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Found 502612 cases where Symptom is Immune system disorder or Immunodeficiency or Immunoglobulins decreased or Lymphadenopathy

Case Details (Sorted by Age)

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VAERS ID:527173 (history)  Vaccinated:2014-02-16
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-03-31
Location:California  Entered:2014-03-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Hair falling out~Influenza (Seasonal) (Fluarix)~~20.33~Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Liver function tests
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  IMRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Alopecia, Back pain, Injection site rash, Liver function test, Rash
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow)
Write-up: There have been many effects but the main ones include persistent back pain and my hair started falling out after my hepatitis B shot. I have a bald spot and my hair has thinned out severely. There have been many articles linking the hepatitis b vaccine to alopecia areata. Additionally, I had rashes that developed on 2 places in my body, one near the injection site and one on my knee.

VAERS ID:527337 (history)  Vaccinated:2014-03-03
Age:20.0  Onset:2014-03-03, Days after vaccination: 0
Gender:Female  Submitted:2014-03-31, Days after onset: 27
Location:North Carolina  Entered:2014-04-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NORVASC; AZOPT; KEPPRA; Losartan; TRILEPTAL; KCL; FOSAMAX; Digoxin; SYNTHROID; Lovastatin; Sertraline; COUMADIN
Current Illness: Admit 2/27 - 3/3/14 for Dx MS secondary hyponatremia but she had recovered, was going home 3-3-14.
Preexisting Conditions: Dementia; Seizure d/o; trigeminal neuralgia; PAFIB; H/O breast CA; HTN; Glaucoma; Hypothyroidism; Dyslipidemia; GERD
Diagnostic Lab Data: RUE X-rays - negative; Venous ultrasound RUE - negative DVT
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0144040UNRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site swelling, Lethargy, Local swelling, Pain, Ultrasound Doppler, Ultrasound scan normal, X-ray limb normal
SMQs:, Angioedema (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt. d/c 3/3/14 had PNEUMOVAX on day of discharge. Returned to hospital the following day with very swollen RUE and lethargy. She was given one dose vancomycin. Admitted and treated with several doses of TORADOL for pain. Started on several days of Amoxicillin which will finish as outpatient. Patient was afebrile, clinically improved and stable at d/c.

VAERS ID:528307 (history)  Vaccinated:2010-04-08
Age:20.0  Onset:2010-04-09, Days after vaccination: 1
Gender:Male  Submitted:2014-04-14, Days after onset: 1466
Location:Texas  Entered:2014-04-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Allergic reaction~Influenza (Seasonal) (no brand name)~~19.00~Patient|adverse reaction~Anthrax (Biothrax)~4~19.00~Patient|advers
Other Medications: Benadryl and Tylenol to counter side effects from the vaccination. That is all that can be remembered as far as additional medication.
Current Illness: N/A
Preexisting Conditions: Allergic to amoxicillin and previous adverse reaction to Anthrax booster #3 given on May 19, 2008 and booster #4 given on October 28, 2008. Just prior to booster #4, severe intestinal inflammation developed which would be diagnosed as Crohn''s disease in 2012. After surgical intervention the symptoms subsided until after reception of boosters 4 and 5.
Diagnostic Lab Data: In October 2012, a Prometheus test was ordered that did indicate that I had Crohn''s Disease with a colonoscopy in March 2013 to support the level of damage. I had several fistulas that are now beginning to close as I am on Remicade. My liver has high hepatic counts for amino and aspartate transphase numbers which prevents me from taking 6MP for Crohn''s.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2264SYRRA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Aspartate aminotransferase increased, Blood test abnormal, Burning sensation, Colonoscopy abnormal, Crohn's disease, Hypersensitivity, Intestinal fistula, Local swelling, Musculoskeletal stiffness, Shock, Skin tightness, Swelling, Vaccination complication, Vaccination site inflammation
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Pseudomembranous colitis (broad), Gastrointestinal premalignant disorders (narrow), Dystonia (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal perforation (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific inflammation (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Severe abdominal pains after booster #3 with swelling and tightness of the arm. Booster #4 left the vaccination site inflammed for several weeks and caused stiffness in the arm. Booster #5 caused immediate burning and swelling. Booster #5 caused me to enter shock which may have been due to an allergic reaction to the shot, or adverse effect. Previous shots had adverse reactions, but nothing was done. After #5 the facility annotated it and provided a permanent exemption from shot series.

VAERS ID:528367 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-04-14
Location:Unknown  Entered:2014-04-14
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: WAES1404USA005225
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Malaise
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to an approximately 20 year old female patient with no pertinent medical history and not known drug allergies. In approximately 2013, reported as "around one year ago", the patient was vaccinated with first dose of GARDASIL (dose and lot number not reported). Two months later in 2013, the patient did not get the second dose of GARDASIL because she was sick (unspecified type of sickness). The pharmacist stated the patient now (on 08-APR-2014) wanted to receive the second dose of GARDASIL. The patient''s outcome was not reported. Relatedness between sickness and GARDASIL was not reported. Additional information is not expected.

VAERS ID:528480 (history)  Vaccinated:2014-04-10
Age:20.0  Onset:2014-04-11, Days after vaccination: 1
Gender:Female  Submitted:2014-04-11, Days after onset: 0
Location:Virginia  Entered:2014-04-15, 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: Fever, leg weakness decreased strenght
Preexisting Conditions:
Diagnostic Lab Data: Poss reaction to meningitis vaccine
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4608A UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Asthenia, Muscular weakness, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Fever, bil leg weakness, decreased strength legs.

VAERS ID:528518 (history)  Vaccinated:2014-04-09
Age:20.0  Onset:2014-04-09, Days after vaccination: 0
Gender:Female  Submitted:2014-04-10, Days after onset: 1
Location:Texas  Entered:2014-04-15, Days after submission: 5
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: PCN allergy
Diagnostic Lab Data: BP check: 78/62, 103/70
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA12026 IMUN
Administered by: Other     Purchased by: Private
Symptoms: Blindness transient, Hypotension, Nausea, Pallor, Staring, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt was observed for 15 min and during the 15 min observation she reported being nauseous. While speaking to her she started looking pale and staring into space. She startd to faint but we caught her before she fell to the ground avoiding head injury. She reported lack of vision for 1 minute but recovered. EMT was called and they advised pt to go to ER with them b/c pt''s hypotension. BP at first check was 78/62. Second check 103/70.

VAERS ID:528565 (history)  Vaccinated:2014-04-11
Age:20.0  Onset:2014-04-11, Days after vaccination: 0
Gender:Female  Submitted:2014-04-15, Days after onset: 4
Location:Unknown  Entered:2014-04-15
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:
CDC Split Type: WAES1404USA007915
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0686AE SCLA
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report was received from a registered nurse, refers to a 20 year old female patient. No pertinent medical history was reported. On 11-APR-2014, reported as today, the patient was vaccinated with MMR II, (lot # 0686AE; Exp. Date: 02-APR-2014), Dose: 0.5 ml, subcutaneous injection in the left arm. Co-suspect or concomitant therapies were not reported. The reporter nurse stated that patient was vaccinated with expired MMR II vaccine. No adverse effects reported.At the time of the report, the outcome of the event was unknown. Additional information is not expected.

VAERS ID:528826 (history)  Vaccinated:2014-04-09
Age:20.0  Onset:2014-04-09, Days after vaccination: 0
Gender:Female  Submitted:2014-04-12, Days after onset: 3
Location:New Jersey  Entered:2014-04-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS793JR0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling abnormal, Loss of consciousness, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (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)
Write-up: After receiving the vaccination, patient stood up to leave vaccination area. When she reached the waiting area she sat in a chair and passed out. She was dazed and non-responsive for 2 to 3 minutes. When she was able to respond she informed us that she has passed out before unrelated to vaccines.

VAERS ID:529057 (history)  Vaccinated:2014-04-08
Age:20.0  Onset:2014-04-08, Days after vaccination: 0
Gender:Female  Submitted:2014-04-08, Days after onset: 0
Location:Tennessee  Entered:2014-04-22, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Iron
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0127680UNLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ16290UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Dysgeusia, Immediate post-injection reaction
SMQs:, Taste and smell disorders (narrow), Hypersensitivity (narrow)
Write-up: Immediately after receiving injections pt. states "I have a metallic taste in my mouth".

VAERS ID:529239 (history)  Vaccinated:2014-03-28
Age:20.0  Onset:2014-03-28, Days after vaccination: 0
Gender:Female  Submitted:2014-04-07, Days after onset: 10
Location:Michigan  Entered:2014-04-22, Days after submission: 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0009850IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0206920IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4804AA5IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0063571IMRA
Administered by: Private     Purchased by: Private
Symptoms: Underdose
SMQs:
Write-up: Pediatric dose of HepA was given to adult. Pt and Dr. notified.

VAERS ID:529384 (history)  Vaccinated:2014-04-16
Age:20.0  Onset:2014-04-18, Days after vaccination: 2
Gender:Female  Submitted:2014-04-25, Days after onset: 7
Location:Unknown  Entered:2014-04-25
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: WAES1404USA011938
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J009827 IDUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling, Wrong drug administered
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a healthcare worker refers to a 20 year old female patient. Patients pertinent medical history, drug reactions and allergies were reported as none. On 16-APR-2014, the patient accidentally received PNEUMOVAX 23 injection, (lot number J009827 expiry date 10-AUG-2014), 0.5 ml, subdermal instead of Purified Protein Derivative (PPD) test. Concomitant therapy was reported as none. The healthcare worker states that the patient was seen in the office on 18-APR-2014 to have her PPD read and it was realized then that PNEUMOVAX 23 was accidentally administered on 16-APR-2014 instead. On 18-APR-2014, swelling was noted at the injection site. The patient reported that the physician prescribed the patient ZYRTEC on 18-APR-2014. No lab diagnostics studies were performed. No product quality complaint was involved. The outcome of event swelling was noted at the injection site was reported as recovering. The outcome of a patient accidentally received PNEUMOVAX 23 instead of a PPD test and PNEUMOVAX 23 administered subdermally was unknown. The reporters causality assessment for the event swelling was noted at the injection site with the therapy of PNEUMOVAX 23 was not reported. Additional information has been requested.

VAERS ID:529452 (history)  Vaccinated:2014-04-25
Age:20.0  Onset:2014-04-25, Days after vaccination: 0
Gender:Female  Submitted:2014-04-25, Days after onset: 0
Location:Washington  Entered:2014-04-25
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: None.
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0090981IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Approximately 7-10 minutes after administration, MA notified this RN that pt was pale, diaphoretic, and felt faint. Upon entering exam room, pt was sitting in the procedure chair at a 45 degree angle. Her lips were pale, she was slightly diaphoretic, alert and oriented x 3. This RN placed pt in Trendelenburg position. After 2-3 minutes pt''s lips gained faint pinkness, she stated she was starting to feel a little bit better. MA obtained pt vital signs and remained in room with patient. Blood pressure 98/82 with 98F tympanic. This RN re-checked pt after 5 minutes in Trendelenburg position. Pt has regained full color in her face and lips. She is no longer diaphoretic. She states she feels 90% improved and feels she can leave comfortably. MA rechecked blood pressure, now up to 118/60. Pt slowly stood up from the procedure chair with this RN and MA by her side. MA walked with patient to the parking lot. Pt left clinic in stable condition with no concerns.

VAERS ID:529546 (history)  Vaccinated:2014-04-24
Age:20.0  Onset:2014-04-26, Days after vaccination: 2
Gender:Female  Submitted:2014-04-28, Days after onset: 2
Location:Pennsylvania  Entered:2014-04-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Beyaz
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (NO BRAND NAME)UNKNOWN MANUFACTURER 3PO 
Administered by: Other     Purchased by: Other
Symptoms: Rash macular
SMQs:, Hypersensitivity (narrow)
Write-up: Took 3 of 4 doses. On day 3 a macular non-urticarial rash developed.

VAERS ID:529678 (history)  Vaccinated:2014-04-29
Age:20.0  Onset:2014-04-29, Days after vaccination: 0
Gender:Female  Submitted:2014-04-29, Days after onset: 0
Location:Ohio  Entered:2014-04-29
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:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3FZ74 IMRA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Client felt dizzy and vomited.

VAERS ID:529880 (history)  Vaccinated:2014-03-03
Age:20.0  Onset:2014-03-03, Days after vaccination: 0
Gender:Female  Submitted:2014-04-30, Days after onset: 57
Location:Unknown  Entered:2014-04-30
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: WAES1404USA015675
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J006953 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to an unspecified number of patients of unknown ages and genders. On an unknown date, the patients were vaccinated with M-M-R II (dose, route and lot number were not reported), vaccine had been exposed to multiple excursions with highest temperature reaching 57F for total time of 206 hours and these vaccines stability could not be supported. No adverse effects reported. This is one of several reports from the same source. Follow up information was received with patient identifiers. This case reported that M-M-R II (dose and route not reported, lot# J006953, therapy type unknown, expired date 07-JUN-2015, also reported as 07-JUL-2015) was administered to a 20 year old patient on 03-MAR-2014. This is case 3 of 3 patients which were exposed to M-M-R II. This case was linked to cases: 1403USA006581 and 1404USA015674. Additional information has been requested.

VAERS ID:530551 (history)  Vaccinated:2014-04-05
Age:20.0  Onset:2014-04-17, Days after vaccination: 12
Gender:Male  Submitted:2014-05-09, Days after onset: 22
Location:Minnesota  Entered:2014-05-09
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: Past medical history: Infectious mononucleosis, hepatomagaly, Acne vulgaris, Esophageal reflux, ADHD. No known allergies.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV349A0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ16310IMRA
Administered by: Military     Purchased by: Military
Symptoms: Acne, Cellulitis, Facial pain, Nausea, Pain of skin, Rash, Rash erythematous, Salivary hypersecretion, Tenderness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypersensitivity (narrow)
Write-up: Member states he woke up and noticed some bumps on his face and scalp that were somewhat painful. He states his mouth was ver watery too. He states that since waking, he has felt nauseous. Seen at Hospital - Provider states seeing"small red bump on the left occipital scalp similar appearance to acne, smallwhite head visualized. Tender to palpation, Tender red bump below the lower lip in midline chin, No abscesses. Prescribed Keflex Diagnosed at hospital with Cellulitis. Member came into clinic on 9 May 2014 and states the Keflex worked and everything cleared up.

VAERS ID:530560 (history)  Vaccinated:2014-04-17
Age:20.0  Onset:2014-05-05, Days after vaccination: 18
Gender:Female  Submitted:2014-05-09, Days after onset: 4
Location:Arizona  Entered:2014-05-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, Adderall
Current Illness: NONE
Preexisting Conditions: Allergies, ADHD
Diagnostic Lab Data: Lab work has not returned
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J0109931IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Grip strength decreased, Impaired driving ability, Laboratory test
SMQs:, Arthritis (broad)
Write-up: Severe joint pain of hands, fingers, feet and toes. Unable to hold even a glass of water or drive.

VAERS ID:530674 (history)  Vaccinated:2014-05-02
Age:20.0  Onset:2014-05-04, Days after vaccination: 2
Gender:Female  Submitted:2014-05-04, Days after onset: 0
Location:Texas  Entered:2014-05-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB skin test
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J013069 SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4869AA UNAR
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J009987 SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Local swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Cellulitis to (R) arm, redness, swelling and itching.

VAERS ID:530719 (history)  Vaccinated:2014-04-24
Age:20.0  Onset:2014-04-25, Days after vaccination: 1
Gender:Female  Submitted:2014-05-12, Days after onset: 17
Location:Massachusetts  Entered:2014-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0118890SCLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness, tenderness at injection site w/in 24 hrs. Referred to PCP - treated with Antibiotics x 10 days.

VAERS ID:530738 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Unknown  Submitted:2014-05-13
Location:Unknown  Entered:2014-05-13
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: IgM/IgG index ratio (11 days after rash onset): 0.2; Measles-specific IgG avidity (3 days after rash onset): High (82%); Measles-specific IgG avidity (6 days after rash onset): High (70%); Measles-specific IgG avidity (11 days after rash onset): High (73%); 2011, Body temperature, 38.9 degrees C; 2011, Measles antibody, Positive, 3 days after rash onset; 2011, Measles antibody, Positive, 11 days after rash onset; 2011, Measles antibody, Positive, 11 days after rash onset; 2011, Measles antibody, Positive, 6 days after rash onset; 2011, Measles antibody, Positive, 3 days after rash onset; 2011, Measles antibody, Positive, 6 days after rash onset; 2011, Neutralising antibodies, 87.155 mIU/mL, 3 days after rash onset; 2011, Neutralising antibo
CDC Split Type: WAES1405USA005755
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure to communicable disease, Measles antibody positive, Measles post vaccine, Morbillivirus test positive, Neutralising antibodies, Oropharyngeal pain, Polymerase chain reaction, Pyrexia, Rash generalised, Vaccination failure
SMQs:, Anaphylactic reaction (broad), Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: This literature marketed report as received from a physician refers to a 20 year old patient of unknown gender (case 3 in the article). The patient had no pertinent medical history. The patient was vaccinated with MMR vaccine (manufacturer unknown) in 1992 and 1996. Strength, dose and lot number were unknown. During a measles outbreak in 2011 suspected patients and contacts were investigated. A 22 year old female patient (also referred to as the index patient by the authors) was noted to have measles despite receipt of two doses of MMR through routine surveillance at the Department of Health and Mental Hygiene (see linked case 1405USA004782). Eighty-eight exposed contacts aged 20-65 years were identified during the index patient''s infectious period, of whom 66 (75%) had documentation of immunity, 10 (11%) were not immune to measles at the time of exposure, and 12 (14%) had unknown immune status. Four additional measles patients were identified among contacts of the index patient. Three of the secondary patients were healthcare workers at a clinic where the index patient received care and were exposed to the index patient on her day of rash onset. The other secondary patient (the patient in this case) was a coworker of the index patient and was exposed to the index patient 2 days prior to her rash onset. The secondary patients had no epidemiologic links to any other patient with measles. These secondary patients had a generalized rash with onset between days 12 and 16 after exposure to the index patient. Two of the secondary patients had 2 documented doses of MMR vaccine and 2 had prior positive measles IgG antibody results. The patient in this case is one of the 2 secondary patients with documented doses of MMR vaccine (for other patient, see linked case 1405USA005754). On an unknown date in 2011 the patient developed rash, sore throat and fever (38.9 degrees Celsius). Measles was confirmed by laboratory testing. The patient was positive for measles IgG and measles IgM antibodies 3, 6 and 11 days after rash onset. Eleven days from rash onset, IgM/IgG index ratio was 0.2. Measles reverse transcription polymerase chain reaction from nasopharyngeal specimens was positive for measles RNA. Sequencing for genotype was not done. IgG activity was high 3, 6 and 11 days after rash onset (82%, 70% and 73% respectively). Measles neutralizing antibody titer, measured by plaque reduction neutralization (PRN) test, was 87.155 mIU/mL 3 days after rash onset, 221.291 mIU/mL 6 days after rash onset and 168.036 mIU/mL 11 days after rash onset. Duration of rash was 4 days. The patient was not hospitalized and there were no complications. Patient outcome was not specified. An additional 231 contacts were identified as exposed to the secondary patients. No tertiary cases were identified among these contacts. Per the authors, this was the first report in which a person with a verified secondary vaccine failure despite receipt of two doses of MMR was demonstrated to be capable of transmitting disease to other individuals. The laboratory results of intermediate or high-avidity IgG antibody indicated that the index patient and all of the secondary patients had past immunologic experience with measles through vaccination or natural measles infection. However, the index patient''s relatively high IgM to IgG ratio was typical of a primary response, whereas those of the 4 secondary patients were consistent with a secondary immune response. The 4 secondary patients all had an early and robust antibody response within a few days after rash onset, with PRN titers 6-60 times higher than those observed after primary infection with natural disease or following measles vaccination. Despite $g200 exposures identified through investigations following notification of the 4 secondary patients, no additional cases were detected. Per authors, this was in agreement with other published investigations describing a lack of transmission by documented cases of secondary vacci

VAERS ID:530743 (history)  Vaccinated:1994-05-23
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-05-13
Location:Unknown  Entered:2014-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: Unknown
Preexisting Conditions: Irritable bowel syndrome; Asthma
Diagnostic Lab Data: Hepatitis B antibosy, Negative
CDC Split Type: WAES1405USA006218
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER1301W2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis B antibody negative, Underdose
SMQs:
Write-up: This spontaneous report as received from a other registered nurse refers to a 20 year old female patient. The patient''s pertinent medical history included asthma and irritable bowel syndrome (IBS). No drug reactions/allergies. On 27-DEC-1993 the patient was vaccinated with hepatitis b vaccine (recombinant) (manufacturer unknown)) dose 1, 5 MCG/0.5 ml, intramuscular. On 28-JAN-1994 and on 23-MAY-1994 the patient received respectively dose 2 and dose 3 (5MCG/0.5 ml intramuscular). The lot number provided for all 3 of those doses is 1301W. Concomitant therapies included ALBUTEROL. Recently the patient was found to have negative antibody titers for hepatitis B. The outcome and the causal relationship were not provided. Furthermore it was reported that the patient on 28-APR-2014 received a pediatric dose of RECOMBIVAX HB (captured in MARRS 1405USA00093). Additional information has been requested.

