventilation. Metabolic acidosis. Diarrhea. Rotavirus positive. umbilical hernia. Vomiting. Presented with 1 day history of cough and diarrhea. Increased volume of stool but no fever, vomiting, hematochezia or change in activity. In ED appeared dusky, tachycardic and irritable with distended abdomen, sunken fontanelle and poor peripheral perfusion.

VAERS ID:303768 (history)  Vaccinated:2008-01-23
Age:4.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Male  Submitted:2008-01-28, Days after onset: 3
Location:California  Entered:2008-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: unknown
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU1965AB4IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHBVB213AA1IMRA
Administered by: Unknown     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: 4yo male vaccinated with DTap and HAV on 01/23/08 Right deltoid. Following day developed a large tender, red swelling of right upper arm 8cm x 10 cm. Right arm painful. No fever, no chills, no lymph node swelling. Physician diagnosis-Vaccine reaction. No antibiotics.

VAERS ID:303773 (history)  Vaccinated:2008-01-23
Age:65.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Male  Submitted:2008-01-28, Days after onset: 3
Location:Michigan  Entered:2008-01-28
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: Diabetes PMH: diabetes, HTN, hyperlipidemia, bilat TKR
Diagnostic Lab Data: LABS: MRI brain scan WNL.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1852U0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diplopia, Eyelid ptosis, IIIrd nerve paralysis, Nerve injury, Nuclear magnetic resonance imaging brain normal
SMQs:, Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: Partial third cranial nerve palsy two days after Zostavax administration. Most likely due to history of type II diabetes, but timing so soon after vaccination warrents reporting. 2/19/08 Reviewed reporter/neuro medical records of 1/28/2008. FINAL DX: acute partial right third cranial nerve palsy, strongly suspect nerve ischemia related to diabetes. Records reveal patient experienced acute onset diplopia x 3 days followed by right ptosis.

VAERS ID:303816 (history)  Vaccinated:2008-01-23
Age:68.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-29, Days after onset: 5
Location:Iowa  Entered:2008-01-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SIMVASTATIN 10MG 1 EACH PM. CITRICAL 2 TABS DAILY
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)SANOFI PASTEURU1962AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The following day after receiving the tetanus vaccine pt. developed redness in her left arm that has spread to her elbow. It is tender and warm on palpation. Saw PA-C in the ER Urgent care and was placed on Keflex mg 4 times a day for 7 days on 1/26/08.

VAERS ID:303850 (history)  Vaccinated:2008-01-23
Age:1.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-01-23, Days after onset: 0
Location:Florida  Entered:2008-01-29, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1324F0UNRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB70143F3UNRL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.147140UNLL
Administered by: Private     Purchased by: Public
Symptoms: Insomnia, Irritability, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: 103 degree F fever, irritability. No sleep. Facial flushing immediately following vaccine (1 hour).

VAERS ID:303852 (history)  Vaccinated:2008-01-23
Age:44.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-28, Days after onset: 4
Location:Virginia  Entered:2008-01-29, 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: None
Current Illness: No
Preexisting Conditions: Medication allergy to Penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0748U1SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2766AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass, Injection site nodule, Injection site pain, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt rec''vd MMR #2 Rt arm with Tdap (L) arm 1/23/08. Noted some redness, soreness at both injection sites next day. Then on 1/23 she noted a lump at (L) arm injection site along with sl. itch and The Rt arm sx improved but Lump persists at (L) arm with some tenderness 20 mm palpable nodule with 25mm diam overlying erythema, no axillary nodes. Temp 99.1. To Reck in 7-10 days.

VAERS ID:303854 (history)  Vaccinated:2008-01-23
Age:13.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-01-28, Days after onset: 4
Location:Virginia  Entered:2008-01-29, 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: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2560AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1560U1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Influenza serology negative, Streptococcus identification test negative, White blood cell count increased
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: Onset of sx. on 1/24/08; numbness in R arm & legs; seen in ER - pt had elevated WBC; Flu & strep were negative.

VAERS ID:303870 (history)  Vaccinated:2008-01-23
Age:1.2  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-01-25, Days after onset: 1
Location:New York  Entered:2008-01-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Cold symptoms
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT2474BA1UNUN
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Had hives 24 hours after receiving flu vaccine.

VAERS ID:303967 (history)  Vaccinated:2008-01-23
Age:0.5  Onset:2008-01-23, Days after vaccination: 0
Gender:Male  Submitted:2008-01-30, Days after onset: 7
Location:Texas  Entered:2008-01-30
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
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2760AA0IMLL
IPV: POLIO VIRUS, INACT. (POLIOVAX)SANOFI PASTEURA03010IMRL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Crying, Insomnia, Sleep disorder
SMQs:, Depression (excl suicide and self injury) (broad)
Write-up: Cried on and off for four days, did not sleep for 13 hours day after vaccines were administered, and when he did sleep, he woke up screaming.

VAERS ID:303985 (history)  Vaccinated:2008-01-23
Age:64.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-01-30, Days after onset: 6
Location:Colorado  Entered:2008-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar; Lipitor; ASA
Current Illness: None
Preexisting Conditions: CAD, HTN, OSA, DDD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1381U3UNLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: The arm became painful to move for several days. Then became red and painful to the touch.

VAERS ID:304038 (history)  Vaccinated:2008-01-23
Age:5.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-01-24, Days after onset: 0
Location:Oregon  Entered:2008-01-31, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B067BA4IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01693SCRA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.1228U0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site erythema, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness, pruritis, slight cellulitis 18cm x 16cm (L) arm.

VAERS ID:304058 (history)  Vaccinated:2008-01-23
Age:1.5  Onset:2008-01-29, Days after vaccination: 6
Gender:Male  Submitted:2008-01-31, Days after onset: 2
Location:Idaho  Entered:2008-02-01, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B067AA3IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT2494BA0IMRL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB242AA0IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0866U0SCRL
Administered by: Private     Purchased by: Public
Symptoms: Febrile convulsion
SMQs:, Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Febrile seizure 1/29/08.

VAERS ID:304103 (history)  Vaccinated:2008-01-23
Age:11.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-01-25, Days after onset: 1
Location:South Dakota  Entered:2008-02-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Obesity
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2537AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2758AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1464U1SC 
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Induration, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: VZV2, Menactra, Tdap admin on 1/23. 1/24 noted redness to right arm and sore. 1/25 came in with 20 cm erythematous area cm right port 3mm with 5 cm indurated tandem. No fluctuant area in location of Varicella.

VAERS ID:304106 (history)  Vaccinated:2008-01-23
Age:35.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-01-25, Days after onset: 2
Location:Rhode Island  Entered:2008-02-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OCP
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2904AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Feeling cold, Lymph node pain, Malaise, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Malaise, fever, chill, local pain, swelling, tender lymph node.

VAERS ID:304115 (history)  Vaccinated:2008-01-23
Age:4.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-01-28, Days after onset: 4
Location:Texas  Entered:2008-02-01, 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: None
Preexisting Conditions: Congenital adrenal hyperplasia
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B138BA4 LA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB213AA1 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0283U1 RA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Per mother, child had symptoms the next day after immunizations. On 1-25-08 child came to clinic with symptoms of swollen left deltoid muscle, approximately 2"; skin was red and hot to touch. Advised cool compress, Tylenol and Benadryl to help symptoms.

