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Found 588638 cases where Symptom is Immune system disorder or Immunodeficiency or Immunoglobulins decreased or Lymphadenopathy

Case Details (Sorted by Age)

This is page 304 out of 589

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VAERS ID:584765 (history)  Vaccinated:2015-07-07
Age:12.0  Onset:2015-07-07, Days after vaccination: 0
Gender:Male  Submitted:2015-07-07, Days after onset: 0
Location:Massachusetts  Entered:2015-07-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None identified
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0169660IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Feeling abnormal, Injection site reaction
SMQs:, Dementia (broad)
Write-up: 1230 pm, pt c/o R arm where imm given felt like "could not pick things up". No numbness or tingling, but yes "felt funny". Denied pain. Exam normal tone, symmetric movements, shoulder abd/adduction. Sensation intact light touch, strength 5/5, fingers normal ROM, normal finger opposition/strength thumb/2nd and thumb/5th digit B. Felt "better" after a few minutes. Discussed with dad observe, can try ibuprofen if complains of arm sore, if weakness/funny feeling returns, or if any sxms or concerns to call asap.

VAERS ID:584861 (history)  Vaccinated:2015-07-07
Age:12.0  Onset:2015-07-07, Days after vaccination: 0
Gender:Female  Submitted:2015-07-07, Days after onset: 0
Location:Oregon  Entered:2015-07-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No reported medications
Current Illness: No
Preexisting Conditions: Allergy to latex gloves
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0159720SCLA
Administered by: Private     Purchased by: Other
Symptoms: Abdominal pain, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Weakness in legs, crampy feeling below sternum.

VAERS ID:584880 (history)  Vaccinated:2014-08-11
Age:12.0  Onset:2014-09-01, Days after vaccination: 21
Gender:Female  Submitted:2015-07-08, Days after onset: 310
Location:Ohio  Entered:2015-07-08
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: Spinal Fusion for Scoliosis in December 2013; Narrow Septum of heart with murmur
Diagnostic Lab Data: Saw Immunologist at Hospital
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0112720IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM130460IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4456AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0061611SCRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever and rash beginning approximately 3 weeks post vaccination and continued to occur approximately every three weeks through the 2nd week in March. No further rash or fever since the 2nd week in March.

VAERS ID:585111 (history)  Vaccinated:2015-07-09
Age:12.0  Onset:2015-07-09, Days after vaccination: 0
Gender:Female  Submitted:2015-07-09, Days after onset: 0
Location:Ohio  Entered:2015-07-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.K026247 IM 
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5058AC IM 
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSBL9BD IM 
Administered by: Unknown     Purchased by: Private
Symptoms: Crying, Hallucination, visual
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad)
Write-up: HALLUCINATIONS INVOLVING SEEING A DARK MAN-SHAPED FIGURE, WITHOUT ARMS OR LEGS, CRAWLING ACROSS THE CEILING AND ATTACKING AND CHEWING ON HER TWIN SISTER. TERRIFIED OF WHAT SHE WAS SEEING, CRYING. LASTED APPROXIMATELY 45-60 MINUTES PER FATHER.

VAERS ID:585164 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:2015-03-25
Gender:Unknown  Submitted:2015-04-03, Days after onset: 9
Location:Unknown  Entered:2015-07-09, Days after submission: 97
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Extra dose administered, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Busy clinic, late in the day and interpreter needed for adolescent visit for MCV and Tdap vaccines. HPV vaccine series completed previously. Nurse gave HPV vaccine given instead of MCV.

VAERS ID:585285 (history)  Vaccinated:2015-06-24
Age:12.0  Onset:2015-06-24, Days after vaccination: 0
Gender:Male  Submitted:2015-07-06, Days after onset: 12
Location:Texas  Entered:2015-07-09, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K010250IMRA
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUH503AA SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4543AA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Asthenia, Blood glucose normal, Dizziness, Headache, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient stated that he was feeling lightheaded, weak and had a headache. Patient asked to sit down and blood pressure was taken at approx. 1:55 pm (110/70). Patient given water to drink and two fig bars, which he drank and ate. BP rechecked at approx 2:00 pm (90/60). Patient still stated feeling weak and headache. BP rechecked at 2:04 pm (91/58) and glucose was 156. BP rechecked at approx 2:15pm (101/64). Patient states he is feeling better but still has a headache. Mom instructed to take him to be seen immed. if symptoms persist or get worse but he could be given TYLENOL for headache, fever or pain. Patient''s mother called on 6/25/15, patient reports soreness in right arm but no other symptoms.

VAERS ID:585259 (history)  Vaccinated:2015-07-08
Age:12.0  Onset:2015-07-09, Days after vaccination: 1
Gender:Female  Submitted:2015-07-10, Days after onset: 1
Location:Michigan  Entered:2015-07-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Evaluated by doctor in emergency room
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Severe headache and vomiting lasting 7 hours.

VAERS ID:585400 (history)  Vaccinated:2015-07-09
Age:12.0  Onset:2015-07-09, Days after vaccination: 0
Gender:Female  Submitted:2015-07-10, Days after onset: 1
Location:Minnesota  Entered:2015-07-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0013121IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient given #2 HPV, and felt ok, no dizziness, moved to chair from exam table so brother could get his vaccines. Patient had no complaints. Sibling finished with vaccines, and patient complains of dizziness. She immediately fainted and body did have muscle contractions. Patient did immediately open eyes. Assisted patient to exam table to lie down, propped knees with pillow. Placed cool cloth on forehead, offered orange juice. BP taken 112/76. Patient allowed to rest for 15 mins. No further complaints, feels better. BP rechecked 100/61. Patient assisted to sitting position in which she sat for 3 min before brought to standing position. She still feels no further symptoms. Recommended to walk slowly with assistance. Have food when arrive home, and call with any further questions or concerns. Mom and patient verbalized understanding.

VAERS ID:585417 (history)  Vaccinated:2015-05-20
Age:12.0  Onset:2015-05-20, Days after vaccination: 0
Gender:Unknown  Submitted:2015-07-10, Days after onset: 51
Location:Unknown  Entered:2015-07-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507USA001145
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0068500UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a registered nurse refers to unspecified number of patients of unknown age and gender. No concurrent conditions or medical history were reported. Since an excursion in February 2015, unspecified number of patients, on unspecified date, were vaccinated with doses of GARDASIL (lot # J006850, expiration date 31-MAR-2015) (route not reported), which have been exposed to temperature outside of the recommended range also reported as improperly stored vaccines. No concomitant medications were reported. No adverse effect (AE) had been observed or reported. Follow up information has been received from the Registered Nurse on 11-JUN-2015. During a follow up phone call attempt, the nurse stated that they were unable to share any patient information as they would need the patient to sign a consent form. A telephone call was received from the registered nurse on 22-JUN-2015, who stated that she had knowledge of two improperly stored doses of GARDASIL that were administered to two different patients. Follow up information has been received from the Registered Nurse on 02-JUL-2015. The nurse practitioner sent information regarding to the 12 year old patient who was vaccinated with GARDASIL (lot # J006850, expiration date 31-MAR-2016). This is on of two reports received from the same reporter. (MARRS # 1505USA002946) General tab, patient and narrative were updated.

VAERS ID:585493 (history)  Vaccinated:2015-07-09
Age:12.0  Onset:2015-07-09, Days after vaccination: 0
Gender:Female  Submitted:2015-07-10, Days after onset: 1
Location:Kansas  Entered:2015-07-10
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: Other contraindication/precaution not listed
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0141910UNLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5049AA0UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4714AA0UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Fatigue, Injection site pain, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 07/09/2015 mild other Patient had fever of 101, nausea, fatigue and pain in upper right arm. Patient started on KEFLEX to provide coverage if infection present.

VAERS ID:585447 (history)  Vaccinated:2013-07-29
Age:12.0  Onset:2013-08-02, Days after vaccination: 4
Gender:Female  Submitted:2015-07-12, Days after onset: 709
Location:Indiana  Entered:2015-07-12
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: Tree and grass pollen
Diagnostic Lab Data: Several laboratory tests cannot determine the cause of her hives and swelling. Patient had several months of severe hives and swelling. Patient was then diagnosed with Chronic a idiopathic Urticaria. She also has a red dye allergy that triggers her hives.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Chronic spontaneous urticaria, Laboratory test normal, Reaction to food additive, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient broke out in hives and swelling all over her body.

VAERS ID:585645 (history)  Vaccinated:2015-06-03
Age:12.0  Onset:2015-06-03, Days after vaccination: 0
Gender:Unknown  Submitted:2015-07-14, Days after onset: 41
Location:Michigan  Entered:2015-07-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507USA003849
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K014191 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Information as received from a certified medical assistant (CMA) refers to a 12-year-old patient of an unknown gender. The patient''s medical history, concurrent conditions and concomitant medications were not reported. On 03-JUN-2015, the patient was vaccinated with a dose of GARDASIL (lot number K014191 and expiration date 10-MAY-2017) (dose and route not reported) which was improperly stored. No adverse effects were reported. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:585750 (history)  Vaccinated:2012-01-12
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-07-13
Location:Unknown  Entered:2015-07-14, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507DNK004982
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.G0049581IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain lower, Activities of daily living impaired, Asthenia, Chest discomfort, Disturbance in attention, Dizziness, Fatigue, Headache, Hyperaesthesia, Loss of consciousness, Memory impairment, Muscle spasms, Nausea, Pain, Pain of skin, Pruritus, Pyrexia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Information has been received from Sanofi Pasteur MSD (SPM) (manufacturer control # E2015-08033) on 10-JUL-2015. Case received from Health Care Professional via health authorities on 08-JUL-2015 under the reference number DK-DKMA-ADR 23052207 and DK-DKMA-EF012592. The case is medically confirmed. The primary reporter was a physician. A 12-year old female patient had received the first and second dose of GARDASIL (batch number: D1: G004958 D2: G004958) via intramuscular route of administration in unspecified site on 27-OCT-2011 (D1) and 12-JAN -2012 (D2). On unspecified dates in 2012, she developed lower abdominal pain, nausea, concentration impairment, memory impairment and headache. On not reported dates, she developed chronic tiredness, dizziness, stinging skin (touch of the skin gives pain), itchy skin, blackout, energy loss, body pain that moves around, sensitive skin (a touch gives pain), chest pressure, the heart cramps and feels as if she has fever. The patient has had absence from school due to the adverse reactions. This case is serious due to the seriousness criteria disability and other medically important condition. No other vaccines or medications. The patient has been evaluated by the pediatric department and gynecologic department, where there were no remarks (not further specified). No information on medical history provided. At the time of reporting, the patient had not recovered from lower abdominal pain, chronic fatigue, nausea, concentration impairment, memory impairment and headache. The outcome of the remaining reactions was unknown.

VAERS ID:585758 (history)  Vaccinated:2015-06-02
Age:12.0  Onset:2015-06-02, Days after vaccination: 0
Gender:Unknown  Submitted:2015-07-14, Days after onset: 42
Location:Michigan  Entered:2015-07-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507USA003846
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K014191 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Information as received from a certified medical assistant (CMA) refers to a 12-year-old patient of an unknown gender. The patient''s medical history, concurrent conditions and concomitant medications were not reported. On 02-JUN-2015, the patient was vaccinated with a dose of GARDASIL (lot number K014191 and expiration date 10-MAY-2017) (dose and route not reported) which was improperly stored. No adverse effects were reported. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:585920 (history)  Vaccinated:2015-07-15
Age:12.0  Onset:2015-07-15, Days after vaccination: 0
Gender:Male  Submitted:2015-07-15, Days after onset: 0
Location:California  Entered:2015-07-15
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
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0047411IMRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: RASH ON FACE WITH REDNESS AROUND THE EYES. WE GIVE PATIENT BENADRYL AND WE KEEP PATIENT FOR 30MIN. WE SEND PATIENT HOME AFTER. NO RASH NOTICED.

VAERS ID:585946 (history)  Vaccinated:2015-07-15
Age:12.0  Onset:2015-07-15, Days after vaccination: 0
Gender:Male  Submitted:2015-07-15, Days after onset: 0
Location:California  Entered:2015-07-15
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: NKDA; asthma
Diagnostic Lab Data: Blood glucose finger stick-100
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0069600IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA140720IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4689BA5IMLA
Administered by: Private     Purchased by: Public
Symptoms: Blood glucose normal, Immediate post-injection reaction, Loss of consciousness, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Vaccine administered-Tdap-LD, HPV, MCV4-RD immediately started to lose consciousness, became pale, not diaphoretic, no salivary excretions, no eye movement, pt. fainted no loss of consciousness. Pt responded to directions and opened eyes.

VAERS ID:586041 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-07-15
Location:Unknown  Entered:2015-07-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: The patient was found to be positive for anti-nuclear, anti-thyroperoxidase and anti-thyroglobulin antibodies.
CDC Split Type: US2015GSK100726
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Anti-thyroid antibody positive, Antinuclear antibody positive, Autoimmune disorder, Chronic fatigue syndrome
SMQs:, Systemic lupus erythematosus (narrow), Hypothyroidism (broad), Hyperthyroidism (broad)
Write-up: This case was reported in a literature article and described the occurrence of autoimmune disorder in a 12-year-old female subject who received Hepatitis B vaccine. On an unknown date, 108 days after receiving Hepatitis B vaccine, the subject developed autoimmune disorder. Serious criteria included GSK medically significant. Additional event(s) included chronic fatigue syndrome. The outcome of autoimmune disorder was unknown. The outcome(s) of the additional event(s) included chronic fatigue syndrome (unknown). The investigator considered that there was a reasonable possibility that the autoimmune disorder and chronic fatigue syndrome may have been caused by Hepatitis B vaccine. Relevant Tests: The patient was found to be positive for anti-nuclear, anti-thyroperoxidase and anti-thyroglobulin antibodies. Diagnostic results (unless otherwise stated, normal values were not provided): On an unknown date, Anti-thyroid antibody result was Positive absent. On an unknown date, Anti-thyroid antibody result was Positive absent. On an unknown date, Antinuclear antibody result was Positive absent. Additional information received: This case was reported in a literature article and it described the occurrence of chronic fatigue syndrome in a 12-year-old female patient who had received unspecified hepatitis B virus vaccine (manufacturer unknown). No further information on the patient''s concurrent medical conditions, medical and family history or concomitant medication was provided. On an unspecified date, between 1990 and 2008, the patient received between 1 and 3 doses of an unspecified hepatitis B vaccine (dosages unknown; administration routes and sites unspecified; batch numbers not provided). The authors reported all the patients following the schedule recommended by the Centers for Disease Control and Prevention protocols (0, 1 and 6 months). On an unspecified date, 108 days after the last vaccination, the patient developed chronic fatigue syndrome. The authors did not specify the symptoms that the patient presented; but they mentioned that they included neurological, psychiatric and musculoskeletal symptoms. The authors commented that they thought this was a case of autoimmune (auto-inflammatory) syndrome induced by adjuvants as it complied with 2 of the major suggested criteria for this condition (exposure to an external stimuli and appearance of typical clinical manifestations). The patient was found to be positive for anti-nuclear, anti-thyroperoxidase and anti-thyroglobulin antibodies. Treatment was unknown. Outcome of the events was unspecified at the time of reporting. The authors believed that this was a case of autoimmune (auto-inflammatory) syndrome induced by the adjuvants in the vaccine. The authors concluded that "this study suggests an association between immunizations with hepatitis B vaccines or to one of its components to chronic fatigue syndrome and fibromyalgia, as part of the autoimmune (auto-inflammatory) syndrome induced by adjuvants. Although a causal association could not be proven, a temporal association was clearly evident in this cohort. An important point to stress is that this temporal association may last longer than is usually expected and in our cohort was observed up to a year following immunization. Several risk factors were noted such as the appearance of adverse event during immunization which may imply an increased risk of developing post-immunization diseases or the presence of autoimmune susceptibility documented by personal or family history or the presence of autoantibodies. Last but not least, the between autoimmune (auto-inflammatory) syndrome induced by adjuvants criteria were fulfilled in all patients eluding the plausible link between autoimmune (auto-inflammatory) syndrome induced by adjuvants and chronic fatigue syndrome and fibromyalgia. Further studies are needed to support our observation and possibly shed more light on genetic, autoimmune and vaccine ingredient related risk factors".

VAERS ID:586203 (history)  Vaccinated:2015-07-14
Age:12.0  Onset:2015-07-15, Days after vaccination: 1
Gender:Male  Submitted:2015-07-16, Days after onset: 1
Location:Connecticut  Entered:2015-07-16
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 PASTEURU4975BA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS4JL440IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Abdominal pain upper, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Per mother, approximately 24 hours after vaccine administration, patient developed a 104.2 fever with body aches and stomach ache. This morning, his temp was 99.9 without TYLENOL or MOTRIN.

VAERS ID:586255 (history)  Vaccinated:2015-07-14
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-07-16
Location:Massachusetts  Entered:2015-07-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0016310IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4680AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURCVX1150IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None.

VAERS ID:586270 (history)  Vaccinated:2008-11-14
Age:12.0  Onset:2008-11-14, Days after vaccination: 0
Gender:Male  Submitted:2015-07-17, Days after onset: 2435
Location:Ohio  Entered:2015-07-17
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Negative (Negative as in finding disease after vaccine)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2768BA5IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Decreased appetite, Incoherent, Laboratory test normal, Loss of consciousness, Vision blurred, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Throwing up, Blurred vision, Passing out, Lack of Appetite, incoherent.