VAERS ID:531060 (history)  Vaccinated:2014-04-22
Age:20.0  Onset:2014-04-23, Days after vaccination: 1
Gender:Male  Submitted:2014-05-15, Days after onset: 22
Location:California  Entered:2014-05-16, 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: Unknown
Current Illness: UNK
Preexisting Conditions: None
Diagnostic Lab Data: Troponin I, 01MAY2014, <0.10 NG/ML; ECG, 01MAY2014, Normal
CDC Split Type: 2014SA061240
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR  IDUN
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Bronchitis, Chest pain, Dyspnoea, Electrocardiogram normal, Headache, Pyrexia, Troponin I normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Initial information was received on 12 May 2014 from an investigator participating in a trial. A 20-year-old male subject, with no relevant medical history, received the following vaccines on 22 April 2014: ACAM2000 (lot number, route and site of administration not reported); typhoid vaccine (manufacturer, lot number, route and site of administration not reported); and anthrax vaccine (other manufacturer, lot number, route and site of administration not reported). One day post-vaccination, on 23 April 2014, he developed chest pain and shortness of breath, headache, and fever. He was seen in the emergency room and diagnosed with bronchitis. On 01 May 2014, ECG and troponin I levels were normal (troponin <0.10 ng/mL). Treatment included MUCINEX, beginning 26 April 2014. The event was considered to be possible myopericarditis, was moderate, and was still ongoing at the time of the report. The investigator considered the event to be possibly related to study vaccine. Documents held by sender: None.

VAERS ID:531165 (history)  Vaccinated:2014-05-09
Age:20.0  Onset:2014-05-10, Days after vaccination: 1
Gender:Female  Submitted:2014-05-16, Days after onset: 6
Location:Rhode Island  Entered:2014-05-19, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: CBC Dif, normal; Strep rapid, negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEURJ17450IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURH14821IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Differential white blood cell count normal, Full blood count normal, Infectious mononucleosis, Oropharyngeal pain, Streptococcus test negative, Throat irritation, Tonsillitis, Urticaria
SMQs:, Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (narrow), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Developed sore throat 24 hours after vaccines exudative tonsillitis with neg strep, CBC nl. Past hx mono and rash developed day 6. Day 7 rash -$g urticarial, throat clearing.

VAERS ID:531263 (history)  Vaccinated:2014-05-08
Age:20.0  Onset:2014-05-18, Days after vaccination: 10
Gender:Female  Submitted:2014-05-20, Days after onset: 2
Location:Ohio  Entered:2014-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J0081530UNLA
Administered by: Public     Purchased by: Public
Symptoms: Eye pain, Limb discomfort, Pyrexia, Rash generalised
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Hypersensitivity (narrow)
Write-up: Fever, eyes hurt, legs feels "weird when walking", rash started on face, rash on stomach, neck back.

VAERS ID:531304 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-05-19
Location:Unknown  Entered:2014-05-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: UNK
Preexisting Conditions: Smoker; No other injections received
Diagnostic Lab Data: Body temperature, Unknown, 103 Degrees F; WBC, Unknown, 22.8, 10E3/MCL
CDC Split Type: 2014SA063512
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Other     Purchased by: Other
Symptoms: Chills, Inflammation, Injection site erythema, Injection site oedema, Injection site warmth, Leukocytosis, Pyrexia, Vomiting, White blood cell count increased
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), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Initial report was retrieved via a search of scientific literature on 14 May 2014. This case contains information for 1 of 5 patients whose clinical data were provided. Information regarding the other 4 patients are captured in case numbers 2014SA063502, 2014SA063511, 2014SA063513 and 2014SA063514. Verbatim from the abstract: Background: Fever, leukocytosis, and large local reactions following the pneumococcal polysaccharide vaccine (PS23) have been described only in isolated case reported in the adult literature. Such atypical reactions can pose difficulty to providers when determining management. Patients experiencing this noninfectious reaction may receive unnecessary treatment if the diagnosis of robust inflammatory response to the PS23 vaccine is not considered. Observations: This is a clinical case series of 5 adult patients who received the influenza and PS23 vaccines and experienced a cellulitis-like reaction, fever, and leukocytosis in the days following vaccination. Four of the five patients received the influenza and PS23 vaccines in the same arm. The patient who received the vaccines in opposite arms had the local findings in the arm that received the PS23 vaccine. All 5 patients sought care and 4 were admitted to the hospital for observation or treatment with intravenous antibiotics. Conclusions: This case series highlights potential side effects of the PS23 vaccine that are not well described in the adult literature. Antibiotics were not helpful in treating these patients'' local and systemic symptoms. Patients with histories consistent with that highlighted in this case series may avoid antibiotics and hospitalization if the providers recognize these symptoms as a noninfectious reaction to the PS23 vaccine. Regarding this case which involves a 20-year-old male patient, with a medical history of smoking, who had received on an unspecified date the following vaccines: an injection of influenza vaccine (manufacturer, lot number, route and anatomical side of administration not reported) and an injection of 23 valent pneumococcal polysaccharide vaccine (manufacturer, lot number, route and anatomical side of administration not reported) vaccine in the same arm. Within 1 day after the vaccination, the patient developed fever with a maximum of 103 degrees F, vomiting and rigors. The patient also developed local erythema, edema and warmth at the site of injection. The patient had significant leukocytosis with a white blood cell (WBC) of 22.8 K/uL. The patient was hospitalized (dates not reported). He received a corrective treatment with antibiotics in the hospital and post discharge. According to the reporter, within 5-7 days all patients experienced improvement in the skin findings and resolution of the systemic symptoms. Outcome was recovered for systemic symptoms and unknown for local reaction. Documents held by sender: none.

VAERS ID:531307 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-05-20
Location:Unknown  Entered:2014-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Tobacco user
Preexisting Conditions:
Diagnostic Lab Data: Body temperature increased, 103 F; White blood cell count, 22.8 K/uL
CDC Split Type: WAES1405USA008574
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Other     Purchased by: Other
Symptoms: Chills, Inflammation, Injection site cellulitis, Injection site erythema, Injection site swelling, Injection site warmth, Leukocytosis, Oedema, Pyrexia, Vomiting, White blood cell count increased
SMQs:, Cardiac failure (broad), 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), Cardiomyopathy (broad)
Write-up: This literature marketed report as received from a other health professional refers to a 20 year old male patient with smoking. This is case 3 of 5 reports. Patient''s medical history was not reported. On an unknown date the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (manufacturer unknown) (dose and frequency unknown) in the arm. Other suspect therapies included influenza virus vaccine (manufacturer unknown). Both the vaccination were received in the same arm. Patient''s concomitant medication was not reported. On an unknown date the patient experienced large local inflammatory reactions (erythema, oedema and warmth) (hospitalization), fever (hospitalization), leucocytosis (hospitalization), rigors (hospitalization), presumed cellulitis (hospitalization) and vomiting (hospitalization). The patient''s laboratory results included WBC 22.8K/microliter and Maximum temperature 103 degree F. The patient sought care within 2-3 d of vaccination and was admitted to the hospital for observation, with or without treatment of presumed cellulitis. Patient received full courses of antibiotics to cover for common skin flora as well as methicillin-resistant staphylococcus aureus. Within 5-7 days, the patient experienced improvement in the skin findings and resolution of the systemic symptoms. In one patient, the local swelling and erythema at the injection site lasted about 2 weeks. The outcome of the events localized inflammation, injection site erythema, warmth and swelling and presumed cellulitis was considered resolving and outcome of fever, leucocytosis, rigors and vomiting was considered as resolved. The reporter considered the events to be not related to influenza virus vaccine (manufacturer unknown). The reporter considered the events to be related to Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown). The author stated that "the 5 patients in this series all had leucocytosis, fever and large local inflammatory reactions following influenza vaccine (manufacturer unknown) and Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown). Based on the known side effects of Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown), the lack of similar findings in patients who receive the influenza vaccine (manufacturer unknown) and the patient 2''s lack of influenza vaccine (manufacturer unknown) associated local symptoms we believe these reactions were due to Pneumococcal Vaccine, Polyvalent (23-valent) (manufacturer unknown)". This case is linked to case # 1405USA008573, 1405USA007995, 1405USA008575 and 1405USA008576.

VAERS ID:531376 (history)  Vaccinated:2014-05-06
Age:20.0  Onset:2014-05-16, Days after vaccination: 10
Gender:Male  Submitted:2014-05-20, Days after onset: 4
Location:California  Entered:2014-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen and acetaminophen
Current Illness: None noted
Preexisting Conditions: None noted
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV349A0IMRA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR17MON0OTLA
Administered by: Military     Purchased by: Military
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt went to the ER 10 days post vaccination with ACAM2000. Has local itchy rash, non-pustular. Pt was given Benadryl, Zofran, and Zantac and discharged to home.

VAERS ID:531786 (history)  Vaccinated:2014-05-05
Age:20.0  Onset:2014-05-22, Days after vaccination: 17
Gender:Male  Submitted:2014-05-23, Days after onset: 1
Location:California  Entered:2014-05-23
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURU402420OTLA
Administered by: Military     Purchased by: Military
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Generalized rash for 2 days (possible generalized vaccinia). Not itchy but bumpy. No treatment given. Reassurance that the patient is ok.

VAERS ID:531842 (history)  Vaccinated:2014-05-21
Age:20.0  Onset:2014-05-21, Days after vaccination: 0
Gender:Female  Submitted:2014-05-23, Days after onset: 2
Location:Maryland  Entered:2014-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Temp 98.2 5-23-14
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH926AA0UNLA
Administered by: Military     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria, hives left neck, right side of face, bilateral lower legs topical anti-itch applied in occupational health. Advise f/u with PCP.

VAERS ID:532065 (history)  Vaccinated:2014-04-16
Age:20.0  Onset:2014-04-16, Days after vaccination: 0
Gender:Female  Submitted:2014-05-23, Days after onset: 37
Location:New Jersey  Entered:2014-05-23
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: WAES1405USA009786
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 3SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from the patient''s mother refers to a 20 year old female patient. In approximately 2009 "four or five years ago", the patient had already completed the series of three GARDASIL injections (dose, route and frequency were not reported), given by her primary physician. On 16-APR-2014, the patient was vaccinated with the "first" injection of GARDASIL (dose, route and frequency were not reported), by her gynecologist. The patient''s mother stated that the patient was not complaining of any adverse reactions at the time of the report. The patient did not seek medical attention. At the time of the report, the patient''s outcome of "received an injection of GARDASIL after already completing the series of three" was unknown. Additional information has been requested.

VAERS ID:531960 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:North Carolina  Entered:2014-05-26
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J006953 IMUN
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Mom stated he has headache, dizziness, fever and aches which start 12 days after vaccine given.

VAERS ID:532063 (history)  Vaccinated:2014-05-27
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-05-27
Location:Ohio  Entered:2014-05-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: Vaccine given on 5/27/14 had expired on 5/14/14. No adverse events noted. Patient re-vaccinated the same day.

VAERS ID:532193 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:2013-05-01
Gender:Female  Submitted:2014-05-28, Days after onset: 392
Location:California  Entered:2014-05-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PRILOSEC
Current Illness: Gastrooesophageal reflux disease
Preexisting Conditions:
Diagnostic Lab Data: A routine PAP Smear was positive for HPV on an unspecified date a year ago. No result from a repeat PAP smear obtained on 22-MAY-2014 was available yet.
CDC Split Type: WAES1405USA012666
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Human papilloma virus test positive, Smear cervix
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 22 year old female patient with reflux and no known drug reactions/allergies. On unknown dates the patient was vaccinated with three doses of GARDASIL (dose and route was not reported). Concomitant therapies included PRILOSEC. In approximately May 2013, a routine Papanicolaou (PAP) Smear was positive for HPV on an unspecified date a year ago. Physician additionally stated there was "no inflammation". No treatment was given for the patient. No result from a repeat PAP smear obtained on 22-MAY-2014 was available yet. At the time of the report, the outcome of the event was unknown. Additional information has been requested.

VAERS ID:532226 (history)  Vaccinated:2014-03-25
Age:20.0  Onset:2014-03-25, Days after vaccination: 0
Gender:Female  Submitted:2014-05-28, Days after onset: 64
Location:New York  Entered:2014-05-28
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: WAES1405USA012800
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0056610UNLA
Administered by: Private     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a healthcare worker refers to an unspecified number of patients of unknown age and gender. On an unknown date, the patients were vaccinated with a dose of GARDASIL (dose, lot# and expiration date not reported) that was exposed to 20 F for an unspecified period of time, which was excursion that was unsupported by in-house stability data. No adverse symptoms were reported. Follow up information has been received on 24-APR-2014 from a nurse. The reporter mentioned that "30 patients or less" received improperly stored GARDASIL that was exposed to 20F for 11 days. Administration dates, lot # and expiration dates were not reported. Follow up information was received a health center manager. The patients identifiers were obtained. This report concerns one of the patients. On 25-MAR-2014 at 14:00, the 20 year old female patient was vaccinated with the first dose of GARDASIL (lot # J005661, exp. 26-SEP-2014) into left deltoid (dose, route not reported). The medication refrigerator was out of range on the following dates: Jan 07, temperature (Degrees Fahrenheit) 44/26; Jan 09, 36/22; Jan 11, 26/40; Jan 14, 22/26; Jan 16, 26; Jan 20, 28/32; Jan 25, 22; Jan 27, 24/26; Jan 28, 20/20; Feb 17, 20/20; Mar 20, 26/40. This is one of several reports received from the same source. Additional information is not expected.

VAERS ID:532227 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:2014-03-17
Gender:Female  Submitted:2014-05-28, Days after onset: 72
Location:New York  Entered:2014-05-28
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: WAES1405USA012799
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0208480UNRA
Administered by: Private     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a healthcare worker refers to an unspecified number of patients of unknown age and gender. On an unknown date, the patients were vaccinated with a dose of GARDASIL (dose, lot # and expiration date not reported) that was exposed to 20 F for an unspecified period of time, which was excursion that was unsupported by in-house stability data. No adverse symptoms were reported. Follow up information has been received on 24-APR-2014 from a nurse. The reporter mentioned that "30 patient or less" received improperly stored GARDASIL that was exposed to 20F for 11 days. Administration dates, lot # and expiration dates were not reported. Follow up information was received a health center manager. The patients'' identifiers were obtained. This report concerns one of the patients. On 17-MAR-2014 at 09:15, the 20 year old female patient was vaccinated with the first dose of GARDASIL (lot # H020848, exp. 03-APR-2015) into right deltoid (dose, route not reported). The medication refrigerator was out of range on the following dates: Jan 07, temperature (Degrees Fahrenheit) 44/26; Jan 09, 36/22; Jan 11, 26/40; Jan 14. 22/26; Jan 16, 26; Jan 20, 28/32; Jan 25, 22; Jan 27, 24/26; Jan 28, 20/20; Feb 17,26/20. This is one of several reports received from the same source. Additional information is not expected.

VAERS ID:532314 (history)  Vaccinated:2014-05-01
Age:20.0  Onset:2014-05-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Mexico  Entered:2014-05-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: GILDESS FE; FLONASE; FLOVENT; Albuterol; SINGULAIR
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J009723 SCRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The evening of the day the pt received vaccine she developed approximately 5cm swelling, aching at site of injection and a warm, red "patch" developed. No fever. The swelling worsened over 2 days and red patch grew to encompass the entire back side of arm from injection site to elbow. She sought out MD on Saturday and took BENADRYL. By May 5th when the student came back to see nurse, the swelling had mostly resolved as did the redness and pain.

VAERS ID:532430 (history)  Vaccinated:2014-05-28
Age:20.0  Onset:2014-05-28, Days after vaccination: 0
Gender:Unknown  Submitted:2014-05-29, Days after onset: 1
Location:Unknown  Entered:2014-05-29
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: WAES1405USA014886
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse refers to a 20 year old patient. On 03-AUG-2009, the patient was vaccinated with the first dose of GARDASIL (dose, route and lot # not reported) and on 28-MAY-2014, the patient received the second dose of GARDASIL (dose, route and lot # not reported). No adverse symptoms were reported. Additional information has been requested.

VAERS ID:532587 (history)  Vaccinated:2014-01-11
Age:20.0  Onset:2014-02-12, Days after vaccination: 32
Gender:Male  Submitted:2014-06-01, Days after onset: 108
Location:Texas  Entered:2014-06-01
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: Heart catherization, blood work and xrays
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS 1  
Administered by: Public     Purchased by: Private
Symptoms: Blood test, Catheterisation cardiac, Myocarditis, Pericarditis, X-ray
SMQs:, Systemic lupus erythematosus (broad), Cardiomyopathy (broad), Chronic kidney disease (broad)
Write-up: Myocarditis and pericarditis.

VAERS ID:532814 (history)  Vaccinated:2014-05-30
Age:20.0  Onset:2014-05-31, Days after vaccination: 1
Gender:Male  Submitted:2014-06-02, Days after onset: 2
Location:Maryland  Entered:2014-06-02
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
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR56508 IMUN
Administered by: Public     Purchased by: Private
Symptoms: Groin pain, Muscle strain
SMQs:, Accidents and injuries (narrow), Osteonecrosis (broad)
Write-up: Groin pain. Saw pediatrician 6/2/14 - muscle strain.

VAERS ID:533150 (history)  Vaccinated:2014-05-29
Age:20.0  Onset:2014-05-29, Days after vaccination: 0
Gender:Female  Submitted:2014-06-06, Days after onset: 8
Location:Georgia  Entered:2014-06-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt had PPD on May 7, 2014. Did not report until after reaction.
Current Illness: None
Preexisting Conditions: NKDA; PCOS; Migraines
Diagnostic Lab Data: Prior to vaccination, Pt had positive titer for varicella but it was "barely" in range and hospital would not accept this for clinicals. Requested she have another vaccination.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0170101SCRA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Erythema, Oedema peripheral, Pain in extremity, Pruritus, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Has Large red edematous area 100mm x 75mm to right arm with brownish-red edema with 4-5 vesicles in center this area is about 40mm. Warm to touch, tender, itching painful. No difficulty breathing or swallowing reported.

VAERS ID:533840 (history)  Vaccinated:2014-06-12
Age:20.0  Onset:2014-06-13, Days after vaccination: 1
Gender:Female  Submitted:2014-06-13, Days after onset: 0
Location:Texas  Entered:2014-06-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0065721SCLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Red circle around injection site. several itchy red bumps on both legs not sure if bug bites or related to arm reaction.

VAERS ID:533903 (history)  Vaccinated:2014-05-20
Age:20.0  Onset:2014-06-08, Days after vaccination: 19
Gender:Male  Submitted:2014-06-16, Days after onset: 8
Location:Texas  Entered:2014-06-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0OTLA
Administered by: Military     Purchased by: Military
Symptoms: Papule
SMQs:
Write-up: Approximately 06/06/14 pt developed asymptomatic papules on the dorsal side of hands, elbows and knees.

VAERS ID:533995 (history)  Vaccinated:2014-06-09
Age:20.0  Onset:2014-06-09, Days after vaccination: 0
Gender:Unknown  Submitted:2014-06-16, Days after onset: 7
Location:Unknown  Entered:2014-06-16
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: WAES1406USA005816
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 20 year old patient. The patient pertinent medical history was not reported. On 09-JUN-20114 the patient was inadvertently vaccinated with pediatric dose of RECOMBIVAX HB. Concomitant medications were not reported. The physician also stated that the dose given on 09-JUN-2014 would be the patient's fourth dose of RECOMBIVAX HB. The physician stated that the patient had the complete series "as an infant" but that the patient''s school was requiring a second series to be administered. No information on titers was reported. No adverse effects reported. The outcome of received pediatric dose and dose given on 09-JUN-2014 would be patient''s fourth dose of RECOMBIVAX HB was unknown. Additional information is not expected.