VAERS ID:304168 (history)  Vaccinated:2008-01-23
Age:0.4  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-02-01, Days after onset: 8
Location:Massachusetts  Entered:2008-02-01
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
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B120AA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF291AC1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB54015C1IMRL
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: T. 100.4 24 hours after imms. Tylenol advised. Call if sx. change.

VAERS ID:304250 (history)  Vaccinated:2008-01-23
Age:57.0  Onset:0000-00-00
Gender:Female  Submitted:2008-01-30
Location:Georgia  Entered:2008-02-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU21720IMUN
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration, No adverse reaction
SMQs:
Write-up: None

VAERS ID:304349 (history)  Vaccinated:2008-01-23
Age:47.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-02-05, Days after onset: 13
Location:South Carolina  Entered:2008-02-05
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: allergic to Tetracycline
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1324F SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood pressure increased, Chest pain, Feeling hot, Hypoaesthesia oral, Laboratory test normal, Lip swelling, Paraesthesia oral, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: On 1-23-2008 employee was given first dose of the MMR vaccine at 8:20am she stayed in this office until 8:50am for routine observation. At 9:00 am she started feeling numbness, swelling and tingling in her lips and tongue after returning to her job. She then c/o of sharp chest pain in right side of chest and that it also felt hot. B/P was elevated. She was taken to emergency room for further evaluation at 12:00 noon. (she did not want to go to er prior) patient was kept for several hours in the er and monitored for any cardiac problems all test for negative and dx chest pain "uncertain cause". She was seen here on 1-24-08 for follow up a rash had developed over chest, back, neck. She was taking Benadryl otc. Dr. saw her on 1/24/08 gave her prescription for Sterapred #6. I spoke with employee on 1-25-08 and 1-28-08 she was doing fine rash had gone no swelling or itching or chest pain. She has declined to take the second dose of MMR.

VAERS ID:304378 (history)  Vaccinated:2008-01-23
Age:41.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-02-05, Days after onset: 12
Location:Tennessee  Entered:2008-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Denies
Preexisting Conditions: Allergies in childhood
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1631UNUN
Administered by: Military     Purchased by: Military
Symptoms: Ear pain, Pain in extremity, Pharyngolaryngeal pain, Postnasal drip, Productive cough, Pyrexia, Respiratory tract congestion, Sinus headache
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Description: I received AVA # 2 12 days ago and had some arm soreness and a low grade fever. What I am concerned about is that within 24 hrs I developed a cough with phlegm and felt like I was catching a cold. this went away and then returned. No fever now but cough and congestion continues. No body pains, but reports sore throat, sinus pressure, post nasal drip, slight stuffy nose and some ear pressure. he is new to the area and has had childhood allergies to dust and certain pollen. Grew in another state. Other than soreness no problem with AVA # 1. Wondering if AVA is causing his problems. Symptom: Cough, productive Start: 01/24/2008; Symptom: fever start: 01/24/2008; Symptom: Nasal Drainage Start: 01/24/2008; Symptom: Ear Pain Start: 01/24/2008; Symptom: Pain Start: 01/24/2008 Comment: throat pain/sore throat.

VAERS ID:304445 (history)  Vaccinated:2008-01-23
Age:37.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-01-25, Days after onset: 1
Location:New York  Entered:2008-02-06, Days after submission: 12
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2889AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Oedema peripheral, Pain in extremity, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: The evening of 1/24/08 patient noticed LUE to have a "sore raised hard area." Came to Dr''s office on 1/25/08 at 3:45 pm 7x6 cm area of erythema and induration noted. Pt also c/o it was "itchy". Denies pain. Dr prescribed Allegra bid and hydrocortisone ointment 2.5% to affected area. Pt instructed to return to MD if Sx worsen or if not resolved by next week.

VAERS ID:304468 (history)  Vaccinated:2008-01-23
Age:68.0  Onset:2008-01-28, Days after vaccination: 5
Gender:Male  Submitted:0000-00-00
Location:Rhode Island  Entered:2008-02-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0993U UNRL
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1413U UNLA
Administered by: Military     Purchased by: Unknown
Symptoms: Herpes zoster, Musculoskeletal pain, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient began having symptoms of shingles on 1/28/08. He had a rash under shoulder blades and pain associated with rash. Patient under treatment.

VAERS ID:304484 (history)  Vaccinated:2008-01-23
Age:1.6  Onset:2008-02-05, Days after vaccination: 13
Gender:Female  Submitted:2008-02-06, Days after onset: 1
Location:Massachusetts  Entered:2008-02-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: chicken pox lesion~ ()~~0~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB148AA1IMUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1655U0SCUN
Administered by: Private     Purchased by: Public
Symptoms: Injection site reaction, Skin lesion, Varicella
SMQs:
Write-up: Definite chicken pox lesion x4 at sight of injection & on scalp.

VAERS ID:304487 (history)  Vaccinated:2008-01-23
Age:4.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-01-25, Days after onset: 2
Location:Nevada  Entered:2008-02-06, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic Rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2798AA4IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURZ08723IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1305U2SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1767U2SCLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient had swelling and redness over the right deltoid area 2 hours after the vaccine is administered. Her arm was warm and she had low grade fever.

VAERS ID:304496 (history)  Vaccinated:2008-01-23
Age:65.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Male  Submitted:2008-02-01, Days after onset: 7
Location:Unknown  Entered:2008-02-06, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1384U IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Angioedema, Erythema, Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt. came to clinic with c/o of his left arm having edema and erythema from upper arm to wrist. Area was red with some edema noted. Pt. stated that area was better today than on yesterday. Seen by Dr. and was advised to take Benadryl 25mg QH for the next 2 days. PT. was advised to go to the local ER if he developed shortness of breath or wheezing. 01/25/2008 ADDENDUM Pt. received a pneumonia vaccine in this arm on 1-23-2008. Symptoms: 1. Angioedema, 2. Skin Rash. Treatment Drug #1 DIPHENHYDRAMINE Dose 25 Units MG Freq TID Route PO.

VAERS ID:304528 (history)  Vaccinated:2008-01-23
Age:1.1  Onset:0000-00-00
Gender:Female  Submitted:2008-02-07
Location:Missouri  Entered:2008-02-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: unknown
Preexisting Conditions: none
Diagnostic Lab Data: No tests, but still evidence of varicella lesions at injection sites, much worse on left upper arm.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNUN
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site rash, Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Rash at site of Varicella vaccine in Left upper arm, then few days later, at injection site in right upper arm. Consistent with varicella.

VAERS ID:304531 (history)  Vaccinated:2008-01-23
Age:62.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-02-07, Days after onset: 15
Location:Illinois  Entered:2008-02-07
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
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.DON''T KNOW0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Herpes zoster, Skin lesion
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: Lesions on upper right arm, under arm, and on breast and pain across the back. Vaccine was given on 1-23-08 about 2pm. Complete case of zoster by 7pm. Called the dr on the 25th he said take Benadryl. On the 1st still in pain. Went to the dr and he diagnosed as such. Gave me Famvir. Today is the 7th of Feb and still in pain.