VAERS ID:586287 (history)  Vaccinated:2015-07-07
Age:12.0  Onset:2015-07-07, Days after vaccination: 0
Gender:Female  Submitted:2015-07-19, Days after onset: 12
Location:Florida  Entered:2015-07-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allergy medicine which she has taken for the last six or more years... Not sure who the manufacturer was because I am only the mom of the patient... It was Pneumococcal Polysaccharide Vaccine. I am guessing Merck, but only the doctor has
Current Illness: No
Preexisting Conditions: Selective IGA Deficiency; Fragrance allergy
Diagnostic Lab Data: We were advised to take her to her regular doctor which we did. She couldn''t keep anything down including the medication to lower the fever and swelling.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Injection site mass, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Large lump at site of injection, redness that spread, fever up to 102.9, vomiting.

VAERS ID:586556 (history)  Vaccinated:2015-07-21
Age:12.0  Onset:2015-07-21, Days after vaccination: 0
Gender:Female  Submitted:2015-07-21, Days after onset: 0
Location:Florida  Entered:2015-07-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSX22P41IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0094822IMLA
Administered by: Public     Purchased by: Public
Symptoms: Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Pt collapsed approximately 5 mins after HPV4#3 and Hep A#2 injections and started to seize for about 30 seconds. BP, P and O2 were taken immediately after she became responsive, 6 mins and 10 mins after. Pt was taken to hospital via EMS for further evaluation.

VAERS ID:586573 (history)  Vaccinated:2015-07-13
Age:12.0  Onset:2015-07-14, Days after vaccination: 1
Gender:Male  Submitted:2015-07-15, Days after onset: 1
Location:Alabama  Entered:2015-07-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0115620IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM141300IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5095AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Cyst, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received Tdap right deltoid 7/13/15, 7/14/15 noticed swelling and redness to right deltoid, MD diagnosed with antigenic cyst and given KEFLEX 250 mg.

VAERS ID:586584 (history)  Vaccinated:2015-07-16
Age:12.0  Onset:2015-07-16, Days after vaccination: 0
Gender:Male  Submitted:2015-07-21, Days after onset: 5
Location:Ohio  Entered:2015-07-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Child was taking no other medications. Has had 5 previous DTaP vaccines with no reactions.
Current Illness: No Illness
Preexisting Conditions: No pre-existing conditions
Diagnostic Lab Data: Child has follow up appt with primary doctor.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS3HY320IMLA
Administered by: Public     Purchased by: Public
Symptoms: Immediate post-injection reaction, Joint contracture, Seizure like phenomena, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Child was sitting on the exam table and was given the Tdap vaccine. Immediately had a syncopal episode then presented with seizure -like activity for approximately 7 seconds. Hand/wrists contracted. Child awoke - was oriented x3. No loss of bladder function nor drooling from the mouth. Mom was instructed to take to the emergency room if any further activity noted and to make an appointment with his primary doctor. Mom verbalized understanding.

VAERS ID:586669 (history)  Vaccinated:2015-07-21
Age:12.0  Onset:2015-07-21, Days after vaccination: 0
Gender:Female  Submitted:2015-07-21, Days after onset: 0
Location:Oklahoma  Entered:2015-07-21
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4975BA0SYRLA
Administered by: Private     Purchased by: Public
Symptoms: Immediate post-injection reaction, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Seizure immediately after administration of MENACTRA injection. Duration of 30 seconds-1 minute.

VAERS ID:586674 (history)  Vaccinated:2015-07-21
Age:12.0  Onset:2015-07-21, Days after vaccination: 0
Gender:Male  Submitted:2015-07-21, Days after onset: 0
Location:New York  Entered:2015-07-21
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: Possibly soy allergy
Diagnostic Lab Data:
CDC Split Type: NYC1500010
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSZT59G3IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0094821IMLA
Administered by: Other     Purchased by: Public
Symptoms: Confusional state, Injection site pain, Pain in extremity, Seizure, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Immediately after GARDASIL was administered today around 12:30 PM, client fainted and convulsed for approximately 3 seconds. He immediately recovered consciousness and appeared confused for a very short time. Questions about name, time and place were asked which he accurately answered. He complained of pain at the site of injections and lower extremities. BP and HR were taken WNL and patient was observed for approximately 1/2 hour. Patient went home verbalizing that he feels well and he appeared fine just like before injection. It is very important to note that his sister received a 3 dose of GARDASIL and hour earlier and surprisingly the same reaction occurred. Adverse event also completed for her.

VAERS ID:586712 (history)  Vaccinated:2015-07-22
Age:12.0  Onset:2015-07-22, Days after vaccination: 0
Gender:Male  Submitted:2015-07-22, Days after onset: 0
Location:Maine  Entered:2015-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0115622IMRA
Administered by: Unknown     Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient fainted after shot was given.

VAERS ID:586950 (history)  Vaccinated:2015-07-23
Age:12.0  Onset:2015-07-23, Days after vaccination: 0
Gender:Male  Submitted:2015-07-23, Days after onset: 0
Location:Ohio  Entered:2015-07-23
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: Allergy to tree nuts and PCN
Diagnostic Lab Data: N/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Private
Symptoms: Muscle twitching, Posture abnormal, Staring
SMQs:, Dyskinesia (broad), Dystonia (broad)
Write-up: Patient slumped over with eyes open in a vacant stare and then facial twitching started.

VAERS ID:587134 (history)  Vaccinated:2015-07-13
Age:12.0  Onset:2015-07-13, Days after vaccination: 0
Gender:Male  Submitted:2015-07-23, Days after onset: 10
Location:Michigan  Entered:2015-07-23
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0061910IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4923BA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS5MG550IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pyrexia, Wrong technique in drug usage process
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Suspected that powder component of MENVEO was diluted with MENACTRA and injected IM. Pt. had a fever for 2 days treated with TYLENOL and MOTRIN. No other symptoms, no arm redness or soreness. Recommended by CDC to repeat dose and mom informed on and plans to do.

VAERS ID:587143 (history)  Vaccinated:2015-07-23
Age:12.0  Onset:2015-07-23, Days after vaccination: 0
Gender:Male  Submitted:2015-07-23, Days after onset: 0
Location:Oregon  Entered:2015-07-23
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: Vital sign during event BP 80/60 P70 Post event 92/60 74
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0069600IMRA
Administered by: Public     Purchased by: Public
Symptoms: Hyperhidrosis, Immediate post-injection reaction, Limb discomfort, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: HPV vaccination (R) deltoid IM - immediately upon administration patient c/o heavy arm, then became pale/diaphoretic-moved patient to supine position with legs elevated. Patient took approx 10 minutes to return to baseline. 7/23/15.

VAERS ID:587014 (history)  Vaccinated:2015-07-20
Age:12.0  Onset:2015-07-20, Days after vaccination: 0
Gender:Female  Submitted:2015-07-24, Days after onset: 4
Location:Unknown  Entered:2015-07-24
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: Anion gap acidosis with hypomagnesemia, elevated ALP and leukocytosis with PMN predominance. Patient had rapid resolution of symptoms following administration of IV diphenhydramine 25mg.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0141912IMRA
Administered by: Military     Purchased by: Military
Symptoms: Anion gap decreased, Ballismus, Blood alkaline phosphatase increased, Blood magnesium decreased, Cyanosis, Dystonia, Hyperthermia, Hypomagnesaemia, Leukocytosis, Mental status changes, Metabolic acidosis, Muscle rigidity, Tachycardia, Tachypnoea, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (narrow), Parkinson-like events (narrow), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Dystonic Reaction: Hyperthermia, Tachypnea, Tachycardia, Distal muscular rigidity, Distal cyanosis, Hemiballismus, and Altered mentation.

VAERS ID:588142 (history)  Vaccinated:2015-07-08
Age:12.0  Onset:2015-07-08, Days after vaccination: 0
Gender:Male  Submitted:2015-07-25, Days after onset: 17
Location:Unknown  Entered:2015-07-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507USA005468
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0078280IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Headache, Immediate post-injection reaction, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: This initial spontaneous report was received from a medical assistant who called on behalf of the patient''s mother, referring to a 12 year old male patient. There was no pertinent medical history or drug allergies/drug reactions. On 08-JUL-2015 the patient was vaccinated with the first dose of GARDASIL intramuscular (0.5ml, once, lot # K007828, expiration date 03/02/2017). There was no concomitant medication. Immediately after received GARDASIL, the patient experienced severe headache, dizziness and sleepiness. The patient sought medical attention by calling the physician, and for the headache, treatment was given with ADVIL. There were no laboratory diagnostic tests performed. At the time of the report, the outcome of severe headache, dizziness and sleepiness was reported as not recovered. The causality for the events was not reported. Additional information has been requested.

VAERS ID:588144 (history)  Vaccinated:2014-09-22
Age:12.0  Onset:2015-07-01, Days after vaccination: 282
Gender:Male  Submitted:2015-07-25, Days after onset: 24
Location:Unknown  Entered:2015-07-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SINGULAIR; PROVENTIL
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507USA008282
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report was received from a registered nurse and refers to a 12 year old male patient with asthma. On 07-JAN-2014, the patient was vaccinated with the first dose of GARDASIL 0.5 ml, intramuscular. On 22-SEP-2014, the patient was vaccinated with the second dose of GARDASIL 0.5 ml, intramuscular. On 14-JUL-2014, the patient was vaccinated with the third dose of GARDASIL (lot number K010574, expiration date 05-APR-2017), 0.5 ml, intramuscular in the arm. Concomitant therapies included SINGULAIR and albuterol sulfate (manufacturer unknown). On an unspecified date in July 2015 the patient experienced redness and injection site swelling. On 16-JUL-2015, the patient sought medical attention (not specified). The reporter stated that the patient had full range of motion in the affected arm and that he was not experiencing any pain. At the reporting time, the outcome of erythema, injection site swelling and injection site reaction was reported as not recovered/not resolved. Additional information has been requested.

VAERS ID:587720 (history)  Vaccinated:2013-10-07
Age:12.0  Onset:2013-10-07, Days after vaccination: 0
Gender:Unknown  Submitted:2013-11-21, Days after onset: 45
Location:Unknown  Entered:2015-07-27, Days after submission: 612
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2013US021111
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Case number PHEH2013US021111 is an initial spontaneous report received from a health care professional on 08 OCT 2013. This report refers to a 12-year-old patient of unknown gender who was inadvertently vaccinated with FLUCELVAX (batch number: unknown) intramuscularly on 07 OCT 2013. No adverse event was reported following this administration error.

VAERS ID:587831 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2013-11-21
Location:Unknown  Entered:2015-07-27, Days after submission: 612
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2013US023211
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Case number PHEH2013US023211 is an initial spontaneous report received from a consumer on 04 NOV 2013. This case refers to a 12-year-old unknown gender patient. Past medical history and concomitant medication were not reported. The patient was vaccinated with FLUCELVAX (batch number: not reported) at dose of 0.5 ml on an unknown date. No adverse event was reported following this administration error.

VAERS ID:587842 (history)  Vaccinated:2013-10-26
Age:12.0  Onset:2013-10-26, Days after vaccination: 0
Gender:Female  Submitted:2013-11-21, Days after onset: 26
Location:Unknown  Entered:2015-07-27, Days after submission: 612
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2013US022650
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS006011A IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Case number PHEH2013US022650 is an initial spontaneous report received from a pharmacist on 28 OCT 2013. This report refers to a 12-year-old female patient who was vaccinated with FLUCELVAX 2013/2014 (batch number: 006011A) intramuscularly on 26 OCT 2013. No adverse event was reported following medication error (inappropriate age at vaccine administration).

VAERS ID:587907 (history)  Vaccinated:2015-07-23
Age:12.0  Onset:2015-07-23, Days after vaccination: 0
Gender:Male  Submitted:2015-07-27, Days after onset: 4
Location:Alabama  Entered:2015-07-27
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: CT head
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS9559K0IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0094820IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5021AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS9245B0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Computerised tomogram head normal, Head injury, Laceration, Suture insertion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient had a syncope episode and hit head on floor causing laceration of chin requiring 4 sutures and follow up head CT (normal results).

VAERS ID:587537 (history)  Vaccinated:2014-08-27
Age:12.0  Onset:2014-09-10, Days after vaccination: 14
Gender:Male  Submitted:2015-07-28, Days after onset: 321
Location:New York  Entered:2015-07-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Panic attacks~HPV (Gardasil)~1~11.42~Patient|Panic attacks~HPV (Gardasil)~2~11.67~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2IMUN
Administered by: Private     Purchased by: Private
Symptoms: Panic attack, Vaccine positive rechallenge
SMQs:
Write-up: Within a week of the shot and extending for a month patient developed panic attacks. Occurred with all three doses of Gardasil vaccine.

VAERS ID:588336 (history)  Vaccinated:2015-07-28
Age:12.0  Onset:2015-07-28, Days after vaccination: 0
Gender:Male  Submitted:2015-07-28, Days after onset: 0
Location:New Jersey  Entered:2015-07-28
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: ADD; ODD; behavioral disorder
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.K0115621IMLA
Administered by: Private     Purchased by: Public
Symptoms: Hypoaesthesia, Pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Within 15 minutes of injection patient had complaint of numbness over suprasternal area then had pain. VS remained normal and physical exam. Didn''t resolve after 1 hour sent to ED.

VAERS ID:588371 (history)  Vaccinated:2015-07-22
Age:12.0  Onset:2015-07-22, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Louisiana  Entered:2015-07-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5068AB UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5068AB UNLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Pain in extremity, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Not to touch. Swollen. Painful to move arm.

VAERS ID:587574 (history)  Vaccinated:2015-07-28
Age:12.0  Onset:2015-07-28, Days after vaccination: 0
Gender:Male  Submitted:2015-07-29, Days after onset: 1
Location:Texas  Entered:2015-07-29
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
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Eye movement disorder, Seizure like phenomena, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Seconds after administration, my son''s eyes rolled back in his head and he became unresponsive, followed by seizure-like twitching.

VAERS ID:587695 (history)  Vaccinated:2015-06-15
Age:12.0  Onset:2015-06-27, Days after vaccination: 12
Gender:Male  Submitted:2015-07-22, Days after onset: 25
Location:Georgia  Entered:2015-07-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: ZYRTEC
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Abnormal platelet counts
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.L0047421IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0142660IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4846AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5013AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Immune thrombocytopenic purpura, Increased tendency to bruise, Platelet count abnormal, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Presented to ER 6-28-15 was transferred to medical center for ITP. Platelet count was low, had unusually easy bruising. Received vaccine 6-15-15.

VAERS ID:588508 (history)  Vaccinated:2015-07-26
Age:12.0  Onset:2015-07-27, Days after vaccination: 1
Gender:Female  Submitted:2015-07-28, Days after onset: 1
Location:Ohio  Entered:2015-07-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4963AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Lymphadenopathy, Oropharyngeal pain, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Body aches, sore joints, swollen glands, mild sore throat, rash-covering almost entire body-rash-started on arms, spread to legs, then to trunk.

VAERS ID:588527 (history)  Vaccinated:2015-06-02
Age:12.0  Onset:2015-06-02, Days after vaccination: 0
Gender:Unknown  Submitted:2015-07-29, Days after onset: 57
Location:Michigan  Entered:2015-07-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507USA013235
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.K018181 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Information has been received from a medical assistant referring a 12-year-old patient of unknown gender who on 02-JUN-2015, was vaccinated with improperly stored VAQTA lot # K018181, expiration date: 04-JUN-2017 (dose and route of administration were not provided). No adverse effects were reported. This is one of several reports received from the same source. Additional information is not expected because all available information has been obtained.

VAERS ID:587986 (history)  Vaccinated:2015-07-28
Age:12.0  Onset:2015-07-28, Days after vaccination: 0
Gender:Male  Submitted:2015-07-30, Days after onset: 2
Location:Unknown  Entered:2015-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1507USA013298
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Seizure like phenomena
SMQs:, Convulsions (narrow)
Write-up: Information had been received on 29-JUL-2015 from a female consumer via social media who reported that her 12 year old son was given the GARDASIL vaccine yesterday and had a seizure-like adverse reaction to it. The consumer reported, "We were told this is normal and happens 3-4 times a day by the administering nurse. I don''t consider seizures to be customary or normal during vaccine administration. I assure you that if there are any negative, short or long-term impacts on my son''s life, I will do everything within my means to ensure that this vaccine is removed from the market and that your company faces criminal charges." The outcome of the seizure-like adverse reaction was not reported. Upon internal review, seizure-like adverse reaction was determined to be medically significant. Additional information is not expected.

VAERS ID:588825 (history)  Vaccinated:2015-07-27
Age:12.0  Onset:2015-07-29, Days after vaccination: 2
Gender:Female  Submitted:2015-07-30, Days after onset: 1
Location:Ohio  Entered:2015-07-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSNK7470IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0072640IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM140710IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5095AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Mother phone on 7/29/15 3 pm stating red area on (L) shoulder. Mother and pt came to our facility. (L) shoulder red, hard area 2" x 2", sore to touch. Afebrile.