VAERS ID:533999 (history)  Vaccinated:2013-12-01
Age:20.0  Onset:2013-12-01, Days after vaccination: 0
Gender:Male  Submitted:2014-06-16, Days after onset: 196
Location:Unknown  Entered:2014-06-16
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: WAES1406USA007652
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist via sales representatives refers to a 20 year old male patient. No information about medical history, concurrent conditions and concomitant medications were reported. Approximately on an unknown date in December 2013 (reported as 7 months ago) the patient was vaccinated with ZOSTAVAX (route and dose not reported). The reported stated that the patient was 20 year old patient and was administered ZOSTAVAX. No adverse effects reported. The outcome of events reported is unknown. No product quality complaint was involved. Additional information has been requested.

VAERS ID:534163 (history)  Vaccinated:2014-06-04
Age:20.0  Onset:2014-06-13, Days after vaccination: 9
Gender:Female  Submitted:2014-06-17, Days after onset: 4
Location:Alaska  Entered:2014-06-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergic to several types of animals, including dogs, cats, rabbits, horses, and dustmites.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC199AA  LA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS793JR  RA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J012083  RA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4426AA  LA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H014194  LA
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever during the nights of 06/13/2014 and 06/14/2014. A small rash appeared on stomach during PM of 06/15/2014 which had spread to face and chest by 06/16/2015. Rash is slightly itchy.

VAERS ID:534208 (history)  Vaccinated:2014-06-12
Age:20.0  Onset:2014-06-12, Days after vaccination: 0
Gender:Female  Submitted:2014-06-12, Days after onset: 0
Location:Virginia  Entered:2014-06-17, 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: ORTHOCYLEN
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1860AA0IMLA
Administered by: Public     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)
Write-up: Less than 30 second episode of syncope s/p GARDASIL vaccination. Patient regained consciousness and was laid supine 2 legs elevated, ice pack to back of neck. Patient remained in office for 15 additional minutes, with boyfriend at bedside. No adverse effects noted. Patient pink, denied dizziness and was released to home with boyfriend.

VAERS ID:534284 (history)  Vaccinated:2014-06-18
Age:20.0  Onset:2014-06-18, Days after vaccination: 0
Gender:Male  Submitted:2014-06-18, Days after onset: 0
Location:Massachusetts  Entered:2014-06-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PT DENIED TAKING ANY MEDICATIONS
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.K0009430IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURK11830IMLA
Administered by: Other     Purchased by: Other
Symptoms: Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: PT REMAINED CONSCIOUS, BECAME PALE AND DIAPHORETIC. NO S/SX OF RESP. DISTRESS, NO CHEST PAIN. Pt remained in sitting position. Pt denied any allergies prior to vaccine, and did not indicate taking any medications.

VAERS ID:534309 (history)  Vaccinated:2014-05-20
Age:20.0  Onset:2014-05-20, Days after vaccination: 0
Gender:Female  Submitted:2014-06-18, Days after onset: 29
Location:California  Entered:2014-06-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4678AA1IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0082291SCLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Erythema, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: WITHIN ONE MINUTE OF RECEIVING VACCINES, PATIENT FELT DIZZY AND FELT FAINT. SHE WAS SWEATING PROFUSELY AND HER FACE WAS RED. WITHIN 5-10 MINUTES OF RECEIVING THE VACCINES, HER SYMPTOMS SUBSIDED.

VAERS ID:534325 (history)  Vaccinated:2014-06-18
Age:20.0  Onset:2014-06-18, Days after vaccination: 0
Gender:Female  Submitted:2014-06-18, Days after onset: 0
Location:Delaware  Entered:2014-06-18
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: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSFB3A30IMUN
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: 10 mins after vaccine given, pt complained of blurred vision, dizziness and increased sweating. Called pt''s PCP and she said to check pt''s bp and see if the pt wanted to go to a walk in clinic.

VAERS ID:534609 (history)  Vaccinated:2014-02-19
Age:20.0  Onset:2014-02-19, Days after vaccination: 0
Gender:Male  Submitted:2014-06-21, Days after onset: 121
Location:California  Entered:2014-06-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VIMPAT; Lamotrigine; Folic Acid; Levetiracetam; Lorazepam
Current Illness: Seizure/convulsions
Preexisting Conditions: Seizures
Diagnostic Lab Data: Pt to discuss with neurology.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1310101 IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0122120IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4593AB1IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0068051SCRA
Administered by: Public     Purchased by: Public
Symptoms: Condition aggravated, Seizure like phenomena
SMQs:, Convulsions (narrow)
Write-up: Mother stated patient had an increase in seizure activity after administration (pt has hx of seizures) mother just notified clinic today (6/21/14).

VAERS ID:534891 (history)  Vaccinated:2014-06-11
Age:20.0  Onset:2014-06-11, Days after vaccination: 0
Gender:Unknown  Submitted:2014-06-24, Days after onset: 13
Location:Unknown  Entered:2014-06-24
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: WAES1406USA009509
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report was received from a registered nurse refers to a 20 years old patient of unknown gender. Medical history was not reported. On 11-JUN-2014 the patient was vaccinated with ZOSTAVAX, lot number, expiration date, strength, dosage and route was not reported. Concomitant therapy was not reported. The reported informed the on 11-JUN-2014 the patient was mistakenly administered ZOSTAVAX instead of VARIVAX. No adverse effects were reported. Additional information is not expected.

VAERS ID:535313 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-06-28
Location:Unknown  Entered:2014-06-28
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: Prophylaxis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1406USA013029
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 3UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report was received from a medical assistant via a field employee regarding a female patient in her 20''s. No information about medical history, drug reactions and allergies was specified. On an unknown ate in 2006, about 8 years ago, the patient was vaccinated with GARDASIL (dose, route not reported)(medical assistant believes that "all 3 doses were given about 8 years ago"). No concomitant medications were reported. The reporter reported to the field employee, "that an adult female patient in her 20''s" received an extra dose of GARDASIL), (a 4th dose on an unspecified date). No adverse effects were reported. The outcome of the event is unknown. The causality of the event was not specified by the reporter. Additional information has been requested.

VAERS ID:535354 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-06-28
Location:Unknown  Entered:2014-06-28
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: WAES1406USA012319
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  SCAR
Administered by: Other     Purchased by: Other
Symptoms: 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 medical assistant via a field employee regarding an adult (reported as some age within his 20''s, exact age not known), male patient. No information about medical history, drug reactions and allergies was specified. On an unknown date in approximately May 2014 (reported as about a month ago), the patient was vaccinated with PNEUMOVAX23 (dose not reported) vial, subcutaneously. No concomitant medications were reported. On an unknown date the patient developed swelling at the injection site and swelling continued to the patient''s elbow of the arm injection was given. The field employee also reported that the medical assistant reported to her that this patient sought medical attention, had to go to emergency room because of this (it is not know whether the patient stayed overnight and the hospital name is unspecified). There was no product quality complaint with PNEUMOVAX23. The outcome of the event is unknown. The causality of the event was not specified by the reporter. Additional information has been requested.

VAERS ID:535969 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-07-04
Location:Unknown  Entered:2014-07-04
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: Hepatitis B virus test, low titer not provided
CDC Split Type: WAES1407USA000019
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis B antibody negative
SMQs:
Write-up: This spontaneous report as received from a nurse regarding a 20 year old male patient. On an unknown date the patient was vaccinated with RECOMBIVAX HB (lot #, dosage regimen were unspecified). Concomitant medications were not reported. On an unknown date the patient had titers drawn at unspecified physician office which indicated he has not responded to the series of hepatitis B vaccine which he received. Reporter stated that vaccine series were administered by another physician practice (unspecified), and she had no original vaccination series data and original product used for patient vaccination. Patient had not experienced any adverse effect due to low titers. The causality and outcome of event was unknown. Additional information has been requested.

VAERS ID:536791 (history)  Vaccinated:2014-06-09
Age:20.0  Onset:2014-07-05, Days after vaccination: 26
Gender:Female  Submitted:2014-07-16, Days after onset: 11
Location:New York  Entered:2014-07-16
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: Corrective lens user
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1407USA005990
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0132771IMLA
Administered by: Other     Purchased by: Other
Symptoms: Disorientation, Retinal detachment, Vision blurred
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow)
Write-up: This spontaneous report as received from a physician refers to a 20 years old female patient. The patient did not have pertinent medical history and no drug reactions/allergies. In October 2013 (date unspecified) the patient was vaccinated with first dose of GARDASIL (dose, route, lot # not reported). On 07-JUN-2014 or 08-JUN-2014 the patient was vaccinated with second dose of GARDASIL (dose, route, lot # not reported). There was no concomitant medication. On the morning 05-JUL-2014 the patient woke up with blurred vision in both eyes. She ignored it for the day because she assumed it was her contacts that were causing the issue. On 06-JUL-2014 she awoke with worsening vision and went to unspecified hospital for Emergency Room visit, but they were not helpful. She saw a doctor on 08-JUL-2014 and was diagnosed with Exuda Retinal Detachment in both right and left eyes. The patient was treated with prednisone (manufacturer unknown) 60mg daily. The patient stated she had some improvement but is not fully recovered and the condition is disorienting. No lab diagnostic studies were performed. The relatedness between Exuda Retinal Detachment and GARDASIL was not specified. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:536792 (history)  Vaccinated:2014-07-14
Age:20.0  Onset:2014-07-14, Days after vaccination: 0
Gender:Female  Submitted:2014-07-16, Days after onset: 2
Location:Unknown  Entered:2014-07-16
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: WAES1407USA006629
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect route of drug administration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report was received from a nurse refers to a 20 year old female patient without drug reactions, allergies and medical history. In 2005 the patient was vaccinated with VARIVAX (Merck) 0.5mL, dose 1, subcutaneously. On 14-JUL-2014 the patient was vaccinated with VARIVAX (Merck) 0.5mL, dose 2, intramuscular. There was no concomitant medication. On 14-JUL-2014 the patient experienced brief stinging sensation at the injection site after administration of her second dose of VARIVAX (Merck). The patient sought medical attention and did not receive any treatment for the adverse event. There were not laboratory diagnostics performed. The outcome of brief stinging sensation at the injection site was reported as recovered/resolved on 14-JUL-2014. Additional information has been requested.

VAERS ID:536944 (history)  Vaccinated:2014-07-07
Age:20.0  Onset:2014-07-09, Days after vaccination: 2
Gender:Female  Submitted:2014-07-17, Days after onset: 8
Location:Missouri  Entered:2014-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: None reported
CDC Split Type: MO1408
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.XD72G0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0123271SCLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal distension, Erythema, Local reaction
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Client came into office to have tst read. Client state she just noticed localized reaction of approsimately 4"x3" redness and swelling on backside of left arm. Advised cool compress, ibuprofen for pain and swelling and to contact the pcp if signs and symptoms persist or worsen.

VAERS ID:537002 (history)  Vaccinated:2014-07-18
Age:20.0  Onset:2014-07-18, Days after vaccination: 0
Gender:Female  Submitted:2014-07-18, Days after onset: 0
Location:Michigan  Entered:2014-07-18
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS59D740IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ05020IMLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH841AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling abnormal, Loss of consciousness, Muscle tightness, Musculoskeletal stiffness
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), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: Pt reported feeling "funny" 1-2 min post vaccines. Upon reclining pt developed stiffness of arm, legs, fist - jaw clenched, and loss of consciousness. Pt responded quickly to ammonia inhalant. Pt was alert and examined by physician following episode. Pt kept in office 1 1/2 hrs post episode without further reaction.

VAERS ID:537051 (history)  Vaccinated:2014-07-16
Age:20.0  Onset:2014-07-16, Days after vaccination: 0
Gender:Female  Submitted:2014-07-18, Days after onset: 2
Location:New York  Entered:2014-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: C/O unilateral neck swelling 1 week after shot was given~Influenza (Seasonal) (no brand name)~UN~0.00~Patient
Other Medications: SYMBICORT; PROVENTIL; Hydroxyzine
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: Site is warm to touch; 7/18/14 Agree with assessment above. Pt examined and counseled on site care by me, FNP.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0123271SCLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Injection site pain, Injection site pruritus, Injection site warmth, Pain, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Pt. c/o needle phobia before shot was given. C/O dizziness, itchiness and pain when shot was given. Went to walk-in clinic 1 day after shot c/o generalized itching - slight relief with BENADRYL. Pain - slight relief with Ibuprofen. Main relief with ice.

VAERS ID:537084 (history)  Vaccinated:2014-07-18
Age:20.0  Onset:2014-07-18, Days after vaccination: 0
Gender:Female  Submitted:2014-07-18, Days after onset: 0
Location:Arizona  Entered:2014-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: fever, nausea~Vaccine not specified (no brand name)~UN~16.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS592D31IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Dizzy, tingling, lightheaded 5 mins after shot. Tx- lay down, H2O.

VAERS ID:537271 (history)  Vaccinated:2014-06-18
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-07-18
Location:Oregon  Entered:2014-07-22, 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: AMBIEN; RITALIN; LOESTRIN
Current Illness:
Preexisting Conditions: NKDA; Anxiety; Migraine; Dysmenorrhea
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA130641UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSL7J440UNLA
Administered by: Private     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Incorrect dose administered, No adverse event
SMQs:
Write-up: She was administered Tdap vaccine when she had Tdap vaccine 11-11-05. No adverse effects reported by patient.

VAERS ID:537489 (history)  Vaccinated:2014-06-09
Age:20.0  Onset:2014-06-09, Days after vaccination: 0
Gender:Male  Submitted:2014-06-26, Days after onset: 17
Location:Unknown  Entered:2014-07-23, Days after submission: 27
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
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEUR  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Wrong technique in drug usage process
SMQs:
Write-up: I am Triage RN and work with 4 LVNs in our clinic. On 6/9/14 one of our patients received the yellow fever vaccine, but the wrong diluent was used for the vaccine. Rather than using NaCl, the LVN used sterile water. Each yellow fever vaccine vial should correspond with a bottle of diluent. They each come in packages of 5. Theoretically, when we have to open a new package of vaccines, we should have to open a package of diluents as they correspond 1:1. Upon review, it was noted that in addition to this incident there were 2 extra vials of diluent in our med room. It is unclear why-whether two other patients received the vaccine with the incorrect diluent, or two vaccines were misplaced, etc., and there was no way to find out. We have tried to track this, look back at patient records, etc., to no avail. For the patient that we are sure did receive the vaccine with the incorrect diluent this writer called both the CDC as well as the manufacturer to determine whether there could be any adverse reactions and to ensure that the vaccine would still be effective. Ultimately the Manufacturer stated there has been no studies or data on this, but that they believe that the vaccine would still be immunogenic as the diluent that was used was without preservatives. We attempted to check the titers for this pt to ensure the vaccine was effective, but despite our efforts we were unable to accomplish this prior to his trip.

VAERS ID:538137 (history)  Vaccinated:2013-07-23
Age:20.0  Onset:2013-07-23, Days after vaccination: 0
Gender:Male  Submitted:2014-07-30, Days after onset: 372
Location:Minnesota  Entered:2014-07-30
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: WAES1407USA013020
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 3IMLA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a 20 year old male patient. On 23-JUL-2013 the patient was vaccinated with a fourth dose of GARDASIL (0.5 ml, intramuscular, in the left arm, lot number was not reported). The reporter stated that this error occurred when they were converting paper charts to electronic records. Vaccinations dates of the previous vaccinations with GARDASIL were not reported. The reporter stated that the patient did not experience any adverse effect due to the extra dose of GARDASIL. This is one of several reports from the same reporter. Additional information is not expected because the reported doesn''t want to be contacted.

VAERS ID:538165 (history)  Vaccinated:2014-07-18
Age:20.0  Onset:2014-07-19, Days after vaccination: 1
Gender:Female  Submitted:2014-07-30, Days after onset: 11
Location:Unknown  Entered:2014-07-30
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: WAES1407USA011650
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Eczema, Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a dermatologist concerning a 20 year old female patient. Relevant medical history was not reported. The patient did not have any allergies. On 18-JUL-2014 the patient was vaccinated with first dose of GARDASIL (dose, route and frequency not provided). The patient had no concomitant medications. On 19-JUL-2014, 2 days after onset of therapy the patient developed a rash. The reporter saw the patient on 23-JUL-2014 and described the rash as unspecified systemic eczema. The patient''s unspecified primary care physician initially prescribed an unspecified antihistamine on an unspecified date which did not seem to affect the rash. The dermatologist stated that the rash was on the patient''s face, neck, trunk and extremities. The rash was very itchy. The dermatologist prescribed an injection of CELESTONE, an unspecified topical steroid and BENADRYL for the patient on 23-JUL-2014. The patient sought medical attention. The outcome of events was reported as not recovered/not resolved. The causality of the event with GARDASIL was not reported. Product quality issue was not involved. Upon internal review the events eczema, rash on the patient''s face, neck, trunk and extremities and itchy rash was considered medically significant. Additional information has been requested.

VAERS ID:538253 (history)  Vaccinated:2014-07-28
Age:20.0  Onset:2014-07-28, Days after vaccination: 0
Gender:Female  Submitted:2014-07-31, Days after onset: 3
Location:Illinois  Entered:2014-07-31
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: CVAE0392014
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30007411PO 
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Tightness in throat, trouble breathing, after 1st dose.

VAERS ID:538528 (history)  Vaccinated:2014-08-01
Age:20.0  Onset:2014-08-01, Days after vaccination: 0
Gender:Male  Submitted:2014-08-03, Days after onset: 2
Location:California  Entered:2014-08-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Meloxicam
Current Illness: Pain In Shoulder
Preexisting Conditions: Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR90715 SYRLA
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER90471 SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Headache, Injection site pain, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Fever, Sore Throat, Pain In Injection Area, Headache, and Weakness.

VAERS ID:538672 (history)  Vaccinated:2014-07-01
Age:20.0  Onset:2014-07-01, Days after vaccination: 0
Gender:Unknown  Submitted:2014-08-03, Days after onset: 33
Location:Unknown  Entered:2014-08-03
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: WAES1407USA012944
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0097880UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a 20 year old patient of unknown gender. The patient''s drug allergies and pertinent medical history was not reported. On 01-JUL-2014 the patient was vaccinated with first dose of GARDASIL (dose, frequency and route of administration were not reported) (lot # J009788, expiry date: 17-MAR-2016) which was stored improperly. No adverse effects were noted. No product quality complaint was reported for GARDASIL. This case is linked to 1407USA010956, 1407USA012902, 1407USA012903, 1407USA012904, 1407USA012905, 1407USA012906, 1407USA012907, 1407USA012908, 1407USA012909, 1407USA012910, 1407USA012911, 1407USA012912, 1407USA012913, 1407USA012914, 1407USA012915, 1407USA012916, 1407USA012917, 1407USA012918, 1407USA012919, 1407USA012920, 1407USA012921, 1407USA012922, 1407USA012923, 1407USA012924, 1407USA012925, 1407USA012926, 1407USA012927, 1407USA012928, 1407USA012929, 1407USA012930, 1407USA012931, 1407USA012932, 1407USA012933, 1407USA012934, 1407USA012935, 1407USA012936, 1407USA012937, 1407USA012938, 1407USA012939, 1407USA012940, 1407USA012941, 1407USA012942, 1407USA012943, 1407USA012945, 1407USA012946, 1407USA012947, 1407USA012948, 1407USA012949, 1407USA012950, 1407USA012951, 1407USA012952, 1407USA012953, 1407USA012954, 1407USA012955, 1407USA012956, 1407USA012957, 1407USA012958, 1407USA012959, 1407USA012960, 1407USA012961, 1407USA012962, 1407USA012963, 1407USA012964, 1407USA012965, 1407USA012966, 1407USA012967, 1407USA012968, 1407USA012969, 1407USA012970, 1407USA012971, 1407USA012972, 1407USA012973, 1407USA012974, 1407USA012975, 1407USA012976, 1407USA012977, 1407USA012978, 1407USA012979, 1407USA012980, 1407USA012981, 1407USA012982, 1407USA012983, 1407USA012984, 1407USA012985, 1407USA012986, 1407USA012987, 1407USA012988, 1407USA012989, 1407USA012990, 1407USA012991, 1407USA012992, 1407USA012993, 1407USA012994, 1407USA012995, 1407USA012996, 1407USA012997, 1407USA012998, 1407USA012999, 1407USA013000, 1407USA013013 and 1407USA013014 (same reporter link). Additional information has been requested.