VAERS ID:304669 (history)  Vaccinated:2008-01-23
Age:2.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Male  Submitted:2008-01-23, Days after onset: 0
Location:Georgia  Entered:2008-02-11, 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: None
Preexisting Conditions:
Diagnostic Lab Data: Client''s mom states child was examined by Dr and MD states child is fine-walked into MD''s office and walked out with on problems-Heart rate normal-No vomiting
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU2290BA3IMUN
Administered by: Public     Purchased by: Public
Symptoms: Heart rate normal, Listless, Muscular weakness, Pallor, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Client''s mom-states child vomited and sent limp in her arms-after having injection child appears pale and listless. Parents took child to their doctor for immediate attention and evaluation.

VAERS ID:304673 (history)  Vaccinated:2008-01-23
Age:9.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Female  Submitted:2008-01-29, Days after onset: 4
Location:California  Entered:2008-02-11, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.064541UNRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Red swollen

VAERS ID:304729 (history)  Vaccinated:2008-01-23
Age:82.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-02-11, Days after onset: 18
Location:Ohio  Entered:2008-02-11
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
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1087U SCUN
Administered by: Military     Purchased by: Other
Symptoms: Herpes zoster, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: - Rash after Zoster vaccine administer (Mild Herpes Zoster, left abdomen)

VAERS ID:304730 (history)  Vaccinated:2008-01-23
Age:1.0  Onset:2008-01-31, Days after vaccination: 8
Gender:Male  Submitted:2008-02-01, Days after onset: 1
Location:Florida  Entered:2008-02-11, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none; tylenol after vaccine
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: See above. Also scrotal US in E.R. All results pending.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURU2290BA3IMRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT2474BA0IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0494U0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0809U0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1462U0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Culture urine, Mumps antibody test, Orchitis, Parotid gland enlargement, Parotitis, Pyrexia, Scrotal swelling, Ultrasound scan
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Seen 1 day after MMR given. Fever for 2 days, History of parotid swelling 1/31, scrotal swelling for 2 days. Possible reaction of fever, parotitis, orchitis. Sent to ER.. Mumps IgM/G and mumps culture -$g urine pending.

VAERS ID:304839 (history)  Vaccinated:2008-01-23
Age:0.6  Onset:2008-01-23, Days after vaccination: 0
Gender:Male  Submitted:2008-02-13, Days after onset: 21
Location:Illinois  Entered:2008-02-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: CBC and BMP WNL, RSV and Influenza A & B negative. Chest xray clear.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B128AB2IMGM
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2481FA0IMGM
HIBV: HIB (ACTHIB)SANOFI PASTEURUF297AA2IMGM
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB54012E0IMGM
Administered by: Private     Purchased by: Unknown
Symptoms: Body temperature increased, Chest X-ray normal, Crying, Full blood count normal, Influenza serology negative, Irritability, Metabolic function test normal, Virus serology test
SMQs:, Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)
Write-up: Temp 104.6, patient fussy, crying. All follow up lab work negative, no other signs and symptomes.

VAERS ID:305126 (history)  Vaccinated:2008-01-23
Age:32.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Female  Submitted:2008-02-19, Days after onset: 25
Location:Oregon  Entered:2008-02-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Has chronic sinus pressure, mold allergies, sneezing per ct - sx not apparent at time of vaccination.
Preexisting Conditions: Spinabifida occulta
Diagnostic Lab Data: Ct reports "seen at ER."
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)SANOFI PASTEURC2904AA IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB143AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site bruising, Injection site erythema, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Vaccinated 1/23/08, On 1/25 ct noted "Bruising, redness, hot to touch, sore, itching welts" Sx began at location of TDAP and spread down "shoulder to elbow". (TDAP given at prox. location on L delt; hep A given 2 inches distal on L deltoid). On 1/26 Ct went to ER and was given "antihistamines, ibuprofen, Keflex, and anti-itching cream". On 1/30/08 sx had resolved to "size of quarter" and on 2/19/08, ct reports sx resoloved had competely 2 weeks post vaccination.

VAERS ID:305188 (history)  Vaccinated:2008-01-23
Age:65.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-02-13, Days after onset: 21
Location:New York  Entered:2008-02-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1537U0UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Limb discomfort, Pruritus, Rash macular, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Very sore upper arm for over 2 days especially one area an inch and one-half in diameter. Outside upper arm red and blotchy an area 4 1/2 inches x 6 inches. Days 6 & 7 light pink, itchy, big spot tender. Day 9 tenderness gone. Day 11 slightly pink.

VAERS ID:305680 (history)  Vaccinated:2008-01-23
Age:0.2  Onset:2008-01-25, Days after vaccination: 2
Gender:Female  Submitted:2008-02-14, Days after onset: 20
Location:Pennsylvania  Entered:2008-02-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0801USA05838
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC. 0PO 
Administered by: Other     Purchased by: Other
Symptoms: Dehydration, Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (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 2 month old female who on 23-JAN-2008 was vaccinated PO with her first 2.0 ml dose of ROTATEQ (lot# not available). On 25-JAN-2008 the patient experienced severe vomiting and diarrhea that led to dehydration. Per physician, the patient was brought to the Emergency Room to seek rehydration therapy on that same day, but was not admitted to the hospital. The outcome was unknown. There was no product quality complaint. Additional information has been requested.

VAERS ID:306098 (history)  Vaccinated:2008-01-23
Age:  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-02-14, Days after onset: 22
Location:Unknown  Entered:2008-02-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0801USA06015
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site discolouration
SMQs:
Write-up: Information has been received from a health professional concerning three female patients who on approximately 23-JAN-2008 were vaccinated intramuscularly with Gardasil. On 23-JAN-2008 the patient experienced discoloration at the injection site. The discoloration was a lighter skin color where the band aid was in contact with the skin. No further information was provided. The patients sought unspecified medical attention. Additional information has been requested.

VAERS ID:305471 (history)  Vaccinated:2008-01-23
Age:30.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Female  Submitted:2008-02-22, Days after onset: 28
Location:Ohio  Entered:2008-02-22
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: No known allergies. Any further conditions not specified by ER beginning Rabies series nor reported by patient on consent form.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEURA023923IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Injection site erythema, Injection site pain
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: After the fourth dose of rabies vaccine administered to this client (Immune Globulin and Imovax Rabies vaccine doses on days 0, 3, and 7 having been given without incident), this patient developed soreness and redness at the area of injection in the left deltoid muscle within a few hours. Family physician was unable to determine if this was a hypersensitivity reaction or possible cellulitis, so prescribed antibiotic. Retrospectively she mentioned that the 3rd dose "had been sore and a little red" as well. The 5th dose scheduled for day 28 was witheld per order of the Health Department Medical Dlirector and corroborated by the Deparatment of Health, the risk for vaccination reaction being considered greater than that for rabies, as contact with the animal (a bat that was not available for testing) was not verifiable. (It had been in her home for an undetermined amount of time, possible during sleep hours.)