VAERS ID:588134 (history)  Vaccinated:2015-07-31
Age:12.0  Onset:2015-08-01, Days after vaccination: 1
Gender:Male  Submitted:2015-08-02, Days after onset: 1
Location:Pennsylvania  Entered:2015-08-02
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5155AB IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5235AA IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Headache, Hypoaesthesia, Musculoskeletal stiffness, Pain, Paraesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever 104 with shooting pain in head, numbness and tingling in hands and feet, neck stiff, body aches.

VAERS ID:588276 (history)  Vaccinated:2015-08-03
Age:12.0  Onset:2015-08-03, Days after vaccination: 0
Gender:Female  Submitted:2015-08-03, Days after onset: 0
Location:Louisiana  Entered:2015-08-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: CBC, WBC, platelets, CMP, BUN, Bicarb, Creatine, Glucose, Calcium.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0141981IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Blood bicarbonate, Blood calcium, Blood creatine, Blood glucose, Blood urea, Full blood count, Metabolic function test, Platelet count, Seizure, White blood cell count
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: PATIENT HAD SEIZURE ACTIVITY AFTER VACCINE WAS ADMINITSTERED.

VAERS ID:589324 (history)  Vaccinated:2015-07-28
Age:12.0  Onset:2015-07-30, Days after vaccination: 2
Gender:Male  Submitted:2015-08-03, Days after onset: 4
Location:North Carolina  Entered:2015-08-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0094820IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5049AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0072262SCLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain, swelling, and tenderness at the injection site. Mother instructed to administer Ibuprofen and use warm compresses and to return call if symptoms do not improve or worsen.

VAERS ID:588446 (history)  Vaccinated:2015-07-17
Age:12.0  Onset:2015-07-17, Days after vaccination: 0
Gender:Female  Submitted:2015-08-04, Days after onset: 18
Location:California  Entered:2015-08-04
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 (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRRA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Nausea, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Dizzy, nausea, then fainted. Vomited.

VAERS ID:588450 (history)  Vaccinated:2015-08-04
Age:12.0  Onset:2015-08-04, Days after vaccination: 0
Gender:Female  Submitted:2015-08-05, Days after onset: 1
Location:Unknown  Entered:2015-08-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diazepam as needed for seizures; Synthroid
Current Illness: Patient has a history of seizures, but no active illness at that time.
Preexisting Conditions: "Epilepsy and recurrent seizures"
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5037AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4712AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Mother states the patient had a seizure about 4 hours after the vaccine, but that this was not unexpected, as she was "due" to have a seizure related to her epilepsy.

VAERS ID:588481 (history)  Vaccinated:2015-07-31
Age:12.0  Onset:2015-07-31, Days after vaccination: 0
Gender:Female  Submitted:2015-08-05, Days after onset: 5
Location:Virginia  Entered:2015-08-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prevacid; albuterol; Nasonex; Pulmicort; prednisone; Epi-Pen; Zyrtec; Multivitamin
Current Illness: None
Preexisting Conditions: Asthma; GERD; Peanut allergy; Unilateral deafness; Allergic rhinitis; childhood obesity; cat hair extract allergy; Egg allergy; Grass pollen allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURERZ00.1290UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.V20.20UNUN
Administered by: Unknown     Purchased by: Other
Symptoms: Pruritus, Rash erythematous, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Itching upper back and chest and face/mouth. No shortness of breath but some tightness in throat. Faint red rash on upper chest and upper back.

VAERS ID:588764 (history)  Vaccinated:2015-08-04
Age:12.0  Onset:2015-08-04, Days after vaccination: 0
Gender:Male  Submitted:2015-08-06, Days after onset: 2
Location:New Mexico  Entered:2015-08-06
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: ECG-normal, CBC/CMP-normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4986AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Electrocardiogram normal, Full blood count normal, Metabolic function test normal, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Vasovagal syncope.

VAERS ID:588829 (history)  Vaccinated:2015-07-28
Age:12.0  Onset:2015-07-28, Days after vaccination: 0
Gender:Male  Submitted:2015-08-06, Days after onset: 9
Location:Mississippi  Entered:2015-08-06
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 PASTEURU4875AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0101441SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Call received from child''s mother on 7/29/2015 stating that child had developed extensive redness and taut edema to upper R arm (site of injection of varicella and TDaP vaccines on 7/28/2015) from acromian process to lower biceps region). Child''s mother is a RN. No other SE''s reported. I checked with her again on 8/4/15. She stated the swelling had about resolved but that there was still an area of deep red discoloration at one of the injection sites. No other adverse effects were reported. Did not seek medical attention.

VAERS ID:588896 (history)  Vaccinated:2015-08-06
Age:12.0  Onset:2015-08-06, Days after vaccination: 0
Gender:Male  Submitted:2015-08-06, Days after onset: 0
Location:New York  Entered:2015-08-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS3RB2G0IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0222850SC 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.10082710SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash on face and trunk, no difficulty breathing. Benadryl given, improved significantly within 10 minutes, oberved and discharged.

VAERS ID:589557 (history)  Vaccinated:2015-08-03
Age:12.0  Onset:2015-08-04, Days after vaccination: 1
Gender:Female  Submitted:2015-08-06, Days after onset: 2
Location:Texas  Entered:2015-08-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA; BENADRYL
Current Illness: None
Preexisting Conditions: Asthma; Atopic dermatitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA141250IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4902BA0IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Erythema, Injection site irritation, Injection site swelling, Pain, Peripheral swelling, Pruritus, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt received MCV4 and Tdap 8/3/15 and 8/4/15 the injection site became irritated, and swollen. It is painful to lift left arm, and feels warm. 8/5/15 patient''s palms on both hands became very itchy, swollen, with redness.

VAERS ID:589794 (history)  Vaccinated:2008-03-11
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-07
Location:Unknown  Entered:2015-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Antibody test, low immunity
CDC Split Type: WAES1508USA000770
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.L006381 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a physician refers to a 12 year old female patient. Pertinent medical history was none. There was no history of drug allergy or reactions. On 22-OCT-1988, the patient was vaccinated with first dose of (Oka/Merck) VARIVAX (unknown route, strength and dose) and on 11-MAR-2008, the patient received the 2nd dose of (Oka/Merck) VARIVAX (unknown route, strength and dose) (inappropriate schedule of drug administration). On 19-JUN-2015. The patient was seen in the office on 19-JUN-2015 and had titers drawn. The medical assistant stated, the titers showed low immunity on an unknown date in 2015. The patient was in the office today, 31-JUL-2015, in order to receive a "booster dose" of (Oka/Merck) VARIVAX due to the "low immunity" however the patient was inadvertently administered a dose of ZOSTAVAX (lot # L006381 and exp. 25-MAY-2016) instead of "booster dose" of (Oka/Merck) VARIVAX. No treatment was received in response to the event. The outcome of the events was unknown. The causality assessment was not provided. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:589856 (history)  Vaccinated:2015-08-06
Age:12.0  Onset:2015-08-06, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:North Dakota  Entered:2015-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Glucose 114 bedside
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.K0262470IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4846BA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5214AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blood glucose normal, Blood pressure decreased, Incontinence, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient has a episode of syncope with incontinence following her vaccines. Syncope occurred within 10 min after receiving her vaccines. She also experienced a blood pressure decrease and pallor. She gradually regained normal activity after taken to exam room for rest.

VAERS ID:589825 (history)  Vaccinated:2015-08-06
Age:12.0  Onset:2015-08-06, Days after vaccination: 0
Gender:Male  Submitted:2015-08-10, Days after onset: 4
Location:Vermont  Entered:2015-08-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS3RB2G1UNLA
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.K0262472UNRA
Administered by: Private     Purchased by: Public
Symptoms: Chills, Decreased appetite, Fatigue, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt received Hep A and HPV vaccine at approximately 11 AM on 8-6-15-mom called at 4:30 the same day with concerns of chills-decreased appetite and fatigue-pt then had severe vomiting for several hrs and went to ER.

VAERS ID:589832 (history)  Vaccinated:2013-01-31
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-07-26
Location:Texas  Entered:2015-08-10, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness: uUnk
Preexisting Conditions: The patient was in good health; her concomitant medications were not reported.
Diagnostic Lab Data: Laboratory details were not reported.
CDC Split Type: 201303492
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4412BA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Initial report received from a healthcare professional on 27 February 2013. A 12-year-old female patient, whose concomitant medications were not reported, had received an intramuscular dose of MENACTRA (Lot number: U4412BA, site of administratoin not reported) on 31 January 2013. The last menstrual period was on 15 November 2012. The patient''s estimated date of delivery was reported as 01 July 2013. As of 27 February 2013, the patient had not experienced any adverse events. The patient health was good during pregnancy. Documents held by sender: none.

VAERS ID:589869 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-07-26
Location:Unknown  Entered:2015-08-10, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Patient rceived first dose of MENACTRA at 11 years of age. No other information was provided.
Diagnostic Lab Data: Not reported
CDC Split Type: 201305649
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Initial misuse report received from a healthcare professional on 24 April 2013. A patient received first dose of MENACTRA at 11 years of age and second dose at 12 year of age. No adverse event was reported. List of documents held by sender: none.

VAERS ID:589885 (history)  Vaccinated:2015-08-06
Age:12.0  Onset:2015-08-07, Days after vaccination: 1
Gender:Female  Submitted:2015-08-07, Days after onset: 0
Location:Texas  Entered:2015-08-10, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0102150IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4689AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling of (L) arm (upper) slight redness w/ warmth.

VAERS ID:589994 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-07-26
Location:Unknown  Entered:2015-08-10, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: The patient had received a dose of MENVEO 15 months ago.
Diagnostic Lab Data: Not reported
CDC Split Type: 201303720
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Initial misuse report received from a healthcare professional on 01 February 2013. A 12-year-old male patient was administered MENACTRA and later it was found that he had received a dose of MENVEO 15 months ago as well. No adverse event was reported. List of documents held by sender: none.

VAERS ID:589995 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-07-26
Location:Unknown  Entered:2015-08-10, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Not reported
Diagnostic Lab Data: Not reported
CDC Split Type: 201303808
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  SYRAR
TDAP: TDAP (ADACEL)SANOFI PASTEUR  SYRAR
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SYRAR
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong technique in product usage process
SMQs:, Medication errors (narrow)
Write-up: Initial misuse report received from a healthcare professional on 19 February 2013. A 12-year-old patient was administered MENACTRA, ADACEL and VARIVAX vaccines mixed in one syringe and as a single injection in the deltoid. The reporter was not sure if the VARIVAX diluent was added to the mixture. No adverse event was reported. List of documents held by sender: none.

VAERS ID:589536 (history)  Vaccinated:2015-08-10
Age:12.0  Onset:2015-08-11, Days after vaccination: 1
Gender:Female  Submitted:2015-08-11, Days after onset: 0
Location:Minnesota  Entered:2015-08-11
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: No.
Preexisting Conditions: Nuts (all nuts), Peanut Butter Flavor, Seafood
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURK033110IMLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUI107AC0 LA
Administered by: Private     Purchased by: Private
Symptoms: Paraesthesia oral, Pharyngeal oedema, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was given YF vaccine and Typhoid injection at 4:45pm. After vaccine was given pt was instructed to wait in waiting room for 25 minutes following administration. At 4:50pm, pt came back into nurses station, c/o lips tingling, throat was feeling itchy, and swelling up. Pt reports that her throat feels like it does after I come into contact with peanuts. Notified NP. NP here, and assessed patient. Pt was given Benadryl 25mg orally at 4:55pm. Pt''s HR-was 100. Pt was layed down in supine position, and Epi Pen (0.3mg was given to pt into right vastus lateralis at 5:00pm). After Epi Pen was injected VS were checked-Temp=98.1 degrees orally, HR-98, and BP=118/54. Pt denied having any further lip tingling or itching in throat. Pt stated that she still thought she had some tightening/bumps in the back of the throat. At 5:05 pm, BP-125/91, HR-69. At 5:10 pm.BP-106/76, HR-82. At 5:15pm, notified MD. Dr. to assess pt. Pt''s BP at 5:15pm-102/78, HR-92. Dr. called and spoke with Dr. in urgent care. Pt denied SOB, tingling in lips, itchy throat, n/v, or throat swelling. Pt did state that she still feels some "nodules" in the back of her throat. Pt''s mom is here and aware. Pt was transfered to Urgent Care to be assessed at 5:20pm.

VAERS ID:590067 (history)  Vaccinated:2015-05-27
Age:12.0  Onset:2015-05-27, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-11, Days after onset: 76
Location:Unknown  Entered:2015-08-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA002919
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC. 3UNUN
Administered by: Other     Purchased by: Other
Symptoms: Extra dose administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Information has been received from a nurse referring to a 12 year old patient of unknown gender. There was no medical history or concurrent condition reported. The patient was vaccinated with 3 doses of PEDVAXHIB (lot#, expiration date, dose and route not reported) on 16-JUL-2003, 23-OCT-2003 and 22-JUN-2004, respectively. On 27-MAY-2015 the patient was vaccinated with a fourth dose of PEDVAXHIB (dosage, strength and route were not reported). There was no concomitant medication provided. At the time of the report, no adverse symptoms were reported. Additional information has been requested.

VAERS ID:590093 (history)  Vaccinated:2015-08-07
Age:12.0  Onset:2015-08-07, Days after vaccination: 0
Gender:Female  Submitted:2015-08-07, Days after onset: 0
Location:North Carolina  Entered:2015-08-11, 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: TYLENOL; Ibuprofen
Current Illness: None
Preexisting Conditions: None-healthy female
Diagnostic Lab Data: Glucose, 107; BP 111/71; HR 104; RR 20; T-98.2 shortly after episode
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0105960IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5155BA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blood glucose normal, Disorientation, Dyskinesia, Fall, Immediate post-injection reaction, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Pt given MENACTRA. Then given HPV in other arm. Immediately after injection pt crossed arms around herself, fell backward and jerking arms and legs. Eyes open. Lasted 3-4 sec. No recollection of episode. Shaking and disoriented after for few seconds. No history of syncope with vaccines or seizures. Monitored 20 min and ok. No erythema around injection.

VAERS ID:590108 (history)  Vaccinated:2015-07-27
Age:12.0  Onset:2015-07-29, Days after vaccination: 2
Gender:Male  Submitted:2015-07-29, Days after onset: 0
Location:Tennessee  Entered:2015-08-11, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Insect bite and headache on and off
Preexisting Conditions: Legg-Calve-Perthes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM141280UNLA
Administered by: Private     Purchased by: Private
Symptoms: Induration, Rash erythematous, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red rash, hard to the touch and hot to touch for 7 hours. To take BENADRYL 25 mg every 6 hours and Ibuprofen 200 mg 2 every 6 hours.

VAERS ID:590184 (history)  Vaccinated:2015-08-11
Age:12.0  Onset:2015-08-11, Days after vaccination: 0
Gender:Male  Submitted:2015-08-11, Days after onset: 0
Location:Texas  Entered:2015-08-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSD7447 IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS59N590IMRL
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5037AA0IMLL
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS33AG50IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K007979 SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Eye movement disorder, Fall, Seizure
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: After administering 5 vaccines the last 2 being Hep A and Tdap, the child swayed, eyes rolled back, fell back on table, convulsed for approx 20 seconds, sat up and asked what happened. BP = 73/38 at 1535. 911 called. Child taken to hospital via private vehicle in stable condition followed by ambulance.

VAERS ID:589696 (history)  Vaccinated:2015-08-11
Age:12.0  Onset:2015-08-12, Days after vaccination: 1
Gender:Female  Submitted:2015-08-12, Days after onset: 0
Location:Texas  Entered:2015-08-12
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: Patient was born tongue tied but no other birth defects or illness
Diagnostic Lab Data: Dr did no testing told me this was common. Which is not so.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 3SYRRA
Administered by: Unknown     Purchased by: Private
Symptoms: Dysphagia, Pain, Peripheral swelling, Pharyngeal oedema, Pyrexia, Swelling face
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever over 103, swollen face, throat, hands and feet.Hard to swallow. Body aches.

VAERS ID:589706 (history)  Vaccinated:2015-08-10
Age:12.0  Onset:2015-08-11, Days after vaccination: 1
Gender:Female  Submitted:2015-08-12, Days after onset: 1
Location:California  Entered:2015-08-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU5189AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness/pain/swelling around injection site.

VAERS ID:590231 (history)  Vaccinated:2015-08-10
Age:12.0  Onset:2015-08-11, Days after vaccination: 1
Gender:Male  Submitted:2015-08-12, Days after onset: 1
Location:Idaho  Entered:2015-08-12
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM14097 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4690BA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Hypersensitivity, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tdap given 08/10/15 by MA at 1126. Pt''s father called today (08/12/15 at 1145) complaining of red, swollen, hot upper arm at injection of Tdap side (Right). Triage nurse, RN, scheduled pt to see PA-C today at 1415 with instructions to go to ER if worsens before appt. Per PA-C, (+) allergic hypersensitivity reaction to Tdap.

VAERS ID:589933 (history)  Vaccinated:2015-08-12
Age:12.0  Onset:2015-08-13, Days after vaccination: 1
Gender:Female  Submitted:2015-08-13, Days after onset: 0
Location:Iowa  Entered:2015-08-13
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSXL9B70IMRA
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0040140IMLL
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5049AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS3HG7R5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0219342SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Mother reports the child has swelling the size of a softball on the Right arm where receiving the vaccine.