VAERS ID:538718 (history)  Vaccinated:2014-07-10
Age:20.0  Onset:2014-07-10, Days after vaccination: 0
Gender:Male  Submitted:2014-08-03, Days after onset: 24
Location:Unknown  Entered:2014-08-03
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: WAES1407USA012908
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0145841UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0050832UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a 20 year old patient of unknown gender. The patient''s drug allergies and patient medical history was not reported. On 10-JUL-2014 the patient was vaccinated with third dose of GARDASIL (dose, frequency and route of administration were not reported) (lot # K005083, expiry date: 04-NOV-2016) and second dose of VAQTA (dose, frequency and route of administration were not reported) (lot # J014584, expiry date: 16-JAN-2016) which were stored improperly. No adverse effects were noted. No product quality complaint was reported for GARDASIL and VAQTA. This case is linked to 1407USA010956, 1407USA012902, 1407USA012903, 1407USA012904, 1407USA012905, 1407USA012906, 1407USA012907, 1407USA012909, 1407USA012910, 1407USA012911, 1407USA012912, 1407USA012913, 1407USA012914, 1407USA012915, 1407USA012916, 1407USA012917, 1407USA012918, 1407USA012919, 1407USA012920, 1407USA012921, 1407USA012922, 1407USA012923, 1407USA012924, 1407USA012925, 1407USA012926, 1407USA012927, 1407USA012928, 1407USA012929, 1407USA012930, 1407USA012931, 1407USA012932, 1407USA012933, 1407USA012934, 1407USA012935, 1407USA012936, 1407USA012937, 1407USA012938, 1407USA012939, 1407USA012940, 1407USA012941, 1407USA012942, 1407USA012943, 1407USA012944, 1407USA012945, 1407USA012946, 1407USA012947, 1407USA012948, 1407USA012949, 1407USA012950, 1407USA012951, 1407USA012952, 1407USA012953, 1407USA012954, 1407USA012955, 1407USA012956, 1407USA012957, 1407USA012958, 1407USA012959, 1407USA012960, 1407USA012961, 1407USA012962, 1407USA012963, 1407USA012964, 1407USA012965, 1407USA012966, 1407USA012967, 1407USA012968, 1407USA012969, 1407USA012970, 1407USA012971, 1407USA012972, 1407USA012973, 1407USA012974, 1407USA012975, 1407USA012976, 1407USA012977, 1407USA012978, 1407USA012979, 1407USA012980, 1407USA012981, 1407USA012982, 1407USA012983, 1407USA012984, 1407USA012985, 1407USA012986, 1407USA012987, 1407USA012988, 1407USA012989, 1407USA012990, 1407USA012991, 1407USA012992, 1407USA012993, 1407USA012994, 1407USA012995, 1407USA012996, 1407USA012997, 1407USA012998, 1407USA012999, 1407USA013000, 1407USA013013 and 1407USA013014 (same reporter link).

VAERS ID:539125 (history)  Vaccinated:2014-08-04
Age:20.0  Onset:2014-08-04, Days after vaccination: 0
Gender:Female  Submitted:2014-08-06, Days after onset: 2
Location:Unknown  Entered:2014-08-06
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: WAES1408USA002394
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, No adverse event, Wrong drug administered
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This spontaneous prospective pregnancy report as received from registered nurse refers to a 20 year old female patient. Patient medical history was not reported. On 04-AUG-2014 the patient who was 34 weeks pregnant was inadvertently vaccinated with GARDASIL (strength, dose number, frequency, route, lot number and expiry date unknown) instead of BOOSTRIX. No concomitant medications were reported. The patient became pregnant with last menstrual period (LMP) of 09-DEC-2013 and estimated delivery date (EDD) of 15-SEP-2014. Patients date of conception was on 23-DEC-2013. Initial exposure of GARDASIL was at 34 week(s). The pregnancy outcome was outcome pending. No adverse effect was reported. The outcome of 34 weeks pregnant, was inadvertently administered a dose of GARDASIL instead of BOOSTRIX and no adverse effect was unknown. No further information was provided. Additional information has been requested.

VAERS ID:539080 (history)  Vaccinated:2014-08-01
Age:20.0  Onset:2014-08-06, Days after vaccination: 5
Gender:Male  Submitted:2014-08-07, Days after onset: 1
Location:Michigan  Entered:2014-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None at this time
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV004003A0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Rash, Rash macular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt developed uticaria, and macular erythematous rash to R arm and across anterior/posterior thorax. Denies pruritis or other symptomology.

VAERS ID:539196 (history)  Vaccinated:2014-08-07
Age:20.0  Onset:2014-08-07, Days after vaccination: 0
Gender:Female  Submitted:2014-08-07, Days after onset: 0
Location:Arizona  Entered:2014-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: PCN allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4904AA IMUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0123281SCUN
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives w/o respiratory/throat probs.

VAERS ID:539330 (history)  Vaccinated:2014-08-07
Age:20.0  Onset:2014-08-07, Days after vaccination: 0
Gender:Female  Submitted:2014-08-08, Days after onset: 1
Location:Virginia  Entered:2014-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None listed on health questionaire at time of visit
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: See above description
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURU10788AA SCRA
Administered by: Public     Purchased by: Other
Symptoms: Chest discomfort, Cough, Eye swelling, Fatigue, Headache, Lacrimation increased, Pruritus, Sneezing, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Client left health dept and in car about 10 mins started sneezing and coughing. Went to restaurant and ate outside but continued sneezing and coughing with eyes watery. Got home about 2:45-3pm and took 20 minute nap. Woke up and chest was tight, throat was tight, eyes swollen, face and ears itchy. Father was home with her. Called health dept and closed, called PCP office and instructed to go to ER. Drove to ER in about 10 minutes and arrived about 4-4:30pm. Seen immediately. Given IV Benadryl, Epi Pen x1. States she felt better immediately. Observed x 2hours. Discharged home with Benadryl OTC to take on 8/8/14 and prescription for Prednisone 20 mg 3 tabs daily for 3 days, Epi Pen for use as needed. Today she feels fine but little tired from Benadryl. Had HA when first work up today but since gone.

VAERS ID:540726 (history)  Vaccinated:2014-08-21
Age:20.0  Onset:2014-08-21, Days after vaccination: 0
Gender:Female  Submitted:2014-08-21, Days after onset: 0
Location:Texas  Entered:2014-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSL5MN21IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: DIZZINESS.

VAERS ID:540818 (history)  Vaccinated:2014-08-19
Age:20.0  Onset:2014-08-19, Days after vaccination: 0
Gender:Female  Submitted:2014-08-21, Days after onset: 2
Location:Pennsylvania  Entered:2014-08-21
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS145203 IMUN
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Injection site reaction, large heated erythematous muscular pain at shoulder.

VAERS ID:540876 (history)  Vaccinated:2014-08-20
Age:20.0  Onset:2014-08-21, Days after vaccination: 1
Gender:Male  Submitted:2014-08-23, Days after onset: 2
Location:Georgia  Entered:2014-08-23
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: n/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K   
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling at site of injection.

VAERS ID:540931 (history)  Vaccinated:2014-08-23
Age:20.0  Onset:2014-08-23, Days after vaccination: 0
Gender:Female  Submitted:2014-08-23, Days after onset: 0
Location:Michigan  Entered:2014-08-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sore throat but no other symptoms
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1411001 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Loss of consciousness, Pallor
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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt. began feeling dizzy and was instructed to sit down. She then turned pale yellow color and "blacked out". The patient was not treated with anything. She awakened about 10-15 seconds later.

VAERS ID:541389 (history)  Vaccinated:2014-08-12
Age:20.0  Onset:2014-08-12, Days after vaccination: 0
Gender:Female  Submitted:2014-08-26, Days after onset: 14
Location:New York  Entered:2014-08-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TB
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CBC, CMP drawn at hospital and were WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4975BA1IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4886AA1IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Full blood count normal, Grand mal convulsion, Metabolic function test normal
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Pt had a tonic clonic seizure lasting 1-2 minutes about 2 minutes after Tdap, meningococcal and PPD were administered/placed. 911 called.

VAERS ID:541770 (history)  Vaccinated:2014-08-14
Age:20.0  Onset:2014-08-14, Days after vaccination: 0
Gender:Male  Submitted:2014-08-22, Days after onset: 8
Location:California  Entered:2014-08-29, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sore throat; chest congestion
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0158680UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema x 7 inches to (L) upper arm. Pain at injection site, ice to site, pt instructed to take OTC ibuprofen and BENADRYL.

VAERS ID:542441 (history)  Vaccinated:2014-09-04
Age:20.0  Onset:2014-09-04, Days after vaccination: 0
Gender:Female  Submitted:2014-09-04, Days after onset: 0
Location:California  Entered:2014-09-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient did not report taking any medications at the time of vaccination. Patient also filled out Travel Vaccine Questionnaire prior to receiving vaccines and listed "none" under Current Medications. No history of reaction or side effects t
Current Illness: None reported by patient.
Preexisting Conditions: NKDA, No diagnosed medical conditions, not pregnant, Acne.
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS9E2GN IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ1201 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Eye movement disorder, Formication, Loss of consciousness, Oxygen saturation immeasurable, Pallor, Posture abnormal, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Patient did have reaction after receiving Hepatitis A vaccine 1st, then Typhoid vaccine 2nd. Patient became pale, slumped over in sitting position, and started having tremor of hands, and eyes rolled back for approximately 1.5 minutes. Patient did not experience fall as she was still in sitting position and LVN stood behind her, and RN stood in front of patient. Initially unable to get pulse ox read during incident, HR 50. Oxygen was administered via facemask at 10L, airway kept open. Dr. (doc of day) was alerted and CODE ALERT called. Patient became alert and oriented after 1.5min, spO2 100%, P65, R20, and states "I was dreaming". After incident, patient A&O x3, patient reports that she did not eat yet, and reports feeling of "lightheaded and dizzy after shots", states after shots she felt like "spiders crawling all over arm" and "felt blackout". Dr. assessed patient. Patient given apple juice, crackers, and water. Monitored in triage room until stable. Left clinic after 1 hour.

VAERS ID:542700 (history)  Vaccinated:2014-09-03
Age:20.0  Onset:2014-09-05, Days after vaccination: 2
Gender:Female  Submitted:2014-09-05, Days after onset: 0
Location:Texas  Entered:2014-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denied.
Current Illness: Denied.
Preexisting Conditions: Denied.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSX9HM30IMAR
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Chest pain, Feeling hot, Rash
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Recieved the flu vaccine on 09/03/14 and then noticed rash to chest and upper abdomen upon awakening on 09/05/14. Also reports "achiness" to upper chest and upper back area. Relates feels like she was running a fever but was noted afebrile.

VAERS ID:542726 (history)  Vaccinated:2014-09-05
Age:20.0  Onset:2014-09-05, Days after vaccination: 0
Gender:Female  Submitted:2014-09-06, Days after onset: 1
Location:Texas  Entered:2014-09-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none reported or on file
Current Illness: none reported
Preexisting Conditions: none reported
Diagnostic Lab Data: EMS arrived and ascertained the patient''s condition, finalizing that the patient did not require additional treatment.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSBT7AG IMRA
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Erythema, Pruritus
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad)
Write-up: Localized redness and itching; tightness of the chest;

VAERS ID:542972 (history)  Vaccinated:2014-09-02
Age:20.0  Onset:2014-09-07, Days after vaccination: 5
Gender:Female  Submitted:2014-09-08, Days after onset: 1
Location:Washington  Entered:2014-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI192AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J011714 IMRA
Administered by: Other     Purchased by: Military
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient experienced swelling/pain in arm where injection occurred. Presented at hospital and received antibiotics.

VAERS ID:543113 (history)  Vaccinated:2008-12-01
Age:20.0  Onset:2008-12-08, Days after vaccination: 7
Gender:Female  Submitted:2014-09-09, Days after onset: 2100
Location:Arizona  Entered:2014-09-09
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: Sulfa Drugs cause Erythema Multiforme
Diagnostic Lab Data: Patient continues to have an elevated Rheumatoid Factor to this date.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.NOT KNOWN   
Administered by: Private     Purchased by: Other
Symptoms: Influenza like illness, Polyarthritis, Rheumatoid arthritis, Rheumatoid factor increased
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Patient developed flu like symptoms and crippling polyarthritis that was later diagnosed as Rheumatoid Arthritis.

VAERS ID:543569 (history)  Vaccinated:2014-08-12
Age:20.0  Onset:2014-08-13, Days after vaccination: 1
Gender:Male  Submitted:2014-09-10, Days after onset: 28
Location:New Mexico  Entered:2014-09-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Environmental allergies
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J005067 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Body temperature increased, Headache, Hypoaesthesia, Influenza like illness, Injection site erythema, Injection site swelling, Injection site warmth, Malaise, Pain
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Headache (0930 AM 8/13/14) Ibuprofen, TYLENOL. Temperature elevation (102 degrees) (1200 8/13/14 - 8/16/14). "Flu" like symptoms, malaise, body aches (8/13 - 8/18/14). Right hand numbness 8/15/14 (prednisone). Injection site (left deltoid) red, hot, swollen (8/15/14). Resolved symptoms 8/23/14.

VAERS ID:543487 (history)  Vaccinated:2014-08-29
Age:20.0  Onset:2014-09-02, Days after vaccination: 4
Gender:Female  Submitted:2014-09-10, Days after onset: 8
Location:Pennsylvania  Entered:2014-09-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 16 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC9666AA UNUN
Administered by: Private     Purchased by: Private
Symptoms: Guillain-Barre syndrome, Intensive care, Muscular weakness, VIIth nerve paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow)
Write-up: Patient had facial droop on 9-2-14 and went to ER and was treated for presumed Bell''s Palsy. Patient returned to ER on 9-8-14 with facial droop and leg weakness and was admitted to ICU for GUILLAIN-BARRE syndrome. She was then transferred to hospital.

VAERS ID:543550 (history)  Vaccinated:2014-09-02
Age:20.0  Onset:2014-09-03, Days after vaccination: 1
Gender:Female  Submitted:2014-09-04, Days after onset: 1
Location:Arizona  Entered:2014-09-12, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0152382SCUN
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: 90 x 80cm of redness around injection site. Warm to touch. Patient states painful and stiff.

VAERS ID:543671 (history)  Vaccinated:2014-08-25
Age:20.0  Onset:2014-09-08, Days after vaccination: 14
Gender:Male  Submitted:2014-09-15, Days after onset: 7
Location:Texas  Entered:2014-09-15
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV374A0IMRA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR    
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ16290 LA
Administered by: Military     Purchased by: Military
Symptoms: Post vaccination autoinoculation, Rash pustular, Scar
SMQs:, Hypersensitivity (narrow)
Write-up: Smallpox self inoculator. Sites to chin, neck, left knee and right thigh. All sites are apparently one week or older (pus filled pockets except for several that patient removed shaving, healed scars at those sites) Patient recieved smallpox vaccine this facillity on 25 August 2014 with major reaction documented on 2 September 2014.

VAERS ID:543849 (history)  Vaccinated:2014-07-11
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-09-08
Location:California  Entered:2014-09-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma, mild
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0035200IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4680AB1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0044830IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Leukocytosis, Local swelling, Pyrexia
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever, leukocytes, headache 1 day after the vaccinations. Local swelling at the arm.

VAERS ID:543969 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Unknown  Submitted:2014-09-15
Location:Unknown  Entered:2014-09-15
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:
CDC Split Type: WAES1409USA005101
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report was received from a pharmacist via company representative refers to a 20 year old patient with unknown gender. Patient medical history and historical conditions were not reported. On an unknown date, the patient inadvertently received ZOSTAVAX (dose, lot # were not reported) instead of VARIVAX (Merck) and no adverse effect reported. That was related to a staff error. Concomitant therapy was not reported. No PQC was involved. Outcome of events was unknown. The reporter considered patient inadvertently received ZOSTAVAX instead of VARIVAX (Merck) and no adverse effect to be not related to ZOSTAVAX. This case was linked to MARRS # 1409USA006963 (same patient link). Additional information has been requested.

VAERS ID:544225 (history)  Vaccinated:2014-09-05
Age:20.0  Onset:2014-09-10, Days after vaccination: 5
Gender:Female  Submitted:2014-09-17, Days after onset: 7
Location:Unknown  Entered:2014-09-17
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: WAES1409USA005423
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction
SMQs:
Write-up: This spontaneous report was received from a healthcare student concerning a 20 year old female patient with no pertinent medical history or drug reaction/allergies. On 04-SEP-2014, the patient was vaccinated with a dose of ZOSTAVAX (dose number not reported) lot #K000996, expiration date 13-MAR-2015, 0.65ml in the left upper arm. Other suspect therapies included PNEUMOVAX23 on left upper arm and FLUVIRIN on right upper arm. Patient sought medical attention at the pharmacy on 10-SEP-2014 for an injection site reaction at the site of ZOSTAVAX administration. A description of the injection site reaction was unspecified. At the time of the report the outcome was reported as not recovered. Patient did not received treatment or performed any lab diagnostics studies for the adverse event. Additional information has been requested.

VAERS ID:544254 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-09-18
Location:Unknown  Entered:2014-09-18
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: WAES1409USA006705
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Personality change, Therapeutic response unexpected
SMQs:, Lack of efficacy/effect (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad)
Write-up: This spontaneous report as received from aunt and caregiver of the patient refers to a 20 year old female patient (age reported as "20", unit approximated to years from the context of the source document). The patient was mildly autistic, she was diagnosed at the age of 7 (units not provided). Patient''s historical drugs included an unspecified chicken pox vaccine which the patient received as a child (date unspecified). The patient''s medical history included being extremely withdrawn. On unknown dates, reported as 4-5 years ago, also reported as at the age of 15 or 16, the patient was vaccinated with the three dose regimen of GARDASIL route reported as injection (dose, anatomical location and lot numbers were not reported). Concomitant medications were not specified. On an unknown date, reported as within a few days of the first GARDASIL dose, the patient became much more social and affectionate, whereas before she was extremely withdrawn. The medical attention had been sought, the reporter mentioned the event to the healthcare professional (HCP). The outcome of became much more social and affectionate, whereas before she was extremely withdrawn was unknown. The relatedness between the event and GARDASIL was not reported. Additional information has been requested.

VAERS ID:544377 (history)  Vaccinated:2014-09-17
Age:20.0  Onset:2014-09-17, Days after vaccination: 0
Gender:Female  Submitted:2014-09-19, Days after onset: 2
Location:Pennsylvania  Entered:2014-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not stated
Preexisting Conditions: PCN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS145405 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt called pharmacy on 9/19 stating that injection site was swollen, felt warm and was firm. Symptoms started that evening and had progressed since.

VAERS ID:544623 (history)  Vaccinated:2014-09-18
Age:20.0  Onset:2014-09-19, Days after vaccination: 1
Gender:Female  Submitted:2014-09-22, Days after onset: 3
Location:Georgia  Entered:2014-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0123751SCLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: REDNESS AND EDEMA AT INJECTION SITE. COMPLAINED OF FEVER.

VAERS ID:544809 (history)  Vaccinated:2014-08-27
Age:20.0  Onset:2014-08-27, Days after vaccination: 0
Gender:Female  Submitted:2014-09-02, Days after onset: 6
Location:Massachusetts  Entered:2014-09-22, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1187AA1IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4869AA1IMRA
Administered by: Other     Purchased by: Public
Symptoms: Grip strength decreased, Hypoaesthesia, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Experienced (R) arm pain within an hour of injection, with increase of pain in arm. On day 3 experienced decreased sensitivity in (R) arm with decreased finger grip strength and arm numbness.

VAERS ID:544820 (history)  Vaccinated:2014-08-29
Age:20.0  Onset:2014-08-29, Days after vaccination: 0
Gender:Unknown  Submitted:2014-09-22, Days after onset: 24
Location:Unknown  Entered:2014-09-22
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: WAES1409USA010279
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 20 year old patient of unknown gender. Patient''s concurrent conditions and relevant medical history was unknown. On 29-AUG-2014 the patient who was intended to receive (Oka/Merck) VARIVAX was inadvertently vaccinated with ZOSTAVAX (single dose), subcutaneous. Concomitant medications were unknown. No adverse effects were reported. The outcome of the events was unknown. The causality of the events with ZOSTAVAX was not reported. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:544902 (history)  Vaccinated:2014-09-22
Age:20.0  Onset:2014-09-22, Days after vaccination: 0
Gender:Male  Submitted:2014-09-24, Days after onset: 2
Location:Unknown  Entered:2014-09-24
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV381A1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash, Vaccination site rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash starting at site of vaccination and spreading to his torso with itching.

VAERS ID:545523 (history)  Vaccinated:2014-09-28
Age:20.0  Onset:2014-09-28, Days after vaccination: 0
Gender:Female  Submitted:2014-09-29, Days after onset: 1
Location:Florida  Entered:2014-09-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergies to roaches, shrimp, dust, dust mites
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1197AD IMLA
Administered by: Public     Purchased by: Private
Symptoms: Headache, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives, itchiness, headache.