VAERS ID:305502 (history)  Vaccinated:2008-01-23
Age:0.2  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-02-21, Days after onset: 28
Location:Unknown  Entered:2008-02-22, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0802USA04029
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.0904U0PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Enema administration, Haematochezia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)
Write-up: Information has been received from a physician concerning a 2 month old female who on 23-JAN-2008 was vaccinated with ROTATEQ (Lot #657673/0904U) PO first dose. On 24-JAN-2008 the patient developed abdominal pain and bloody stool and was colicky at night. The physician performed an air enema which was negative. Therapy with ROTATEQ was discontinued. Subsequently, the patient recovered from colic, abdominal pain and bloody stool. There was no product quality complaint. Colicky, abdominal pain and bloody stool were considered to be disabling. Additional information has been requested.

VAERS ID:305560 (history)  Vaccinated:2008-01-23
Age:65.0  Onset:2008-01-25, Days after vaccination: 2
Gender:Male  Submitted:2008-02-20, Days after onset: 26
Location:West Virginia  Entered:2008-02-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1384U UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt. came to clinic with c/o of him left arm having adema and erythema from upper arm to wrist. Area was red with some adema noted. Pt stated that area was better today than on yesterday. Seen by NP and was advised to take Benadryl 25mg QAH for the next 2 days. Pt. was advised to go to local ER if he developed shortness of breath or wheezing. 01/25/2008 ADENDUM STATUS- COMPLETED; pt. received a pneumonia vaccine in this arm on 1-23-2008.

VAERS ID:305604 (history)  Vaccinated:2008-01-23
Age:30.0  Onset:2008-02-23, Days after vaccination: 31
Gender:Female  Submitted:2008-02-25, Days after onset: 2
Location:Colorado  Entered:2008-02-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Post-Partum
Preexisting Conditions: NKAA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Pruritus, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash (generalized) near trunk, below abdomen and legs and pruritis; Rx with Medrol dose pak x 6 days

VAERS ID:305715 (history)  Vaccinated:2008-01-23
Age:73.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Male  Submitted:2008-02-19, Days after onset: 26
Location:Ohio  Entered:2008-02-26, 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: Ampicillin; Uronatrol; Prilosek; Vitamins.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Wife had injection of shingles vaccine same day, no adverse effects.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Dysphonia, Headache, Myalgia, Night sweats, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad)
Write-up: Headache day after injection, lasted 2 days, hoarseness 2nd day and shoulder muscles ached for 2 days. Fever started 3rd day 101.5 during evenings and nights and down to 96.5 during the day, night sweats 2 or 3 times during the week. The fevers lasted. One week after injection everything back to normal.

VAERS ID:306224 (history)  Vaccinated:2008-01-23
Age:4.0  Onset:2008-02-04, Days after vaccination: 12
Gender:Male  Submitted:2008-02-29, Days after onset: 25
Location:Kentucky  Entered:2008-02-29
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: Allergic to nuts; eggs; strawberries; fish.
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSAC146051AA4UNRL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB171AA0UNLL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01703UNRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0808U1UNLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1338U1UNRL
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient came back to office with rash on right leg for 12 days per mother. 15 cm x 6 cm (hive like lesion). Erythematous.

VAERS ID:306282 (history)  Vaccinated:2008-01-23
Age:0.9  Onset:2008-01-25, Days after vaccination: 2
Gender:Female  Submitted:2008-02-19, Days after onset: 25
Location:New Hampshire  Entered:2008-03-03, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Hx seizure like activity age 4 days; Negative EEG Bili 25.4 age 4d PMH: w/u for seizures in first wk of life, neuro w/u neg. Parent w/hydrocephalus & benign seizures until 3yo.
Diagnostic Lab Data: developmental screening 1/23/08 noted mild right sided fine motor difference; Negative EEG LABS: CBC WNL w/plts 593 (H). Chemistry WNL. Tox screen neg.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (DECAVAC)SANOFI PASTEURU2105AA1IMRL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT2477FA UNLL
HEP: HEP B (FOREIGN)MERCK & CO. INC.1159U2IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF209AA1IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA02731IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC413351IMLL
Administered by: Private     Purchased by: Public
Symptoms: Apnoea, Convulsion, Electroencephalogram normal, Fine motor delay, Full blood count normal, Gaze palsy, Hemiparesis, Hyperhidrosis, Hypotonia, Laboratory test normal, Muscle rigidity, Muscle spasms, Platelet count increased, Pyrexia, Sleep disorder, Toxicologic test normal, Unresponsive to stimuli, Urinary incontinence
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Parkinson-like events (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: History of seizure like activity age 4 days - negative EEG (hosp). 11/8/07 vaccines given (Pediarix) manufacturer GlaxoSmithKline, lot # AC21B128AB, route/site: IM R ant-lat thigh. 1/11/08 admit seizures (24 hrs) - refer neuro. 1/23/08 vaccines given (DT pediarix), manufacturer GlaxoSmithKline, lot # AC21B128AB, route/site: IM R ant-lat thigh. At development screening 1/23/08 noted mild right-sided fine motor difference. 1/25/08 seizures (T 101.2). 1/27 hospital after 4 seizures which lasted 2 days. 3/11/08 Reviewed hospital medical records for 1/11-1/12/2008 FINAL DX: none provided Records reveal patient experienced recurring seizure activity 2 mos prior, 3 wks prior to admission & seizures x 4 the day of admission accompanied that day w/fever. Seizure activity lasting approx 1 min included body spasms, rigidity, diaphoresis, eyes rolling back in head, urinary incontinence, apnea followed by hypotonia & unresponsiveness. Parent noted right sided weakness, dragging left leg & sleep disturbance. Peds neuro consult done. No seizure activity while hospitalized. D/C to home w/peds neuro f/u & antiseizure med if recurs for more than 5 min.

VAERS ID:306765 (history)  Vaccinated:2008-01-23
Age:0.3  Onset:2008-02-03, Days after vaccination: 11
Gender:Female  Submitted:2008-03-09, Days after onset: 35
Location:Nebraska  Entered:2008-03-10
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: RSV
Preexisting Conditions: No known allergies. PMH: 31 wk premie with neonatal respiratory distress and apnea of prematurity. On O2 x 1 mon. NKDA. Fam hx of chronic ITP.
Diagnostic Lab Data: CBC. Labs and Diagnostics: CBC with platelets 19,000 on 2/6/08 up to 125K on 2/7/08.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC2113126AA1UNUN
HIBV: HIB (ACTHIB)SANOFI PASTEURUF292AA1UNUN
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB54007H1UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Blood product transfusion, Full blood count, Idiopathic thrombocytopenic purpura, Petechiae, Platelet count decreased, Rash
SMQs:, Anaphylactic reaction (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow)
Write-up: Pt had immunization on 1/23/08, Synagis on 1/28/08 mother noticed rash on 2/03/08. Admitted to hosp. on 2/06/08. Presented with petechia on abdomen and extremities. With Plt count 26,000 and patient was treated with IVIG 1g/kg x 100. 03/24/2008 MR received for DOS 2/6-7/2008 with DX: ITP. Pt presented for admission from PCP office with platelet count of 26,000 after OV for petechial rash on abdomen, head, palate and extremities. Txd with IVIG

VAERS ID:307452 (history)  Vaccinated:2008-01-23
Age:0.2  Onset:2008-02-03, Days after vaccination: 11
Gender:Male  Submitted:2008-03-14, Days after onset: 39
Location:Unknown  Entered:2008-03-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: stool culture 02/27/08 - positive for rotavirus
CDC Split Type: WAES0802USA06298
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC. 0PO 
Administered by: Other     Purchased by: Other
Symptoms: Culture stool positive, Diarrhoea, Rotavirus infection
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Information has been received from a registered nurse concerning a 2 month old male with no pertinent medical history who on 23-JAN-2008 was vaccinated PO with his first dose of ROTATEQ. On 03-FEB-2008 the patient experienced diarrhea that lasted all month. On 27-FEB-2008 the patient experienced positive stool cultures for rotavirus. The patient sought unspecified medical attention. The outcome was unknown. There was no product quality complaint. Additional information has been requested.