VAERS ID:590380 (history)  Vaccinated:2015-08-12
Age:12.0  Onset:2015-08-12, Days after vaccination: 0
Gender:Male  Submitted:2015-08-13, Days after onset: 1
Location:Ohio  Entered:2015-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0121901UNLL
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Erythema, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Cool compresses applied and BENADRYL given at 10:00 PM on 8-12-15. Left eye started-size of dime rash-c/o burning. Pie shaped area red and slightly swollen progressed.

VAERS ID:590523 (history)  Vaccinated:2015-06-01
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-13
Location:Unknown  Entered:2015-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA005486
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Vaccination site erythema, Vaccination site swelling
SMQs:
Write-up: This spontaneous report as received from a registered nurse via company representative refers to a 12 year old non-pregnant female patient. The patient''s medical history was not reported. In approximately June 2015 (reported as 2 months ago), the patient was vaccinated with her first dose of GARDASIL (route, site of administration, lot # and expiration date were not reported). In approximately 2015 (reported as after receiving GARDASIL), the patient experienced vaccination site erythema and vaccination site was swollen. On an unknown date, a phone call from the patient was placed to the nurse. The patient was advised to treat the injection site with ice and to take ibuprofen as needed. The outcome of events was reported as resolved in approximately 2015. The relatedness between the events and GARDASIL was not reported. Additional information is not expected, because there was no consent to contact the reporter.

VAERS ID:590032 (history)  Vaccinated:2015-07-07
Age:12.0  Onset:2015-07-08, Days after vaccination: 1
Gender:Male  Submitted:2015-08-14, Days after onset: 37
Location:Utah  Entered:2015-08-14
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 reported
Preexisting Conditions: None reported
Diagnostic Lab Data: Unknown - none reported
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5068AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS2224P0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Asthenia, Burning sensation, Chest discomfort, Dyspnoea, Musculoskeletal stiffness, Oral discomfort, Pain in extremity, Pallor, Pyrexia, Swollen tongue, Tongue discolouration, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt started with complaints of arms hurting badly, stiff neck, weakness, paleness and heaviness in his chest. He was given NSAIDS as needed. He was checked by nurse at Health Center. He had intermittent fever and complaints over three days, but then had one day of improvement. However on 07/12/15 he woke up with hives and difficulty breathing. He was taken to urgent care and prescribed prednisone and Benadryl use every 4 hours. The next day, he developed worsening of hives into welts with sensation of "burning up inside". His tongue became hot, red and swollen. He was taken to ER and given epinephrine shot and monitored. He was able to be released, but symptoms worsened again later in the day. The doctor was contacted and prescribed Allegra in addition to Benadryl and prednisone as well as increased fluids. Symptoms came intermittently over next few days with hives appearing to move around his body, but he had no further difficulty with his breathing.

VAERS ID:590035 (history)  Vaccinated:2015-08-13
Age:12.0  Onset:2015-08-13, Days after vaccination: 0
Gender:Female  Submitted:2015-08-14, Days after onset: 1
Location:Illinois  Entered:2015-08-14
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
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0040140IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reports 2 hours after vaccination breaking out in welts and having difficulty breathing. Resolved after administration of Benadryl.

VAERS ID:590072 (history)  Vaccinated:2015-08-13
Age:12.0  Onset:2015-08-13, Days after vaccination: 0
Gender:Male  Submitted:2015-08-14, Days after onset: 1
Location:North Carolina  Entered:2015-08-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4846AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Body temperature increased, Crying, Dizziness, Feeling hot, Headache, Nausea, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: AT APPROXIMATELY 6:00PM, CHILD STARTED CRYING STATING HIS ARM HURT, HAD A HEADACHE, FELT LIGHTHEADED, NAUSEOUS. FELT "HOT". TYLENOL GIVEN PER MOM. CHILD STARTED TO FEEL BETTER. WENT TO SLEEP. APPROXIMATELY 3:30 AM, ARM HURT AGAIN, NAUSEOUS, LIGHTHEADED, TEMP 100.3. TYLENOL GIVEN. VOMITED A FEW MINUTES LATER. BACK TO SLEEP. AT 9:00AM, PATIENT C/O PAIN AND HEAD HURTS. LEGS ALSO HURT. MOTRIN GIVEN BY MOM AT 10:30AM. MOM SPOKE WITH PRIMARY CARE PROVIDER WHO ASSURED HER THIS WAS A NORMAL REACTION TO THE VACCINE. AT 2:30PM 8-14-15 MOM CONTACTED HD TO NOTIFY STAFF OF REACTION. CHILD FEELS OKAY.

VAERS ID:590417 (history)  Vaccinated:2015-08-12
Age:12.0  Onset:2015-08-13, Days after vaccination: 1
Gender:Female  Submitted:2015-08-14, Days after onset: 1
Location:Kansas  Entered:2015-08-14
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: NKA on med. conditions
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS77D7L1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA140700IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS5SR2L IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 7-12-15 immunizations given. 7-13-15 pain and swelling (Mother reports swelling increased tennis ball size). Went to ER. They recommended "ZYRTEC" and vaccine Tdap avoidance. 7/14 swelling reduced per mother swelling measured at approx 50 mm/diameter both directions.

VAERS ID:590148 (history)  Vaccinated:2015-08-14
Age:12.0  Onset:2015-08-14, Days after vaccination: 0
Gender:Male  Submitted:2015-08-16, Days after onset: 2
Location:Massachusetts  Entered:2015-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Allergy to Benadryl
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
MENHIB: MENINGICOCCAL CONJUGATE + HIB (UNKNOWN)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Induration, Nausea, Pain, Pyrexia, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: High fever, nauseas, Pain, located swelling, redness, arm was hot and hard.

VAERS ID:590583 (history)  Vaccinated:2015-08-14
Age:12.0  Onset:2015-08-14, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2015-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU5241AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fall, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient experienced syncope for few second and fell few minutes after receiving Tdap shot.

VAERS ID:590370 (history)  Vaccinated:2015-08-13
Age:12.0  Onset:2015-08-13, Days after vaccination: 0
Gender:Female  Submitted:2015-08-17, Days after onset: 4
Location:Idaho  Entered:2015-08-17
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: NKDA
Diagnostic Lab Data: Call from mother on 8/17/15. Offered f/u appt but declined due to schedule will f/u on 8/18/15.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM14135 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4965AA IMRA
Administered by: Unknown     Purchased by: Public
Symptoms: Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling and "hives" on face. Mother tried oral Benadryl and Benadryl cream.

VAERS ID:590377 (history)  Vaccinated:2015-08-12
Age:12.0  Onset:2015-08-12, Days after vaccination: 0
Gender:Male  Submitted:2015-08-18, Days after onset: 6
Location:Texas  Entered:2015-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: ADHD
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0105960IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5178AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSH52990IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Pt and mother walked out of office without incident, he became dizzy and fainted in the parking lot. Mom helped him up and escorted him back inside the clinic where he was assessed. He was monitored for 15 minutes and recovered without incident. He was discharged home with his mother.

VAERS ID:591035 (history)  Vaccinated:2007-09-27
Age:12.0  Onset:2015-08-08, Days after vaccination: 2872
Gender:Female  Submitted:2015-08-18, Days after onset: 10
Location:Unknown  Entered:2015-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minocycline
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Antibody test, negative
CDC Split Type: WAES1508USA006080
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Inappropriate schedule of drug administration
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report was received from a pharmacist (the patient''s father) and refers to a currently 19 year old female patient with none pertinent medical history, drug reactions or allergies. The patient''s concurrent conditions were not reported. On 03-DEC-1996, the patient was vaccinated with the first dose of (Oka/Merck) VARIVAX and then, on 24-SEP-2007 (which was considered an inappropriate schedule of drug administration) the patient received a second dose of (Oka/Merck) VARIVAX, (dose, route, lot numbers and expiration dates were not reported for both vaccines). The patient''s concomitant therapies included minocycline. On 08-AUG-2015, the result of a titer for immunity to varicella (IgG) was reported as negative 0.8 (units not provided), (antibody test negative). No treatment was given to the patient. At the time of the report, the outcome of the resantibody test negative was unknown. The relatedness between the event and therapy with (Oka/Merck) VARIVAX was not reported. Additional information has been requested.

VAERS ID:590755 (history)  Vaccinated:2011-07-11
Age:12.0  Onset:2011-07-11, Days after vaccination: 0
Gender:Female  Submitted:2015-08-19, Days after onset: 1500
Location:Colorado  Entered:2015-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Normal for anemia, normal for diabetes/glucose, normal for thyroid, normal for cholesterol, no celiac, no h-pylori, no mono, no strep, high heart rate
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Blood cholesterol normal, Blood glucose normal, Blood test normal, Cold sweat, Decreased appetite, Dizziness postural, Fatigue, Feeling cold, Haemoglobin normal, Headache, Heart rate increased, Helicobacter test negative, Lymphadenopathy, Mononucleosis heterophile test negative, Nausea, Night sweats, Pain, Streptococcus test negative, Thyroid function test normal, Wisdom teeth removal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Started with a headache; thought she was having mouth/jaw issues. Had teeth shaved, purchased a night guard, and wisdom teeth removed. Headaches continued, over the years symptoms increased to include aches, extreme fatigue, dizzy upon standing, swollen lymph glands, nausea, no appetite and when hungry nauseous after eating, clammy, night sweats, freezing all the time.

VAERS ID:590792 (history)  Vaccinated:2015-08-14
Age:12.0  Onset:2015-08-14, Days after vaccination: 0
Gender:Male  Submitted:2015-08-19, Days after onset: 5
Location:Ohio  Entered:2015-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS9N74F0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever of 105.5, nausea.

VAERS ID:590850 (history)  Vaccinated:2015-08-17
Age:12.0  Onset:2015-08-19, Days after vaccination: 2
Gender:Male  Submitted:2015-08-19, Days after onset: 0
Location:Florida  Entered:2015-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Pet Dander
Diagnostic Lab Data: Being evaluated today by physician. Unsure.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4775AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Vision blurred, Visual impairment
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Started with seeing black dots in vision. Vision is now blurred and dizzy.

VAERS ID:590975 (history)  Vaccinated:2015-08-04
Age:12.0  Onset:2015-08-09, Days after vaccination: 5
Gender:Male  Submitted:2015-08-19, Days after onset: 10
Location:California  Entered:2015-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM141280UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSH52995UNLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Significant hives within 5 days of vaccinations required ER visit x1 and office visit.

VAERS ID:591098 (history)  Vaccinated:2015-06-17
Age:12.0  Onset:2015-06-17, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-19, Days after onset: 63
Location:Unknown  Entered:2015-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA007781
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a registered nurse refers to a 12 year old patient (unspecified gender). On 17-JUN-2015, the patient was vaccinated with an improperly stored dose of GARDASIL (dose and route were not provided) (lot # K008931 exp. 04-MAR-2017; lot K009482 exp. 06-MAR-2017) which was exposed to below 36F for 361.82 hours. The nurse was requesting assistance in determining revaccination. In addition, excursion below 32F (31.2F) started on 13-JUL-2015. No adverse effects were reported. This is one of several reports received form the same reporter. Additional information has been requested.

VAERS ID:591105 (history)  Vaccinated:2015-06-16
Age:12.0  Onset:2015-06-16, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-19, Days after onset: 64
Location:Unknown  Entered:2015-08-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA007780
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a registered nurse refers to a 12 year old patient (unspecified gender). On 16-JUN-2015, the patient was vaccinated with an improperly stored dose of GARDASIL (dose and route were not provided) (lot # K008931 exp. 04-MAR-2017; lot # K009482 exp. 06-MAR-2017) which was exposed to below 36F for 361.81 hours. The nurse was requesting assistance in determining revaccination. In addition, excursion below 32F (31.2F) started on 13-JUL-2015. No adverse effects were reported. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:591051 (history)  Vaccinated:2015-08-20
Age:12.0  Onset:2015-08-20, Days after vaccination: 0
Gender:Female  Submitted:2015-08-20, Days after onset: 0
Location:Maryland  Entered:2015-08-20
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0201622IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Dyskinesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Fainting and jerking motion of hands. Lasted 1-3 seconds.

VAERS ID:591052 (history)  Vaccinated:2015-08-19
Age:12.0  Onset:2015-08-20, Days after vaccination: 1
Gender:Male  Submitted:2015-08-20, Days after onset: 0
Location:North Carolina  Entered:2015-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ninja Turtle Multivitamins
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: N/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0089310IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM14133 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling, pain at site of injection.

VAERS ID:591103 (history)  Vaccinated:2015-08-20
Age:12.0  Onset:2015-08-20, Days after vaccination: 0
Gender:Female  Submitted:2015-08-20, Days after onset: 0
Location:Florida  Entered:2015-08-20
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: N/A
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS3RB2G1IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0115620IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS5MG555IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Ear discomfort, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: PATIENT STATES IT FELT LIKE COTTON WAS IN HER EARS AND SHE FELT LIKE BOTH EARS WERE RINGING. SHE ALSO STATED SHE FELT DIZZY.

VAERS ID:591171 (history)  Vaccinated:2013-08-26
Age:12.0  Onset:2013-08-27, Days after vaccination: 1
Gender:Male  Submitted:2015-08-19, Days after onset: 722
Location:Texas  Entered:2015-08-21, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0050831UNRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0187941UNLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: HPV #1 -HA and body aches x 1 d after injection. HPV #2 - HA, body aches, with n/v x 2d after injection. Self treated at home.

VAERS ID:591255 (history)  Vaccinated:2015-08-19
Age:12.0  Onset:2015-08-19, Days after vaccination: 0
Gender:Female  Submitted:2015-08-21, Days after onset: 2
Location:Pennsylvania  Entered:2015-08-21
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
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0192860IMRA
Administered by: Private     Purchased by: Other
Symptoms: Eye swelling, Pruritus, Respiratory tract congestion, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 45 min post injection pt had facial and eye swelling, itching and congestion. Given 25mg BENADRYL with relief in 1 hr, complete recovery by 3 hrs.

VAERS ID:591256 (history)  Vaccinated:2015-03-09
Age:12.0  Onset:2015-03-14, Days after vaccination: 5
Gender:Male  Submitted:2015-08-14, Days after onset: 153
Location:California  Entered:2015-08-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None-annual check-up
Preexisting Conditions: None
Diagnostic Lab Data: Have taken him to his regular Pediatrician and Neurologist who has diagnosed him with tics.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0069600UNLA
Administered by: Private     Purchased by: Other
Symptoms: Dyskinesia, Tic, Trismus
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Dystonia (narrow), Noninfectious encephalopathy/delirium (broad)
Write-up: Vaccine administered 3/9-within a few days my son was making involuntary neck/shoulder movements. 2nd vaccination was on 5/27-started having involuntary jaw movements a few days later.

VAERS ID:591268 (history)  Vaccinated:2015-08-13
Age:12.0  Onset:2015-08-14, Days after vaccination: 1
Gender:Male  Submitted:2015-08-17, Days after onset: 3
Location:North Carolina  Entered:2015-08-21, 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: None
Preexisting Conditions: ADHD
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: Private     Purchased by: Private
Symptoms: Erythema, Induration, Pruritus, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: "Hot to touch", red, swollen, hard and itching.

VAERS ID:591324 (history)  Vaccinated:2015-08-18
Age:12.0  Onset:2015-08-18, Days after vaccination: 0
Gender:Male  Submitted:2015-08-21, Days after onset: 3
Location:Virginia  Entered:2015-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0092020IMRA
Administered by: Public     Purchased by: Private
Symptoms: Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Gardasil vaccine administered during well child physical on 8-18-15. Mother called clinic the following day at 12:47 reporting that child had fever, headache and vomiting starting in the middle of the night and woke up with the same. Mother did not have thermometer but gave Ibuprofen. Vomiting has ceased and fever has gone down. Tolerating fluids. Mother told to watch for increased fever, vomiting and go to medical care if worsens 8-21-15. Phone call to mother reports child is well.

VAERS ID:591340 (history)  Vaccinated:2015-08-19
Age:12.0  Onset:2015-08-20, Days after vaccination: 1
Gender:Male  Submitted:2015-08-21, Days after onset: 1
Location:South Carolina  Entered:2015-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Unknown     Purchased by: Private
Symptoms: Asthenia, Fatigue, Headache, Loss of consciousness, Nausea, Visual impairment
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: His vision turned black and his knees became weak. He felt nauseated and began to lose consciousness. He hung is head down until he could see. He made his way to his mother''s bedroom leaning against the wall as his vision continued to be black. His mother laid in bed with him for 2 hours. He began to see white "streaks" across his vision. That lasted all day. He was tired and weak. He complained of a headache (5/10) and nausea throughout the day.

VAERS ID:591376 (history)  Vaccinated:2015-08-17
Age:12.0  Onset:2015-08-18, Days after vaccination: 1
Gender:Female  Submitted:2015-08-21, Days after onset: 3
Location:Minnesota  Entered:2015-08-21
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: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5185BA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5209AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient experienced rash and facial swelling.