VAERS ID:546195 (history)  Vaccinated:2012-12-04
Age:20.0  Onset:2012-12-04, Days after vaccination: 0
Gender:Female  Submitted:2014-09-25, Days after onset: 659
Location:Texas  Entered:2014-09-30, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin 28
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0162380UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 SCRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURG15410UNLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH355AA0SCLA
Administered by: Other     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Injection site streaking, Injection site swelling, Oedema peripheral, Pain, Tenderness, Weight bearing difficulty
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 12/4 after shots patient reported red streaks and swelling in right armpit and around upper arm. Arm tender to touch painful with movement, bearing weight. 12/6 was seen by provider, arm still red/tender. Was treated for cellulitis with Clindamycin and Zyrtec.

VAERS ID:546406 (history)  Vaccinated:2014-10-03
Age:20.0  Onset:2014-10-03, Days after vaccination: 0
Gender:Male  Submitted:2014-10-03, Days after onset: 0
Location:Washington  Entered:2014-10-03
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: EKG by EMS
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1459041IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3FZ742IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB672AA2IMLA
Administered by: Military     Purchased by: Military
Symptoms: Confusional state, Convulsion, Electrocardiogram normal, Fall, Feeling hot, Head injury, Hyperhidrosis, Immediate post-injection reaction, Loss of consciousness, Malaise, Pallor, Presyncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (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), Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: Patient had received 3 injections, influenza, Hep A, and Hep B. He was standing while receiving the injections. Immediately following the Hep B injection, he passed out and fell to the floor, hit his head on a chair leg, and convulsed for about 5 seconds. Patient awoke with confusion and was directed to sit in a chair. He reported no memory of the event, feeling very unwell and hot, and was sweaty and pale. His BP at 11:30 was 92/58 and HR 58bpm. Patient did not have any difficulty breathing or hives. No epinephrine was administered. EMS responded at appx 11:40 AM. His BP was within normal range. He was given an EKG, results within normal range. His HR remained appx 58 bpm, patient is in good cardiovascular condition. EMS suspected the reaction was a vasovagal response. Patient''s father was present immediately following the episode and transported him to the clinic.

VAERS ID:547268 (history)  Vaccinated:2014-08-28
Age:20.0  Onset:2014-08-28, Days after vaccination: 0
Gender:Female  Submitted:2014-10-04, Days after onset: 37
Location:Unknown  Entered:2014-10-04
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: WAES1410USA001871
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J015378 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a 20 years old female patient. On 28-AUG-2014 the patient was vaccinated with a dose of GARDASIL (lot# J015378, expiry date: 09-APR-2016, dose, dose number, route of administration were not reported) that was improperly stored on 08-AUG-2014. No adverse effect was reported. This is one of several reports from the same reporter. Additional information has been requested.

VAERS ID:546745 (history)  Vaccinated:2014-10-03
Age:20.0  Onset:2014-10-03, Days after vaccination: 0
Gender:Male  Submitted:2014-10-06, Days after onset: 3
Location:Virginia  Entered:2014-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisdexamfetamine (Vyvanse) 60mg, Guanfacine (Tenex) 1mg, and Therapeutic Multivitamin Tabs
Current Illness: None
Preexisting Conditions: Allergic to: Penicillin G, Amoxicillin-pot Clavulanate, Cephalexin, and Oseltamivir Phosphate. Medical Conditions: Muscular Dystrophy and ADHD.
Diagnostic Lab Data: No diagnostic tests or laboratory date done.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Private     Purchased by: Other
Symptoms: Ear discomfort, Fatigue, Oropharyngeal pain, Tonsillar hypertrophy
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Temperature around 97 degrees. Adverse Events: Sore throat, fatigue, enlarged right tonsil, and minor ear discomfort (such as when one has ear infection). Events still occur more than 72 hours after FluMist administered.

VAERS ID:547942 (history)  Vaccinated:2014-09-29
Age:20.0  Onset:2014-10-02, Days after vaccination: 3
Gender:Female  Submitted:2014-10-07, Days after onset: 5
Location:Arkansas  Entered:2014-10-07
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: WAES1410USA002239
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K001630UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a physician''s nurse (also reported as physician''s assistant) via a Company Representative referring to a 20 year old female patient. On 29-SEP-2014 the patient was vaccinated with the first dose of GARDASIL (Lot# was reported as K00163) (dose, frequency and route unspecified). On 02-OCT-2014, the patient called her physician reporting that she had bumps on the side of the face and all under her chin. The physician prescribed a metronidazole (manufacturer unknown) 500 mg tablet 4 tablet but the bumps were already present on the patient before she took the first tablet. (The tablet was additional medicine that was ordered along with the GARDASIL). The patient explained the bumps are not itchy, there was no swelling and she did not experience shortness of breath. The patient reported there were no other symptoms except the bumps. The patient had sought medical attention via calling physician''s office. The outcome of "bumps on the side of the face and all under her chin" was reported as not recovered/not resolved. The reporter would like a call back on how to continue therapy and whether or not to continue on with the following scheduled shots of GARDASIL. Additional information has been requested.

VAERS ID:547436 (history)  Vaccinated:2014-10-10
Age:20.0  Onset:2014-10-10, Days after vaccination: 0
Gender:Male  Submitted:2014-10-10, Days after onset: 0
Location:Arizona  Entered:2014-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT594051IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Patient was screened for adverse reaction prior to flu administration at the mass flu shot and had indicated he had a adverse reaction as a child of age 5 with vomiting and hives. Pt was screened by provider and was recommended to give shot. Pt was given Afluria LOT #T59406 EXP: 30Jun15 in L arm using a 25G needle in the L arm and observed for symptoms. Approx 10 min later pt developed several small hives localized in area of injection. 50 mg of Benadryl was administered and soldier was placed on monitor. Vital signs remained stable and pt was released without further reaction.

VAERS ID:550483 (history)  Vaccinated:2014-10-06
Age:20.0  Onset:2014-10-09, Days after vaccination: 3
Gender:Female  Submitted:2014-10-09, Days after onset: 0
Location:Texas  Entered:2014-10-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA14041 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash type around injection site, spread to small area on the lower arm. Will take BENADRYL/ibuprofen to see Dr if not getting better in a day.

VAERS ID:547509 (history)  Vaccinated:2014-10-11
Age:20.0  Onset:2014-10-12, Days after vaccination: 1
Gender:Female  Submitted:2014-10-12, Days after onset: 0
Location:Michigan  Entered:2014-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Microgestin Fe
Current Illness: In ER for IBS symptoms
Preexisting Conditions: Crustacean, mollusk, mold, dander allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Feeling drunk, Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: Feeling dizzy, intoxicated. Faint. Cannot think straight.

VAERS ID:550547 (history)  Vaccinated:2014-10-11
Age:20.0  Onset:2014-10-11, Days after vaccination: 0
Gender:Male  Submitted:2014-10-11, Days after onset: 0
Location:Idaho  Entered:2014-10-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS160234 UNUN
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSN45BR0UNUN
Administered by: Military     Purchased by: Military
Symptoms: Incorrect dose administered
SMQs:
Write-up: None.

VAERS ID:547697 (history)  Vaccinated:2014-10-11
Age:20.0  Onset:2014-10-12, Days after vaccination: 1
Gender:Female  Submitted:2014-10-13, Days after onset: 1
Location:Indiana  Entered:2014-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
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
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS3RE4F0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Rash/Hives on both arms not relieved by oral Benadryl, that spread to chest and torso by the next day. RPh advised visit to MD for evaluation and possible steroid.

VAERS ID:547978 (history)  Vaccinated:2014-10-15
Age:20.0  Onset:2014-10-15, Days after vaccination: 0
Gender:Female  Submitted:2014-10-15, Days after onset: 0
Location:Ohio  Entered:2014-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, birth control pill, and vitamin D
Current Illness: None reported
Preexisting Conditions: Latex Allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14108015IMLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling hot, Hyperhidrosis, Hypoaesthesia, Injection site anaesthesia, Injection site pain, Injection site reaction, Musculoskeletal pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient did not report any problems at the time of administration. 45 minutes after administration the patient notified us that she experienced pain at the injection site which started 5-10 minutes after the vaccine was administered. The patient stated started as numbness and tingling in arm which traveled from the administration site down to the tips of fingers. Stated 5-10 minutes after adminsitration and worsened over the 45 minutes. Observed the patient for 15 additional minutes and symptoms had not changed. She also stated that she was feeling hot and diaphoretic. Advised to take ibuprofen. Patient took 400mg ibuprofen. 1 hour later (2 hours after administration) patient stated localized numbness resolved but still with pain in elbow and tingling fingertips. Also stating pain in shoulder blade area.

VAERS ID:548164 (history)  Vaccinated:2014-01-09
Age:20.0  Onset:2014-01-23, Days after vaccination: 14
Gender:Male  Submitted:2014-10-15, Days after onset: 264
Location:Unknown  Entered:2014-10-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unk
Preexisting Conditions: None
Diagnostic Lab Data: Troponin I, 29JAN2014, 04.30 ng/ml; ECG, 23JAN2014, Normal; echocardiogram, 29JAN2014, Normal; MRI, 31JAN2014, Normal
CDC Split Type: 2014SA138934
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR  IDUN
Administered by: Military     Purchased by: Military
Symptoms: Echocardiogram normal, Electrocardiogram normal, Myocarditis, Nuclear magnetic resonance imaging normal, Pericardial disease, Troponin I increased
SMQs:, Myocardial infarction (narrow), Cardiomyopathy (broad)
Write-up: Note: Any requests for follow-up information on this case should be sent directly to the sponsor of this study, Sanofi Pasteur. This study case was received from the investigator in a trial on 06 October 2014. A 20 year-old male subject with no significant past medical history was found to have acute myocarditis other, acute myocarditis and unspecified disease of pericardium 14, 14 and 20 days respectively after the subject had received the following vaccines on 09 January 2014: an injection of ACAM2000 (lot number and site of administration not reported) and Anthrax 1 (manufacturer, lot number, route and site of administration not reported). On 23 January 2014, the subject had a normal ECG. On 29 January 2014, Troponin I result was abnormal with highest record value of 04.30 ng/mL and a normal echocardiogram. On 31 January 2014, the subject had a normal MRI (heart). A lumbar puncture, MRI of brain and spinal cord were not performed. Treatments were not reported. The subject''s outcome was not reported. Note: There is no reporter causality assessment as this is a safety surveillance (data mining, non-interventional) study. Documents held by sender: none.

VAERS ID:548675 (history)  Vaccinated:2009-07-06
Age:20.0  Onset:2011-09-06, Days after vaccination: 792
Gender:Female  Submitted:2014-10-18, Days after onset: 1138
Location:New York  Entered:2014-10-18
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: None
Current Illness: No
Preexisting Conditions: Occasional acne flare ups
Diagnostic Lab Data: Cat scans, MRIs, many lab tests, neurological exams
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1702X0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Alopecia, Anxiety, Chest pain, Computerised tomogram, Depression, Dysphagia, Headache, Heart rate irregular, Laboratory test, Muscular weakness, Nausea, Neurological examination, Nuclear magnetic resonance imaging, Vertigo, Visual impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (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), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Cardiac arrhythmia terms, nonspecific (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (narrow)
Write-up: First event was hair loss, then progressed to headaches, vertigo, weakness in extremities, visual disturbances, anxiety, depression, chest pain, irregular heartbeat, nausea, difficulty swallowing.

VAERS ID:548753 (history)  Vaccinated:2014-10-19
Age:20.0  Onset:2014-10-19, Days after vaccination: 0
Gender:Female  Submitted:2014-10-19, Days after onset: 0
Location:Florida  Entered:2014-10-19
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: BP: 100/60, pO2 99%, HR 111 at time of transport
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT597072IMLA
Administered by: Other     Purchased by: Private
Symptoms: Decorticate posture, Muscle rigidity, Tonic convulsion
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Tonic seizure activity of approximately 45 secs duration followed almost immediately by a second episode that included decorticate rigidity. Administered 0.3mg epinephrine by EpiPen. Transported by EMS in stable condition to local emergency room.

VAERS ID:548760 (history)  Vaccinated:2014-10-16
Age:20.0  Onset:2014-10-16, Days after vaccination: 0
Gender:Male  Submitted:2014-10-20, Days after onset: 4
Location:Unknown  Entered:2014-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Allergy to Ceftin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CJ20050IN 
Administered by: Military     Purchased by: Military
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Clinical history and exam consistent with acute urticaria, likely secondary to FluMist exposure. Absence of historical red flags or exam findings concerning for anaphylaxis or imminent threat to pulmonary capabilities. Will treat as outpatient with oral Benadryl and recommend avoidance of FluMist in the future. Warning signs/symptoms prompting reevaluation reviewed and pt vocalized understanding. Will f/u with PCM on PRN basis. Medication(s): -UCC/MOD DIPHENHYDRAMINE 25MG CAP (12/BTL - TAKE 1 TO 2 CAPSULE BY MOUTH THREE TIMES A DAY AS NEEDED FOR ALLERGY SYMPTOMS #12 RF0

VAERS ID:548814 (history)  Vaccinated:2014-08-26
Age:20.0  Onset:2014-08-26, Days after vaccination: 0
Gender:Female  Submitted:2014-10-14, Days after onset: 49
Location:New York  Entered:2014-10-20, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CT Scan of Head - Skull fracture and bleed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0097880IMAR
Administered by: Private     Purchased by: Private
Symptoms: Computerised tomogram head abnormal, Fall, Haemorrhage, Head injury, Skull fracture, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient received GARDASIL vaccine and was observed in office. After checking out pt fainted/fell and hit head on a column in the waiting room. She suffered a skull fracture with ongoing treatment.

VAERS ID:548894 (history)  Vaccinated:2014-10-17
Age:20.0  Onset:2014-10-18, Days after vaccination: 1
Gender:Female  Submitted:2014-10-20, Days after onset: 2
Location:South Carolina  Entered:2014-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Dermatologist prescribed cream/ointment for skin reaction to face -unknown cause and unknown name of cream/ointment
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0034101SCLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Redness and itching around 10am, called ED for information and was told not to touch wait until seen by EHS on Monday morning per employee.

VAERS ID:548944 (history)  Vaccinated:2014-10-19
Age:20.0  Onset:2014-10-19, Days after vaccination: 0
Gender:Male  Submitted:2014-10-20, Days after onset: 1
Location:Pennsylvania  Entered:2014-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE LISTED FIRST TIME TO OUR PHARMACY
Current Illness: NONE AT TIME-- PT WAS INSTRUCTED TO WAIT 20 MINUTES AFTER ADMINISTRATION AND SIT BY PHARMACY. HE WAITED ABOUT 5 TO 10 MIN SAID FELT FINE AND WAS GOING TO GO.
Preexisting Conditions: NOTHING LISTED ON QUESTIONNAIRE
Diagnostic Lab Data: NONE GIVEN TO PHARMACY
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS145402 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Chills, Headache, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: PT GOT SHOT AFTER 5 TO 10 MIN WENT HOME, ATE, THEN GOT NAUSEA, VOMITED, HEADACHE, CHILLS. WENT TO CLASS NEXT DAY. FELT NO BETTER. WENT TO STUDENT HEALTH HAD 104 FEVER. THEY SENT HIM TO HOSPITAL.

VAERS ID:549354 (history)  Vaccinated:2014-10-22
Age:20.0  Onset:2014-10-22, Days after vaccination: 0
Gender:Female  Submitted:2014-10-22, Days after onset: 0
Location:Texas  Entered:2014-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None disclosed
Current Illness: None
Preexisting Conditions: CECLOR allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1412901 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site rash, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash appeared on both shoulders, elbows, trunk and forehead. Blood pressure and heart rate stayed stable. Patient took 2 cap of 25 mg BENADRYL. Rash subsided in 30 minutes, post meds.

VAERS ID:549414 (history)  Vaccinated:2014-10-22
Age:20.0  Onset:2014-10-22, Days after vaccination: 0
Gender:Male  Submitted:2014-10-22, Days after onset: 0
Location:New York  Entered:2014-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Nut allergies
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1453050UNLA
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt fainted and a few minutes after given the FLUVIRIN 14-15 vaccine. He was our for not even a minutes. Got up on his own, sat for 15 minutes. Then left with his mom.

VAERS ID:549681 (history)  Vaccinated:2014-04-21
Age:20.0  Onset:2014-05-01, Days after vaccination: 10
Gender:Male  Submitted:2014-10-23, Days after onset: 175
Location:Virginia  Entered:2014-10-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unk
Preexisting Conditions: Abnormal ECG
Diagnostic Lab Data: ECG, 01MAY2014, Normal; Echocardiogram, 01MAY2014, Normal; Troponin I, 08MAY2014, Normal
CDC Split Type: 2014SA142323
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR  IDUN
Administered by: Military     Purchased by: Military
Symptoms: Echocardiogram normal, Electrocardiogram normal, Pericardial disease, Troponin I normal
SMQs:
Write-up: Note: Any requests for follow-up information on this case should be sent directly to the sponsor of this study, Sanofi Pasteur. This study case was received from the investigator in a trial on 15 October 2014. A 20-year-old male patient, with a past medical history of abnormal ECG, received an injection of ACAM2000 (lot number not reported) on 21 April 2014. He was diagnosed with unspecified disease of the pericardium on 01 May 2014, i.e. 10 days post-vaccination. Troponin I on 08 May 2014 and ECG and echocardiogram on 01 May 2014 were all normal. Outcome was not reported. Additional information will be requested from the investigator. Note: There is no reporter causality assessment as this is a safety surveillance (data mining, non-interventional) study. Documents held by sender: None.

VAERS ID:550016 (history)  Vaccinated:2014-10-20
Age:20.0  Onset:2014-10-20, Days after vaccination: 0
Gender:Female  Submitted:2014-10-25, Days after onset: 5
Location:Texas  Entered:2014-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported
Current Illness: No illness reported
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.K004810 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Anxiety, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Employee reported that approx 15-20 min after recieving vaccination became very nauseated, and anxious feeling. Was reported to medical staff.

VAERS ID:550085 (history)  Vaccinated:2014-01-28
Age:20.0  Onset:2014-01-28, Days after vaccination: 0
Gender:Male  Submitted:2014-10-26, Days after onset: 270
Location:Unknown  Entered:2014-10-26
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: NKDA
Diagnostic Lab Data: Pending dermatology referral
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR 0IDRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site reaction
SMQs:
Write-up: Persistent immunization site reaction.