VAERS ID:307376 (history)  Vaccinated:2008-01-23
Age:55.0  Onset:2008-02-06, Days after vaccination: 14
Gender:Female  Submitted:2008-03-19, Days after onset: 41
Location:Utah  Entered:2008-03-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None PMH: hypothyroidism. Low back pain. Has child w/MS.
Diagnostic Lab Data: LABS: CRP 1.7 (H). CSF: protein 130 (H), glucose 48 (N), GGT 239 (H). Spinal MRI: degenerative changes. Peak alk phos 401, ALT 165, AST 120. CRP 0.9. Hep C surface antibody (+) reactive. MRI of head WNL. US of liver abnormal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB413AA2IMLA
HEPA: HEP A (VAQTA)MERCK & CO. INC.0420U1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Alanine aminotransferase increased, Areflexia, Aspartate aminotransferase increased, Asthenia, Back pain, Balance disorder, Blood alkaline phosphatase increased, Blood product transfusion, C-reactive protein increased, CSF glucose normal, CSF protein increased, Chest discomfort, Decreased appetite, Dyspnoea, Fatigue, Gait disturbance, Guillain-Barre syndrome, Hepatic enzyme abnormal, Hepatitis C antibody positive, Hypoaesthesia, Hypoaesthesia oral, Hyporeflexia, Lumbar puncture, Muscle tightness, Muscular weakness, Neurological examination abnormal, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal, Paraesthesia, Sensory loss, Stress, Ultrasound liver abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Liver infections (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Demyelination (narrow), Vestibular disorders (broad)
Write-up: 14-15 days after receiving vaccines she started having tingling in right hand and foot. Next day same thing on left side. Also some numbness in extremities. Gradually got worse over the next several days. Felt like "electricity shooting out". Numbness also went up her back. Went to MD on Feb 12. Blood tests ordered.Liver enzymes were elevated so Hepatitis blood tests done. On Feb 15 brain MRI done which showed nothing. Next day, Feb 16 went to ER because of increased tightening of muscles in chest (diaphram area). Dr.''s focused on heart and gallbladder. She and husband went home and started looking up things on internet. Found symptoms of Guillain Barre which fit perfectly so the next day (Sunday, Feb 17) drove to the ER there so she could see a neurologist. A spinal tap was done and another test on a special machine which confirmed diagnosis of Guillain Barre. She was hospitalized that night until Friday the 22nd. There she received large daily doses of immune globulin. As of March 18, she is feeling better. The tingling and numbness is still there but is decreased. Dr. told her it should be gone by 6 months. 4/4/08 Reviewed hospital medical records of 2/17-2/22/08. FINAL DX: Guillain Barre syndrome Records reveal patient experienced progressive weakness, numbness & tingling of both right upper & lower extremity x 9 days followed by same on left side x 8 days with gait disturbance & balance difficulty x 2 days. Had chest tightening x 4-5 days w/progressive fatigue & SOB. Exam revealed distal sensory loss, areflexia, markedly weak hamstring muscles. Admitted for IVIG x 4-5 doses. Neuro consult done. Progressed & d/c w/continued home health PT. 7/11/08 Reviewed PCP medical records of 2/12-6/19/2008. FINAL DX: Guillain Barre syndrome, resolving Records of 2/12/08 reveal patient experienced weakness, pain, decreased appetite, LBP, LUQ abdominal pain & numbness of hands, feet & tongue for approx 2 wks. Appearance was extremely tired & stressed. DTRs diminished or absent in LEs. Follow-up: Still having some tingling in fingertips and toes -off and on. Happens more when she exercises. States it is about only 5% of what is was in the beginning. Still has tingling and numbness in fingers and toes on both sides of body but states is 50-75% less than in the beginning. Also occasional feelings of "electricity" mostly around nose area. She believes it all will be gone within 2 more months.

VAERS ID:309096 (history)  Vaccinated:2008-01-23
Age:0.8  Onset:2008-02-14, Days after vaccination: 22
Gender:Female  Submitted:2008-04-08, Days after onset: 53
Location:Texas  Entered:2008-04-08
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:
Preexisting Conditions: PMH: Hx of spells where infant would become limp with apnea and cyanosis beginning 10/2007.
Diagnostic Lab Data: Client had MRI and CT scan. Labs and Diagnostics: CBC with WBCs 25.6. EEG WNL. CT scan normal. CXR WNL. CSF WNL except (+) RBCs, no organisms. Chemistry and UA WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B110AB1IMRL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF090AA1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHB58845E1IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: CSF test normal, Chest X-ray normal, Complex partial seizures, Computerised tomogram, Convulsion, Cyanosis, Electroencephalogram normal, Full blood count, Hypotonia, Laboratory test normal, Nuclear magnetic resonance imaging, Otitis media, Pallor, Red blood cells CSF positive, Tympanic membrane hyperaemia, Urine analysis normal, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Apparent seizure on 2-14-2008. Taken to medical facility emergency room and was held in the hospital overnight for observation. Patient was transferred to Hospital. She was seen in the emergency room by Dr., pediatric neurologist, started on phenobarbital and will return to see him on 4-14-2008. 04/18/2008 MR received for DOS 2/15-16/2008 with D/C DX: Complex Partial Seizure. Otitis media. Pt transfered to facility after being found in crib limp, pale and cyanotic with open eyes. Infant had been crying previous to the event and suddenly stopped. Admitted for w/u. PE (+) for R TM redness. Neuro exam WNL.

VAERS ID:309987 (history)  Vaccinated:2008-01-23
Age:  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-03-26, Days after onset: 62
Location:Unknown  Entered:2008-04-16, Days after submission: 21
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: WAES0802USA01253
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Information has been received from a registered nurse concerning a female who on approximately 23-JAN-2008 was vaccinated with a dose of Zostavax (Oka/Merck). It was reported that after vaccination the patient experienced significant itching and redness on arms and legs. It was reported that the nurse had not seen the patient nor had the patient seen by any healthcare provider. At the time of report the patient had not recovered. No further information is available.

VAERS ID:310252 (history)  Vaccinated:2008-01-23
Age:20.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-04-07, Days after onset: 74
Location:Unknown  Entered:2008-04-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Pregnancy NOS (LMP = 12/11/2007)
Preexisting Conditions:
Diagnostic Lab Data: beta-human chorionic
CDC Split Type: WAES0803USA00503
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0188U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Genital haemorrhage, Pregnancy test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a 20 year old female consumer for Merck pregnancy registry who on 23-JAN-2008 was vaccinated IM with a 0.5 ml first dose of Gardasil (lot# 657006/0188U). There was no concomitant medication. The patient indicated that she is now pregnant. She had been experiencing "very light spotting" over the past two weeks which she did not experience with her previous pregnancies. Medical attention was not sought. The patient''s very light spotting persisted. The pregnancy outcome is unknown. Additional information has been requested.