VAERS ID:591379 (history)  Vaccinated:2015-08-19
Age:12.0  Onset:2015-08-20, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Colorado  Entered:2015-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4975AB0UNRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 4.5 cm W 5.5 cm H $g erythema, mildly warm, no induration. No systemic symptoms.

VAERS ID:591396 (history)  Vaccinated:2015-08-20
Age:12.0  Onset:2015-08-21, Days after vaccination: 1
Gender:Male  Submitted:2015-08-24, Days after onset: 3
Location:North Carolina  Entered:2015-08-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol inhaler as needed; Flonase nasal spray.
Current Illness: No
Preexisting Conditions: Restrictive airway syndrome/asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Discomfort, Injection site mass, Injection site warmth, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Arm that received vaccine developed large amount of swelling all the way down to elbow. Lump that developed that was about the size of a grapefruit, and was hot to the touch. Swelling peaked approximately 36-40 hours after shot. We used ice packs, Benadryl and ibuprofen to relieve discomfort. The reaction occurred over a weekend and we did not seek medical consultation.

VAERS ID:591562 (history)  Vaccinated:2015-08-11
Age:12.0  Onset:2015-08-12, Days after vaccination: 1
Gender:Male  Submitted:2015-08-24, Days after onset: 12
Location:Michigan  Entered:2015-08-24
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: Seasonal allergies
Diagnostic Lab Data: CBC, ESR, normal. Ultrasound done.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4847BA UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5235AA UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Full blood count normal, Mass, Red blood cell sedimentation rate normal, Ultrasound scan
SMQs:
Write-up: Tdap was given on 8/11/15. Next day morning noticed a 1 inch x 1/2 inch freely moving lump over the left clavicle. Not better in one week. No pain but discomfort while wearing protective gear for sports. Lump has remained unchanged.

VAERS ID:591568 (history)  Vaccinated:2015-07-16
Age:12.0  Onset:2015-07-16, Days after vaccination: 0
Gender:Female  Submitted:2015-08-24, Days after onset: 39
Location:Kentucky  Entered:2015-08-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA002462
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Feeling hot, Injection site pain
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)
Write-up: This spontaneous report as received from a medical assistant (working in a physician''s practice) refers to a 12 year old female patient with no concurrent conditions and no medical history. The patient did not take any concomitant medicines. On 16-JUL-2015 the patient was vaccinated with the first dose of GARDASIL 9 (lot# and expiry date were not provided) 1 dosage form (DF), intramuscularly (indication reported as vaccination). On 16-JUL-2015 the patient experienced severe injection site pain after receiving GARDASIL 9. Then "about 15 minutes later" she felt hot and light-headed. The physician laid the patient down and placed a cold cloth on her forehead. The patient rested for five minutes, then rose slowly and took long slow deep breaths as the physician instructed. No laboratory diagnostic tests were performed. The patient felt better and was sent home. The outcome of feeling hot, light-headed and injection site pain was described as recovering/resolving (the patient''s soreness lessened but was still present at the time of the patient''s most recent visit with the physician on 04-AUG-2015). It was unclear if the patient would continue with her GARDASIL 9 series. The relatedness between the all events and suspect therapy was unknown. Additional information has been requested.

VAERS ID:591582 (history)  Vaccinated:2015-08-24
Age:12.0  Onset:2015-08-24, Days after vaccination: 0
Gender:Male  Submitted:2015-08-24, Days after onset: 0
Location:Kansas  Entered:2015-08-24
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0089310IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM141360IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSH52990IMRA
Administered by: Public     Purchased by: Private
Symptoms: Feeling hot, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)
Write-up: HPV4 was given pt got hot and started to sweat. Laid him down put feet up, and put a wet cool rag on neck. Pt wouldn''t let nurse cont to given vaccine. After 5 minutes MCV4 was given again got hot and sweating. Applied ice behind neck gave cool H2O to drink. Wait about 5 minutes then gave Tdap. Ice applied again. Waited for 15 minutes and felt better.

VAERS ID:591597 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-24
Location:Unknown  Entered:2015-08-24
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA009480
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Amnesia, Anxiety, Arthralgia, Asthenia, Attention deficit/hyperactivity disorder, Back pain, Bipolar disorder, Chest pain, Depression, Dysmenorrhoea, Dyspnoea, Emotional distress, Fatigue, Gastroenteritis viral, Haemorrhage, Headache, Impaired gastric emptying, Malnutrition, Menorrhagia, Musculoskeletal chest pain, Musculoskeletal pain, Myalgia, Nausea, Pain, Pain in extremity, Sensory disturbance, Suicidal ideation, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Suicide/self-injury (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: This spontaneous report was received via a social media from a consumer (the mother of the patient) concerning her 12 year old daughter who received GARDASIL on an unspecified date(s). Concomitant medications and medical history were not provided. The reporter made the following statements on the social media site: "[Daughter''s name] menstrual cycle after GARDASIL-constant bleeding/pain like birthing a porcupine, infertility?" "[Daughter''s name] life matters. GARDASIL destroyed her/suffering 5 years". "Anxiety, ADHD, bipolar, severe memory loss, depression, suicidal after losing soccer/school/friends". "Headaches, muscle/joint pain, SOB [shortness of breath], excruciating back/rib.shoulder/legs/chest pain, abnormal sensations". "Athlete now has gastroparesis/imagine at 15 your stomach virus is 24/7/365 forever". "Vomits daily, malnourished, nauseated, debilitating pain, chronic fatigue". "My teen is up to date including GARDASIL. Played Russian Roulette/destroyed my daughter''s life". "My 12 year old daughter did and is still suffering now at 16 1/2. What she endured is inhumane". The outcome of the events were not recovered. Upon internal review, suicidal after losing soccer/school/friends was considered medically significant. Excruciating back/rib/knee/shoulder/leg pain/debilitating pain was considered disabling. Additional information is not expected.

VAERS ID:591626 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-08-24
Location:Unknown  Entered:2015-08-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010191
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a nurse and refers to unspecified number of male patients of unknown age. No information regarding the patients'' medical history or concurrent conditions was provided. On unknown dates, reported as within the last 1-2 years, the patients were vaccinated intramuscularly with doses of GARDASIL injection (dose, frequency, lot # and expiration date were not provided). No concomitant therapy was reported. The patients complained about stinging at the site of injection immediately after vaccination (dates unspecified). The stinging only lasted for a few seconds and all of the patients recovered from the event (dates unspecified). No treatment was given for the events. No product quality complaint (PQC) was involved. The relatedness between GARDASIL and the events was not reported. Follow up information has been received on 13-AUG-2015. All telephone attempts to obtain follow up information has been unsuccessful. Follow up information has been received from a nurse on 18-AUG-2015. The nurse clarified that she was referring to 12 year old males. She was not able to provide identifiers, lot number and expiration date and dates of vaccination. She stated that this was a few years ago at another location. This is one of the several reports from the same reporter. Additional information has been requested. Patient details, event tab and narrative were updated.

VAERS ID:591637 (history)  Vaccinated:2015-08-11
Age:12.0  Onset:2015-08-11, Days after vaccination: 0
Gender:Female  Submitted:2015-08-24, Days after onset: 13
Location:Unknown  Entered:2015-08-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA006232
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC. 0SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from two licensed practical nurse referring to a 12 year old female patient. The patient had no known allergy. On 11-AUG-2015 the patient was vaccinated with the first dose of GARDASIL 9 (lot # was reported as L004014 with expired date 04-MAR-2017, dose and route were unspecified) for HPV prevention. No concomitant medication was taken by the patient. On the same day, the patient experienced a syncopal episode immediately following the administration of the vaccine and recovered 15-20 minutes after the injection site in the care of the two reporters for medical attention. No lab tests was performed. The patient was fully recovered from the episode on an unknown date in August 2015. Lot number L004014 is an invalid lot number GARDASIL 9. This is one of two reports received from the same reporter. Additional information has been requested.

VAERS ID:592179 (history)  Vaccinated:2015-08-19
Age:12.0  Onset:2015-08-19, Days after vaccination: 0
Gender:Male  Submitted:2015-08-19, Days after onset: 0
Location:Ohio  Entered:2015-08-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4694AA IMUN
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSX9LB70IMUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.60061930IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4929BA0IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Child is 12 yr old. DAPTACEL given instead of ADACEL.

VAERS ID:591493 (history)  Vaccinated:2015-08-21
Age:12.0  Onset:2015-08-22, Days after vaccination: 1
Gender:Male  Submitted:2015-08-25, Days after onset: 3
Location:North Carolina  Entered:2015-08-25
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: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM150181IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site was very swollen and enlarged.

VAERS ID:591496 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-08-25
Location:Unknown  Entered:2015-08-25
Life Threatening? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA009285
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Death
SMQs:
Write-up: This spontaneous report as received from a physician via company representative refers to a 12 year old patient of unknown gender. On an unknown date, the patient was vaccinated with GARDASIL (dose, lot# and route of administration was not reported). No concomitant medication was reported. The physician stated that unspecified person watched television show which reported that on an unknown date the patient died after receiving GARDASIL. Causality assessment was not provided. Additional information has been requested.

VAERS ID:591802 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:2015-02-04
Gender:Male  Submitted:2015-02-04, Days after onset: 0
Location:Unknown  Entered:2015-08-25, Days after submission: 201
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug (s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015SE11827
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CK2057 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)
Write-up: A report has been received from a Health Professional concerning a 12 year old, Male subject, who had been receiving Nasal FLUMIST (INTRANASAL). FLUMIST (INTRANASAL) started on an unknown date. Administration of expired product to two patients was reported by the health professional which started on 04-Feb-2015. The outcome of the event of ADMINISTRATION OF EXPIRED PRODUCT TO TWO PATIENTS is unknown. The report was considered to be non-serious.

VAERS ID:591862 (history)  Vaccinated:2014-12-31
Age:12.0  Onset:2014-12-31, Days after vaccination: 0
Gender:Male  Submitted:2014-12-31, Days after onset: 0
Location:Washington  Entered:2015-08-25, Days after submission: 236
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015SE00358
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CJ2126 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)
Write-up: A spontaneous report has been received from a Health Professional concerning a patient born on 09-MAR-2002, male subject, who had been receiving FLUMIST Quadrivalent. FLUMIST Quadrivalent started on an unknown date. The reporter stated that patient was accidentally given expired FLUMIST Quadrivalent to two patients on 31-DEC-2014. The outcome of the event of accidentally gave expired FLUMIST Quadrivalent to two patients is unknown. The report was considered to be non-serious.

VAERS ID:591895 (history)  Vaccinated:2014-12-09
Age:12.0  Onset:2014-12-09, Days after vaccination: 0
Gender:Male  Submitted:2014-12-22, Days after onset: 13
Location:Unknown  Entered:2015-08-25, Days after submission: 245
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2014SE98353
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CH2061 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)
Write-up: A report has been received from a Health Professional concerning a 12 year old, Male subject, who had been receiving FLUMIST quadrivalent (intranasal). FLUMIST quadrivalent started on 098-Dec-2014. It was reported that two patients received expired FLUMIST quadrivalent which started on 09-Dec-2014. The outcome of the event of two patients received expired FLUMIST quadrivalent is unknown. The report was considered to be non-serious.

VAERS ID:591896 (history)  Vaccinated:2014-12-19
Age:12.0  Onset:2014-12-19, Days after vaccination: 0
Gender:Female  Submitted:2014-12-19, Days after onset: 0
Location:Utah  Entered:2015-08-25, Days after submission: 248
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2014SE98311
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CF2251 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)
Write-up: A report has been received from a Health Professional concerning a 12 year old, Female subject, who had been receiving FLUMIST quadrivalent (intranasal). FLUMIST quadrivalent started on an unknown date. It was reported that expired FLUMIST quadrivalent was inadvertently administered to three patients on 19-Dec-2014. The outcome of the event of inadvertently administered expired FLUMIST quadrivalent to three patients was unknown. The report was considered to be non-serious.

VAERS ID:591903 (history)  Vaccinated:2014-12-31
Age:12.0  Onset:2014-12-31, Days after vaccination: 0
Gender:Male  Submitted:2014-12-31, Days after onset: 0
Location:Maryland  Entered:2015-08-25, Days after submission: 236
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drug(s) not reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015SE00461
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CJ2126 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)
Write-up: A report has been received from a physician concerning a 12 year old, male subject, who had been receiving FLUMIST QUADRIVALEN (Intranasal). FLUMIST QUADRIVALENT (Intranasal) started on 31-Dec-2014. The reporter stated that the patient experienced inadvertently administered expired FLUMIST QUADRIVALENT to four patients on 31-Dec-2014. The outcome of the event of inadvertently administered expired FLUMIST QUADRIVALENT to four patients is unknown. The report was considered to be non-serious.

VAERS ID:591936 (history)  Vaccinated:2015-01-06
Age:12.0  Onset:2015-01-06, Days after vaccination: 0
Gender:Female  Submitted:2015-01-08, Days after onset: 2
Location:New Jersey  Entered:2015-08-25, Days after submission: 228
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015SE03550
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CJ2129 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered
SMQs:, Medication errors (narrow)
Write-up: A report has been received from a health professional concerning a 12 year old, female subject, who had been receiving nasal FLUMIST Quadrivalent. FLUMIST Quadrivalent started on 05-JAN-2015. The patient was administered of expired product on 05-JAN-2015. FLUMIST Quadrivalent was discontinued on 06-JAN-2015. The outcome of the event of administration of expired product is unknown. The report was considered to be non-serious.

VAERS ID:592088 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:2014-01-15
Gender:Female  Submitted:2014-11-18, Days after onset: 307
Location:Unknown  Entered:2015-08-25, Days after submission: 279
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: 2014SE87875
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Influenza virus test positive, Oropharyngeal pain, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A consumer report had been received concerning a 12 year old female patient. The relevant history and concomitant disease of the patient was not reported. The concomitant medications of the patient were not provided. The patient was receiving nasal FLUMIST Quadrivalent started on an unknown date. Reporter stated that my daughter received FLUMIST Quadrivalent on Thursday late afternoon and on Saturday, she had a runny nose, on Sunday developed a sore throat, on Monday she had a fever of 100.7. This morning patient was tested positive for the flu at the doctor''s office. At the time of reporting, the events of sore throat, fever (100.7) and runny nose was improving and the outcome of the event of tested positive for flu was unknown. The reporter considered the seriousness of the events of sore throat, fever (100.7), runny nose as non-serious. The event of tested positive for flu was captured and assessed as non-serious by company physician.

VAERS ID:592148 (history)  Vaccinated:2014-10-15
Age:12.0  Onset:2014-12-05, Days after vaccination: 51
Gender:Female  Submitted:2014-12-10, Days after onset: 5
Location:Georgia  Entered:2015-08-25, Days after submission: 257
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: 2014SE95375
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CH2060 IN 
Administered by: Other     Purchased by: Other
Symptoms: Influenza A virus test positive
SMQs:
Write-up: A report has been received from a Pharmacy concerning a 12 year old, female subject, who had been receiving nasal FLUMIST Quadrivalent. FLUMIST Quadrivalent started on 15-OCT-2014. The patient experienced multiple patients received FLUMIST Quadrivalent and tested positive for Flu A which started on 06-DEC-2014. The outcome of the event of multiple patients received FLUMIST Quadrivalent and tested positive for Flu A is unknown. The report was considered to be non-serious.

VAERS ID:592392 (history)  Vaccinated:2015-08-19
Age:12.0  Onset:2015-08-19, Days after vaccination: 0
Gender:Female  Submitted:2015-08-20, Days after onset: 1
Location:Iowa  Entered:2015-08-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0262460IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM150080IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSL7J445IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0219371SCRA
Administered by: Public     Purchased by: Public
Symptoms: Altered state of consciousness, Cold sweat, Dysstasia, Pallor
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Complained feeling "like I''m going to pass out." Pale, clammy, rested for several minutes and drank water. Feeling better; attempted to walk to restroom and was unable to stand straight and said "I''m gonna pass out." Lowered to chair. Assisted to cot where she rested approx 30 min. Drank H2o and had a snack. Felt better. Left with mother. Called that eve and pt was feeling fine.

VAERS ID:592483 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-08-25
Location:Texas  Entered:2015-08-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blister to left arm near inj. sitr
Preexisting Conditions: Autism and ADHD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM14069 UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS5DM3Y UNLA
Administered by: Private     Purchased by: Public
Symptoms: Blister
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Blister to LA.

VAERS ID:591577 (history)  Vaccinated:2015-08-24
Age:12.0  Onset:2015-08-24, Days after vaccination: 0
Gender:Female  Submitted:2015-08-26, Days after onset: 2
Location:Texas  Entered:2015-08-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported to nurse
Current Illness: None reported to nurse
Preexisting Conditions: None reported to nurse
Diagnostic Lab Data: Mother states that she gave Benadryl times 2 before going to ER. Mother states patient was given 2 injections at the ER.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM150080IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4775AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0110842SCRA
Administered by: Public     Purchased by: Public
Symptoms: Ear swelling, Rash generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash all over body, hives, swelling to ears.