VAERS ID:550209 (history)  Vaccinated:2012-11-02
Age:20.0  Onset:2012-11-16, Days after vaccination: 14
Gender:Female  Submitted:2014-03-31, Days after onset: 499
Location:Texas  Entered:2014-10-27, Days after submission: 210
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
Preexisting Conditions: None known
Diagnostic Lab Data: (27JUN13, 1045) Nuclear Ab Panel- Nuclear Ab serum POSITIVE AT 1:640 DILUTION (H), POSITIVE (H), Speckled pattern. (27JUN13, 1045) Factor II Gene Mutation G20210A Normal / Factor V Gene Mutation Analysis Normal. (27JUN13) CBC w/ Diff essentially WNL. (27JUN13, 1045) ESR 40 (H); CMP WNL; Fibrin D-Dimer WNL; Protime/INR WNL; APTT WNL. (27SEP13, 0848) Fluorescent Treponema pallidum Ab Serum Non-reactive. (25SEP2013, 1601) UA: hazy, trace Leukocyte Esterase, trace protein, squamous epithelial cells 10H. (25SEP13) Tissue Exam, Hx: Pt with photoskin type III-IV with a 8.0 x 44.0 cm linear firm very irregularly shaped plaque with a high ANA 1:640 and high ESR 40mm/hr. Pre-Op Diff Dx: Livedo reticularis vs. antiphospholipid antibody syndrome vs. s
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ADEN_4_7: ADENOVIRUS TYPES 4 & 7, LIVE, ORAL (NO BRAND NAME)TEVA PHARMACEUTICALS346000740PO 
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP59007 IMUN
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEUR1604 SCUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4414AA UNUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B099AA UNUN
Administered by: Military     Purchased by: Military
Symptoms: Activated partial thromboplastin time normal, Anti-cyclic citrullinated peptide antibody negative, Antinuclear antibody, Antinuclear antibody negative, Antinuclear antibody positive, Antiphospholipid syndrome, Biopsy skin abnormal, Burning sensation, Coagulation test normal, Complement factor C3 increased, Complement factor C4 decreased, Complement factor decreased, Cytogenetic analysis normal, Differential white blood cell count normal, Dizziness, Dry skin, Fatigue, Fibrin D dimer normal, Full blood count normal, Gene mutation identification test negative, Glucose-6-phosphate dehydrogenase abnormal, Glucose-6-phosphate dehydrogenase deficiency, Haematocrit decreased, Haemoglobin decreased, Hepatitis B core antibody negative, Hepatitis B surface antibody negative, Hepatitis C antibody negative, Human chorionic gonadotropin positive, Injection site erythema, Injection site oedema, International normalised ratio normal, Itching scar, Livedo reticularis, Maternal exposure before pregnancy, Metabolic function test normal, Morphoea, Protein urine present, Prothrombin level normal, Prothrombin time normal, Pruritus, Red blood cell sedimentation rate increased, Rhinitis seasonal, Scleroderma, Skin discolouration, Skin hyperpigmentation, Skin hypertrophy, Skin induration, Skin irritation, Skin lesion, Systemic lupus erythematosus, Thrombophlebitis superficial, Treponema test negative, Ultrasound Doppler normal, Ultrasound scan normal, Upper respiratory tract infection, Urinary sediment present, Urine abnormality, Urine leukocyte esterase positive, Wisdom teeth removal
SMQs:, Acute renal failure (broad), Haemolytic disorders (narrow), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Congenital, familial and genetic disorders (narrow), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Tumour markers (narrow), Thrombophlebitis (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Conjunctival disorders (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Skin tumours of unspecified malignancy (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad)
Write-up: This pleasant 22 y/o married patient was referred to Healthcare Center for Vaccine Causality Assessment following the patient''s receipt of multiple vaccines on 02NOV12. The patient received the following vaccines on 02NOV12: (1) Adenovirus Type 4 and 7 #1 (live/oral); (2) IPV (inactivated); (3) IIV3 (inactivated); (4) MCG A, C, Y, W-135 Diphtheria Conj (inactivated) and (5) Tdap (inactivated). Two to three weeks later, the pt. reports the onset of itching, discoloration, hyperpigmentation, and sclerotic changes over the medial aspect of her right lower extremity (RLE). The skin changes skipped the medial aspect of her right calf and resumed just above the medial aspect of her right ankle. By early DEC 2012, the pruritus, hyperpigmentation and sclerotic linear areas extended up her right inner thigh and rt. inguinal area. She noted similar, but more subtle skin changes several weeks later over the left (Lt.) anterior and lateral aspect of her Lt upper thigh and Lt inguinal area, extending to her Lt anterior hip. The patient denies any viral or GI illness within 30 days prior to having her vaccines. She denies any facial, eye or lip swelling or any difficulty swallowing or wheezing in the first 15 min to 3 hours s/p receipt of vaccines. She does endorse some mild local erythema/edema at the injection site in one of her upper arms, which lasted about 2-3 days, but cannot remember which arm it was or which vaccine it was related to. She does not recall any systemic malaise, HA, chills, body ache, fever or generalized rash or hives during the first 7-10 days s/p receipt of her vaccines. However, record review indicates that on 09NOV12 (1 week s/p receipt of vaccines), the patient was seen for a c/o of ''lightheadedness/fatigue" stating she was "not used to doing physical activity in such humidity." From an immunological standpoint, these symptoms could be related to a "cytokine surge" one week s/p her receipt of multiple vaccines. She was evaluated for dehydration and to r/o anemia (Hgb 11.0 L / Hct 32.5 L). On 11NOV12 she was found to be G6PD deficient (6.6L), but Sickle Cell Negative. Her family history (FH) is significant for a maternal aunt with sickle cell, as well as a + FH of sarcoidosis. The patient endorses that sometime mid to late November 2012, she began to experience an "irritation, itching and change in color" (purplish brown hue) over the inner (medial) aspect of her right (rt.) lower leg, just below her rt. knee. The patient thought it was simply an irritation or chafing from her skin rubbing against her uniform pants and applied OTC lotion on the affected areas w/o significant relief of her sx. By early Dec of 2012, she noticed that the skin over the inner aspect or her rt. leg, from below her knee all the way up her rt. inner thigh looked purplish brown and seemed rough and thick. Again, she did not seek medical attention, as she began AIT on 26DEC12, immediately after completing her Basic Training. She completed AIT on 26FEB13. She arrived at new location on 27FEB13, where she joined her husband. Per medical record review, the patient in-processed at Occ Health on 20MAR13. She was seen at Health Clinic on 26MAR13 for Seasonal Allergic Rhinitis and treated with Loratadine 10 mg po qd, MUCINEX D 1200 /120 mg XR tab 1 po Q 12h. There were not any critical items noted on her PHA on 03APR13. She saw PCM on 16APR13 for a Women''s Wellness Exam / PAP- Dx BV, Rx w/ FLAGYL 250 mg po BID x 5 days. HCG Neg. Started ORTHO TRI-CYCLEN LO (28-day). (16APR13) URI (post-nasal drip vs. allergies) seen at Health Clinic, Rx w/ MUCINEX/AFRIN. (30APR13) Serum HCG POSITIVE. LMP 26MAR13. Ref OB Clinic. (07JUN13) HCG repeated negative s/p TA, secondary to concern for possible worsening of her symptoms during pregnancy. (25JUN13) Patient reported h/o "discoloration and hardening of skin over right inner thigh" with onset 2-3 weeks s/p receipt vaccines to PCM. Sx have gradually progressed up her thigh and down below her knee. Denies hx of kn

VAERS ID:551051 (history)  Vaccinated:2014-10-25
Age:20.0  Onset:2014-10-26, Days after vaccination: 1
Gender:Male  Submitted:2014-10-28, Days after onset: 2
Location:Vermont  Entered:2014-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI171AC IMRA
Administered by: Other     Purchased by: Private
Symptoms: Axillary pain, Injection site erythema, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient had redness and swelling at site next day but then 2 days after injection also experienced soreness and pain under arm hurts to move arm. Patients PCP was consulted and did not advise treatment.

VAERS ID:551068 (history)  Vaccinated:2014-09-26
Age:20.0  Onset:2014-10-09, Days after vaccination: 13
Gender:Male  Submitted:2014-10-29, Days after onset: 20
Location:Unknown  Entered:2014-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV387A0UNUN
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICST58B051UNUN
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVVD4-003A0 UN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ16290UNUN
Administered by: Military     Purchased by: Unknown
Symptoms: Blood bilirubin increased, Pruritus, Rash generalised
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Biliary system related investigations, signs and symptoms (narrow), Hypersensitivity (narrow)
Write-up: Rash which began in legs and then spread to rest of body including face and hands. Some pruritis. Afebrile. Mild increase bilirubin 1.4. Given BENADRYL.

VAERS ID:554185 (history)  Vaccinated:2014-08-12
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-10-29
Location:Virginia  Entered:2014-10-29
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: On an unspecified date in 2014, blood work showed no response to VARIVAX (negative)
CDC Split Type: WAES1410USA011220
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Erythema, Local reaction
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: This spontaneous report as received from a physician via company representative refers to a 20 year old female patient. Current conditions and other relevant medical history were not reported. On 12-AUG-2014 the patient was vaccinated with the first dose of VARIVAX (Merck) (Subcutaneous injection, dose 1, 0.5 ml; route, anatomical location, batch/lot # and expiration date not reported). Concomitant therapies were not reported. The physician informed that after the first dose of VARIVAX (Merck), on an unspecified date in 2014, the patient experienced extended local reaction with redness. The physician also stated that after the blood work test, performed on an unspecified date in 2014, the patient''s titer showed no response to VARIVAX (Merck). The patient sought medical attention. The outcome of the events was not reported. Causality assessment was not provided by the reporter. Additional information is not expected because the physician did not consent to be contacted for further follow-up.

VAERS ID:551341 (history)  Vaccinated:2014-10-29
Age:20.0  Onset:2014-10-30, Days after vaccination: 1
Gender:Female  Submitted:2014-10-30, Days after onset: 0
Location:Maryland  Entered:2014-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14112011IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0035202IMRA
Administered by: Private     Purchased by: Public
Symptoms: Body temperature increased, Chills, Injection site induration, Injection site warmth, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: Warm indurated injection site (Lt arm). Temp 99.8 associated w/ myalgias and chills. No other cause of infection noted.

VAERS ID:551725 (history)  Vaccinated:2014-11-03
Age:20.0  Onset:2014-11-03, Days after vaccination: 0
Gender:Female  Submitted:2014-11-03, Days after onset: 0
Location:California  Entered:2014-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other known prescription or non-prescription medications at time of vaccine
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Patient went to emergency room
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED09949221A0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Posture abnormal
SMQs:, Dystonia (broad)
Write-up: Patient slumped in chair, and looked to possibly have a seizure. Then 5 minutes later patient drooped head again.

VAERS ID:551862 (history)  Vaccinated:2014-10-09
Age:20.0  Onset:2014-10-09, Days after vaccination: 0
Gender:Female  Submitted:2014-11-03, Days after onset: 25
Location:New York  Entered:2014-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BCP
Current Illness: No
Preexisting Conditions: Seasonal/Bee sting allergies; Depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI191AB IMLA
Administered by: Other     Purchased by: Private
Symptoms: Heart rate increased, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: syncopal episode 8 hrs after vaccine administration with stated elevated HR. Seen at local hospital. R/O DVT.

VAERS ID:552380 (history)  Vaccinated:2014-07-29
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-11-06
Location:New York  Entered:2014-11-06
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: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Private
Symptoms: Nervous system disorder
SMQs:
Write-up: Neurological problems.

VAERS ID:552561 (history)  Vaccinated:2014-11-01
Age:20.0  Onset:2014-11-01, Days after vaccination: 0
Gender:Female  Submitted:2014-11-06, Days after onset: 5
Location:Colorado  Entered:2014-11-06
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1414001 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Swelling of tongue 30 minutes after vaccination given, urgent care gave short course of steriods and swelling resolved.

VAERS ID:552697 (history)  Vaccinated:2014-11-07
Age:20.0  Onset:2014-11-07, Days after vaccination: 0
Gender:Male  Submitted:2014-11-07, Days after onset: 0
Location:North Carolina  Entered:2014-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: weakness~Influenza (Seasonal) (no brand name)~1~19.00~Patient
Other Medications: None
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: Appeared to feel improved at time he departed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALST588061IMRA
Administered by: Other     Purchased by: Military
Symptoms: Asthenia, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: Patient completed his 20 minute observance without incident. He then reported to the medic 2 hr after vaccine was given, c/o weakness, and inability to walk without assistance. Vital signs remained normal for another 15 minutes. He indicated he had a similar episode one year prior but did not seek care. He refused medical evacuation or further evaluation and departed the area.

VAERS ID:552719 (history)  Vaccinated:2014-10-29
Age:20.0  Onset:2014-10-29, Days after vaccination: 0
Gender:Female  Submitted:2014-11-07, Days after onset: 9
Location:California  Entered:2014-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Injection site pain, Muscular weakness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Faint, dizzy, weakness and pain in whole arm of injection.

VAERS ID:555475 (history)  Vaccinated:2014-08-14
Age:20.0  Onset:2014-09-21, Days after vaccination: 38
Gender:Female  Submitted:2014-11-04, Days after onset: 44
Location:Colorado  Entered:2014-11-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Sever shellfish - apple allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0042040UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Diarrhoea, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea starting 8/15/14 lasting 4 weeks, contact dr. said possible side effect. At 5 weeks massive hive break out 3 trips to ER. 3 trips to allergist, felt internal hive break out from stress on her body. No one thinks its related to shot, but we do.

VAERS ID:553038 (history)  Vaccinated:2014-11-07
Age:20.0  Onset:2014-11-09, Days after vaccination: 2
Gender:Male  Submitted:2014-11-11, Days after onset: 2
Location:Maine  Entered:2014-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Denied
Preexisting Conditions: Denied
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS9X3L30IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Woke with fever and hives over entire body. No respiratory or throat symptoms.

VAERS ID:553224 (history)  Vaccinated:2012-08-07
Age:20.0  Onset:2014-03-01, Days after vaccination: 571
Gender:Male  Submitted:2014-11-12, Days after onset: 256
Location:Florida  Entered:2014-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: No
Preexisting Conditions: N/A
Diagnostic Lab Data: Seen by urologist; Aldara prescribed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200022IMUN
Administered by: Unknown     Purchased by: Private
Symptoms: Anogenital warts
SMQs:
Write-up: Genital warts.

VAERS ID:553363 (history)  Vaccinated:2013-11-10
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-11-12
Location:Arkansas  Entered:2014-11-12
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: No adverse event, At the time of reporting, it was unknown if there were concomitant medications or relevant medical history. It was unknown if there were adverse events following previous vaccinations.
Diagnostic Lab Data:
CDC Split Type: A1051659A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  UNRA
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSB457F2SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of arm pain at injection site in a 20-year-old female subject who was vaccinated with TWINRIX (GlaxoSmithKline). Concurrent vaccination included seasonal influenza vaccine (non-gsk); Novartis; unknown right arm given on 10 November 2013. On 10 November 2013 at 16:21 the subject received 3rd dose of TWINRIX (1 ml, unknown route, left arm). In November 2013, within days of vaccination with TWINRIX, the subject experienced arm pain at injection site. The arm pain at injection site was described as "short stabbing pain going down left arm." The subject did consult a healthcare professional regarding the event. At the time of reporting the event was unresolved.

VAERS ID:555729 (history)  Vaccinated:2014-10-09
Age:20.0  Onset:2014-10-11, Days after vaccination: 2
Gender:Female  Submitted:2014-10-23, Days after onset: 12
Location:Illinois  Entered:2014-11-12, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPO
Current Illness: No
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0035200IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on trunk of body (back and abdomen) and on thighs - large in size, also c/o itching, took OTC BENADRYL 10/11/14 and 10/12/14. Saw PCP 10/13/14 received "shot" and advised to cont. BENADRYL. 10/14/14 AM hives and itching gone. No problems since.

VAERS ID:554807 (history)  Vaccinated:2014-11-18
Age:20.0  Onset:2014-11-18, Days after vaccination: 0
Gender:Male  Submitted:2014-11-19, Days after onset: 1
Location:Georgia  Entered:2014-11-19
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 nuts
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1456010IMRA
Administered by: Public     Purchased by: Private
Symptoms: Nerve injury, 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)
Write-up: Vaccine appeared to hit a nerve in arm. Patient fainted.

VAERS ID:557063 (history)  Vaccinated:2014-11-20
Age:20.0  Onset:2014-11-21, Days after vaccination: 1
Gender:Female  Submitted:2014-11-22, Days after onset: 1
Location:North Carolina  Entered:2014-11-23, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Bipolar; Anxiety
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0098740IMAR
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal pain, Musculoskeletal stiffness, Pain, Rash, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: PNEUMOVAX 23 administered on 11/20/14 - pt reports swelling and pain on 11/21/14 - says pain and soreness along with stiffness into shoulder - has rash on 11/22/14. ER visit. MD prescribes prednisone/ULTRAM/CLEOCIN.

VAERS ID:555351 (history)  Vaccinated:2014-11-19
Age:20.0  Onset:2014-11-19, Days after vaccination: 0
Gender:Male  Submitted:2014-11-24, Days after onset: 5
Location:Minnesota  Entered:2014-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: SWEATING, RINGING IN EAR, TINGLING IN HAND.
Preexisting Conditions: NA
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4870BA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Hyperhidrosis, Paraesthesia, Tinnitus
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hearing impairment (narrow)
Write-up: DONOR EXPERIENCED SWEATING, RINGING IN EARS, AND TINGING IN HANDS FOR ABOUT 5 MINS AFTER RECEIVING VACCINATION.

VAERS ID:555414 (history)  Vaccinated:2014-11-09
Age:20.0  Onset:2014-11-10, Days after vaccination: 1
Gender:Female  Submitted:2014-11-24, Days after onset: 14
Location:Maryland  Entered:2014-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: POST-DIPHENHYDRAMINE OVERDOSE
Preexisting Conditions: ALLERGY TO SULFA (HIVES); HISTORY OF ASTHMA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS  IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K008409 IMRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Leukocytosis, Pyrexia, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Low-grade fever with pain, swelling, and redness at injection site that worsened initially before symptoms/signs resolved 2-3 days after initial presentation. Treatment included analgesics - acetaminophen and ibuprofen. Patient''s tachycardia and leukocytosis also worsened, but improved with treatment - fluids and antibiotics.

VAERS ID:556058 (history)  Vaccinated:2014-11-29
Age:20.0  Onset:2014-11-29, Days after vaccination: 0
Gender:Female  Submitted:2014-11-29, Days after onset: 0
Location:Illinois  Entered:2014-11-29
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: Blood pressure 120/79 pulse 83
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS995J5 IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS95L3P IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURK0248 IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUI068AA SCLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Feeling jittery, 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), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Patient became very faint with severe syncope and briefly blacked out. This was after administration of 4 vaccines. Patient rested and was given orange juice and crackers. Blood pressure was checked and was 120/79. Patient felt weak and jittery. Did not display signs/symptoms of anaphylactic reaction. No effect on breathing. No rash. Lasted about one hour total and the patient was able to walk out with her mother.

VAERS ID:556341 (history)  Vaccinated:2014-11-10
Age:20.0  Onset:2014-11-11, Days after vaccination: 1
Gender:Male  Submitted:2014-11-20, Days after onset: 9
Location:Illinois  Entered:2014-12-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TRILEPTAL; TOPAMAX; LAMICTAL XR
Current Illness: None
Preexisting Conditions: Grade 5 AVM (RF Lobe); Simple partial seizures
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT50207 UNRA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Condition aggravated, Convulsion, Dry mouth, Ear pain, Feeling cold, Headache, Neck pain, Pain, Pain in extremity, Paraesthesia, Vaccination complication
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad)
Write-up: Pt Dx 2007 with Grade 5 Arteriovenous Malformation (RF Lobe); causes Simple Partial Seizures; three (3) anti-seizure medications to control seizures. Adverse Event, Symptoms, Duration: Within 12 hours after the injection, my 20 y/o son had an very serious adverse reaction to the flu shot. Awoke from sleep with massive headache, sharp, shooting pain "like a knife" in both ears and in both earlobes; sharp shooting pain in lower back of neck; "pins and needles" sensation in his torso (chest and back); arm pain; dry mouth; body temperatures was normal, but he felt cold, was shivering, teeth chattering, and needed to wrap himself up in a blanket. Be advised that these symptoms mimic the symptoms experienced by my son to the onset of a seizure. Pt did not, however, experience a seizure. Pt was not well enough to go to work, and lost a full day of pay; my husband came home from work to stay with patient. I reported the symptoms and the adverse event to both patient''s neurologist and the pharmacy.

VAERS ID:556352 (history)  Vaccinated:2014-11-10
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-11-20
Location:Ohio  Entered:2014-12-02, Days after submission: 12
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS4B299 UNRA
Administered by: Public     Purchased by: Public
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: Patient was given pediatric dose of Hepatitis A in place of adult dose: Lot ## 4B299 on 11/10/14 around 2:40 pm. Manufacturer - GSK.

VAERS ID:556463 (history)  Vaccinated:2014-12-01
Age:20.0  Onset:2014-12-01, Days after vaccination: 0
Gender:Female  Submitted:2014-12-02, Days after onset: 1
Location:Oregon  Entered:2014-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Does not remember~Hep B (no brand name)~1~16.00~Patient
Other Medications: Aderal, Propranolol
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.K0048100IMRA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Back pain, Chills, Headache, Musculoskeletal stiffness, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Back and joint pain, stiffness, High temperature, Chills, Headache, Vomits (3).

VAERS ID:556976 (history)  Vaccinated:2014-09-09
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-12-04
Location:Unknown  Entered:2014-12-04
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: History of Eczema
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0OTLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site pruritus, Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: The patient came in today on05 December 2014 with the large rash to upper left ams. Patient reports he has scratched at the upper left arm site a couple of times.

VAERS ID:557296 (history)  Vaccinated:2014-12-08
Age:20.0  Onset:2014-12-08, Days after vaccination: 0
Gender:Female  Submitted:2014-12-08, Days after onset: 0
Location:West Virginia  Entered:2014-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: NO
Preexisting Conditions: Patient is pregnant
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT53309 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Headache, Hypoaesthesia oral, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient originally complained of "numb lips" and feeling nauseous. Later also said that she was experiencing tightness in her chest and a headache too. Never had any problems breathing or anything like that. Never emergent enough to need Epipen or Benadryl, but we called paramedics as a precaution and they ended up taking her to a hospital for observation.

VAERS ID:557478 (history)  Vaccinated:2014-12-05
Age:20.0  Onset:2014-12-05, Days after vaccination: 0
Gender:Male  Submitted:2014-12-09, Days after onset: 4
Location:Ohio  Entered:2014-12-09
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
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURK11830IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Had a fever (highest temperature was 101.0).

VAERS ID:557765 (history)  Vaccinated:2014-12-10
Age:20.0  Onset:2014-12-10, Days after vaccination: 0
Gender:Male  Submitted:2014-12-10, Days after onset: 0
Location:Oregon  Entered:2014-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: None reported, dehydration detected by EMT
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI188AB0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Pt fainted.