VAERS ID:313004 (history)  Vaccinated:2008-01-23
Age:24.0  Onset:2008-01-24, Days after vaccination: 1
Gender:Female  Submitted:2008-05-16, Days after onset: 112
Location:Vermont  Entered:2008-05-22, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0515U1IMUN
Administered by: Private     Purchased by: Public
Symptoms: Chills, Myalgia, Nausea, Pyrexia, Vaccine positive rechallenge, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Chills, fever, myalgias nausea vomiting 24 hours after GARDASIL vaccine after each dose #1 11-20-07 #2 1-23-08

VAERS ID:313631 (history)  Vaccinated:2008-01-23
Age:1.1  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Oregon  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:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0803USA00596
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.0442U1IMUN
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0700F1SCUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1366U1SCUN
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a medical assistant concerning a 13 month old female patient who was vaccinated with varicella virus vaccine live (Oka/Merck) (Lot #659155/1366U). Subsequently, the patient developed an injection site reaction described as injection site swelling and injection site itching. The patient sought unspecified medical attention. There was no product quality complaint. This report is one of several from the same source. Follow up information has been received on 24-MAR-2008 from a medical assistant concerning a white 13 month old female patient who on 23-JAN-2008 was vaccinated with a second dose of VARIVAX (lot # 659155/1366U), dose unknown. Subcutaneously in the right thigh. Other vaccination received on 23-JAN-2008 included hepatitis A virus vaccine inactivated (MSD) ( lot number 657307/0440U) intramuscularly, left thigh and MMR II (lot number 656544/0700F) subcutaneously, left thigh. On an unspecified date, the patient experienced a red raised are on right thigh around VARIVAX site. It was also reported that in an unspecified date, the patient experienced swelling and itching afte receiving VARIVAX. On an unknown date, the patient recovered. No further information is available.

VAERS ID:315727 (history)  Vaccinated:2008-01-23
Age:37.0  Onset:0000-00-00
Gender:Female  Submitted:2008-04-01
Location:Georgia  Entered:2008-06-09, Days after submission: 69
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: GA08020
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B021AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: None given vaccine not licensed for this age.

VAERS ID:317268 (history)  Vaccinated:2008-01-23
Age:15.0  Onset:2008-02-14, Days after vaccination: 22
Gender:Female  Submitted:2008-06-22, Days after onset: 128
Location:Massachusetts  Entered:2008-06-24, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.05220IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Malaise, Pain in extremity, Skin exfoliation, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives all over body, x 5days, scaling feet and hands, pain feet with walking, c/w severe sickness; treated Prednisone P8. Benadryl. hives still continue /on/off

VAERS ID:319869 (history)  Vaccinated:2008-01-23
Age:17.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-07-15, Days after onset: 173
Location:Pennsylvania  Entered:2008-07-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN
Current Illness:
Preexisting Conditions: Irregular periods, Anorexia
Diagnostic Lab Data: None
CDC Split Type: WAES0806USA02500
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Metrorrhagia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from the Merck Pregnancy Registry for GARDASIL vaccine (yeast) via a health professional concerning a 17 year old female with a history of irregular periods (April 2005) and anorexia (March 2006) who on 19-NOV-2007 was vaccinated with a first dose of GARDASIL vaccine (yeast). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI-CYCLEN). In January 2008, the patient was seen by the physician for metrorrhagia that was resolved. On 23-JAN-2008 the patient was vaccinated IM with a second 0.5 ml dose of GARDASIL vaccine (yeast) and then discovered she was pregnant. Estimated date of last menstrual period was 22-JAN-2008. Gestation at the time of the report was "5 months along." Estimated date of delivery is 28-OCT-2008. At the time of the report the pregnancy outcome was unknown. Additional information has been requested.

VAERS ID:326384 (history)  Vaccinated:2008-01-23
Age:16.0  Onset:2008-01-23, Days after vaccination: 0
Gender:Female  Submitted:2008-09-26, Days after onset: 246
Location:Unknown  Entered:2008-09-29, 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: vitamins (unspecified)
Current Illness:
Preexisting Conditions: Tonsillectomy
Diagnostic Lab Data: ultrasound, 05/02/08, sex of baby: within normal limits
CDC Split Type: WAES0802USA03155
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1487U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Breech presentation, Caesarean section, Drug exposure during pregnancy, Foetal disorder, Ultrasound scan normal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)
Write-up: Information has been received from Merck pregnancy registry through a health professional concerning a 16 year old female with a medical history of tonsillectomy 4 years ago, and with no allergies, who on 23-JAN-2008 was vaccinated IM with the first dose of GARDASIL (lot# 659657/1487U). Concomitant therapy included Tdap and MMR II (Enders-Edmonston, Jeryl Lynn, Wistar RA 27/3) (MSD). On 28-Feb-2008 it was determined that the patient was pregnant with a LMP of 09-Dec-2007. The patient will be seeing the physician. The patient''s outcome is unknown. Follow up information was received from a physician who reported that the patient was taking prenatal vitamins during her pregnancy. On 02-MAY-2008 the patient had ultrasound test for sex of baby and the result indicated within normal limits. On 01-SEP-2008 due to the baby was breech, the patient underwent c-section and delivered a normal, but small male baby whose weight was 4 pounds and 9 ounces and height was 17 inches. Upon internal review, c-section due to breech presentation was determined to be an other important medical event. Additional information is not expected.