VAERS ID:591618 (history)  Vaccinated:2015-08-18
Age:12.0  Onset:2015-08-25, Days after vaccination: 7
Gender:Male  Submitted:2015-08-26, Days after onset: 1
Location:Florida  Entered:2015-08-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported by mother
Current Illness: none noted
Preexisting Conditions: none noted
Diagnostic Lab Data: none reported by patient''s mother
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS43   
Administered by: Public     Purchased by: Public
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: Golf ball size area of redness and swelling at the injection site with itching at the site only (localized)

VAERS ID:591619 (history)  Vaccinated:2015-08-25
Age:12.0  Onset:2015-08-25, Days after vaccination: 0
Gender:Female  Submitted:2015-08-26, Days after onset: 1
Location:Indiana  Entered:2015-08-26
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0006101IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia, Injection site hypoaesthesia, Injection site reaction, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Numbness and Tingling at injection site and then it began to spread down the arm stopping at the wrist and then up into the shoulder. Patient came into office for evaluation on 08/26/2015, Doctor evaluated the patient and treatment was observation and consultation with a neurologist.

VAERS ID:591723 (history)  Vaccinated:2015-08-25
Age:12.0  Onset:2015-08-26, Days after vaccination: 1
Gender:Male  Submitted:2015-08-27, Days after onset: 1
Location:Ohio  Entered:2015-08-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase
Current Illness: Nasal congestion
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0118460IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5185BA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4690BA5IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: L arm red and indurated 4cm diameter red rash on arm. Urticaria on forearms and legs

VAERS ID:594036 (history)  Vaccinated:2009-10-12
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-29
Location:Unknown  Entered:2015-08-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Low titers for VARIVAX, not provided
CDC Split Type: WAES1508USA010822
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Inappropriate schedule of drug administration
SMQs:, Medication errors (narrow)
Write-up: Information has been received from a physician assistant referring to a female patient of unknown age. Patient''s relevant medical history, concurrent conditions and drug reactions/allergies were unspecified. She was not pregnant. On 12-OCT-2009 the patient was vaccinated with second dose of (Oka/Merck) VARIVAX subcutaneous (strength, dose, frequency, lot # , expiry date not reported) (inappropriate schedule of drug administration). Patient received her first dose of (Oka/Merck) VARIVAX on 17-MAR-1998. No concomitant medications were reported. Reporting physician assistant stated that patient had low titers for (Oka/Merck) VARIVAX (antibody test negative). Patient did not required medical attention. No treatment was provided for the adverse event). Outcome of the event, antibody test negative was unknown. Reporting physician assistant did not assessed the causality of the event with respect to vaccination with (Oka/Merck) VARIVAX. Additional information has been requested.

VAERS ID:594079 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-30
Location:Unknown  Entered:2015-08-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010535
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to an 12 years old female patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, dose number 1, lot #K004204, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594098 (history)  Vaccinated:2015-03-20
Age:12.0  Onset:2015-03-20, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-30, Days after onset: 163
Location:California  Entered:2015-08-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010530
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0042041UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to an 12 years old patient (unknown gender). No concurrent condition, medical history or allergy/drug reactions were reported. On 20-MAR-2015, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, dose number 1, lot #K004204, exp. date: 12-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594102 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-30
Location:Unknown  Entered:2015-08-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010531
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old female patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594148 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-08-30
Location:Unknown  Entered:2015-08-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010575
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old male patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594096 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010577
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old male patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594142 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010539
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old female patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594143 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010545
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old male patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594144 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010581
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old female patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594161 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010543
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old male patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594166 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010541
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old female patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594241 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010583
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old female patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594243 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010552
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old female patient. No concurrent condition, medical history or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594325 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-31
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010550
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K005881 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old female patient. No concurrent condition, medical history, or allergy/drug reactions were reported. On an unspecified date, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, lot # K005881, exp. date: 14-JAN-2017 (dose, strength unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594363 (history)  Vaccinated:2015-04-30
Age:12.0  Onset:2015-04-30, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-31, Days after onset: 123
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010556
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0069600SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old patient (unknown gender). No concurrent condition, medical history or allergy/drug reactions were reported. On 30-APR-2015, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, dose number 1, lot # K006960, exp. date: 19-FEB-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594375 (history)  Vaccinated:2015-08-27
Age:12.0  Onset:2015-08-27, Days after vaccination: 0
Gender:Female  Submitted:2015-08-31, Days after onset: 4
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA013697
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.K026247 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Interchange of vaccine products, No adverse event
SMQs:, Medication errors (broad)
Write-up: This spontaneous report was received from a registered nurse regarding a 12 year old female patient. The patient''s pertinent medical history, drug reactions or allergies and concomitant medications were not reported. On 18-AUG-2014, the patient was vaccinated with a dose of GARDASIL (dose and route were not reported, lot # K005083, expiration date 04-NOV-2016). On 27-AUG-2015, the patient was vaccinated with a dose of GARDASIL 9 (dose and route were not reported, lot # K026247). There was no adverse experience reported. Additional information has been requested.

VAERS ID:594479 (history)  Vaccinated:2015-05-28
Age:12.0  Onset:2015-05-28, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-31, Days after onset: 95
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010558
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0069600SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old patient (unknown gender). No concurrent condition, medical history or allergy/drug reactions were reported. On 28-MAY-2015, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, dose number 1, lot # K006960, exp. date: 19-FEB-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594481 (history)  Vaccinated:2015-06-02
Age:12.0  Onset:2015-06-02, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-31, Days after onset: 90
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010557
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0069600SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old patient (unknown gender). No concurrent condition, medical history or allergy/drug reactions were reported. On 02-JUN-2015, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, dose number 1, lot # K006960, exp. date: 19-FEB-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594486 (history)  Vaccinated:2015-06-03
Age:12.0  Onset:2015-06-03, Days after vaccination: 0
Gender:Unknown  Submitted:2015-08-31, Days after onset: 89
Location:Unknown  Entered:2015-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA010566
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0069602SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 years old patient (unknown gender). No concurrent condition, medical history or allergy/drug reactions were reported. On 03-JUN-2015, the patient was vaccinated with improperly stored (exposed to 52.8 Fahrenheit for a total of 105 hours) GARDASIL injection, dose number 3, lot # K006960, exp. date: 19-FEB-2017 (dose, strength and route unspecified). No concomitant medications were reported. No adverse experiences have been reported so far. There were no product quality complaints (PQC) involved. No additional information was provided. This is one of several reports received from the same reporter. Additional information is not expected, no contact details were provided.

VAERS ID:594640 (history)  Vaccinated:2015-08-25
Age:12.0  Onset:2015-08-26, Days after vaccination: 1
Gender:Female  Submitted:2015-08-27, Days after onset: 1
Location:Michigan  Entered:2015-09-01, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM141336IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS4R3MJ0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Headache, swollen red (R) upper arm "hard and red" per mother, MENVEO was on right. Left arm was BOOSTRIX and smaller red area not as swollen.

VAERS ID:594688 (history)  Vaccinated:2015-08-28
Age:12.0  Onset:2015-08-30, Days after vaccination: 2
Gender:Female  Submitted:2015-09-01, Days after onset: 2
Location:Pennsylvania  Entered:2015-09-01
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: Obesity
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURX14081 SCRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS9245B IMLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Induration, Pain in extremity, Peripheral swelling
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), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt stated her arms were sore on Saturday morning. Her right arm became very swollen and reddened/hard. Pts mother took her to the ER on Sunday 8-30-15. She was given MOTRIN/KEFLEX and BENADRYL. No fever noted. On 9/2 pt arm was without swelling, redness, slightly sore. Only one dose of KEFLEX given, KEFLEX dc''d, arm was WNL.

VAERS ID:592537 (history)  Vaccinated:2015-08-19
Age:12.0  Onset:2015-08-19, Days after vaccination: 0
Gender:Female  Submitted:2015-09-02, Days after onset: 14
Location:Utah  Entered:2015-09-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS2M5273IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: PT did not have a reaction she recieved incorrect vaccination.

VAERS ID:592553 (history)  Vaccinated:2015-09-01
Age:12.0  Onset:2015-09-01, Days after vaccination: 0
Gender:Male  Submitted:2015-09-02, Days after onset: 1
Location:Georgia  Entered:2015-09-02
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5058AB1SCRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS9NA321IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Raised red whelps on right arm with itching. Mother rushed patient to ER. Raised red whelps on torso by time they got to ER. Child placed on Benadryl and Prednisone and improved. Went to school next day and whelps improved per mother.

VAERS ID:594739 (history)  Vaccinated:2015-08-20
Age:12.0  Onset:2015-08-20, Days after vaccination: 0
Gender:Female  Submitted:2015-09-01, Days after onset: 12
Location:Unknown  Entered:2015-09-02, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1508USA009459
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L011846 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 12 year old female patient. The patient''s pertinent medical history and drug reactions/allergies were not reported. The nurse stated that the patient received first dose of GARDASIL (lot #, exp. date, dose, frequency and route were not reported) on 18-AUG-2014, and then she received GARDASIL 9, (lot # L011846 exp. date 16-JUN-2017) 0.5 ml intramuscular on 20-AUG-2015. No adverse effects were reported. No product quality complaint was involved. Additional information has been requested.

VAERS ID:595143 (history)  Vaccinated:2015-08-28
Age:12.0  Onset:2015-08-31, Days after vaccination: 3
Gender:Male  Submitted:2015-08-31, Days after onset: 0
Location:Texas  Entered:2015-09-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0115620UNRA
Administered by: Private     Purchased by: Public
Symptoms: Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pain, itching, swelling. Rx: observation.

VAERS ID:595154 (history)  Vaccinated:2015-08-26
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-08-31
Location:Louisiana  Entered:2015-09-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Prematurity as an infant
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM140710IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4497AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: TC from mom on 8/31/15 8AM, states child experienced 102 degree fever w/n 48 hrs of injection. Site became red, swollen and hot to touch and is still like that 5 days post injection. Giving TYLENOL, applying compresses, giving BENADRYL.

VAERS ID:595449 (history)  Vaccinated:2015-09-03
Age:12.0  Onset:2015-09-03, Days after vaccination: 0
Gender:Male  Submitted:2015-09-04, Days after onset: 1
Location:New Hampshire  Entered:2015-09-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Anxiety
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS9CJ5Y0IMRA
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0040140IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5058AC0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS43MP20IMLA
Administered by: Private     Purchased by: Public
Symptoms: Syncope, Tonic clonic movements
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Patient fainted with tonic-clonic activity of extremities lasting less than 10 seconds. After laying down and resting 20-30 minutes after he recovered.

VAERS ID:594187 (history)  Vaccinated:2015-08-20
Age:12.0  Onset:2015-08-22, Days after vaccination: 2
Gender:Female  Submitted:2015-09-08, Days after onset: 17
Location:North Carolina  Entered:2015-09-08
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: Dairy Allergy; Identified low growth hormone of .1; Low vitamin D levels
Diagnostic Lab Data: Visual check at the doctor''s office 48 hours after the shot.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5178AA0SYRLA
Administered by: Unknown     Purchased by: Private
Symptoms: Feeling hot, Immediate post-injection reaction, Injection site urticaria, Musculoskeletal stiffness, Neck pain, Pain
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Immediately after the shot was administered my daughter had soreness and warmth, but nothing else. Exactly 48 hours after the injection was given Hives developed at the injection site, and the area was warm to the touch. I took her to the after hours doctor who measured the welts as being 2 1/2" x 3.25". She drew a circle around the welts, and gave my daughter Benadryl in the office. Welts lowered. Exactly two days later... on 8/24/15 at 6:00 pm. The welts reappeared in the same area as the injection (left upper arm), but were in a larger area than on the first revisit. She also had a new symptom of a stiff neck with the hives this time. I contacted the doctor and they said that it wasn''t a worry unless she was screaming in pain trying to lower her head to her chest. Gave her topical and oral Benadryl. Welts went down, but she had a stiff, hurting neck for about 3 days longer. Pain didn''t go away from the stiff neck until then. 9/7/15 - she developed hives in a new place, around 5:00 pm. Rash on her upper chest area. Applied topical Benadryl and the hives went down.

VAERS ID:594191 (history)  Vaccinated:2015-07-14
Age:12.0  Onset:2015-07-14, Days after vaccination: 0
Gender:Male  Submitted:2015-09-08, Days after onset: 56
Location:Texas  Entered:2015-09-08
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: TX140037PR
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0169660IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Eye swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives on trunk 2-3 hours after hpv admin left eye swollen next day after vaccine given.

VAERS ID:595648 (history)  Vaccinated:2015-08-27
Age:12.0  Onset:2015-08-27, Days after vaccination: 0
Gender:Male  Submitted:2015-09-02, Days after onset: 6
Location:Ohio  Entered:2015-09-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Acetaminophen; heart murmur
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS294X90IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0075600IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS5MG550IMLA
Administered by: Public     Purchased by: Private
Symptoms: Abdominal pain upper, Fatigue, Musculoskeletal stiffness, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: 8/27/15 - arm stiffness. 8/28/15 - arm stiffness. 8/29/15 - stomach pain, legs achy, achy all over, tired. 8/30/15 - same more fatigue, stomach ache. 8/31/15 - same. 9/1/15 mild symptoms. 9/2/15 repeat as 8/29/15.

VAERS ID:595782 (history)  Vaccinated:2015-08-26
Age:12.0  Onset:2015-08-31, Days after vaccination: 5
Gender:Male  Submitted:2015-09-03, Days after onset: 3
Location:Georgia  Entered:2015-09-09, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Keratosis pilaris
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0040140IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Grape-sized deep nodule formed at injection site 5 days after HPV-9.

VAERS ID:594692 (history)  Vaccinated:2015-04-10
Age:12.0  Onset:2015-04-10, Days after vaccination: 0
Gender:Female  Submitted:2015-09-01, Days after onset: 144
Location:Unknown  Entered:2015-09-10, 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: Ethosuximide
Current Illness: Petit mal epilepsy
Preexisting Conditions:
Diagnostic Lab Data: Urine test for pregnancy; confirmed to be pregnant, positive
CDC Split Type: WAES1508USA013973
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, Pregnancy test urine positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: This spontaneous prospective pregnancy report as received from a nurse refers to a 12 year old female patient. The patient''s concurrent conditions included absent seizures. There was no history of drug allergies or reactions. On 26-NOV-2014, the patient was vaccinated with first dose of GARDASIL (unknown strength, route and lot#). The patient received the second dose of GARDASIL on 10-APR-2015 (inappropriate schedule of drug administration). On 27-AUG-2015, the patient was vaccinated with third dose of GARDASIL (unknown strength) lot # L004014 with expiration date of 04-MAR-2017 intramuscular. Concomitant therapies included ethosuximide (unknown manufacturer). Th patient became pregnant with approximated date of last month period in 2015. ON 27-AUG-2015, the patient was confirmed to be pregnant via a urine test after being vaccinated with GARDASIL. The patient sought medical attention and via palpation and measurement and they believed that the patient to be six months pregnant. The pregnancy outcome was pending. The patient has an appointment with an Obstetrics/gynecologist next week. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:594753 (history)  Vaccinated:2015-09-04
Age:12.0  Onset:2015-09-06, Days after vaccination: 2
Gender:Female  Submitted:2015-09-10, Days after onset: 4
Location:Minnesota  Entered:2015-09-10
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 known
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS150170IMRA
Administered by: Other     Purchased by: Other
Symptoms: Neck pain, Pain
SMQs:, Arthritis (broad)
Write-up: SHOOTING PAIN UP R SIDE OF NECK.

VAERS ID:595989 (history)  Vaccinated:2015-08-10
Age:12.0  Onset:2015-08-30, Days after vaccination: 20
Gender:Male  Submitted:2015-09-08, Days after onset: 9
Location:Pennsylvania  Entered:2015-09-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergic rhinitis; bicuspid aortic valve; ichthyosis; Tourette''s
Diagnostic Lab Data: Platelets 4,000 -$g 9-3-15; 1,000 -$g 9-6-15; 9,000 -$g 9-8-15
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0141980IMLA
Administered by: Private     Purchased by: Private
Symptoms: Contusion, Petechiae, Platelet count decreased
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 8-30-15 -$g mom noticed bruising. 9-3-15 to ER for petechiae, plts 4,000. 9-6-15 -$g plts 1,000. Placed on high dose steroids. 9-8-15 plts 9,000. Followed by Hematology at hospital. Appts for repeat blood work.

VAERS ID:594837 (history)  Vaccinated:2015-08-31
Age:12.0  Onset:2015-09-06, Days after vaccination: 6
Gender:Male  Submitted:2015-09-11, Days after onset: 5
Location:Rhode Island  Entered:2015-09-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Mycoplasma bacteria
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC. 1SYRRA
Administered by: Private     Purchased by: Other
Symptoms: Chest pain, Dizziness, Headache, Mycoplasma test
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Dizziness, prolong head ache, chest pain.

VAERS ID:594908 (history)  Vaccinated:2015-09-11
Age:12.0  Onset:2015-09-11, Days after vaccination: 0
Gender:Male  Submitted:2015-09-11, Days after onset: 0
Location:Ohio  Entered:2015-09-11
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: Amoxicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.L0092140SCLA
Administered by: Public     Purchased by: Private
Symptoms: Deafness, Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Dizziness, Partial hearing loss, blurred vision.