VAERS ID:558925 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-12-11
Location:Unknown  Entered:2014-12-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1412USA000781
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to an adult female patient (exact age was not provided). Patient''s medical history was not reported. On an unknown dates also reported as when "she was 20 years old", the patient was vaccinated with her first two doses of GARDASIL (frequency, route of administration and lot # were not provided). Concomitant medication was not reported. The patient stated that she would like to receive her third dose of GARDASIL. No adverse symptoms were reported. Product quality complaint (PQC) was not involved. Additional information has been requested.

VAERS ID:558781 (history)  Vaccinated:2014-12-16
Age:20.0  Onset:2014-12-16, Days after vaccination: 0
Gender:Female  Submitted:2014-12-16, Days after onset: 0
Location:California  Entered:2014-12-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICSK154020UNLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dyspnoea, Lip swelling, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Pt requested flu shot w/o any allergy. Shortly after administering FLUVIRIN, pt complained of dizziness. Pt''s condition get worse w/swelling lips, shortness of breath, tightening her throat. Called 911. EPIPEN 0.3 mg was administered. Paramedic came and took pt to hospital.

VAERS ID:559266 (history)  Vaccinated:2014-12-08
Age:20.0  Onset:2014-12-09, Days after vaccination: 1
Gender:Female  Submitted:2014-12-10, Days after onset: 1
Location:Arizona  Entered:2014-12-18, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: EES; DEPO-PROVERA
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0141521SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 70mm redness and 30mm induration at injection site.

VAERS ID:558998 (history)  Vaccinated:2014-12-19
Age:20.0  Onset:2014-12-19, Days after vaccination: 0
Gender:Female  Submitted:2014-12-19, Days after onset: 0
Location:California  Entered:2014-12-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PRENATAL VITAMINS; IRON SUPPLEMENT
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4875AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Immediate post-injection reaction, Injection site bruising, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: IMMEDIATE SWELLING AND BRUISING AT INJECTION SITE.

VAERS ID:559441 (history)  Vaccinated:2014-12-16
Age:20.0  Onset:2014-12-16, Days after vaccination: 0
Gender:Female  Submitted:2014-12-16, Days after onset: 0
Location:Pennsylvania  Entered:2014-12-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Fentanyl - had syncopal episode; h/o depression, in remission
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0094822IMLA
Administered by: Private     Purchased by: Private
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)
Write-up: Pt. had syncopal reaction immediately after receiving GARDASIL vaccine. She recovered within 2-3 minutes, no head trauma, returned to baseline.

VAERS ID:559450 (history)  Vaccinated:2014-11-11
Age:20.0  Onset:2014-11-12, Days after vaccination: 1
Gender:Male  Submitted:2014-12-17, Days after onset: 35
Location:Connecticut  Entered:2014-12-23, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS146305 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Syringe issue
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Sore muscle off and on since administration. Had a problem with plunger of syringe.

VAERS ID:559808 (history)  Vaccinated:2014-12-26
Age:20.0  Onset:2014-12-27, Days after vaccination: 1
Gender:Male  Submitted:2014-12-27, Days after onset: 0
Location:North Carolina  Entered:2014-12-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Keppra
Current Illness: None
Preexisting Conditions: Seizure. Last episode in March 2014
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED 0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Generalised tonic-clonic seizure, Postictal state
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Tonic clonic seizure lasting about 45 sec with post ictal phase of 5 min.

VAERS ID:560291 (history)  Vaccinated:2014-12-22
Age:20.0  Onset:2014-12-22, Days after vaccination: 0
Gender:Female  Submitted:2014-12-31, Days after onset: 9
Location:California  Entered:2014-12-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BENADRYL
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CJ21300IN 
Administered by: Private     Purchased by: Private
Symptoms: Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient broke out in hives and "got puffy in her face" - 1 1/2 hrs after receiving the nasal flu vaccine.

VAERS ID:560429 (history)  Vaccinated:2014-12-22
Age:20.0  Onset:2014-12-22, Days after vaccination: 0
Gender:Male  Submitted:2015-01-03, Days after onset: 12
Location:Colorado  Entered:2015-01-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: dizziness (similar)~Td Adsorbed (no brand name)~~11.67~Patient
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.K0185250IMRA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU4669AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, 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), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Significant dizziness/blacking out starting within about 30 seconds of the injection and lasting for about 5 minutes. Did not feel quite like I was going to pass out, but definitely had to remain sitting down for several minutes.

VAERS ID:561299 (history)  Vaccinated:2014-09-30
Age:20.0  Onset:2014-09-30, Days after vaccination: 0
Gender:Female  Submitted:2014-11-21, Days after onset: 52
Location:Unknown  Entered:2015-01-08, Days after submission: 48
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: PHEH2014US019871
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS141901 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Accidental exposure to product, No adverse event
SMQs:
Write-up: Case number PHEH2014US019871, is an initial spontaneous report from a medical assistant received on 01 OCT 2014. This report refers to a 20-year-old female patient (nurse). Historical conditions were not reported. No concomitant medication was reported. It was reported that the FLUVIRIN 2014/2015 (batch number: 141901) vaccine leaked onto patient (nurse) skin with no reaction noted on 30 SEP 2014. No adverse reaction reported following the inadvertent exposure to vaccine.

VAERS ID:561324 (history)  Vaccinated:2014-10-10
Age:20.0  Onset:2014-10-10, Days after vaccination: 0
Gender:Female  Submitted:2014-11-21, Days after onset: 42
Location:Unknown  Entered:2015-01-08, Days after submission: 48
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: PHEH2014US020573
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1412121 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: Case number PHEH2014US020573, is an initial spontaneous report from a nurse received on 10 OCT 2014. This report refers to a 20-year-old-female. Past medical history and concomitant medications were not reported. On 10 OCT 2014, the patient was vaccinated with 0.5 ml of FLUVIRIN 2014/2015 (batch number: 1412121) intramuscularly. It was reported that the patient received FLUVIRIN from open multiple dose vial (MDV) that reached 72 F overnight. No adverse event was reported following this medication error (incorrect storage of drug).

VAERS ID:565014 (history)  Vaccinated:2015-01-07
Age:20.0  Onset:2015-01-07, Days after vaccination: 0
Gender:Female  Submitted:2015-01-09, Days after onset: 2
Location:Unknown  Entered:2015-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ABILIFY
Current Illness: Bipolar disorder
Preexisting Conditions:
Diagnostic Lab Data: 07-JAN-2015: urine pregnancy test positive.
CDC Split Type: WAES1501USA002066
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K006138 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, No adverse event, 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 registered nurse refers to a 20 year old female patient with no drug reactions/allergies. Patient''s concurrent conditions included bipolar disorder. The patient became pregnant with last menstrual period (LMP) of 06-DEC-2014 and estimated date of delivery (EDD) of 12-SEP-2015. On 07-JAN-2015 the patient was inadvertently vaccinated with a dose of VARIVAX (Merck) dose: 0.5 ml, subcutaneously (lot # K006138, expiration date: 29-APR-2016). Concomitant therapies included ABILIFY (also reported as ''ABILFY''). Urine pregnancy test: positive on 07-JAN-2015. Initial exposure to VARIVAX (Merck) was at 4 weeks. The pregnancy outcome was outcome pending. The patient sought medical attention by visiting the office. No treatment was given for the event. No adverse effects reported. Additional information has been requested.

VAERS ID:565030 (history)  Vaccinated:2013-09-18
Age:20.0  Onset:2013-09-20, Days after vaccination: 2
Gender:Female  Submitted:2015-01-12, Days after onset: 479
Location:Unknown  Entered:2015-01-12
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: Exposure via blood
Preexisting Conditions: Hep B vaccine, prophylaxis
Diagnostic Lab Data: Hepatitis B surface antigen, Positive
CDC Split Type: A1082564A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSY9RX5 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis B surface antigen positive
SMQs:, Liver infections (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of hepatitis B surface antigen positive in a 20-year-old female subject who was vaccinated with ENGERIX B (GlaxoSmithKline). In 1993, the subject had completed the hepatitis B series. Concurrent medical conditions included exposure via blood. On 18 September 2013 the subject received booster dose of ENGERIX B vaccine (unknown route and injection site) after a blood exposure. 2 days after vaccination with ENGERIX B vaccine, the subject experienced hepatitis B surface antigen positive. At the time of reporting, the outcome of the event was unspecified. This is one of the 2 cases reported by the same reporter.

VAERS ID:565057 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2015-01-12
Location:Unknown  Entered:2015-01-12
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: Titer showed low level. Follow-up information of 16 September 2014: Repeated titers and had immunity to Hep B
CDC Split Type: A1084103A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 3UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, Underdose, Viral titre increased
SMQs:
Write-up: This case was reported by a healthcare professional and described the occurrence of decreased therapeutic response in a 20-year-old female subject who was vaccinated with ENGERIX B pediatric (GlaxoSmithKline). On an unspecified date, the subject received the complete ENGERIX B pediatric series in childhood (unknown route, injection site and batch number); but a recent titer showed a low level. Therefore, a new series was started. In 2014, the subject received 4th dose ENGERIX B pediatric (.5ml, unknown route, injection site and batch number) instead of an adult dose, which led to a vaccine underdose and inappropriate age at vaccine administration. Follow-up information received on 16 September 2014: The date of birth, the weight and the height had been added. The subject repeated titers and at the time of reporting, she had immunity to Hepatitis B.

VAERS ID:565070 (history)  Vaccinated:2014-12-22
Age:20.0  Onset:2014-12-23, Days after vaccination: 1
Gender:Female  Submitted:2015-01-12, Days after onset: 20
Location:Virginia  Entered:2015-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Generic ZOLOFT
Current Illness: None
Preexisting Conditions: Amoxicillin
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS552011A1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 1 day after injection - arm became swollen, tender, red at site - golf ball size lasting x4 days. Vomiting started 1 day post injection x 3 1/2d; Day 4 post injection - decreased swelling; Day 5 swelling resolved and no vomiting.

VAERS ID:561235 (history)  Vaccinated:2015-01-12
Age:20.0  Onset:2015-01-12, Days after vaccination: 0
Gender:Female  Submitted:2015-01-13, Days after onset: 1
Location:California  Entered:2015-01-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pregnant
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSLZ4S25IMLA
Administered by: Public     Purchased by: Other
Symptoms: Extra dose administered, Wrong drug administered
SMQs:
Write-up: Patient given Fluarix instead of Tdap vaccine. Patient had received Fluvirin on 9/19/14. Dr. notified of event. No treatment necessary. Patient called and informed of above.

VAERS ID:561403 (history)  Vaccinated:2014-12-26
Age:20.0  Onset:2015-01-01, Days after vaccination: 6
Gender:Unknown  Submitted:0000-00-00
Location:Montana  Entered:2015-01-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Nauseated, fever~Tdap (no brand name)~1~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 5 days before reaction took lymph/acute/vaccine tox/thymus support
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CJ21290IN 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0081980SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0139050SCRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site induration, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain from injection site on rt. arm to elbow area hard at site of inject several days after inject. Today tender to touch, warm to touch.

VAERS ID:564995 (history)  Vaccinated:2014-11-01
Age:20.0  Onset:2014-11-01, Days after vaccination: 0
Gender:Female  Submitted:2015-01-15, Days after onset: 75
Location:Unknown  Entered:2015-01-15
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:
CDC Split Type: WAES1412USA008987
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: Information has been received from a physician on 17-DEC-2014 via a company representative. The physician, who was also the mother of a 20 year old female patient, disclosed that her daughter has been getting headaches after receiving her first dose of GARDASIL (lot number and expiration date not provided) about 30 days ago. These headaches have been persistent for the last 30 days. The outcome was not reported. The causality was not reported. No other information was provided. Additional information is not expected.

VAERS ID:565361 (history)  Vaccinated:2014-11-24
Age:20.0  Onset:2014-11-24, Days after vaccination: 0
Gender:Male  Submitted:2015-01-16, Days after onset: 53
Location:Unknown  Entered:2015-01-16
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: WAES1412USA008232
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report was received from a registered nurse and refers to a 20 year old male patient. Medical history and concomitant medications were not reported. The patient received his first dose of GARDASIL on 05-AUG-2013 and his second dose on 24-NOV-2014. No adverse experience was observed. Additional information has been requested.

VAERS ID:561941 (history)  Vaccinated:2013-08-28
Age:20.0  Onset:2013-08-28, Days after vaccination: 0
Gender:Female  Submitted:2014-02-24, Days after onset: 180
Location:Ohio  Entered:2015-01-19, Days after submission: 329
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: None
Preexisting Conditions: NKDA, No relevant history
Diagnostic Lab Data:
CDC Split Type: 13AV00015SP
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3080IMAR
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR 0IMUN
Administered by: Military     Purchased by: Military
Symptoms: Expired product administered
SMQs:
Write-up: Information received from a nurse on 29AUG2013 regarding a 33 year old female who was administered expired vaccine without adverse event. On 28AUG2013 the female received a primary dose of BIOTHRAX (Lot FAV308; exp. 14AUG2013) and a primary dose of Typhoid vaccine both intramuscularly in an unspecified arm. It was later noted, that the BIOTHRAX had exceeded its expiry date at the time of administration. There were no reported associated adverse events.

VAERS ID:562000 (history)  Vaccinated:2015-01-19
Age:20.0  Onset:2015-01-20, Days after vaccination: 1
Gender:Female  Submitted:2015-01-21, Days after onset: 1
Location:North Carolina  Entered:2015-01-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K008213 IM 
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, swollen, hot to the touch.

VAERS ID:565653 (history)  Vaccinated:2014-07-21
Age:20.0  Onset:2014-07-21, Days after vaccination: 0
Gender:Female  Submitted:2015-01-21, Days after onset: 184
Location:Unknown  Entered:2015-01-21
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: On 21-JUL-2014, hepatitis B titer was "less than 5", reported as "low titer".
CDC Split Type: WAES1501USA002613
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1572AA3UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered, Extra dose administered, Hepatitis B antibody negative
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 20 year old female patient with no pertinent medical history or drug reactions/allergies. On 23-JAN-1994, 21-FEB-1994, and 27-JUL-1994, the patient was respectively vaccinated with the first, the second and the third dose of RECOMBIVAX HB, (dose, route, lot # and expiration date not reported). There was no concomitant medication. On 21-JUL-2014, the result of "hepatitis B titer" was "less than 5 (units not provided)". As a treatment for the "low titer", on that same date, the patient may had been administered an expired dose (fourth dose) of RECOMBIVAX HB, (possibly from lot # 1572AA and expiration date 26-MAY-2014). At the time of the report, the outcome of the events was unknown. Additional information has been requested.

VAERS ID:565798 (history)  Vaccinated:2014-12-29
Age:20.0  Onset:2014-12-29, Days after vaccination: 0
Gender:Female  Submitted:2015-01-23, Days after onset: 25
Location:New Jersey  Entered:2015-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: methylphenidate
Current Illness: Asthma
Preexisting Conditions: Attention deficit/hyperactivity disorder
Diagnostic Lab Data: 04/21/2014, Hepatitis B antibody, not immune, Negative
CDC Split Type: WAES1501USA004324
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.K0083342IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, Hepatitis B antibody negative
SMQs:
Write-up: This spontaneous report has been received from a physician and refers to a 19 year old female patient with asthma and without drug reactions or allergies. The patient''s medical history included attention deficit/hyperactivity disorder. The patient received three unspecified Hepatitis B vaccines (manufacturer unknown) when she was "younger" and on 21-APR-2014 the patient had titers drawn for the hepatitis B and the results showed that the patient was not immune (related case # 1501USA006194). So the patient was administered RECOMBIVAX HB on the following dates: 0.5ml (physician confirmed that the patient was administered 0.5ml) of RECOMBIVAX HB (lot# J007946 and expiration date 24-MAR-2016) intramuscular on 22-APR-2014, an unspecified dose of RECOMBIVAX HB (lot# J007946 and expiration date 24-MAR-2016) intramuscular on 26-JUN-2014 (the second vaccine should be given on 22-MAY-2014) and the "pediatric version" (unspecified dose) of RECOMBIVAX HB (lot# K008334 and expiration date 09-JUN-2016) intramuscular on 29-DEC-2014 (the third vaccine should be given on 22-OCT-2014 and should be given as adult formulation, other than "pediatric version"). Concomitant therapies included methylphenidate. Additional information is not expected as the physician is not allowed to be contacted.

VAERS ID:564123 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-11-03
Location:Unknown  Entered:2015-01-26, Days after submission: 84
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Diagnostic Lab Data: Lab tests unknown
CDC Split Type: 2013SA122148
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Initial report reported by consumer on 18 November 2013. A 20 year old female, medical history and concomitant unknown, received dose of Flu vaccine (Lot#, vaccination site was unknown). Patient think vaccination was given intramuscular but she was not sure. It was reported that she experienced injection site pain and the pain travelled through her shoulder blade. Patient was recovered from the event on next day. Documents held by sender: none.

VAERS ID:564128 (history)  Vaccinated:2013-11-15
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2014-11-03
Location:Unknown  Entered:2015-01-26, Days after submission: 84
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: 2013SA120021
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Initial information received from a consumer on 18 November 2013. A 20-year-old female patient whose medical history was not reported had received a flu shot (manufacturer unknown) (batch number, route and site of administration not reported) on 15 November 2013. On an unspecified date, the patient had lot of pain at the injection site but also traveled through her shoulder blade. The patient was ok very next day. Lab investigations and treatment medications were not reported. List of documents held by sender: none Follow-up information received from a health care professional on 17 January 2014: No additional information was available.

VAERS ID:563073 (history)  Vaccinated:2015-01-19
Age:20.0  Onset:2015-01-22, Days after vaccination: 3
Gender:Female  Submitted:2015-01-29, Days after onset: 7
Location:Ohio  Entered:2015-01-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None to report
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4874AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Patient experienced numbness in 3 fingers in her left hand on 1/22/15. Numbness continued to her left hand and stopped at left elbow. No Medical attention sought by patient. Patient stated today on 1/29/15 numbness is improving and is only located in left hand and finger tips. The numbness comes and goes. She stated work/activity at home may have been a contributing factor.

VAERS ID:563827 (history)  Vaccinated:2014-10-16
Age:20.0  Onset:2014-10-17, Days after vaccination: 1
Gender:Male  Submitted:2015-02-05, Days after onset: 111
Location:Colorado  Entered:2015-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: NKDA; Healthy male
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Chills, Myalgia, Pyrexia, Swelling face
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Right lower facial swelling, fever, chills, myalgia.

VAERS ID:563967 (history)  Vaccinated:2015-01-16
Age:20.0  Onset:2015-01-16, Days after vaccination: 0
Gender:Female  Submitted:2015-02-05, Days after onset: 20
Location:Alaska  Entered:2015-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vyvanse, ranitadine, D3, B complex, mega 3 fish oil
Current Illness: No
Preexisting Conditions: Allergy Septra and Respiradone causes rash hives; suicide attempts, raped, abused 4-5 yrs ago
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0042252IMRA
Administered by: Public     Purchased by: Public
Symptoms: Immediate post-injection reaction, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Insomnia
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: I in bump immediately after injection 10:30 AM: 3-5 days later itching, warmth then pain at injection site: 02/03/2015 "so painful it interrupted sleep/" bump was smaller in size. 02-05-2015 not so painful and can sleep, but bump still present but smaller.

VAERS ID:563970 (history)  Vaccinated:2012-09-12
Age:20.0  Onset:2012-10-05, Days after vaccination: 23
Gender:Male  Submitted:2015-02-05, Days after onset: 853
Location:Arizona  Entered:2015-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: No illness.
Preexisting Conditions:
Diagnostic Lab Data: After detoxing.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 2IMLA
TTOX: TETANUS TOXOID (TEVAX)GLAXOSMITHKLINE BIOLOGICALS 2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy, Malaise, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad)
Write-up: Started getting general ill feeling, losing weight, within two months lost 20 lbs, lymphnodes swelled everywhere.

VAERS ID:568248 (history)  Vaccinated:2015-02-03
Age:20.0  Onset:2015-02-04, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Georgia  Entered:2015-02-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 20~Influenza (Seasonal) (no brand name)~UN~0.00~Sibling
Other Medications:
Current Illness: None-healthy
Preexisting Conditions:
Diagnostic Lab Data: None at this time
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0059570IMLA
Administered by: Other     Purchased by: Other
Symptoms: Headache, Injection site swelling, Nausea, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Throat irritation
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm pain, swelling to injection site. Body ache, fever 101 (oral), headache, itchy sore throat, nausea 2/4/15 1930 - felt worse.

VAERS ID:568946 (history)  Vaccinated:2013-12-11
Age:20.0  Onset:2013-12-11, Days after vaccination: 0
Gender:Female  Submitted:2014-02-24, Days after onset: 75
Location:Unknown  Entered:2015-02-11, Days after submission: 352
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: PHEH2013US025763
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM12129 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product formulation administered, No adverse event
SMQs:
Write-up: Case number PHEH2013US025763 is an initial spontaneous report received from a nurse on 12 Dec 2013 with a follow-up received on 13 Jan 2014: This report refers to a 20-year-old female patient. She was given only MenCYW-135 liquid component of MENVEO (batch number: M12129) intramuscularly in to the left deltoid on 11 Dec 2013. On the same day she was also vaccinated with GARDASIL (other manufacturer, batch number: unknown) intramuscularly at 0.5 ml. No adverse event was reported following this administration error. Follow-up received from the nurse on 13 Jan 2014: Updated patient demographics, concomitant vaccination and site of application of MENVEO.

VAERS ID:564941 (history)  Vaccinated:2014-12-03
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:2015-02-12
Location:Unknown  Entered:2015-02-12
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: US2014GSK040269
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B094AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired product administered
SMQs:
Write-up: This case was reported by a pharmacist and described the occurrence of expired vaccine used in a 20-year-old female patient who received BOOSTRIX (batch number AC52B094AA, expiry date 8th November 2014). On 3rd December 2041, the patient received BOOSTRIX .5 ml. On an unknown date, an unknown time after receiving BOOSTRIX, the patient experienced expired vaccine used. On an unknown date, the outcome of the expired vaccine used was unknown.

VAERS ID:569263 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2015-02-12
Location:Unknown  Entered:2015-02-12
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: WAES1502USA002496
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Autism
SMQs:
Write-up: Information has been received from a consumer refers to his current 20 year old male grandson. No relevant history was reported. In 1995, the patient was vaccinated with M-M-R II (dose, route and lot number not provided) for vaccine. On an unknown date the patient experienced autism. The outcome of autism was unknown. This is one of several reports received from the same source. The other report is 1502USA002550. Additional information is not expected as no contact information.

VAERS ID:566078 (history)  Vaccinated:2015-02-16
Age:20.0  Onset:2015-02-16, Days after vaccination: 0
Gender:Female  Submitted:2015-02-19, Days after onset: 3
Location:Georgia  Entered:2015-02-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4853AA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash on right arm. Injection given on left arm.

VAERS ID:569856 (history)  Vaccinated:2015-01-23
Age:20.0  Onset:2015-02-05, Days after vaccination: 13
Gender:Female  Submitted:2015-02-09, Days after onset: 4
Location:Oregon  Entered:2015-02-19, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills; ADVAIR inhaler; ALBUTEROL Inhaler
Current Illness: None identified
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.3K010337 SCLA
Administered by: Private     Purchased by: Other
Symptoms: Induration, Rash, Skin hyperpigmentation
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Rash on chest, upper arms bilateral, 2MNS diameter. Hyperpigmentation and slight firmness upper rear left arm measures 2cm by 2cm diameter.

VAERS ID:566732 (history)  Vaccinated:2015-01-20
Age:20.0  Onset:2015-01-28, Days after vaccination: 8
Gender:Male  Submitted:2015-02-24, Days after onset: 27
Location:Virginia  Entered:2015-02-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV387A1IMLA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A1OTRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ050211IMLA
Administered by: Military     Purchased by: Military
Symptoms: Stevens-Johnson syndrome
SMQs:, Severe cutaneous adverse reactions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Stevens-Johnson syndrome.

VAERS ID:570030 (history)  Vaccinated:2015-02-15
Age:20.0  Onset:2015-02-16, Days after vaccination: 1
Gender:Female  Submitted:2015-02-17, Days after onset: 1
Location:Arizona  Entered:2015-02-24, 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: TB skin test
Current Illness: Cough
Preexisting Conditions: Allergic to cats
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0185401SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt states she noticed the site of Varicella #2 itchy with redness and warm to the touch the day after injection. Pt states she has not scratched the site and now it is painful and she avoids touching the site.

VAERS ID:567081 (history)  Vaccinated:2009-09-18
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2014-10-06
Location:Unknown  Entered:2015-02-25, Days after submission: 142
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2014SE77044
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Military     Purchased by: Military
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: This report to VAERS provides the following narrative: A report from VAERS (Health Authority) concerns a 20 year old male. Patient''s relevant history and concomitant disease were not reported. Patient received FLUMIST (intranasal) on 18-Sep-2009 and H1N1 (intranasal) on an unknown date. He experienced Guillain-Barre syndrome like symptoms. The outcome of the Guillain-Barre syndrome was unknown. The reporter considered the Guillain Barre syndrome to be serious by criteria of hospitalization and patient also required emergency room.

VAERS ID:567281 (history)  Vaccinated:2015-02-25
Age:20.0  Onset:2015-02-26, Days after vaccination: 1
Gender:Male  Submitted:2015-02-26, Days after onset: 0
Location:Unknown  Entered:2015-02-26
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: Erythemic lesion traced with skin marker to diagnose possible cellulitis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0051780SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema and pain at site of inoculation.

VAERS ID:567696 (history)  Vaccinated:2015-02-26
Age:20.0  Onset:2015-02-27, Days after vaccination: 1
Gender:Male  Submitted:2015-03-02, Days after onset: 3
Location:California  Entered:2015-03-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ondansetron, Singulair, albuterol, BeYaz, fluticasone
Current Illness: No
Preexisting Conditions: Asthma, food allergy to mangos, medication allergy to codeine, GERDS/acid reflux
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRRA
HPV4: HPV (GARDASIL)MERCK & CO. INC. 4SYRRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0SYRLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0SYRLA
Administered by: Unknown     Purchased by: Other
Symptoms: Cough, Dysphagia, Dyspnoea, Fatigue, Headache, Injection site erythema, Injection site induration, Injection site mass, Injection site pain, Injection site swelling, Oropharyngeal pain, Sneezing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), 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), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Excessive pain, redness and swelling near injection site the day it was given; hard, painful red lumps developed surrounding and well below the injection sight for 3 days, headache, difficulty breathing, fatigue, sore throat, sneezing, dry cough, difficulty swallowing. Self treated with Benadryl.

VAERS ID:567884 (history)  Vaccinated:2015-03-02
Age:20.0  Onset:2015-03-02, Days after vaccination: 0
Gender:Male  Submitted:2015-03-03, Days after onset: 1
Location:Illinois  Entered:2015-03-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None; MMR#3 administered since first MMR dose was given 6/6/1995, prior to first birthday
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0063962SCLA
Administered by: Unknown     Purchased by: Other
Symptoms: Coordination abnormal, Headache, Visual field defect
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Retinal disorders (broad)
Write-up: Per NP, when he looked back on yesterday, patient thinks he had difficulty with coordination for about one hour later in the day after getting vaccinated. Patient states today had a black spot in visual field. NP administered Acetaminophen, 500mg tabs x 2 for c/o mild headache. Referred patient to Immediate Care for further evaluation and treatment.

VAERS ID:568294 (history)  Vaccinated:2015-03-03
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2015-03-05
Location:Oregon  Entered:2015-03-05
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
MENB: MENINGOCOCCAL B (TRUMENBA)PFIZER/WYETH 0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Severe redness around injection site.

VAERS ID:568539 (history)  Vaccinated:2015-03-06
Age:20.0  Onset:2015-03-06, Days after vaccination: 0
Gender:Female  Submitted:2015-03-07, Days after onset: 1
Location:Arkansas  Entered:2015-03-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin, Colace, Motrin, Vicodin, topical dermoplast
Current Illness: No- postpartum from vaginal delivery on 3/4
Preexisting Conditions: Anemia
Diagnostic Lab Data: None other than VS stated above
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4690BA IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Body temperature increased, Chills, Headache, Hyperhidrosis, Nausea, Retching, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Adacel TDaP given IM prior to planned d/c home 3/6/15 at 1714. At her vax reassessment at 1744 the pt reported nausea and btwn then and 1800 was dry heaving. After a walk and cooling down nausea persisted and MD was notified- Zofran order was obtained. Zofran PO was given @ 1815 and pt immediately vomited. She vomited 3 times within the next 30 mins, temp was 97.6. Pt reports chills starting @ 2145 after her shower. Vomiting continued til 2200. Temps following were: 2210: 99.4, 0215: 99.2, 0540: 99.4 (none prior exceeded 98.2)- BPs remained within normal range of pt prior to IM vaccine. Headache started @ 0200 (rated 8/10 at am assessment), Tylenol was given @ 0744 and pt reported resolution of h/a and sweating a lot during her morning nap following the med.

VAERS ID:568546 (history)  Vaccinated:2015-03-05
Age:20.0  Onset:2015-03-05, Days after vaccination: 0
Gender:Female  Submitted:2015-03-07, Days after onset: 2
Location:Oregon  Entered:2015-03-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MENB: MENINGOCOCCAL B (TRUMENBA)PFIZER/WYETH 1SYRLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fever, headache, body aches, nausea.

VAERS ID:572791 (history)  Vaccinated:2013-09-17
Age:20.0  Onset:2014-10-15, Days after vaccination: 393
Gender:Male  Submitted:0000-00-00
Location:Nebraska  Entered:2015-04-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DOANS OTC; ZYRTEC
Current Illness: None
Preexisting Conditions: Seasonal allergies; back pain
Diagnostic Lab Data: Mildly increased mast cells, but not diagnostic skin biopsy; normal tryptase
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A IDLA
Administered by: Military     Purchased by: Military
Symptoms: Biopsy skin abnormal, Injection site pruritus, Injection site scar, Injection site urticaria, Paraesthesia, Rash, Tryptase
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Guillain-Barre syndrome (broad), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow)
Write-up: Recurrent solitary urticarial lesion with pruritus at Jennerian scar site of previous smallpox vaccine. Rash, oth nonspecific skin eruption, Disturbance of skin sensation. We did biopsy evaluation and tryptase, showed some abnormalities but did not meet clinical diagnosis. We have given him a dx of recall urticaria, with trx of prn ZYRTEC.

VAERS ID:572761 (history)  Vaccinated:2012-10-01
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:2015-04-03
Location:Colorado  Entered:2015-04-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 2012, Laboratory test, diagnosed with pancreatitis
CDC Split Type: WAES1504USA000707
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Cholecystectomy, Gastrointestinal disorder, Incomplete course of vaccination, Laboratory test abnormal, Pancreatitis
SMQs:, Acute pancreatitis (narrow), Gallbladder related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: This spontaneous report was received from a consumer (patient''s father) refers to a 20 year old male patient. Concurrent conditions and medical history was not reported. On an unknown date in August 2012, the patient was vaccinated with GARDASIL INJ (dose 1, dose and therapy route was not provided). No concomitant therapy was reported. Shortly thereafter on an unknown date the patient started experiencing gastrointestinal symptoms and stomach pain. The patient then received a second dose of GARDASIL on an unknown date in October 2012 and again shortly thereafter the patient was hospitalized on an unknown date approximately in 2012. Ultimately after many tests (unspecified) the patient was diagnosed with pancreatitis (hospitalization and medically significant) on an unknown date in approximately in 2012. Patient sought medical attention and had office visits. The patient had been prescribed many pain medications (unspecified) and this was the only medical treatment identified. On an unknown date the gallbladder was removed after the pancreatitis diagnosis (after the year of 2012). Therapy with GARDASIL was discontinued and the patient never received its third dose and does not plan to do so. Reporter stated that his son should be compensated for the adverse effects. The outcome of the event pancreatitis was reported as not recovered and outcome of cholecystectomy was unknown. The causality assessment was not provided. There was no product quality issue reported. Upon internal review the event of cholecystectomy and pancreatitis were considered medically significant. Additional information has been requested.

VAERS ID:29144 (history)  Vaccinated:1990-11-19
Age:20.0  Onset:1990-11-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Foreign  Entered:1991-03-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: oral contraceptive, nos
Current Illness:
Preexisting Conditions: HX of hyperventilation; paresthesia, dysmenorrhea, allergy
Diagnostic Lab Data: none
CDC Split Type: WAES91021191
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Dizziness, Headache, Hyperhidrosis, Hyperventilation, Nausea, Paraesthesia, Tetany, Tremor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: 45 min /p vax dev headache, hyperventilation, tetany, diaphoresis, dizziness, tingling sensation in mouth, fingers & legs, abd pain, nausea & tremor, Hospitalized & /p 1 hr sx resolved, MD felt rxn related to Recombivax

VAERS ID:29512 (history)  Vaccinated:1987-02-27
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Foreign  Entered:1991-04-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NO relevant hx
Diagnostic Lab Data: EEG 28FEB87 - abnormal
CDC Split Type: WAES91030944
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Convulsion, Electroencephalogram abnormal, Nausea, Visual disturbance
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), 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), Generalised convulsive seizures following immunisation (narrow)
Write-up: on 28FEB87, pt developed "epileptic" sz & was hospitalized; Upon admission, an EEG revealed unspecified abnormalities; Subsequently, pt developed back pain, nausea & visual disturbances;

VAERS ID:30722 (history)  Vaccinated:1991-05-01
Age:20.0  Onset:1991-05-01, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Foreign  Entered:1991-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: vaccinee suffers fr stress & is allergic to PCn, pets, dust, & milk;
Diagnostic Lab Data: BP 110/70
CDC Split Type: EBW918024
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM685A4 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Hyperventilation, Shock, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Pt rec''d 1st dose of vax experienced SOB, Tachycardia, collapse & hyperventilation; Hospitalized & rec''d tx w/oxygen & IV saline;

VAERS ID:43398 (history)  Vaccinated:1991-07-25
Age:20.0  Onset:1991-07-27, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Foreign  Entered:1992-07-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: encephalomyelitis; paresthesia, extremities; goiter, diffuse;
Diagnostic Lab Data: 1991 Gammaglobulin 56.5 mg/l; EEG-temporal, left, focal change; lymphocytes-10 cells in CSF;
CDC Split Type: WAES92065541
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: CSF test abnormal, Electroencephalogram abnormal, Hyporeflexia, Immunoglobulins increased, Multiple sclerosis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Optic nerve disorders (broad), Demyelination (narrow), Hypersensitivity (broad)
Write-up: Pt recvd 2nd dose vax 25JUL91 & on 27JUL91 devel paresthesia of feet; hospitalized & lab eval revealed change in CSF (10 lymphocytes), gammaglobulin inc to 56.6 mg/l, focal lt temporal change in EEG & poor abd reflex; dx MS;

VAERS ID:53149 (history)  Vaccinated:1992-01-18
Age:20.0  Onset:0000-00-00
Gender:Male  Submitted:1993-05-20
Location:Foreign  Entered:1993-05-24, 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: oth
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO4800
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIES1G31076   
Administered by: Other     Purchased by: Unknown
Symptoms: Drug ineffective, Infection, Sepsis
SMQs:, Agranulocytosis (broad), Lack of efficacy/effect (narrow)
Write-up: Meningococcemia, type not specified, 301 day p/vax; Recovered w/o sequellae;

VAERS ID:59122 (history)  Vaccinated:1993-09-06
Age:20.4  Onset:1993-09-06, Days after vaccination: 0
Gender:Female  Submitted:1994-01-12, Days after onset: 128
Location:Foreign  Entered:1994-01-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 930026401
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Headache, Hyperaesthesia, Infection, Laryngospasm, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 4 hrs p/vax pt exp viral like illness w/sensation of swollen throat, dyspnea, h/a, nausea, body aches & inc skin sensitivity;

VAERS ID:64581 (history)  Vaccinated:1993-11-02
Age:20.8  Onset:1993-12-24, Days after vaccination: 52
Gender:Female  Submitted:1994-07-07, Days after onset: 194
Location:Foreign  Entered:1994-07-11, Days after submission: 4
Life Threatening? No
Died? Yes
   Date died: 1993-12-31
   Days after onset: 7
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations: in pt: listless, vomit, h/a, fever, unwell p/1st dose hep b given 20SEP93;
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 940059271
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM947A4 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Brain oedema, Confusional state, Convulsion, Encephalitis, Headache, Hypersensitivity, Necrosis
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: pt recvd vax & devel severe vomiting & felt unwell; pt went to ER; pt''s mom all tests performed in hosp were neg; 25DEC93 transferred to hosp dx encephalitis (probably viral) was made; 30DEC93 neruro stated illness was allerg react;

VAERS ID:72133 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:1995-03-16
Location:Foreign  Entered:1995-03-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: tonsillectomy; appendectomy;
Diagnostic Lab Data: ESR 12MM/H;Rheumatoid factor 84 IE/ML;C Reactive Protein 1.31 MG/DL;X-Ray destruction in all carpalia;HLA HLA-DR4 expression,all in Jan94;
CDC Split Type: WAES95025551
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 2  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Arthropathy, Bone disorder, Hypokinesia, Osteoarthritis, Red blood cell sedimentation rate increased, Rheumatoid arthritis
SMQs:, Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: pt recvd 1st dose of vax;exp arthritis in rt wrist;2nd dose arthritis more severe swelling/pain,rapid progression & stiffness;total stiff rt joint;reduced range in rt wrist;elev ESR,HLA pos;erosive destruction carpalia;rheumatoid arthritis;

VAERS ID:73862 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:1995-04-27
Location:Foreign  Entered:1995-05-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO5901
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIES  SC 
Administered by: Other     Purchased by: Other
Symptoms: Serum sickness
SMQs:, Hypersensitivity (narrow)
Write-up: serum sickness-like disorder; was sick listed; pt recovered w/o sequelae;

VAERS ID:75896 (history)  Vaccinated:1995-04-01
Age:20.0  Onset:1995-05-01, Days after vaccination: 30
Gender:Male  Submitted:1995-07-10, Days after onset: 70
Location:Foreign  Entered:1995-07-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: infectious mononucleosis in 1994 (full date not specified)
Diagnostic Lab Data:
CDC Split Type: 950057111
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Uveitis
SMQs:, Ocular infections (broad)
Write-up: pt recv vax APR95 & 15 days later uveitis was noted for which 2 days hospitalization was needed for clinical assessment; sarcoidosis & multiple sclerosis were excluded; serological results are not yet available;

VAERS ID:76133 (history)  Vaccinated:0000-00-00
Age:20.0  Onset:0000-00-00
Gender:Female  Submitted:1995-07-21
Location:Foreign  Entered:1995-07-25, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 950064561
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myopathy
SMQs:, Rhabdomyolysis/myopathy (narrow)
Write-up: pt recv vax; had rhabdomyolisis;

VAERS ID:76189 (history)  Vaccinated:1995-01-17
Age:20.4  Onset:1995-01-19, Days after vaccination: 2
Gender:Male  Submitted:1995-07-25, Days after onset: 186
Location:Foreign  Entered:1995-07-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Erythrocyte sed rate-1; JAN95 HR 2; WBC count 9400; JAN95 BC neg;
CDC Split Type: 950013691
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Gastroenteritis, Headache, Infection, Malaise, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: pt recv vax 17JAN95 & 3 days later 19JAN95 hospitalized for 2 days for malaise, diarrhea, vomiting, h/a & fever which resolved; BC were neg; poss viral gastroenteritis;

VAERS ID:76422 (history)  Vaccinated:1995-06-15
Age:20.0  Onset:1995-06-15, Days after vaccination: 0
Gender:Female  Submitted:1995-08-01, Days after onset: 47
Location:Foreign  Entered:1995-08-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: CO6034
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (J-VAX)CONNAUGHT LABORATORIESEJN113A1IM 
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.VHA430860IM 
Administered by: Other     Purchased by: Other
Symptoms: Convulsion, Hypertonia, Rash, Stupor, Syncope, Vasodilatation
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: pt recv vax;exp red,blotchy rash;had spasm,went rigid & collapsed to floor;LOC for approx 15 sec;remained rigid like a petit mal for another 15 sec;drowsy for at least 20 mins;past hx of ?epileptic fit in 1986,tests showed neg for epilepsy;

VAERS ID:76577 (history)  Vaccinated:1995-02-04
Age:20.5  Onset:1995-03-01, Days after vaccination: 25
Gender:Female  Submitted:1995-08-02, Days after onset: 153
Location:Foreign  Entered:1995-08-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Cycleane, TIlcotil, Vibramycine
Current Illness:
Preexisting Conditions: acne, contraception, lombalgia; appendectomy
Diagnostic Lab Data: 10MAR95 Chlamydia culture neg; Erythrocyte sed rate 1; HR; Plasma Renin random; Angiotensin converting enzyme neg; CXR nl; Mycoplasma serology neg; Stool culture neg; Yersiniae serology neg;
CDC Split Type: 950037481
Vaccination
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