VAERS ID:327734 (history)  Vaccinated:2008-01-23
Age:78.0  Onset:2008-02-01, Days after vaccination: 9
Gender:Female  Submitted:2008-09-24, Days after onset: 235
Location:Illinois  Entered:2008-10-08, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL 325 mg, aspirin 325 mg, LIPITOR, calcium (unspecified) (+) 600 mg, OS-CAL D, PLAVIX 75 mg, gastrointestinal preparations 100 mg, HYDRODIURIL 12.5 mg, LEVEMIR, HUMALOG, isosorbide, SYNTHROID 100 microgm, COZAAR 25 mg, metoprolol 25 m
Current Illness: Cardiac disorder; Diabetes; Coronary artery atherosclerosis; Essential hypertension; Pure hypercholesterolaemia; Hypothyoidism
Preexisting Conditions: Bypass surgery; Cardiac failure congestive; Angioplasty; Stent placement
Diagnostic Lab Data: skin biopsy, 06/20/08 - subacute dermatitis with scattered eosinophils; blood pressure, 05/08/08, 150/5mmHg -; blood pressure, 05/09/08, 84/54mmHg -; skin and/or subcutaneous, 03/20/08 - staphylococcus growth; acinetobacter lwoffii growth;
CDC Split Type: WAES0806USA03120
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Biopsy skin abnormal, Blood glucose abnormal, Blood pressure, Dermatitis, Eczema infected, Excoriation, Gram stain negative, Impetigo, Rash, Rash erythematous, Rash generalised, Rash papular, Rash pruritic, Rash vesicular, Skin hyperpigmentation, Staphylococcal infection, Viral DNA test negative
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Accidents and injuries (broad), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a 78 year old female with a history of cardiac disorder, diabetes pure hypercholesterolaemia, hypothyroidism, congestive heart failure, essential hypertension, coronary atherosclerosis, angioplasty with stent placement (on 13-JUL-2007) and triple bypass surgery and no drug reaction/allergies history reported, who on 23-JAN-2008 was vaccinated with a first dose of ZOSTAVAX vaccine(Oka/Merck) (route and administrating site, Lot number not reported). Concomitant therapy included hydrochlorothiazide (manufacturer unknown) 12.5 mg daily, PLAVIX 75mg daily, LIPITOR 40mg daily, metoprolol 12.5mg AM and PM, SYNTHROID 100 mcg daily, isosorbide 60mg daily, Aspirin 325mg daily, Osteo-Renewer 600 mg bid, calcium carbonate (-) OSCAL D 500 bid; stool softener 2 tablets daily; LEVEMIR 8-12 UNITS DAILY; HUMALOG inject 6 units tid; multi-vitamin 1 tablet daily, nitroglycerin 0.4mg 1 tablet sublingual every 5 minutes as needed, up to 3 per episode, TYLENOL 650 mg every 4 hours as needed and MSD 25mg daily. Two weeks later, the patient developed a rash. The rash started on her lower back with three spots (one large, one medium, and one small). The patient went to see her dermatologist, by the time she got to the office her back had all these little red dots resembling a chicken pox or shingles type rash. Then the patient had skin eruptions all over her body. On 04-Feb-2008, serum glucose test was performed. The patient had skin eruptions all over her body. On 04-Feb-2008, Serum glucose test was performed. The result was 293 mg/dl (normal range 70/100 mg/dl). On 20-MAR-2008 skin tissue gram stain was performed. No organisms and WBC;s were seen; a skin tissue culture was done, the result indicated that staphylococcus and acinetobacter lwoffii growth. The physicians diagnosed her as having a minor staph infection and provided her with a medication for treatment, but that did not work. The patient did not know the name of the manufacturer or name of that product. The rashes developed into massive quar

VAERS ID:332721 (history)  Vaccinated:2008-01-23
Age:16.0  Onset:2008-01-30, Days after vaccination: 7
Gender:Female  Submitted:2008-11-18, Days after onset: 293
Location:Alabama  Entered:2008-11-18
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations: none~ ()~~0~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: none at that time. PMH: GERD. Migraine. Allergy to Augmentin
Diagnostic Lab Data: CT scan of sinus,MRI of Head and neck, Lumbar Puncture, Allergy testing, complete blood workups. Labs and Diagnostics: CPK increased. Recent CT scan head (-). MRI brain and cervical spine WNL. EEG WNL. CSF (+) RBCs no WBCs (rare WBCs o
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1424F1  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Allergy test, Amnesia, Anxiety disorder due to a general medical condition, Asthenia, Blood creatine phosphokinase increased, Blood test, CSF culture negative, CSF glucose normal, CSF pressure normal, CSF protein normal, Chills, Computerised tomogram normal, Disturbance in attention, Dizziness, Electroencephalogram normal, Fatigue, Fibromyalgia, Gram stain, Headache, Hemiparesis, Injection site pain, Lethargy, Lumbar puncture, Migraine, Mood disorder due to a general medical condition, Muscle spasms, Muscle tightness, Myalgia, Nasopharyngitis, Nausea, Neck pain, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain normal, Nuclear magnetic resonance imaging normal, Pain, Pharyngitis, Phonophobia, Photophobia, Polymyositis, Productive cough, Pyrexia, Red blood cells CSF positive, Sinusitis, Sleep disorder, Tension headache, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Oropharyngeal infections (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Gardasil shots - 1st shot (11/12/07) Painful at shot location and had a dull headache November through January. 2nd Shot (1/23/08)Pain at immunization site for a couple of weeks. Developed cold and sinus issues by the next day. Migraine type headache (very painful) began on 01/30/08. She began having major fatigue,dizziness, muscle pain, major sensitivity to light and sound, nausea and vomiting. We had several tests ran and trips to the emergency room. She had CT scans, MRI of head and neck, and lumbar puncture. She was out of school for 3 months unable to concentrate, short term memory loss, continuous pain (head and body). Improved enough after doctors, medications, massage therapists to return to school for the last month and a half. 3rd shot (06/03/08)with 3 other shots. She developed a cold sinus and her headache came back within a week to a worse level that before. Her headache has never went away since January 30th. She has muscle pain and spasms, short term memory loss, lethargic, dizziness, major sensitivity to light and sounds, nausea and vomiting. She has no energy and basically has had no life for the last 11 months of her life. 12/19/2008 MR received from PCP. Seen 11/12/07 for 1st HPV and Flu vax. Returned 11/27/07 with c/o chills, low grade fever, tight neck muscles. Dx: Nausea, Vomiting. 2nd HPV 1/23/08. Returned 1/30/08 with c/o fatigue. Dx: sinusitis/pharyngitis. Returned 2/5/08 with c/o h/a, neck soreness, productive cough and light sensitivity. Dx: H/A. F/U visit 6/3/08 for hospital stay for h/a and 3rd HPV, to f/u with neurologist. OV 8/8/08 with c/o muscle spasms on back with shooting pain down left. DX: Muscle spasm ? Polymyositis. Tx with Flexeril. OV 8/22/08 with c/o worsening H/A, nausea, and photo/phono phobia. DX: Tension H/a. To see neurologist. 1/12/09 MR received for 2 ER visits and one outpt visit. Pt presented to ER on 2/26/08 with c/o 3 1/2 week hx of constant frontal h/A with intermittent emesis. No releif with previously prescibed meds. (+) photophobi

VAERS ID:336457 (history)  Vaccinated:2008-01-23
Age:15.0  Onset:2008-03-25, Days after vaccination: 62
Gender:Female  Submitted:2009-01-05, Days after onset: 286
Location:Massachusetts  Entered:2009-01-05
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 HPV #2 given 3/24/08, lot # 1446U, LA.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0522U0IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Discomfort, Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Extreme Hives, trouble breathing / problems have continued since first injection / she breaks out in hives when there is a change of temperature (outside to inside / inside to outside) / has trouble breathing when exerting (cross country runner / basketball player) / has continued with sports but pushes through discomfort / very frustrating 1/23/09 Received PCP medical records of 3/24/08 FINAL DX: hives Records reveal patient w/daily hives since 2/15/08. Referred to specialist & declined further in series. No further records available.

VAERS ID:336852 (history)  Vaccinated:2008-01-23
Age:26.0  Onset:2008-03-08, Days after vaccination: 45
Gender:Female  Submitted:2009-01-07, Days after onset: 305
Location:Minnesota  Entered:2009-01-08, 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: folic acid; vitamins (unspecified)
Current Illness:
Preexisting Conditions: Drug hypersensitivity
Diagnostic Lab Data: Beta-human chorionic, positive
CDC Split Type: WAES0805USA00247
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1267U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Caesarean section, Drug exposure during pregnancy, Failed induction of labour, Gestational diabetes, Nausea, Pregnancy test positive
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Initial and follow up information has been received from a licensed practical nurse (L.P.N.) for the Pregnancy Registry for GARDASIL concerning a 26 year old female with a history of drug hypersensitivity to TYLENOL #3, DEMEROL, and CODEINE, who on 23-JAN-2008 was IM vaccinated with her first dose of GARDASIL (lot number 659439/1267U). On 24-MAR-2008 the patient was IM vaccinated with her second dose of GARDASIL (lot number 659964/1978U). The patient became pregnant after receiving two doses. She has not received her third dose yet. The patient''s LMP is 08-Mar-2008. The patient sought unspecified medical treatment with an office visit. The patient has had one previous pregnancy and one previous live birth, with no birth defects and no infant complications reported. Patient outcome was not reported. Follow-up information was received 05-JAN-2009 from the L.P.N. indicating that the patient''s estimated conception date was approximately 22-MAR-2008. Ultrasounds were performed on 07-JUL-2008, 19-AUG-2008, 15-SEP-2008, 22-OCT-2008 and 04-NOV-2008, respectively (results not provided). Other medication used during this pregnancy included HUMALOG daily for the treatment of gestational diabetes, LANTUS daily for the treatment of gestational diabetes, "gummi vitamin/folic acid" daily and ZOFRAN), as needed for the treatment of nausea. On 03-DEC-2008, the patient had a C-section due to failure to progress and delivered a normal female baby, weighing 6 pounds, 12 ounces. The baby''s length was 18 inches, head circumference was 13 inches and apgar score was 9/9. There were no congenital anomalies or other complications. The patient had no concurrent medical conditions. The outcome of the patient was not reported. Upon internal review, "C-section due to failure to progress" was determined to be an other important medical event. Additional information has been requested.

VAERS ID:345622 (history)  Vaccinated:2008-01-23
Age:74.0  Onset:2008-12-09, Days after vaccination: 321
Gender:Female  Submitted:2009-03-27, Days after onset: 107
Location:Michigan  Entered:2009-04-08, Days after submission: 12
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: WAES0812USA03603
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1824U SCUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: Information has been received from a registered pharmacist concerning a 75 year old female patient who on 23-JAN-2008 was vaccinated with a dose of ZOSTAVAX (Oka/Merck) (Lot # 659326/1824U). On 09-DEC-2008 the patient was diagnosed with shingles. The patient developed 4-5 lesions in the right axillary area. No treatment was prescribed. As of 17-DEC-2008 the patient was recovering. Additional information has been requested.

VAERS ID:346744 (history)  Vaccinated:2008-01-23
Age:0.2  Onset:2009-01-23, Days after vaccination: 366
Gender:Male  Submitted:2009-05-20, Days after onset: 116
Location:Utah  Entered:2009-05-20
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
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2797AA0IMRL
HBHEPB: HIB + HEP B (COMVAX)MERCK & CO. INC.116000IMRL
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01690SCLL
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.C575390IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.1205U0PO 
Administered by: Private     Purchased by: Private
Symptoms: Opisthotonus, Screaming, Staring, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad)
Write-up: DEVELOPED HIGH-PITCHED SCREAMING WHEN LAYED DOWN, ARCHING OF BACK TREMOR AND OPEN, GLAZED EYES WITHIN AN HOUR OF FIRST IMMUNIZATIONS. THESE SYMPTOMS LASTED ABOUT A WEEK BUT TOOK ABOUT 3 WEEKS TO GET BACK TO NORMAL.

VAERS ID:350689 (history)  Vaccinated:2008-01-23
Age:0.2  Onset:2008-01-28, Days after vaccination: 5
Gender:Female  Submitted:2009-07-02, Days after onset: 520
Location:Louisiana  Entered:2009-07-02
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: none
Current Illness: none
Preexisting Conditions: none. 7/13/09 Hospital records received DOS 3/6/08 to 3/7/08. Born by caesarean section. Jaundice. Anal opening mildly displaced. 7/13/09 PCP medical records received DOS 11/19/07 to 9/17/08. Reflux, hiccups, gassy. Presacral dimple. Discharge from umbilicus. Total Bilirubin 16.2 MG/DL (H)
Diagnostic Lab Data: COLITIS from stool sample. 7/13/09 Hospital records received DOS 3/6/08 to 3/7/08. LABS and DIAGNOSTICS: AST 89 (H). CBC - Eosinophils 8% (H) Platelets 485000 (Elevated). KUB - increased gas. X-Ray Abdomen - Consistent with colitis, gas in
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2800AA0IDLL
HEP: HEP B (GENHEVAC B)SANOFI PASTEURAHBVB516AA0IDLA
HIBV: HIB (ACTHIB)SANOFI PASTEURUF206AA0IDLL
PPV: PNEUMO (PNU-IMUNE)PFIZER/WYETHB97283A0IDLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.162OU0IDLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal X-ray, Abdominal distension, Abdominal pain, Abdominal pain upper, Allergic colitis, Aspartate aminotransferase increased, Basophil count increased, Colitis, Crying, Diarrhoea, Eosinophil percentage increased, Eosinophilia, Faeces discoloured, Feeding disorder neonatal, Flatulence, Gastrooesophageal reflux disease, Infantile spitting up, Irritability, Mucous stools, Platelet count increased, Regurgitation, Screaming, Stool analysis abnormal, Urinary system X-ray, X-ray abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Functional lactation disorders (narrow), Neonatal disorders (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Persistent (more than 3 weeks) mucous in stools; persistent belly pain; required hospitalization of 2 days; diagnosed with COLITIS; could no longer breast feed; had to feed baby only Nutramigen for next 9 months. 7/13/09 Hospital records received DOS 3/6/08 to 3/7/08. Final Diagnosis: Allergic Colitis Suspected, Gastroesophageal Reflux Disease Suspected. Parent reports child has diarrhea, colicky, ''pepper jelly stool'', screaming, distended abdomen. Peripheral eosinophilia. Patient presents with irritability and mucoid stools. Cries after feeding. Greenish stools. Regurgitation, spitting up. Gassy. 7/13/09 PCP medical records received DOS 11/19/07 to 9/17/08. Assessment: Colitis Presents with mucousy stool, abdominal pain, colic. Diarrhea. Pasty green yellow stool.

VAERS ID:388952 (history)  Vaccinated:2008-01-23
Age:4.0  Onset:2010-01-15, Days after vaccination: 723
Gender:Male  Submitted:2010-05-14, Days after onset: 118
Location:Unknown  Entered:2010-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: serum immunoglobulin M, 01/17/10, <1:10; serum immunoglobulin G, 01/17/10, 7.18; serum amylase test, 01/17/10, 166
CDC Split Type: WAES1002USA01349
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blood amylase, Blood immunoglobulin G, Blood immunoglobulin M, Ear pain, Mumps, Parotitis
SMQs:, Oropharyngeal infections (narrow)
Write-up: Information has been received from a physician concerning a 6 year old male who on 12-OCT-2004 and 23-JAN-2008 was vaccinated with the first and second doses of MMR II (route and lot# not reported). On 15-JAN-2010 the patient experienced mumps. 17-JAN-2010, the patient was diagnosed with mumps. The parotitis was on the left side. The patient experienced left ear pain. None other symptoms reported. On 17-JAN-2010, a first blood work was performed, and showed that : IgM, <1:10; IgG, 7.18; serum amylase, 166. The patient had not received the third dose of MMR II. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.

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