VAERS ID:596053 (history)  Vaccinated:2015-09-09
Age:12.0  Onset:2015-09-10, Days after vaccination: 1
Gender:Male  Submitted:2015-09-11, Days after onset: 1
Location:Virginia  Entered:2015-09-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS7XB320IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA150230IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSX4J7D0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injected limb mobility decreased, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt''s (L) arm was swollen, red, hot to touch and decrease in ROM. Pt. was treated with a 10 day course of abx. (KEFLEX).

VAERS ID:596121 (history)  Vaccinated:2015-09-08
Age:12.0  Onset:2015-09-08, Days after vaccination: 0
Gender:Female  Submitted:2015-09-11, Days after onset: 3
Location:Colorado  Entered:2015-09-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1509USA005314
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC. 0UNUN
Administered by: Private     Purchased by: Other
Symptoms: Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)
Write-up: This spontaneous report as received from a medical assistant refers to a 12 year old female patient with none drug reactions or allergies. Pertinent medical history was not reported. On 03-MAR-2015 and on 05-MAY-2015, the patient was vaccinated with the first dose and second dose, respectively, of GARDASIL (Lot number, expiration date, route and dose were not provided). On 08-SEP-2015, the patient was vaccinated with the first dose (reported as the third dose) of GARDASIL 9 (Lot number, expiration date, route and dose were not provided). Concomitant medications were not reported. The reporter stated that within minutes after being vaccinated with GARDASIL 9, the patient developed blurred vision and a sharp headache. The patient was instructed to lie down in the office "for a few minutes" and to had a few sips of water to drink. No laboratory diagnostic studies were performed. The patient recovered of sharp headache and blurred vision on 08-SEP-2015. The reporter did not assess the relatedness of GARDASIL and GARDASIL 9 and GARDASIL to sharp headache and blurred vision. Additional information has been requested.

VAERS ID:596134 (history)  Vaccinated:2015-09-08
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-09-11
Location:Rhode Island  Entered:2015-09-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Eczema; skin sensitivity
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5068AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS2224P0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0150470SCLA
Administered by: Private     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient behind on immunizations, always got them one at a time. In an attempt to catch up, 3 given at one time and patient developed urticaria.

VAERS ID:595084 (history)  Vaccinated:2015-08-31
Age:12.0  Onset:2015-08-31, Days after vaccination: 0
Gender:Female  Submitted:2015-09-02, Days after onset: 2
Location:Tennessee  Entered:2015-09-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Respiratory Panel-neg x 2; CXR-left lower lobe infiltrate-sm effusion
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MENB: MENINGOCOCCAL B (TRUMENBA)PFIZER/WYETH289231IMAR
Administered by: Private     Purchased by: Private
Symptoms: Chest X-ray abnormal, Headache, Laboratory test normal, Myalgia, Pleural effusion, Pneumonia, Pyrexia, Respiratory viral panel
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient had onset of fever, myalgias & headache within several hours of vaccine. Temp has persisted up to 103 - subsequently diagnosed with left lower lobe pneumonia - failed outpatient antibiotics - admitted x 24 hrs for IV antibiotics.

VAERS ID:595179 (history)  Vaccinated:2015-08-04
Age:12.0  Onset:2015-08-04, Days after vaccination: 0
Gender:Male  Submitted:2015-09-14, Days after onset: 41
Location:California  Entered:2015-09-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none~ ()~~0.00~Patient|N/A~ ()~~0.00~Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma 2 years previously; none since; no meds
Diagnostic Lab Data: None done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEUR565011A2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling abnormal, Malaise, Pyrexia, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Mom reports that around 10:00 PM patient just did not feel well. She gave him some water, put him to bed-he was OK. At 11:30, he awoke with temp of 102, blurry vision and said his arms and legs "felt funny". She gave him Tylenol and took him to ED. (around 1:00 AM 8/5/15) There temp was 34, his neuro sx had resolved, and his P.E. was normal. Sent home with no therapy and with Dx of post- immunization fever.

VAERS ID:596353 (history)  Vaccinated:2015-07-08
Age:12.0  Onset:2015-07-08, Days after vaccination: 0
Gender:Male  Submitted:2015-09-10, Days after onset: 64
Location:Florida  Entered:2015-09-14, 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: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0115620IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt. came into office on 9-9-15 for second dose of HPV. At that time he informed the Dr. that his arm was numb and he had "pins and needles" since the time of the first. HPV given on 7-8-15. Pt is not having any difficulty using the arm - no limitations.

VAERS ID:595280 (history)  Vaccinated:2015-09-14
Age:12.0  Onset:2015-09-14, Days after vaccination: 0
Gender:Male  Submitted:2015-09-15, Days after onset: 1
Location:Minnesota  Entered:2015-09-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness. Pt was at the clinic for Well Child Check.
Preexisting Conditions: No allerigies, no medication taken. No previous Diagnoses.
Diagnostic Lab Data: N/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.0134291IMLA
Administered by: Public     Purchased by: Public
Symptoms: Immediate post-injection reaction, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Immediately after adm injection of HPV child fainted. Child did not respond for seconds, his face was pale; BP 109/68; P 70. Observed pt and child was able to respond to questions. Oriented to person and place.

VAERS ID:595330 (history)  Vaccinated:2015-08-26
Age:12.0  Onset:2015-08-27, Days after vaccination: 1
Gender:Female  Submitted:2015-09-15, Days after onset: 19
Location:Texas  Entered:2015-09-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0075600IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4775AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash generalised, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Welts/rash that itched broke out on patient''s skin, beginning on both arms and progressing to rest of body.

VAERS ID:595527 (history)  Vaccinated:2011-11-09
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-09-15
Location:Iowa  Entered:2015-09-15
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions: N/a
Diagnostic Lab Data: Blood Lab Tests. Vitamin D levels low. Problems persist, took to different Dr.''s office. Showed mono, then later low white blood count, low vit. D, went to specialist more tests. Epstein Barr, HPPV 6. Chronic fatigue, with suppressed immune system, mild neutropenia. Not much that can be done. Mother has researched: This problem is happening with lots of girls. Other countries have suspended their recommendation of Gardasil because of these type of problems. This type of problem is being documented as occurring on a regular basis and is devastating to the lives of many girls. Our daughter is one such victim. Patients should be warned of these side effects. If I had known, I would never had allowed this vaccine to be used on my daughter.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0840AA2UNUN
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Asthenia, Decreased immune responsiveness, Epstein-Barr virus test, Fatigue, Human herpes virus 6 serology, Immunodeficiency, Mononucleosis heterophile test, Neutropenia, Neutrophil count decreased, Somnolence, Syncope, Vitamin D decreased, Weight gain poor, White blood cell count decreased
SMQs:, Torsade de pointes/QT prolongation (broad), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pre-Gardasil: Daughter had lots of energy & exceptional immune system (rarely ill, could be around sick people and not catch illness). Very active. After Gardasil: It took a while after the last shot in the series for the issue to take hold and for her parents to notice. Parents at first push it off as a growth spurt. Fatigue to such a level falls asleep in car before and after school--on way to and fro. Lacks stamina she had in past for exercise and sports, no longer enjoys taking part in cross country team. Low energy. Eats tremendous amounts, but doesn''t gain weight. Daughter gets sick very easily (catches colds, flu, etc... Parents can be exposed to same illnesses and do not come down with it. Before Gardasil, parents more likely to become ill than daughter). Parents taking daughter in to Drs. about concerns in 2012-2015 (last Gardasil shot in late 2011). Fainting incident at school. Very low Vitamin D levels. Later, blood tests show low white cell count, Epstein Barr, mild neutropena, mono. Daughter gets ill very easily and is ill often. Chronic fatigue persists. Daughter no longer goes out for cross country, changes life to accommodate fatigue and compromised immune system.

VAERS ID:595779 (history)  Vaccinated:2015-09-04
Age:12.0  Onset:2015-09-04, Days after vaccination: 0
Gender:Male  Submitted:2015-09-16, Days after onset: 12
Location:Georgia  Entered:2015-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Viral illness; Dysuria
Preexisting Conditions: H/O headaches; H/O seizures in 2012 (none since EEG history)
Diagnostic Lab Data: HR & BP assessed after incident P 80 BP 86/52
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Dyskinesia, Fall, Head injury, Hypophagia, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Syncope episode after receiving second scheduled dose of HPV vaccine, with resultant fall from parents lap. Pt had involuntary motions and short loss of awareness. After hitting floor s/p fall & hitting head. Monitored, EMS called, resolved prior to EMS visit. Had decreased PO intake first day per patient.

VAERS ID:596504 (history)  Vaccinated:2015-09-14
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2015-09-15
Location:Maryland  Entered:2015-09-16, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSFA545 UNUN
Administered by: Private     Purchased by: Public
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: Pt was given an INFANRIX in error was to receive ADACEL.

VAERS ID:596520 (history)  Vaccinated:2015-09-08
Age:12.0  Onset:2015-09-09, Days after vaccination: 1
Gender:Male  Submitted:2015-09-10, Days after onset: 1
Location:Pennsylvania  Entered:2015-09-16, 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: multivitamin; omega-3 for kids
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5186AA SYRAR
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Chills, Decreased appetite, Headache, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Joint aches in legs, sore at shot site, bad headache, chills, loss of appetite.

VAERS ID:596674 (history)  Vaccinated:2015-09-14
Age:12.0  Onset:2015-09-15, Days after vaccination: 1
Gender:Male  Submitted:2015-09-16, Days after onset: 1
Location:Arizona  Entered:2015-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L011846 UNRA
Administered by: Public     Purchased by: Public
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Per mom pt received 1 vaccine on 9-14-15 on 9-15-15 pt broke out in rash from head to toe. Went to urgent care given BENADRYL and steroids per mom.

VAERS ID:596115 (history)  Vaccinated:2015-09-10
Age:12.0  Onset:2015-09-10, Days after vaccination: 0
Gender:Male  Submitted:2015-09-18, Days after onset: 8
Location:North Carolina  Entered:2015-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~DTaP (Tripedia)~5~4.00~Patient|~Polio Virus, Inact. (Ipol)~4~4.00~Patient|~Measles + Mumps + Rubella + Varicella (ProQuad)~2~4.
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma. Allergy to Penicillin.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0105740IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM140790IMLA
Administered by: Public     Purchased by: Public
Symptoms: Blood pressure increased, Flushing, Headache, Hypertension, Induration, Injection site erythema, Neck pain, Peripheral swelling, Pruritus, Rash, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient''s parent reports that patient had headache and stated he was itching following the vaccinations at 6 pm that evening. Also, that evening the mother reports that the patient''s injection site on the left arm became red and arms bilaterally were swollen. Patient''s mother also reports that patient''s left arm had a 3" x3" area on left arm that was hot to the touch and firm. Mother states that patient then developed a rash and neck pain on Saturday Sept. 12th, 2015 as well as still having the headache. Monday September 14th, 2015 the mother presented the patient to the emergency room. At the emergency room the mother reported the patient was hypertensive with blood pressure of 148/70. Mother reports ER prescribed a steroid to be given for five days. Patient''s mother stated that the school nurse from the patient''s school called mother on Tuesday Sept 15 and informed mother that her son was still complaining of headache, neck pain, his blood pressure was elevated and he was flushed. Mother reported adverse event to Health Department on Thursday September 17th, 2015.

VAERS ID:596139 (history)  Vaccinated:2015-09-15
Age:12.0  Onset:2015-09-16, Days after vaccination: 1
Gender:Male  Submitted:2015-09-18, Days after onset: 2
Location:California  Entered:2015-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0164280IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5020AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site haemorrhage, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling (15cm) hard, warm erythematous and ecchymosis noted to upper left arm.

VAERS ID:596182 (history)  Vaccinated:2015-09-16
Age:12.0  Onset:2015-09-17, Days after vaccination: 1
Gender:Female  Submitted:2015-09-18, Days after onset: 1
Location:California  Entered:2015-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.J0058911IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0042050IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURK11691IMLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.L0241231SCLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5063AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Rash generalised, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient developed a papular rash all over her body. No other symptoms.

VAERS ID:596589 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Male  Submitted:2011-04-12
Location:California  Entered:2015-09-21, Days after submission: 1623
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concomitant medications were not reported.
Current Illness: Unknown
Preexisting Conditions: Information regarding the total number of PREVNAR doses received was not provided.
Diagnostic Lab Data: Culture (results: Streptococcus pneumoniae) was done in 2010.
CDC Split Type: USWYEH15194310
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC: PNEUMO (PREVNAR)PFIZER/WYETH  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Meningitis pneumococcal, Streptococcus test positive
SMQs:
Write-up: This was created to reflect the correct country of origin. The cancelled # was UR-WYE-H15177110. Follow-up information was received regarding recovery status. Information regarding PREVNAR was received from a healthcare professional regarding a 12-year-old male patient who experienced pneumococcal meningitis and drug ineffective. The patient received a dose on an unspecified date at the age of three. In 2010, the date unknown, the patient experienced pneumococcal meningitis and was hospitalized. The patient recovered. No additional information was available at the time of this report. Following the integration of the legacy safety adverse event reporting databases, this case has been migrated from the legacy company database into the current safety database for processing follow-up information. As a consequence of this migration, the follow-up CIOMS I, MedWatch or VAERS report may indicate in the appropriate field that it is an initial report. Follow-up (13Dec2010): This contactable physician reported that the patient recovered.

VAERS ID:597178 (history)  Vaccinated:2015-09-16
Age:12.0  Onset:2015-09-18, Days after vaccination: 2
Gender:Female  Submitted:2015-09-21, Days after onset: 3
Location:New York  Entered:2015-09-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURK133013IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5058AB0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4432AB0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0104401IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Peripheral swelling, Upper extremity mass
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt has a large swollen lump on L arm. Area as per grandmother is red and swollen and the size of the bottom of a coffee mug.

VAERS ID:597791 (history)  Vaccinated:2015-06-16
Age:12.0  Onset:2015-06-16, Days after vaccination: 0
Gender:Male  Submitted:2015-08-13, Days after onset: 58
Location:Unknown  Entered:2015-09-21, Days after submission: 39
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2015206390
Vaccination
Manufacturer
Lot
Dose
Route
Site
MENB: MENINGOCOCCAL B (TRUMENBA)PFIZER/WYETHJ292030UNUN
Administered by: Private     Purchased by: Other
Symptoms: Fatigue, Malaise, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This is a spontaneous report from a contactable consumer (father). A 12-year-old male patient of unknown ethnicity received the first dose of TRUMENBA, lot number J296203 at 0.5 ml single dose on 16JUN2015. Medical history and concomitant medications were not reported. Approximately 12 hours from receiving the injection, on 16JUN2015, the patient developed a temperature of 37.6, fatigue, nausea. The patient also got sick overnight (16JUN2015). Temperature returned to normal with ibuprofen, then on 17JUN2015, the patient vomited and temperature reached highest point of 38.7C. Outcome was unknown. Follow-up attempts completed. No further information expected.

VAERS ID:597365 (history)  Vaccinated:2015-08-24
Age:12.0  Onset:2015-08-24, Days after vaccination: 0
Gender:Female  Submitted:2015-08-26, Days after onset: 2
Location:Michigan  Entered:2015-09-22, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergies to environmental
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.  SYRUN
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: General malaise. Fever - 102. Injection site pain.

VAERS ID:597120 (history)  Vaccinated:2015-09-11
Age:12.0  Onset:2015-09-18, Days after vaccination: 7
Gender:Male  Submitted:2015-09-24, Days after onset: 6
Location:Michigan  Entered:2015-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Migraines
Diagnostic Lab Data: Did blood draw for thyroid function and strep in blood upon our request.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS 0IMRA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Activities of daily living impaired, Dyskinesia, Muscle twitching, Streptococcus test, Thyroid function test, Tic
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad), Dyskinesia (narrow), Dystonia (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: It started with involuntary head movements at school. Friday September 11 in the afternoon. At 8:30 that evening we noticed nonstop tapping. Then by Saturday 9/12/15 the involuntary head movement was non stop. Sunday morning at 9:30 AM constant snapping of fingers started. Sunday evening at around 6 PM involuntary lifting of right hand would make him hit things when it rose. He was not able to attend school Monday September 13. Facial twitching Monday September 13 started while at doctor appointment we scheduled at 5 PM. Tuesday September 14 returned to school after working with school staff. Vocal tic clicking of the tongue and having to say "moo". The vocal tic didn''t last. However, the continued involuntary head movement, snapping and right arm lifting has.

VAERS ID:597153 (history)  Vaccinated:2015-09-24
Age:12.0  Onset:2015-09-24, Days after vaccination: 0
Gender:Male  Submitted:2015-09-24, Days after onset: 0
Location:New York  Entered:2015-09-24
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: AUTISM
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0138271SCLA
Administered by: Private     Purchased by: Private
Symptoms: Petit mal epilepsy
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow)
Write-up: ABSENCE SEIZURE.

VAERS ID:598148 (history)  Vaccinated:2015-09-23
Age:12.0  Onset:2015-09-23, Days after vaccination: 0
Gender:Female  Submitted:2015-09-24, Days after onset: 1
Location:Georgia  Entered:2015-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0192870UNLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Diarrhoea, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Seen at Medical Center ER on the evening of 9/23/15 with stomach pain, nausea and diarrhea. Eval from ER was normal. Was given a prescription for ZOFRAN and CULTURELLE. Recheck visit at PCP''s office on 9-24-15 was normal.

VAERS ID:598329 (history)  Vaccinated:2015-09-21
Age:12.0  Onset:2015-09-21, Days after vaccination: 0
Gender:Female  Submitted:2015-09-25, Days after onset: 4
Location:Ohio  Entered:2015-09-25
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: Overweight
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0115621IMLA
Administered by: Private     Purchased by: Public
Symptoms: Fall, Pallor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient was scheduling next appt 10-15 min after vaccine administered and started to stare. Patient unresponsive to sound and movement. Patient fell backwards into a chair because extremely pale. Patient was immediately

VAERS ID:598506 (history)  Vaccinated:2015-09-15
Age:12.0  Onset:2015-09-15, Days after vaccination: 0
Gender:Male  Submitted:2015-09-24, Days after onset: 9
Location:Oregon  Entered:2015-09-25, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4690BA0UNLA
Administered by: Private     Purchased by: Public
Symptoms: Headache, Hypoaesthesia, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, headache, face numb - started the evening he got the Tdap vaccine. Improved the next day.

VAERS ID:598508 (history)  Vaccinated:2015-09-15
Age:12.0  Onset:2015-09-15, Days after vaccination: 0
Gender:Male  Submitted:2015-09-24, Days after onset: 9
Location:Oregon  Entered:2015-09-25, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURERC4690BA0UNLA
Administered by: Private     Purchased by: Public
Symptoms: Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Body aches, fever, headache the night he got TDap.

VAERS ID:597425 (history)  Vaccinated:2013-10-01
Age:12.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Male  Submitted:2015-09-26, Days after onset: 725
Location:Illinois  Entered:2015-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Private
Symptoms: Blindness, Dizziness, Tinnitus
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: At first light headed, then loss of vision, ringing in ears, ready to faint.

VAERS ID:600862 (history)  Vaccinated:2015-09-22
Age:12.0  Onset:2015-09-22, Days after vaccination: 0
Gender:Male  Submitted:2015-09-22, Days after onset: 0
Location:Texas  Entered:2015-09-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS77D7L1IMUN
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0075600IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM150080IMUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALST4N790IMUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0010841SCUN
Administered by: Other     Purchased by: Public
Symptoms: Abnormal behaviour, Anxiety, Dizziness, Fear, Immediate post-injection reaction, Lacrimation increased, Muscular weakness, Nausea, Panic attack, Somnolence, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Patient receive immunizations 1200 after eating lunch. Hep A, Varicella, Tdap, MCV-4 and HPV-9. Immediately after receiving immunizations listed above patient complained of dizziness and nausea. Patient feet was elevated and a ice pack was applied to the back of his neck. Patient started feeling sleepy with sinking episodes. Patient was placed in a supine trendelenburg position. 1225 Vitals 124/76 Pulse 85 Temp 98.1 Resp 16. Patient was alert, orientated to name, place and time. Skin dry and warm to touch. Resp even and unlabored. Denies SOB, chest pain, throat/lips without redness or swelling, able to move all extremities with weakness noted, lungs clear to auscultation in all lobes, skin color without paleness, no rash/hives or itching noted. Patient started with increased complaints, everything in the room appeared green, the bird in the ceiling was moving and a overall abnormal behavior with his eyes roaming the room with a fearful look and tears rolling down his eyes, patient not recovering after 30 minutes and having symptoms of anxiety/panic attack, Dr notified and agree to call "911". Mother agreed with the plan of care. 1230 BP 150/107 HR 82 Resp 16 Temp 98.0. Attempted to distract patient with the phone and he dropped the phone. He stated "My arms are weak". 1235 EMS at the bedside, transported to stretcher and sent to ER with his mother. Vitals 114/42 HR 65 Resp 16 Temp 98.0 oral. Patient was alert. Patient symptoms remain the same but visions was clear. Patient was alert, OX3 and stable at time of transfer. Instructed mother to follow-up with EMS as directed by the ER, mother verbalize good understanding and agree with the plan of care. Report given to EMS using SBAR.

VAERS ID:597851 (history)  Vaccinated:2015-09-29
Age:12.0  Onset:2015-09-29, Days after vaccination: 0
Gender:Male  Submitted:2015-09-29, Days after onset: 0
Location:California  Entered:2015-09-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.FJ21595IN 
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0192860IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5178AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dyskinesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Approximately 5 minutes after receiving vaccines, walking out of office and had syncopal episode lasting only a few seconds with brief jerking movements. Rested in office for approx 30 min and given some water and apple juice.

VAERS ID:600989 (history)  Vaccinated:2015-04-20
Age:12.0  Onset:2015-08-22, Days after vaccination: 124
Gender:Female  Submitted:2015-09-28, Days after onset: 37
Location:Unknown  Entered:2015-09-29, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1509USA008984
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.  IMUN
HIBV: HIB (PEDVAXHIB)MERCK & CO. INC.  IMUN
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCUN
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Ear infection, Flat affect, Insomnia, Weight increased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad)
Write-up: On 20-APR-2015, the patient was vaccinated with a doses of MMR II (lot #, expiration date, dose and route were not reported), LIQUID PEDVAXHIB (lot #, expiration date, dose and route were not reported), (Oka-Merck) PROQUAD (lot #, expiration date, dose and route were not reported), RECOMBIVAX HB (lot #, expiration date, dose and route were not reported), VAQTA (lot #, expiration date, dose and route were not reported), (Oka/Merck) VARIVAX and GARDASIL 9 (lot #, expiration date, dose and route were not reported) as well as 5 other unspecified vaccines (non Merck manufactured) all in one visit. On 22-AUG-2015, the patient experienced severe ear infections, weight gain, lack of energy, sleeplessness, dragging along at school, her eyes were hollow, she was showing no signs of emotion anymore. The mother reported that her daughter looked like she had been poisoned. There was no labs diagnostics studies performed. The patient was treated with ibuprofen, ofloxacin and amoxicillin. The outcome adverse events was reported as not recovered. The patient sought medical attention via visiting her doctor. The relatedness between adverse events and suspected therapies was not reported. Additional information has been requested.

VAERS ID:597904 (history)  Vaccinated:2015-09-30
Age:12.0  Onset:2015-09-30, Days after vaccination: 0
Gender:Male  Submitted:2015-09-30, Days after onset: 0
Location:Ohio  Entered:2015-09-30
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0050830IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSX150080IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4497AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Passed out for <1 minute after 3rd injection. Tdap first, Menveo second, and HPV given third.

VAERS ID:597922 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-09-24
Location:North Carolina  Entered:2015-09-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: Temp 97.3 oral 100/70 84 20
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5309AA1IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5178AA0IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Student c/o feeling like wanted to vomit, feeling faint, pale. Mom reports student has not eaten she has had this reaction 1 year ago cold pack, pretzels and water.

VAERS ID:598058 (history)  Vaccinated:2015-08-27
Age:12.0  Onset:2015-09-09, Days after vaccination: 13
Gender:Male  Submitted:2015-09-30, Days after onset: 21
Location:Iowa  Entered:2015-09-30
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: Quick Strep test and throat culture.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS4235D0IMRA
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0192860IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM150090IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS5MG550IMLA
Administered by: Public     Purchased by: Private
Symptoms: Autoimmune dermatitis, Culture throat, Pyrexia, Rash, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed a rash and fever. Started on 9/9/15. Was seen in a urgent care on 9/12/15. Tested for strep which was negative. Put on Amoxicillin. Rash continued so went to doctor on 9/16/15. No other symptoms noted. Diagnosed with auto immune dermatitis and physician stated in notes it could have been a reaction/side effect from the meningococcal vaccine.

VAERS ID:598499 (history)  Vaccinated:2015-10-04
Age:12.0  Onset:2015-10-05, Days after vaccination: 1
Gender:Female  Submitted:2015-10-05, Days after onset: 0
Location:Florida  Entered:2015-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: seizures~Pertussis (no brand name)~1~0.25~Patient
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0286640IMRA
Administered by: Other     Purchased by: Private
Symptoms: Feeding disorder, Pain in jaw, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Osteonecrosis (broad), Hypoglycaemia (broad)
Write-up: Very blurry vision, almost unable to see. Extreme Jaw Pain, unable to eat.

VAERS ID:598664 (history)  Vaccinated:2015-09-30
Age:12.0  Onset:2015-09-30, Days after vaccination: 0
Gender:Male  Submitted:2015-10-05, Days after onset: 5
Location:Idaho  Entered:2015-10-05
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: PCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC. 3IN 
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Dysphagia, Joint stiffness, Musculoskeletal stiffness, Odynophagia, Pain in extremity, Pharyngeal oedema, Swelling face, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives, swelling of face, tongue, and throat, pain and stiffness in hands/wrists and feet/ankles, painful and difficulty swallowing. Treated with Benadryl, Zyrtec, and Motrin during first 48 hours. Started oral steroids at 36 hours for residual facial swelling.

VAERS ID:602363 (history)  Vaccinated:2015-09-23
Age:12.0  Onset:2015-09-23, Days after vaccination: 0
Gender:Unknown  Submitted:2015-10-03, Days after onset: 10
Location:Georgia  Entered:2015-10-05, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1509USA014468
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L000610 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a licensed practical nurse refers to a 12 year old patient of unknown gender. The patient''s pertinent medical history and drug reactions or allergies were not reported. On 23-SEP-2015, the patient was vaccinated with a dose of improperly stored GARDASIL 9 (lot number L000610 and expiration date 31-JAN-2017) (dose and route of administration were not reported). Concomitant therapy was not reported. No adverse effects were reported. Additional information has been requested.

VAERS ID:600752 (history)  Vaccinated:2015-09-21
Age:12.0  Onset:0000-00-00
Gender:Female  Submitted:2015-09-23
Location:Colorado  Entered:2015-10-06, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: swelling~DTaP (no brand name)~1~0.20~Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI431AA9IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0164280IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5178AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU5243AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: No adverse event
SMQs:
Write-up: There were no observed adverse events; however, patient has history of reaction to Dtap and was given a Tdap. She was examined approximately one hour after the vaccine.

VAERS ID:600949 (history)  Vaccinated:2015-09-28
Age:12.0  Onset:2015-09-28, Days after vaccination: 0
Gender:Male  Submitted:2015-10-05, Days after onset: 7
Location:Massachusetts  Entered:2015-10-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine; Flucanazole spray; Dexmethylphenidate; Ketotifen
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.FJ20990IN 
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Headache, Immediate post-injection reaction
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Dizzy and headache immediately after immunization. Lasted for several hours.

VAERS ID:602487 (history)  Vaccinated:2015-10-05
Age:12.0  Onset:2015-10-06, Days after vaccination: 1
Gender:Female  Submitted:2015-10-06, Days after onset: 0
Location:Georgia  Entered:2015-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minocycline
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5058AC0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt and mother reports pt awoke at 3:00 AM morning after vaccination w/ MENACTRA. Fever of 102.7 and redness and severe swelling of injection site. Pt and mother report site swollen 4-5 inches in diameter. MOTRIN 600mg by mouth administered. Visit to RN at Health dept at 1 pm on 10/6/15 advised pt to continue ice packs to area, continue alternating TYLENOL and MOTRIN every 4 hours and give patient BENADRYL for itching. Called pt at 3:30 - per mother patient resting w/ slight improvement.

VAERS ID:601304 (history)  Vaccinated:2015-09-22
Age:12.0  Onset:2015-09-22, Days after vaccination: 0
Gender:Male  Submitted:2015-10-08, Days after onset: 16
Location:North Carolina  Entered:2015-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MELATONIN
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0192870IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM150230IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness and warm to touch noticed the evening of 09/24/2015. Denies fever. Seen in clinic 09/25/2015 with 10cm x 13cm area of warm, erythema, and mildly tender. Treated with Keflex 500mg q 12hrs x 10days.

VAERS ID:601334 (history)  Vaccinated:2015-10-05
Age:12.0  Onset:2015-10-07, Days after vaccination: 2
Gender:Female  Submitted:2015-10-08, Days after onset: 1
Location:Minnesota  Entered:2015-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: moderate swelling and redness~Mumps (Mumpsvax II)~2~4.67~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions: Mumps vaccine - similar reaction; Neomycin-bacitracin-polymixin
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS150190IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site oedema, Injection site reaction, Local swelling, Rash, Skin tightness, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness of entire circumference of left upper arm, very taut. Slightly raised erythema developed on neck and bilateral preauricular region of face. Parents gave her Claritin. 24 hours later, when seen by phsyician, rash was resolving, but there was mild erythema on face and uppper arm and mild edema of upper arm present.

VAERS ID:601410 (history)  Vaccinated:2015-10-02
Age:12.0  Onset:2015-10-06, Days after vaccination: 4
Gender:Female  Submitted:2015-10-08, Days after onset: 2
Location:Alabama  Entered:2015-10-08
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: Allergies - amoxicillin; Hx of scoliosis
Diagnostic Lab Data: EEG performed, awaiting results
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.FJ21894IN 
Administered by: Other     Purchased by: Private
Symptoms: Electroencephalogram, Hypotonia, Nausea, Postictal state, Seizure, Unresponsive to stimuli
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Pt had seizure in bathroom, mom found her limp and unresponsive. EMS on scene gave Zofran during post-ictal state since pt was nauseated. Pt taken to ER for labs.

VAERS ID:601725 (history)  Vaccinated:2015-10-06
Age:12.0  Onset:2015-10-06, Days after vaccination: 0
Gender:Female  Submitted:2015-10-09, Days after onset: 3
Location:West Virginia  Entered:2015-10-09
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: Headaches
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K011561IMRL
Administered by: Private     Purchased by: Private
Symptoms: Abdominal discomfort, Dysgeusia, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 2nd dose in series: vomiting, bilateral leg pain, stomach discomfort, metal-taste described in mouth after vomiting. These same Sx occurred after 1st dose of vaccine, but mom attributed to viral illness coexisting at time of immunization.

VAERS ID:601884 (history)  Vaccinated:2015-10-02
Age:12.0  Onset:2015-10-02, Days after vaccination: 0
Gender:Male  Submitted:2015-10-02, Days after onset: 0
Location:Texas  Entered:2015-10-09, 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: BENADRYL
Current Illness: Rt. leg pain
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI422AB IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0141912IMLA
Administered by: Public     Purchased by: Other
Symptoms: Crying, Pain, Rash, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Child was given HPV and Flu shot. Child feet pain, starting crying, maculopapular rash developed on face and neck area. No resp. distress.

VAERS ID:602078 (history)  Vaccinated:2015-10-11
Age:12.0  Onset:2015-10-11, Days after vaccination: 0
Gender:Female  Submitted:2015-10-11, Days after onset: 0
Location:Missouri  Entered:2015-10-11
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: Roxices
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1517801 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Patient received vaccine then fainted while sittting in the chair. Regained consciousness after a few seconds.

VAERS ID:601905 (history)  Vaccinated:2015-09-22
Age:12.0  Onset:2015-09-22, Days after vaccination: 0
Gender:Male  Submitted:2015-10-12, Days after onset: 20
Location:Michigan  Entered:2015-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, clonidine
Current Illness: None
Preexisting Conditions: ADHD
Diagnostic Lab Data: Lab work white blood cell count drawn. Xrays.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM1500080IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Mobility decreased, Pain in extremity, White blood cell count, X-ray
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)
Write-up: Unable to move both legs. Extreme pain to legs.

VAERS ID:601938 (history)  Vaccinated:2015-10-12
Age:12.0  Onset:2015-10-12, Days after vaccination: 0
Gender:Female  Submitted:2015-10-12, Days after onset: 0
Location:Tennessee  Entered:2015-10-12
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0102152IMRA
Administered by: Private     Purchased by: Private
Symptoms: Cold sweat, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Approximately 5 minutes after receiving imm., patient became pale, clammy and had a syncope episode that lasted for a few seconds. Staff layed patient on soft mat on floor and raised her feet above her heart. Her vital signs were normal (B/P 90/60, heartrate 80). Patient had not had breakfast..staff gave her apple juice. When patient felt well enough to sit up, she was also given peanut butter and crackers. Staff continued to monitor patient''s condition and vitals. Seemed back to normal around 10:30 and patient discharged.

VAERS ID:603992 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:2015-08-15
Gender:Female  Submitted:2015-10-13, Days after onset: 59
Location:Unknown  Entered:2015-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA001630
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Menstrual disorder
SMQs:
Write-up: This spontaneous report as received from a consumer refers to his/her 12 year old granddaughter. The patient''s pertinent medical history and drug allergies were unspecified. On an unknown date, the patient was vaccinated with first dose of GARDASIL (dose, frequency, route and lot# were not reported) and on the same day, the patient received a booster shot, unknown vaccine name. Concomitant medications were none. From 15-AUG-2015, the patient experienced back to back menstrual cycles (polymenorrhoea). The outcome of the event was unknown. The relatedness of the event with GARDASIL was not reported. Additional information is not expected as the reporter did not wish to contact.

VAERS ID:602251 (history)  Vaccinated:2015-07-10
Age:12.0  Onset:2015-07-10, Days after vaccination: 0
Gender:Male  Submitted:2015-10-14, Days after onset: 96
Location:Puerto Rico  Entered:2015-10-14
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: No
CDC Split Type: PR1515
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5026AA IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4730BA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L00329 SCLA
Administered by: Other     Purchased by: Public
Symptoms: