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Found 485502 cases where Symptom is Immune system disorder or Immunodeficiency or Immunoglobulins decreased or Lymphadenopathy

Case Details (Sorted by Age)

This is page 304 out of 486

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VAERS ID:345850 (history)  Vaccinated:2008-02-08
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-05-06
Location:Hawaii  Entered:2009-05-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Pregnancy NOS (LMP = Unknown)
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0802USA03044
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Ectopic pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a pharmacist concerning a 23 year old female who on 08-FEB-2008 was vaccinated with her second dose of GARDASIL. The pharmacist reported on 12-FEB-2008, that the patient subsequently learned she was pregnant. The patient did not seek medical attention. No adverse reactions were reported. Follow-up information was received from a staff in the office and the registered pharmacist. The staff in the office reported that the patient had a tubal pregnancy in approximately February 2008 and "it had nothing to do with the GARDASIL". The registered pharmacist reported that she had received a request for the office for the third dose of GARDASIL for the patient in April 2008. The request note said that the patient was not pregnant at that time. The registered pharmacist had no any more information about the pregnancy. Upon internal review, tubal pregnancy was determined to be an other important medical event. No further information is available.

VAERS ID:345892 (history)  Vaccinated:2009-04-30
Age:23.0  Onset:2009-05-01, Days after vaccination: 1
Gender:Male  Submitted:2009-05-07, Days after onset: 6
Location:Washington  Entered:2009-05-07
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: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV164 ID 
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURERVV04-003A ID 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURB04242 ID 
Administered by: Military     Purchased by: Unknown
Symptoms: Folliculitis
SMQs:
Write-up: Pt. w/ peri-umbilical follicultis on 2 May 09. No tx. required.

VAERS ID:346369 (history)  Vaccinated:2009-05-14
Age:23.0  Onset:2009-05-14, Days after vaccination: 0
Gender:Male  Submitted:2009-05-14, Days after onset: 0
Location:Guam  Entered:2009-05-14
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: Aspirin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA192AA IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB697CA IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB302BA IMRA
Administered by: Military     Purchased by: Unknown
Symptoms: Asthenia, Blood pressure decreased, Chest discomfort, Dizziness
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: 0840- IM injection given - HEPA. HEPB & INFLUENZA given 0845 - Patient feeling weak, dizzy, chest tightness, HR60 blood pressure 60/40 0850 - Patient laid in trendelenbung position 08:53 - Blood pressure 90/70, patient given water, juice 0855 - Blood pressure 100/70

VAERS ID:346512 (history)  Vaccinated:2009-04-14
Age:23.0  Onset:2009-04-23, Days after vaccination: 9
Gender:Unknown  Submitted:2009-05-18, Days after onset: 25
Location:Virginia  Entered:2009-05-18
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: Pregnancy Test Qual 23 Apr 2009 1038; hCG SERUM POSITIVE (H); Chlamydia + Gonococcus DNA Panel NAAT 05 May 2009 2045 Chlamydia trachomatis DNA ENDOCERVIX CONFIRMED POSITIVE (H) Neisseria gonorrhoeae DNA ENDOCERVIX NEGATIVE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV113 UNLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2831AA UNRA
Administered by: Other     Purchased by: Unknown
Symptoms: Amenorrhoea, Blood human chorionic gonadotropin positive, Chlamydia identification test positive, Drug exposure during pregnancy
SMQs:, Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Fertility disorders (broad)
Write-up: Pt had AVA and Influenza shot on 4/14/09 and SPV 4/16/09. She returned to the Imm Clinic on 4/23/09 for evaluation of SPV (major take); pt requested a pg test which was positive (LMP 3/16/09). Pt indicated that she was not pg on the SPV questionnaire. Symptoms: Amenorrhea.

VAERS ID:346555 (history)  Vaccinated:2007-08-12
Age:23.0  Onset:2007-08-12, Days after vaccination: 0
Gender:Male  Submitted:2009-05-18, Days after onset: 645
Location:Unknown  Entered:2009-05-18
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: NKDA; No medical conditions; No birth effects.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV113 UNUN
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 25 y/o WM ADSM is referred from a study for evaluation of previous local reaction to AVA #2. Symptoms: Edema @ injection site 50-120mm, Pain, Erythema.

VAERS ID:346556 (history)  Vaccinated:2007-08-12
Age:23.0  Onset:2007-08-13, Days after vaccination: 1
Gender:Male  Submitted:2009-05-18, Days after onset: 644
Location:Unknown  Entered:2009-05-18
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: NKDA; No medical conditions; NKDA
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV113 UNUN
Administered by: Military     Purchased by: Military
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 24 y/o WM ADSM is referred from the HMJF Anthrax research study site for evaluation of local reaction after AVA # 2. Symptoms: Edema at injection site 50-120mm, Pain.

VAERS ID:346672 (history)  Vaccinated:2009-04-02
Age:23.0  Onset:2009-04-02, Days after vaccination: 0
Gender:Female  Submitted:2009-05-14, Days after onset: 42
Location:New Jersey  Entered:2009-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: XANAX; LAMICTAL; GEODON
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES0904USA00379
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1312X UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blood pressure decreased, Dizziness, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Information has been received from a nurse concerning a 23 year old female with a penicillin allergy who on 02-APR-2009 was vaccinated with GARDASIL, lot number 661846/1312X. Concomitant therapy included XANAX, LAMICTAL and GEODON. On 01-APR-2009, the nurse reported the patient''s blood pressure dropped and her color became pale after a dose of GARDASIL was given. The patient complained of "feeling faint but did not actually faint". The patient sought medical attention she spoke with the nurse. The patient was recovered on 2-APR-2009. No further information was reported. Additional information has been requested.

VAERS ID:346783 (history)  Vaccinated:2009-03-16
Age:23.0  Onset:2009-03-21, Days after vaccination: 5
Gender:Female  Submitted:2009-05-14, Days after onset: 54
Location:Unknown  Entered:2009-05-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sulfonamide allergy
Preexisting Conditions: Contraception
Diagnostic Lab Data: None
CDC 'Split Type': WAES0904USA00634
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a Pharm. T. concerning a 23 year old female with sulfonamide allergy and a history of birth control who on 16-MAR-2009 was vaccinated with the first 0.5ml dose of GARDASIL. Concomitant therapy included YAZ. On 21-MAR-2009 the patient developed injection site pain. The patient was not recovered at the time of reporting. The patient sought unspecified medical attention. No further information is available.

VAERS ID:346564 (history)  Vaccinated:2008-04-30
Age:23.0  Onset:2008-06-19, Days after vaccination: 50
Gender:Female  Submitted:2009-05-18, Days after onset: 333
Location:Unknown  Entered:2009-05-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Pregnancy NOS (LMP = 6/19/2008)
Preexisting Conditions:
Diagnostic Lab Data: urine beta-human, 08/05/08, positive
CDC 'Split Type': WAES0808USA00976
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0243U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abortion induced, Drug exposure during pregnancy, Urine human chorionic gonadotropin positive
SMQs:, Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a nurse practitioner (N.P.), for the Pregnancy Registry for GARDASIL, concerning a 23 year old female with no pertinent medical history, drug reactions or allergies who on 30-APR-2008 was vaccinated intramuscularly with a first 0.5 ml dose of GARDASIL (Lot #656372/0243U). There was no concomitant medication. Subsequently the patient was discovered that she was pregnant. On 05-AUG-2008 a urine pregnancy test was performed at the office and result was positive. Her LMP was 19-JUN-2008. Expected date of delivery was 26-MAR-2009. No adverse effects were reported. The patient had office visit. Follow-up information was received from the N.P. indicating that the patient terminated her pregnancy. The date of the termination was not available. No further information was provided. Upon internal review, pregnancy termination was determined to be an other important medical event. Additional information has been requested.

VAERS ID:346612 (history)  Vaccinated:2009-05-13
Age:23.0  Onset:2009-05-19, Days after vaccination: 6
Gender:Male  Submitted:2009-05-19, Days after onset: 0
Location:Arizona  Entered:2009-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions:
Diagnostic Lab Data: Site check 6-10 days after administration to see viability of vaccine
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV 155 IMRA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04-003A OTLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURB0424-2 IMRA
Administered by: Military     Purchased by: Military
Symptoms: Incorrect drug dosage form administered
SMQs:
Write-up: Patient recieved smallpox vaccine that was reconstituted with sterile water instead of 50% glycerin, and 0.25% phenol in Sterile Water. Patient does not have any adverse reaction site looks within normal limits.

VAERS ID:346992 (history)  Vaccinated:2009-05-22
Age:23.0  Onset:2009-05-22, Days after vaccination: 0
Gender:Female  Submitted:2009-05-22, Days after onset: 0
Location:Georgia  Entered:2009-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0558X1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: As medication was being injected, became faint. Has not done this with other injections. Once patient sat for a few minutse and sipped on Coke, felt much better.

VAERS ID:347047 (history)  Vaccinated:1998-11-02
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-05-21
Location:Mississippi  Entered:2009-05-22, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: 4/10/2009: Evaluation by the agency and dermatology noted several active areas of scattered fine red slightly raised pruritic single papules & plaques bilateral lateral arms and forearms about elbows but not to antecubital space, bilateral anterior groin-upper thighs (per pt), and across lower back and upper chest region. Dermatology completed a skin biopsy of one rash site for diagnostic information. A diagnosis of urticaria was given on h/o formaldehyde allergy questioning problem with uniform/clothing or creams, etc as active trigger. She was given ALLEGRA 120 mg BID (off label) and CYCIOCORT slush in place of CLARITIN and TAC cream. Her biopsy results showed spongiotic dermatitis with microvesiculation. Differential diagnoses included
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Biopsy skin, Dermatitis, Dermatitis contact, Drug eruption, Erythema, Injection site irritation, Injection site nodule, Injection site pain, Rash macular, Rash papular, Rash pruritic, Skin irritation, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Initial VAERS filed Feb 2003. This 33 year old received her first three ANTHRAX vaccination 02 Nov 1998, 12 Nov 1998, & 28 Nov 1998. AVA #4 and #5 were administered 15 Dec 1998 and 02 Aug 1999. She remembers the injection sites burning then sore with a nodule for approximately one week with full resolution of symptoms. This SM advised late (Nov/Dec?) 1999-early 2000 she experienced a small fine red macular itchy rash to right side of chest under her bra line that resolved with 1-2 days of TRIAMCINOLONE. (No wire in bra.) This rash was attributed to irritation due to fabric softeners. She was transferred to another state in March/April 2000. On 17 July 2000 she reported to ER with a 2 week history of a reoccurring itchy maculopapular rash to "bilateral extensor surfaces of forearms and medial thighs". She was diagnosed with contact dermatitis and advised to discontinue fabric softeners. Rash continues as of 2009 with reflare after 11/12/2008 IM Flu and Yellow fever vaccinations.

VAERS ID:347554 (history)  Vaccinated:2008-05-04
Age:23.0  Onset:2008-05-14, Days after vaccination: 10
Gender:Male  Submitted:2009-05-27, Days after onset: 378
Location:Maryland  Entered:2009-05-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: None, member started Wellbutrin for depression but AFTER he received the Anthrax vaccine. Started Wellbutrin in Sept 2008.
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV1632UNUN
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Chest discomfort, Dyspnoea, Fatigue, Muscle fatigue
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: tightness in chest, shortness of breath, EXTREME fatigue, chronic joint pain, muscle fatigue.

VAERS ID:348148 (history)  Vaccinated:2009-05-26
Age:23.0  Onset:2009-05-27, Days after vaccination: 1
Gender:Male  Submitted:2009-05-29, Days after onset: 2
Location:Texas  Entered:2009-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None. NKD/FA
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0398X3IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1363X2SCLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2637AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1960U0SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3158AA0IMRA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURERC3151AA1IDLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0320X0SCRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Injection site erythema, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient states that he had vaccinations administered on Tuesday and wednesday afternoon around 1:30 p.m. he began having fever and chills. He also had body aches on Thursday, with some residual body aches today. Patient was febrile on Wednesday and Thursday, with fever resolving itself on Friday morning. Patient also has erythemia to posterior side of left upper arm. According to consent, the vaccinations administered in this region were MMR and PPV23. Patient has no swelling to any other areas of arms. Patient has had no anti-biotics therapy, but has been taking Alieve for fever and body aches.

VAERS ID:348367 (history)  Vaccinated:2009-06-02
Age:23.0  Onset:2009-06-02, Days after vaccination: 0
Gender:Female  Submitted:2009-06-02, Days after onset: 0
Location:Nebraska  Entered:2009-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Other     Purchased by: Private
Symptoms: Feeling hot, Flushing, Headache, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Headache, too warm, flushing and nausea.

VAERS ID:348417 (history)  Vaccinated:2008-04-17
Age:23.0  Onset:2009-03-10, Days after vaccination: 327
Gender:Female  Submitted:2009-03-27, Days after onset: 17
Location:Unknown  Entered:2009-06-03, Days after submission: 68
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:
Diagnostic Lab Data: MRI spine w/o contrast 3/10/09; Angio Arch Cervicocerebral 3/18/09; Angio Carotid External Bilateral 3/18/09
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Angiogram, Myelitis transverse, Nuclear magnetic resonance imaging, Paralysis, Spinal cord infarction
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Patient admitted to hospital with paralysis below the neck. History of GARDASIL vaccination; Last dose 04/17/2008. No definite diagnosis. Described as either Traverse Myelitis or Spinal cord infarction.

VAERS ID:348570 (history)  Vaccinated:2009-05-15
Age:23.0  Onset:2009-05-24, Days after vaccination: 9
Gender:Male  Submitted:2009-05-27, Days after onset: 3
Location:Oregon  Entered:2009-06-05, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORATIDINE
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None performed Pt. never felt that he required being seen by a physician.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB131AB1IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1369X1SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3158AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Body temperature increased, Chills, Lymphadenopathy, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 5/24/09 experienced swelling in the lymph node of the left armpit. 5/25/09 chills, generalized malaise, Temp 99.8 5/26/09 Malaise continued, fever at night 100.2 5/27/09 fever gone, feeling better, able to do ADLs without any problems.

VAERS ID:348613 (history)  Vaccinated:2009-06-04
Age:23.0  Onset:2009-06-05, Days after vaccination: 1
Gender:Male  Submitted:2009-06-05, Days after onset: 0
Location:California  Entered:2009-06-05
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: sulfa drugs
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1679U1SCLA
Administered by: Private     Purchased by: Military
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: swelling in left arm wth mild erythema on the site not likely cellulitis.

VAERS ID:348918 (history)  Vaccinated:2009-05-29
Age:23.0  Onset:2009-05-29, Days after vaccination: 0
Gender:Female  Submitted:2009-06-10, Days after onset: 12
Location:Texas  Entered:2009-06-11, 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:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0906USA00544
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Unknown     Purchased by: Other
Symptoms: Arthralgia, Pain in jaw, Paraesthesia oral, Sensation of foreign body, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Osteonecrosis (broad), Arthritis (broad)
Write-up: Information has been received from a nurse concerning a 23 year old female who on 29-MAY-2009 was vaccinated with the first dose of GARDASIL, 0.5ml/IM. After about 20 minutes the patient experienced the feeling of a lump in her throat, tingling of her tongue, achy joints and body tremors. Follow up information has been received from a physician reporting that when the patient had gone to the emergency room she was given I.V. BENADRYL and Benztropine mesylate (MSD) and released. The physician stated that he received a call from the patient a few minutes ago and the patient said that she was starting to have body tremors again as well as aching of her jaw. At the report time the patient was on her way to see the physician and the outcome was unknown. Upon internal review tingling of her tongue, body tremors and lump in her throat were considered as Other Important Medical Events. Additional information has been requested.

VAERS ID:349025 (history)  Vaccinated:2009-06-10
Age:23.0  Onset:2009-06-11, Days after vaccination: 1
Gender:Female  Submitted:2009-06-12, Days after onset: 1
Location:Virginia  Entered:2009-06-12
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
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB116AA2IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0947 X2IMLA
Administered by: Military     Purchased by: Military
Symptoms: Hypoaesthesia, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Approximately 24 hrs after vaccination. Noted left arm swelling and c/o numbness from shoulder to wrist. After 48 hrs remains swollen but no erythema numbness improving from elbow to wrist. Normal ROM,no weakness. Will try ibuprofen for inflammation.

VAERS ID:349286 (history)  Vaccinated:2009-03-04
Age:23.0  Onset:2009-05-04, Days after vaccination: 61
Gender:Female  Submitted:2009-06-12, Days after onset: 39
Location:Unknown  Entered:2009-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0905USA00944
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Menstruation delayed
SMQs:, Fertility disorders (broad)
Write-up: Information has been received from a 23 year old female who on 04-MAR-2009 was vaccinated with with second dose of GARDASIL. The patient had no medical history. It was reported that the patient had her period was right after getting the second dose of GARDASIL. On 07-MAY-2009, the patient reported that her period was 3 days late. The patient didn''t know if she was pregnant and didn''t do any pregnancy test yet. The patient did not seek medical attention. At the time of reporting, the patient had not recovered. No further information is available.

VAERS ID:349287 (history)  Vaccinated:0000-00-00
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-06-12
Location:New Jersey  Entered:2009-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omega-3 marine triglycerides
Current Illness:
Preexisting Conditions: Eczema; Food allergy
Diagnostic Lab Data: Biopsy, negative; Diagnostic laboratory, test for sexually transmitted diseases-negative; Skin and/or subcutaneous, negative; Abscess culture, negative
CDC 'Split Type': WAES0905USA00950
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Biopsy site unspecified normal, Culture negative, Laboratory test normal, Rash, Skin test negative, Vaginal abscess
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a consumer concerning her daughter a 23 year old female with a history of eczema and Dairy allergies (cause of the eczema) who completed vaccination series of GARDASIL "just about a year ago". Concomitant therapy included omega-3 marine triglycerides, proboitics, and pure essential brand (Dr. Ashes Brand). The patient didn''t experience any symptoms after the first or second dose of GARDASIL. Two days after the third dose the patient developed a vaginal rash during her menstruation the rash became worse. The patient also had "abscesses" that had developed on the outside of the vagina. She stated that the abscesses were caused from an e-coli bacteria. The patient had been test for sexually transmitted diseases, skin cultures, abscess cultures, and biopsies all of which had been negative. The mother also stated her daughter has not engaged in any sexual activity and could not identify a source for rashes. The patient had been placed on antibiotics that do not provide relief and was last prescribed a cortisone cream that states "has settled things a little bit this week during her period." The mother and her daughter believed in "doing everything natural and only received GARDASIL after it was highly recommended by a physician who is a friend of the family." The office manager at the gynecologist explained the patient didn''t receive her vaccinations at their office and speculated that the vaccines were given either at school or by the patient''s father, who is a physician. The patient was now visiting her physician about two times a week due to "flare ups" and was going to be seeing an infectious disease physician. The patient was not recovered. Additional information has been requested.

VAERS ID:349293 (history)  Vaccinated:2009-05-01
Age:23.0  Onset:2009-05-01, Days after vaccination: 0
Gender:Female  Submitted:2009-06-12, Days after onset: 42
Location:Unknown  Entered:2009-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flagyl
Current Illness: Pregnancy NOS (LMP) = Unknown
Preexisting Conditions:
Diagnostic Lab Data: Diagnostic laboratory, blood work, pregnant ; Urine beta-human, 05/01/09, negative
CDC 'Split Type': WAES0905USA01140
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Drug exposure during pregnancy, Pregnancy test positive
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a 23 year old female with no medical history or drug allergy who on 01-May-2009 was vaccinated with the first dose of GARDASIL and found out later she was pregnant. Concomitant therapy included Flagyl. The patient stated that her original visit to the practice was because she thought she was pregnant, however after a urine test the office stated she wasn''t and administered the vaccine. The patient reported after getting the vaccine she started experiencing some abdominal pain and went for testing again and found out she was pregnant. The patient had "blood work" performed. At the time of the report the patient was recovered. No further information is available.

VAERS ID:349333 (history)  Vaccinated:2009-03-10
Age:23.0  Onset:2009-03-11, Days after vaccination: 1
Gender:Female  Submitted:2009-06-12, Days after onset: 93
Location:Florida  Entered:2009-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0905USA03367
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0074Y0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a medical assistant concerning a 23 year old female with not reported drug reactions/allergies and medical history, who on 10-MAR-2009 was vaccinated IM with 0.5 ml first dose of GARDASIL (lot number: 0074Y). There was no concomitant medication. The medical assistant reported that the patient developed hives on her shoulder and back, after receiving her first and only dose of the GARDASIL vaccine. The patient was recovered "3 days after vaccination" (13-MAR-2009). The patient did not seek medical attention. Additional information has been requested.

VAERS ID:349370 (history)  Vaccinated:0000-00-00
Age:23.0  Onset:2008-03-03
Gender:Female  Submitted:2009-06-12, Days after onset: 465
Location:Unknown  Entered:2009-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NECON 1/35, EFFEXOR
Current Illness: Pregnancy NOS (LMP = 3/2/2008) Sulfonamide allergy; Allergic reaction to antibiotics
Preexisting Conditions: Attention deficit disorder; Depression; Anxiety; Obesity
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0905USA03695
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a nurse practitioner for GARDASIL, a Pregnancy Registry product, concerning a 23 year old female with allergies to sulfa, MACROBID and a medical history of Attention Deficit Disorder, depression, anxiety and obesity who on unspecified date was vaccinated with the 1st and 2nd dose of GARDASIL. Concomitant therapy included EFFEXOR and NECON 1/35. The doses were administered at a different facility so the nurse practitioner did not have specific dates or lot numbers. The nurse practitioner stated that the patient did not document if she received any concomitant vaccines when she received the GARDASIL. Subsequently, after two doses of GARDASIL, the patient became pregnant. Unspecified medical attention had been sought. The patient delivered her baby at 33 weeks on 20-Oct-2008. The patient told the nurse practitioner that the baby was "doing great". Dose 3 has not been administered yet. Dose 3 was due in April 2008 but was never administered. At the time of reporting, the patient status was "fine". Additional information has been requested.

VAERS ID:349379 (history)  Vaccinated:2009-05-20
Age:23.0  Onset:2009-05-26, Days after vaccination: 6
Gender:Female  Submitted:2009-06-12, Days after onset: 17
Location:South Carolina  Entered:2009-06-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0905USA03905
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0294Y1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:
Write-up: Information has been received from a nurse concerning a 23 year old female patient who on 20-MAY-2009 was vaccinated with a second dose of GARDASIL (Lot # 0294Y). On 26-MAY-2009 she could hardly move her arm due to pain. On 27-MAY-2009 the patient went to the physician and he stated there was no cellulitis. At the time on the report on 27-MAY-2009 the patient had not recovered. Additional information has been requested.

VAERS ID:349265 (history)  Vaccinated:2009-06-06
Age:23.0  Onset:2009-06-09, Days after vaccination: 3
Gender:Male  Submitted:2009-06-16, Days after onset: 7
Location:Washington  Entered:2009-06-16
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: pt states allergy to spiders and bees
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1740IMLA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0OTRA
Administered by: Military     Purchased by: Military
Symptoms: Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt received smallpox vaccination on June 6, 2009, a Saturday. On the following Tuesday, his right arm started to hurt and gradually worsened. On Friday June 12th, his arm was very sore and swollen and he went to an emergency room for treatment. He received anti-inflammatory and pain medication and was sent home a few hours later.

VAERS ID:350053 (history)  Vaccinated:0000-00-00
Age:23.0  Onset:2006-06-06
Gender:Male  Submitted:2009-05-29, Days after onset: 1088
Location:Pennsylvania  Entered:2009-06-17, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: serum measles IgG, 06/06/06, negative
CDC 'Split Type': WAES0809USA00514
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Measles antibody negative
SMQs:
Write-up: Information has been received from a physician concerning a 23 year old male with no known allergies or medical history who in approximately 1986 (15 months old) and approximately 1995 (10 years old) was vaccinated with the first and second doses respectively of MMR II (dose and route not reported). There was no concomitant medication. On 06-JUN-2006, it was discovered that the patient had a negative measles titer. It became an issue when the patient applied to medical school. The patient did not seek medical attention. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:349579 (history)  Vaccinated:2009-06-04
Age:23.0  Onset:2009-06-04, Days after vaccination: 0
Gender:Female  Submitted:2009-06-19, Days after onset: 15
Location:North Carolina  Entered:2009-06-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1480IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURB10260IMRA
Administered by: Military     Purchased by: Military
Symptoms: Incorrect storage of drug
SMQs:
Write-up: Anthrax Vaccine exceeded the recommended temperature range. Shipping and Handling requirements were discussed. No harm done to patient.

VAERS ID:349851 (history)  Vaccinated:2009-06-12
Age:23.0  Onset:2009-06-13, Days after vaccination: 1
Gender:Male  Submitted:2009-06-23, Days after onset: 10
Location:Colorado  Entered:2009-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no known illness at time of vaccination
Preexisting Conditions: none noted
Diagnostic Lab Data: Blood testing at Emergency Room, also X-Rays were taken. results unknown.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1692IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30014160PO 
Administered by: Military     Purchased by: Military
Symptoms: Blood test, Chills, Influenza like illness, Oropharyngeal pain, Pyrexia, X-ray
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: 12 Jun 09/1:32pm-Anthrax vax rec''d IM L. Delt. 13 Jun 09/2:00am-Sore throat/fever/chills/flu-like symptoms noticed. Went to ER later in the day when symptoms got worse. The Hospital gave "IV fluids, Benedryl pills, & pills for headache" They also took blood for testing and X-rays - results weren''t made known to patient.

VAERS ID:349863 (history)  Vaccinated:2009-06-22
Age:23.0  Onset:2009-06-22, Days after vaccination: 0
Gender:Female  Submitted:2009-06-23, Days after onset: 1
Location:Mississippi  Entered:2009-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV0400340IDLA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Member complains of "severe itching" head-to-toe. Member given BENADRYL and CLARITIN by doctor.

VAERS ID:350017 (history)  Vaccinated:2009-06-18
Age:23.0  Onset:2009-06-19, Days after vaccination: 1
Gender:Female  Submitted:2009-06-24, Days after onset: 5
Location:Vermont  Entered:2009-06-24
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 Medical records received 6/29/09 PMH: nasal fx. Allergy: Keflex.
Diagnostic Lab Data: Medical records received 6/29/09 LABS: WBC 14.1(H), ANC 12.13(H)lymphs 8%(L).
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0653X0UNRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal discomfort, Chills, Dizziness, Dyskinesia, General physical health deterioration, Hyperhidrosis, Hypersomnia, Immediate post-injection reaction, Lymphocyte percentage decreased, Malaise, Neutrophil count increased, No reaction on previous exposure to drug, Presyncope, Tremor, Vaccination complication, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Right after i recieved the vaccination i did not feel well and slept all afternoon i recieved the shot in the morning. I was vomitting, almost fainted, sweating uncontrollably. Then my whole body was shaking and would not stop. This happened the morning after i recieved the vaccination. I was very dizzy and had to go to the emergency room that afternoon to recieve medicine to stop shaking, vomitting. I stayed in bed for two days straight sleeping. I was very dizzy. Now I still have stomach issues and my body and health does not feel the same. 6/29/09 Received ER medical records for 6/19/2009. FINAL DX: Vaccine reaction Records reveal patient experienced dizziness, chills, shakiness, vomiting x 1, near syncope x 1 day. No previous reactions to immunizations. Tx w/IVF & meds. Improved & d/c tohome w/anti vertigo meds. 8/10/09 Received PCP medical records for 6/18-19/09 Records reveal patient on antidepressant & requesting BCP. Meds adjusted & vax provided. 6/19/09 reported lightheadedness & shaking jerky movements of UEs. Sent to ER.

VAERS ID:350092 (history)  Vaccinated:2007-09-10
Age:23.0  Onset:2007-12-14, Days after vaccination: 95
Gender:Female  Submitted:2009-06-24, Days after onset: 557
Location:North Carolina  Entered:2009-06-25, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins (unspecified)
Current Illness: Pregnancy NOS (LMP = 12/14/2007)
Preexisting Conditions:
Diagnostic Lab Data: complete blood cell; serum progesterone test; HIV antibody screen; Rapid plasma reagin; serum rubella IgG; serum gonadotropin-; erythrocyte ABO antigen; red blood cell antibody; hemoglobin S test; urine beta-human; Apgar score, 8/9; glucose
CDC 'Split Type': WAES0802USA00127
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1061U1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Anti-erythrocyte antibody, Blood gonadotrophin, Blood grouping, Caesarean section, Drug exposure during pregnancy, Foetal disorder, Full blood count, Glucose tolerance test normal, HIV antibody, Haemoglobin S, Oblique presentation, Progesterone, Rubella antibody test, Syphilis test, Urine human chorionic gonadotropin
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow)
Write-up: Information has been received through the Merck pregnancy registry from a physician concerning a 23 year old female who on 12-JUL-2007 was vaccinated with her first dose of GARDASIL (lot# 657736/0389U). On 10-SEP-2007 the patient was vaccinated with her second dose of GARDASIL (lot# 658558/1061U). On 10-JAN-2008 the patient was vaccinated with her third dose of GARDASIL (lot# 659653/1448U) and was pregnant. The patient was 6 weeks, 5 days. Concomitant therapy included prenatal vitamins. Lab tests performed included quantitative HCG, CBC, Progesterone, HIV, RPR, Rubella, RH type, ABO, antibody screen and sickle cell prep. The patient sought unspecified medical attention and her outcome was not reported. Follow up information was received from an assistant of physician which reported that they did not have pregnancy outcome information. Follow up information was received from a medical records manager at the OB office, for GARDASIL, a Pregnancy Registry product, concerning the patient who on 10-SEP-2008 (39.5 weeks from LMP) delivered a normal male infant (weighted 8 pounds, 15 ounces). The Apgar score were 8 and 9 respectively. The patient delivered by cesarean section with pre and post-operative diagnosis of oblique lie and suspected macrosomia. There were no complications in the pregnancy, and the patient had a normal glucose tolerance test. The patient recovered without complication as well, and the baby was fine at the postpartum visit. Upon internal review, oblique lie and suspected macrosomia were determined to be other important medical events as they resulted in a cesarean section. Additional information is not expected.

VAERS ID:350365 (history)  Vaccinated:2009-06-22
Age:23.0  Onset:2009-06-22, Days after vaccination: 0
Gender:Female  Submitted:2009-06-29, Days after onset: 7
Location:New York  Entered:2009-06-29
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
RAB: RABIES (IMOVAX)SANOFI PASTEURB0661-20IMRA
Administered by: Public     Purchased by: Private
Symptoms: Headache, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Client stated that she developed hives on both arms and had a headache approximately 1 hour after receiving the vaccine. She called her doctor''s office who advised that she take 25 mg benadryl. Client stated the symptoms resolved.

VAERS ID:350752 (history)  Vaccinated:2008-05-16
Age:23.0  Onset:2008-05-16, Days after vaccination: 0
Gender:Female  Submitted:2009-07-02, Days after onset: 412
Location:Connecticut  Entered:2009-07-06, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Pregnancy NOS (LMP=4/20/2008)
Preexisting Conditions:
Diagnostic Lab Data: beta-human chorionic, positive; beta-human chorionic, 05/16/08, negative
CDC 'Split Type': WAES0805USA04794
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain, Abortion induced, Drug exposure during pregnancy, Intra-uterine death, Pregnancy test positive, Uterine dilation and curettage
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a 23 years old female for the Pregnancy Registry for GARDASIL who on 16-MAY-2008 was vaccinated intramuscularly with her first dose GARDASIL and found out three days later that she was pregnant. The patient''s estimated LMP was 20-APR-2008 and she had a positive pregnancy test. Subsequently the patient experienced no adverse event symptoms and sought unspecified medical attention on an unspecified date by calling the office. Follow up information has been received from the patient who stated that she did get the GARDASIL last year but at 10 weeks in her pregnancy she had a miscarriage. At the time of her receiving the first dose of GARDASIL, she had a negative pregnancy test at the office. After one to two weeks, she performed a home pregnancy test which was positive. She called the physician''s office to report it as she was concerned. On her initial prenatal visit, her physical exam was completely normal, and an ultrasound was not routinely done. When she sent to have an ultrasound at the office at 10 weeks, it was found there was no fetal heartbeat. She was asymptomatic. She stated the doctor told her it looked like the fetus had stopped developing about a week or two before that. After the ultrasound, she had some abdominal cramping type pain, but did not spontaneously pass the pregnancy. She "ended up needing a D&C". That went OK, she said, and at her 2 week checkup "everything was fine". Upon internal review, the intra-uterine death and abortion induced were considered as Other Important Medical Events. Additional information has been requested.

VAERS ID:350860 (history)  Vaccinated:2007-06-04
Age:23.0  Onset:2008-03-18, Days after vaccination: 288
Gender:Female  Submitted:2009-07-06, Days after onset: 475
Location:Virginia  Entered:2009-07-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Pregnancy NOS (LMP = Unknown)
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0906USA05633
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Caesarean section, Drug exposure during pregnancy, Hypertension
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a licensed practical nurse, for GARDASIL, a pregnancy registry product, concerning a 24 years old female patient with no medical history and no allergies who on 09-APR-2007 was vaccinated IM with the first 0.5ml dose of GARDASIL (lot # 657005/0314U). The patient received IM the second 0.5ml dose of GARDASIL on 04-JUN-2007 (lot # 657002/0337U, which belongs to VARIVAX ). There was no concomitant medication. On 29-JUN-2009, the patient received the third dose of GARDASIL (lot # 661841/0653x). The patient did not receive any concomitant vaccinations when the three doses of GARDASIL were administered. After the patient was administered her second dose of GARDASIL she was determined to be pregnant. The patient required an unscheduled c-section on 18-MAR-2008 due to hypertension. The infant was a normal, full term baby with no complications. At the time of this report, the patient had recovered. It was reported that the patient sought unspecified medical attention. Upon internal review, the unscheduled c-section due to hypertension was determined to be an other important medical event. Additional information has been requested.

VAERS ID:350908 (history)  Vaccinated:2009-06-20
Age:23.0  Onset:2009-06-20, Days after vaccination: 0
Gender:Female  Submitted:2009-06-30, Days after onset: 10
Location:Massachusetts  Entered:2009-07-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol; CLARITIN; FLOVENT; RECLIPSEN
Current Illness: nasal congestion; sneezing
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0112Y2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Nausea, Pyrexia, Swelling, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: ER x2 6/22/09, Redness, fever, nausea, vomiting, swelling, pain. AUGMENTIN; BACTRIM DS, VICODIN, IBUPROFEN. 16 x14 cm erythematous warm macular lesion surrounding site left deltoid, then 20x16 cm site of erythema moved distal to original site. Still has pain at site. Requiring VICODIN . Out of work since 6/21/09.

VAERS ID:351329 (history)  Vaccinated:2009-06-08
Age:23.0  Onset:2009-06-09, Days after vaccination: 1
Gender:Female  Submitted:2009-07-14, Days after onset: 35
Location:Florida  Entered:2009-07-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO COMPLAINTS OR ANY OBVIOUS SIGNS/SYMPTOMS
Preexisting Conditions: ASTHMA Obesity
Diagnostic Lab Data: CXR: poor inspiratory effort, infiltrate left lower lobe base, resolving infiltrate. Labs: WBC 16.6(H),Auto ANC14.6(H),HGB 10.9-11.4(L), HCT 32.3-34(L), MCV 77.4(L), MCH 25.8(L),RDW 15.5-16.4(H),ANC 15272(H),Neutrophils 83.9-86(H), Bands 6(H), Lymphocytes 6-15.7(L), monocytes 2(L)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0866X2IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB285AB1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Band neutrophil count increased, Breath sounds abnormal, Chest X-ray abnormal, Chest discomfort, Diarrhoea, Dyspnoea, Haematocrit decreased, Haemoglobin decreased, Heart rate increased, Heart rate irregular, Lung infiltration, Lymphocyte count decreased, Mean cell haemoglobin decreased, Mean cell volume abnormal, Monocyte count decreased, Nausea, Neutrophil count increased, Pyrexia, Red cell distribution width increased, Tachycardia, Vomiting, Wheezing, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: Client stated that she experienced chest tightnes accompanied by shortness of breath and acelerated heart rate on Tuesday morning 6/09/09. She received the vaccine 6/8/09@ 1:35pm She left the clinic without complaints. 9/23/09 Medical records received for date of service 6/11/09 to 6/13/09. Presented in ED with c/o shortness of breath, wheezing, fever, nausea/vomiting, diarrhea. ED DX: Asthma exacerbation, fever. Findings: Diminished breath sounds at base of lungs, wheezing, irregular heart rhythem, tachycardia.

VAERS ID:351426 (history)  Vaccinated:0000-00-00
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-07-14
Location:Colorado  Entered:2009-07-15, 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:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0907USA01296
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Coma
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Information has been received from a physician concerning a 23 year old female patient who on an unknown date was vaccinated with a dose of GARDASIL. Within 24 hours of receiving GARDASIL the patient went into a coma. The patient sought unspecified medical attention. The patient''s final outcome was not reported. Upon internal review coma was considered to be another important medical event. Additional information has been requested.

VAERS ID:351486 (history)  Vaccinated:2009-06-24
Age:23.0  Onset:2009-07-03, Days after vaccination: 9
Gender:Male  Submitted:2009-07-15, Days after onset: 12
Location:North Carolina  Entered:2009-07-15
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: 7/7/09, Creatine Kinase SERUM 88; Troponin T Cardiac SERUM 0.028; Creatine Kinase MB SERUM 2.760; ERS 15 Min BLOOD 25 (H); abnormal EKG on 7/7/09
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A IDUN
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase normal, Chest pain, Decreased appetite, Dyspepsia, Dyspnoea, Electrocardiogram abnormal, Fatigue, Red blood cell sedimentation rate normal, Troponin T
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Patient woke up with chest pain that got worse as the day wore on, 8/10. Went to the ER at 2100 that night and had normal EKG per patient. Was told his chest pain was related to heartburn from taking OTC NSAIDS for treatment of his robust take which had been phone triaged on 7/2/09 by facility. Patient also c/o fatigue and decreased appetite. Symptoms: Dyspnea (shortness of breath) .

VAERS ID:351547 (history)  Vaccinated:2009-07-06
Age:23.0  Onset:2009-07-07, Days after vaccination: 1
Gender:Male  Submitted:2009-07-07, Days after onset: 0
Location:Hawaii  Entered:2009-07-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2063UNRA
JEV: JAPANESE ENCEPHALITIS (JE-VAX)SANOFI PASTEUREJN235A4UNRA
Administered by: Military     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 had moderate swelling R deltoid, TTP. LT prescribed BENADRYL 25mg q6hrs for TX.

VAERS ID:351639 (history)  Vaccinated:2009-07-02
Age:23.0  Onset:2009-07-03, Days after vaccination: 1
Gender:Female  Submitted:2009-07-16, Days after onset: 13
Location:Ohio  Entered:2009-07-16
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: CF; Diabetic; GERD; Gastroparesis; Allergic Rhinitis; Chronic OBST asthma
Diagnostic Lab Data: Ultrasound of upper extremity; CT of shoulder & upper arm
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0519X IMLA
Administered by: Private     Purchased by: Other
Symptoms: Computerised tomogram, Injection site pain, Injection site swelling, Injection site warmth, Nuclear magnetic resonance imaging, Ultrasound scan
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Friday after injection arm became extremely swollen & painful. Saturday was started on PREONISONE. Monday swelling decreasing also taking NAPROXEN. Twice daily saw doctor on Monday swelling mild & mild pain in area. 7/8/09 Saw MD. NAPROXEN continue pain present yet, warm to touch. Some swelling (mild) start on DARVOCET stop NAPROXEN. 7/13 arm pain unchanged 7/13 - Patient admitted to hospital for unrelated issue seen by neurology & rhumetalogy; given FENTEYL for discomfort in arm. Then 7/15 switched pain med to DILAUDID and MRI ordered.

VAERS ID:352082 (history)  Vaccinated:2009-05-01
Age:23.0  Onset:2009-05-28, Days after vaccination: 27
Gender:Female  Submitted:2009-07-15, Days after onset: 48
Location:Oklahoma  Entered:2009-07-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Pap test, 05/28/09, atypical cells of undetermined significance with high risk HPV include HPV 16 and 18
CDC 'Split Type': WAES0906USA01774
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cervical dysplasia, Human papilloma virus test positive, Smear cervix abnormal
SMQs:, Reproductive premalignant disorders (narrow), Uterine and fallopian tube malignant tumours (broad)
Write-up: Information has been received from a licensed practical nurse concerning a 23 year old female with no medical history and drugs allergies, who in November 2007, was vaccinated with a first dose of GARDASIL. The second and the third dose were given in January 2008 and May 2008 respectively. There was no concomitant medication. On 28-MAY-2009 the patient had an abnormal Pap test. The Pap test revealed "atypical cells of undetermined significance with high risk HPV to include HPV types 16 and 18". The nurse added that this was the patient''s first abnormal Pap test. The patient sought medical attention through an office visit. At the time of this report the patient had not recovered. Additional information has been requested.

VAERS ID:352092 (history)  Vaccinated:2009-03-26
Age:23.0  Onset:2009-03-26, Days after vaccination: 0
Gender:Female  Submitted:2009-07-15, Days after onset: 111
Location:Alabama  Entered:2009-07-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: none
CDC 'Split Type': WAES0906USA02088
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0074Y1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Headache, Inappropriate schedule of drug administration
SMQs:
Write-up: Information has been received from a registered nurse concerning a 23 year old female patient with no pertinent medical history or allergies who on 27-JAN-2009 was vaccinated IM with the first 0.5 ml dose of GARDASIL. On 26-MAR-2009 the patient was vaccinated IM with the second of GARDASIL (lot # 0074Y). On 02-JUN-2009 the patient was vaccinated IM with the third 0.5 ml dose of GARDASIL (lot # 0294Y). There was no concomitant medication. After the patient received the second dose she experienced persistent headaches. At the time of this report, the patient had not recovered. The patient sought medical attention through a phone call. Headaches were considered to be disabling. Additional information has been requested.

VAERS ID:352179 (history)  Vaccinated:2009-05-20
Age:23.0  Onset:2009-05-21, Days after vaccination: 1
Gender:Female  Submitted:2009-07-15, Days after onset: 55
Location:Unknown  Entered:2009-07-17, 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: SEASONIQUE
Current Illness: Latex allergy
Preexisting Conditions:
Diagnostic Lab Data: body temp, 5/21/09, 102 degrees
CDC 'Split Type': WAES0906USA02915
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0652X2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Injection site pain, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Information has been received concerning a 23 year old female with latex allergy and no pertinent medical history who on 03-DEC-2008 was vaccinated IM with the first 0.5mL dose of GARDASIL (lot # 66012/0229X). On 04-FEB-2009 was vaccinated IM with the second 0.5 mL dose of GARDASIL (lot # 660612/0229X), and on 20-MAY-2009 was vaccinated IM with the third 0.5 mL dose of GARDASIL (lot # 661766/0652X). On 21-MAY-2009, the patient developed nausea, muscle arm soreness near the injection site, a temperature of 102 degrees F and 2 episodes of vomiting. The patient recovered on 22-MAY-2009. Additional information has been requested.

VAERS ID:352318 (history)  Vaccinated:2009-06-19
Age:23.0  Onset:2009-06-19, Days after vaccination: 0
Gender:Female  Submitted:2009-07-15, Days after onset: 26
Location:Unknown  Entered:2009-07-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0906USA05019
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 23 year old female with no known pertinent medical history, who on 19-JUN-2009 was vaccinated with the first dose of GARDASIL. Lot No was not provided. The physician reported that on 19-JUN-2009, the patient developed upper body rash after getting the first dose of GARDASIL. On 23-JAN-2009, the patient recovered. No laboratories diagnostic studies were performed. The patient sought medical attention. Additional information has been requested.

VAERS ID:352337 (history)  Vaccinated:2009-06-09
Age:23.0  Onset:2009-06-09, Days after vaccination: 0
Gender:Female  Submitted:2009-07-15, Days after onset: 36
Location:Kentucky  Entered:2009-07-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LODRANE
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0906USA05666
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0650X0UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Headache, Loss of consciousness, Paraesthesia
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), Guillain-Barre syndrome (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: Information has been received from a nurse concerning a 23 year old female who on 09-UN-2009 was vaccinated with the first dose of GARDASIL (661764/0650X). Concomitant therapy included (LODRANE). On 09-JUN-2009 the patient passed out after the first vaccination. The patient was alright to leave the office but was recommended to go up to the urgent care. Then the next day. 10-JUN-2009, the patient called the office stating that the urgent care would not see her because she did not received the vaccination there and also stated she was experiencing dizziness. Then on 15-JUN-2009 the patient called the office and stated she was experiencing dizziness, headache and tingling all over her body. The nurse reported that the patient had not called back stating she was still having any issues so they were not sure how she was doing at this point. At the report time the patient status was unknown. Additional information has been requested.

VAERS ID:352345 (history)  Vaccinated:2009-06-22
Age:23.0  Onset:2009-06-28, Days after vaccination: 6
Gender:Female  Submitted:2009-07-15, Days after onset: 17
Location:Unknown  Entered:2009-07-17, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Drug-induced hallucinosis
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0907USA00070
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0087Y1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia, Rash, Tachycardia, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician''s assistant concerning a 23 year old female patient with hallucinations induced by steroids who on 22-APR-2009 was vaccinated IM with the first dose of GARDASIL and on 22-JUN-2009 received IM the second dose of GARDASIL (lot #662518/0087Y). There was no concomitant medication. On 28-JUN-2009, the patient developed rash on lower extremities and chest, wheezing, tachycardia and intermittent fever. The patient sought unspecified medical attention. The patient''s final outcome was not reported. Additional information has been requested.

VAERS ID:352012 (history)  Vaccinated:2009-07-17
Age:23.0  Onset:2009-07-18, Days after vaccination: 1
Gender:Female  Submitted:2009-07-21, Days after onset: 3
Location:Massachusetts  Entered:2009-07-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKA
Diagnostic Lab Data: evaluation only per patient''s husband
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (POLIOVAX)SANOFI PASTEURDO422 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1679U0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Headache, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient complained of right swollen arm and slight temp of 99. She also complained of a headache. This was initially relieved with aspirin and Benadryl but later spiked to 102. Consulted PCP who advised current treatment in which temperature did go down. FYI Patient received HPV vaccine at civil surgeon''s office and not at facility.

VAERS ID:352041 (history)  Vaccinated:2009-07-15
Age:23.0  Onset:2009-07-16, Days after vaccination: 1
Gender:Female  Submitted:2009-07-17, Days after onset: 1
Location:North Dakota  Entered:2009-07-21, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergy to PNC- beestings (carries EPI-PEN)
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0087Y1IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURUF460BA1IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0500Y1SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Rt arm-area red-warm-swollen-tender to touch. (varicella like) raised area about size of silver dollar-red area about 3" wide and 4 1/2-5" long- Recommended ice 20 min on-20 min off and Ibuprofen if no relief or s/s increase to see phy. for eval.

VAERS ID:352191 (history)  Vaccinated:2009-07-20
Age:23.0  Onset:2009-07-20, Days after vaccination: 0
Gender:Female  Submitted:2009-07-22, Days after onset: 2
Location:California  Entered:2009-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: then Ophth. Sacortin, 2 g hr pid TD
Current Illness: Corneal Abrasion
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABA024A UNLA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Hyperhidrosis, Nausea, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Fever, sweats, nausea, vomiting & shortness of breath within a few hours after injection & seen the next AM 20 hours post injection with no fever, GSVB, some nausea & vomiting no treatment.

VAERS ID:352199 (history)  Vaccinated:2009-07-21
Age:23.0  Onset:2009-07-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Alaska  Entered:2009-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Iodine
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB697AA IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B039BA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Pt came back to clinic after 15 min c/o tightness in her chest, she had audible wheezing. She was treated with 50mg BENADRYL (IM), albuterol via Neb, and 125mg SOLU-MEDROL IM.

VAERS ID:352386 (history)  Vaccinated:2009-07-23
Age:23.0  Onset:2009-07-23, Days after vaccination: 0
Gender:Male  Submitted:2009-07-23, Days after onset: 0
Location:Texas  Entered:2009-07-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB340AA1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Dysphagia
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Difficulty swallowing began 15 minutes after injection was administered Pt. was given BENADRYL. Patient''s condition has improved

VAERS ID:352935 (history)  Vaccinated:2009-07-29
Age:23.0  Onset:2009-07-31, Days after vaccination: 2
Gender:Female  Submitted:2009-07-31, Days after onset: 0
Location:New York  Entered:2009-07-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0383Y SCRA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt presented to clinic 2 days after injection. Site red, swollen and hot. Pt was diagnosed with cellulitis and given KEFLEX 500mg QID x ten days.

VAERS ID:353079 (history)  Vaccinated:2008-06-12
Age:23.0  Onset:2008-08-15, Days after vaccination: 64
Gender:Female  Submitted:2009-08-03, Days after onset: 353
Location:South Carolina  Entered:2009-08-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LEXAPRO
Current Illness: Pregnancy NOS (LMP = 8/15/2008)
Preexisting Conditions:
Diagnostic Lab Data: Ultrasound, normal; Echocardiography, 05/01?/08, fetal normal; Blood pressure, 05/08/09, pregnancy induced hypertension; Blood pressure, 07/21/09, normal, 120/70; Urine protein, normal
CDC 'Split Type': WAES0907USA03319
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0063X1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Caesarean section, Drug exposure during pregnancy, Haemorrhage, Hypertension, Oedema, Pre-eclampsia, Pregnancy induced hypertension, Protein urine absent, Ultrasound scan normal, Vaginal haemorrhage
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Initial and follow-up information has been received from a nurse, for GARDASIL, a Pregnancy Registry product, concerning a 23 year old female who on 07-JAN-2008 was vaccinated with the first dose of GARDASIL (lot# 659439/1267U, IM, 0.5ml). On 12-JUN-2008 the patient received the second dose of GARDASIL (lot# 660391/0063X, IM, 0.5ml). Concomitant therapy included LEXAPRO. After the second dose the patient was pregnant and her last menstrual period (LMP) date was at 15-AUG-2008. On 26-SEP-2008 the patient experienced pre-eclampsia and spotting/bleeding; intervention was observation. Lab diagnostics studies included ultrasounds-normal, fetal echocardiogram at 37 weeks-normal, urine protein test-normal. On 08-MAY-2009 the patient was admitted for delivery at hospital. The patient did experience "pregnancy induced hypertension" at delivery, but hospitalization was not prolonged due to this event. The baby boy (8lb 4oz) born with no complications. The patient was seen in the office on 21-JUL-2009, blood pressure (B/P) was normal (120/72) at that visit. The patient had not yet received the 3rd dose of GARDASIL. At the report time the patient''s status was unknown. In follow-up, a nurse reported the 23 year old white female had no previous pregnancies. Her concurrent medical conditions were reported as "stable". Other medication used during her pregnancy included precare vitamin (the date of use was reported as "25-SEP-2009"). Her pregnancy was complicated by pregnancy-induced hypertension and she developed edema. Subsequently, on 09-MAY-2009, the patient delivered a normal male baby by C-section delivery weighing 8 pounds 4 ounces. The baby had no congenital anomalies or any other complications or abnormalities. No further information is available.

VAERS ID:353080 (history)  Vaccinated:2008-11-12
Age:23.0  Onset:2008-12-15, Days after vaccination: 33
Gender:Female  Submitted:2009-08-03, Days after onset: 230
Location:New Jersey  Entered:2009-08-04, 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. 8/7/09 Medical records received DOS 11/12/08 to 7/28/09. ''B12 pills''
Current Illness: 8/7/09 Medical records received DOS 11/12/08 to 7/28/09. C/O heartburn, rosacea, joint stiffness.
Preexisting Conditions: Unknown. 8/10/09 Hospital records received DOS 12/26/09 to 1/24/09. B12 deficiency, bipolar disease, asthma. Septoplasty. Alcohol, tobacco use. Fibromyalgia. Sulfa allergy.
Diagnostic Lab Data: Unknown. 8/7/09 Medical records received DOS 11/12/08 to 7/28/09. LABS and DIAGNOSTICS: Mantoux. 8/10/09 Hospital records received DOS 12/26/09 to 1/24/09. LABS and DIAGNOSTICS: MRI Cervical Spine - Right sided predominant disc bulge at
CDC 'Split Type': WAES0907USA04234
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR02926AA UNLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.0843X1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Abasia, Alanine aminotransferase decreased, Aspartate aminotransferase decreased, Back pain, Blood calcium decreased, Blood sodium decreased, Blood zinc decreased, Cerebellar syndrome, Chest pain, Computerised tomogram normal, Eosinophil count decreased, Epidural anaesthesia, Haematocrit decreased, Hyperreflexia, Insomnia, Intervertebral disc protrusion, Lumbar puncture normal, Mean cell haemoglobin increased, Mean cell volume increased, Monocyte percentage decreased, Multiple sclerosis, Muscle twitching, Muscular weakness, Neck pain, Nerve conduction studies, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal, Oedema peripheral, Pain in extremity, Paraesthesia, Peripheral coldness, Red blood cell count decreased, Skin discolouration, Tongue paralysis, Tuberculin test, Ultrasound scan normal, X-ray limb normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Arthritis (broad), Tumour lysis syndrome (broad)
Write-up: Information has been received from a physician concerning a female who in January 2009, was vaccinated IM with the second 0.5ml dose of GARDASIL (lot# not reported). The patient exhibited "multiple sclerosis (MS)-like symptoms". The date of onset of the symptoms was unknown. The patient was hospitalized overnight at hospital for testing to rule-out multiple sclerosis. The physician relayed that unspecified test results were "non-specific". The dates of hospitalization were unknown. The physician did not provide details of the specific symptoms experienced by the patient but added that "the symptoms are improving." Follow up information was received via telephone call from the patient''s mother who worked in the doctor''s office and was not a Health Professional provided the patient''s full name and birth date. It was reported that the patient was 23 year old and had received 2 doses of GARDASIL. The patient received the first dose of GARDASIL from her gynecologist (GYN) physician (date, dose and lot number unknown to reporter). The patient received the second dose of GARDASIL on 12-NOV-2008 (lot# 659184/0843X) (previously reported as January 2009). The patient began having the following symptoms in the middle of December 2008; "Swelling in her arm, twitches, constant back pain, could not walk at times". The patient was hospitalized of over night, early in 2009 to rule out (R/O) multiple sclerosis (MS) (hospital name and hospitalization dates not reported). The patient''s mother stated that the patient could walk and was improving. Follow up information was received via telephone call from a person from the patient''s gynecologist''s office who provided the doctor''s address and reported that the patient received the first dose of GARDASIL on 05-MAY-2008 (expiration date 14-JUN-2009). Additional information has been requested. 8/7/09 Medical records received DOS 11/12/08 to 7/28/09. C/O heartburn, rosacea, joint stiffness. Second dose of Gardasil administered. Post vaccination patient presents with back pain, insomn

VAERS ID:353082 (history)  Vaccinated:2008-11-06
Age:23.0  Onset:2008-11-06, Days after vaccination: 0
Gender:Female  Submitted:2009-08-03, Days after onset: 269
Location:Unknown  Entered:2009-08-04, 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: NEXIUM
Current Illness: Sulfonamide allergy
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0907USA04362
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dehydration, Stool analysis, Urine analysis
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad)
Write-up: Information has been received from a 23 year old female patient with no pertinent medical history and sulfonamide allergy who on 06-NOV-2008 was vaccinated with the first dose of GARDASIL (lot number not reported). On 03-FEB-2009 the patient was vaccinated with the second dose of GARDASIL (lot number not reported). Concomitant therapy included NEXIUM. On 06-NOV-2008 the patient was submitted to hospital because she was dehydrated after a fight. A urinalysis was performed and stool sample was collected for dehydration (results not provided). At the time of the report, the outcome of the patient was unknown. Additional information has been requested.

VAERS ID:353122 (history)  Vaccinated:2009-08-01
Age:23.0  Onset:2009-08-01, Days after vaccination: 0
Gender:Female  Submitted:2009-08-04, Days after onset: 3
Location:Colorado  Entered:2009-08-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Seroquel, Fioricet, Effexor, Klonopin, Vicodin, Oxycontin, Ambien
Current Illness: status-post splenectomy after fall from 2 story balcony 8/31/09-records received-Fell of a balcony landed on left side, immedia
Preexisting Conditions: Anxiety, migraines, and endometriosis
Diagnostic Lab Data: 8/2/09- Fever 104, Heart rate 104 bpm, BP 80/60mmHg, and marked leukocytosis. WBC- 24,000 /L, RBC 2.77 mil/uL, Hemoglobin 8.9 g/dL, Hematocrit 26.4%, Platelet 11,680,000/uL. CT Scan of abdomen was negative for any post-operative complicatio
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (OMNIHIB)SANOFI PASTEUR4F52299 IMLL
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR4291899 SCLL
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.05284 SCLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Computerised tomogram normal, Dehydration, Dyspnoea, Haemoglobin decreased, Hypersensitivity, Hypoalbuminaemia, Hypotension, Injection site pain, Lethargy, Micturition urgency, Pyrexia, Rash macular, Red blood cell count decreased, Serum sickness, Tachycardia, Thrombocythaemia, Urinary retention, White blood cell count increased
SMQs:, Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (narrow), Angioedema (broad), Haematopoietic erythropenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Hypersensitivity (narrow)
Write-up: Approximately 1 week prior patient was admitted into the hospital after a 2-story fall that subsequently required her to undergo a splenectomy on 7/27/09. Prior to discharge the vaccinations were ordered and given on 8/1/09. The patient returned to the Emergency department with fever of 104, increasing abdominal pain, severe pain in left lateral thigh where vaccines were given and some dyspnea. Patient became increasingly lethargic and developed a macular rash. She reported urinary urgency but unable to void. Mother accompanied patient to the ED and reported that every time she received vaccinations as a child the patient would develop terrible fevers and injection site reaction. Patient was admitted into the intensive care unit and medically managed for serum sickness secondary to vaccine administration. 8/31/09-records received for DOS 7/28-8/1/09-DC DX: Systemic inflammatory response syndrome from immunization (serum sickness). Hyponatremia. Dehyrdration. Fever. Lethargy. Hypoabluminemia. Thrombocytosis. On day of discharge received vaccines subsequently seen in ED for fever. Developed truncal rash, complaints of left thigh pain, lethargy, tachycardic, hypotensive. Impression: systemic inflammatory response syndrome most likely related to vaccine and allergic reation. ICD-9 codes: 865.03. 958.4, 864.85, 285.1, E882, E849.0, 300.00 and 238.71.

VAERS ID:353246 (history)  Vaccinated:2009-07-20
Age:23.0  Onset:2009-07-23, Days after vaccination: 3
Gender:Male  Submitted:2009-08-04, Days after onset: 12
Location:California  Entered:2009-08-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: seen in office 7/29/09
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0727X0UNRA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU25900A6UNLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: On 7/20/09 received a T booster F and first Hepatitis B vaccine- 3 days later hot red itchy urticarial rash - this spread from torso out to limbs. No other suspicious cause.

VAERS ID:353458 (history)  Vaccinated:2009-04-28
Age:23.0  Onset:2009-05-16, Days after vaccination: 18
Gender:Male  Submitted:2009-08-07, Days after onset: 83
Location:Nevada  Entered:2009-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: None noted
Diagnostic Lab Data: none noted
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1710IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURB10261IMRA
Administered by: Military     Purchased by: Military
Symptoms: Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Red, itchy rash on trunk, shest, and upper back

VAERS ID:354032 (history)  Vaccinated:0000-00-00
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-12
Location:Unknown  Entered:2009-08-13, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0908USA01533
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Carcinoma in situ
SMQs:, Malignant tumours (narrow)
Write-up: Information has been received from a physician concerning a 23 year old female patient who was vaccinated with the series of GARDASIL, 0.5 ml and developed "CIS 2" after completing the vaccination series. No information regarding the time frame for the first, second and third dose of GARDASIL. No lot number was provided. Unspecified medical attention had been sought. Upon internal review, "CIS 2" was determined to be an other important medical event. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:354119 (history)  Vaccinated:2009-07-15
Age:23.0  Onset:2009-08-07, Days after vaccination: 23
Gender:Female  Submitted:2009-08-13, Days after onset: 6
Location:Washington  Entered:2009-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2021IMLA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003AA1IDLA
Administered by: Military     Purchased by: Military
Symptoms: Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Pt was given Smallpox vaccine and Anthrax vaccine. Pt did not know that she was pregnat at time of vaccine

VAERS ID:355600 (history)  Vaccinated:2008-09-30
Age:23.0  Onset:2008-09-30, Days after vaccination: 0
Gender:Female  Submitted:2008-12-24, Days after onset: 85
Location:Maryland  Entered:2009-08-13, Days after submission: 231
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': MEDI0007670
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Public     Purchased by: Other
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Vaccine exposure during pregnancy. A spontaneous non-serious report of administration to pregnant female was received from a nurse concerning a 23 year old female patient. On 30-Sep-2008, FLUMIST was administered to the patient at the health department. The patient was two to three weeks pregnant. In November 2008, the patient discovered she was pregnant. She had no symptoms or problems at the time of the report. There was no adverse event associated with this FLUMIST exposure to a pregnant female. Treatment and reporter/sponsor causality assessments are not applicable. The reporter was asked to inform when the pregnancy has ended and also to inform if the patient/subject experiences any adverse events during the pregnancy.

VAERS ID:355931 (history)  Vaccinated:2009-01-12
Age:23.0  Onset:2009-01-12, Days after vaccination: 0
Gender:Female  Submitted:2009-05-12, Days after onset: 119
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008158
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old female. Neither medical history nor concomitant medications were reported. On 12-Jan-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. There was no adverse events associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause of the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the product expired. Additional information was received on 18-Mar-2009 that indicated no adverse events were reported through the medical clinic and patient demographics provided. Follow-up information was received on 12-May-2009: Product Complaint Investigation results.

VAERS ID:355932 (history)  Vaccinated:2009-02-24
Age:23.0  Onset:2009-02-24, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 76
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008159
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old male. Neither medical history nor concomitant medications were reported. On 24-Feb-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. As of 18-Mar-2009, there was no adverse events associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause of the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the product expired. Follow-up information was received on 12-May-2009: Product Complaint Investigation results.

VAERS ID:355960 (history)  Vaccinated:2009-02-24
Age:23.0  Onset:2009-02-24, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 76
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008169
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old male. Neither medical history nor concomitant medication were reported. On 24-Feb-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. As of 18-Mar-2009, there were no adverse events associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flue season resulting in some medication errors that occurred shortly after the product expired. Follow-up information was received on 12-May-2009: Product Complaint Investigation results.

VAERS ID:355978 (history)  Vaccinated:2009-01-12
Age:23.0  Onset:2009-01-12, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 119
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008188
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: Expired vaccine used. A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse in the military concerning a 23-year-old male. Neither medical history nor concomitant medications were reported. On 12-Jan-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. There was no adverse events associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the product expired. Additional information was received on 18-Mar-2009 that indicated no adverse events were reported through the medical clinic and patient demographic data was received. Additional information was received on 12-May-2009: Product Complaint Investigation results.

VAERS ID:355990 (history)  Vaccinated:2009-01-12
Age:23.0  Onset:2009-01-12, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 119
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type': MEDI0008203
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old male. Neither medical history nor concomitant medications were reported. On 12-Jan-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. There was no adverse events associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root case for medication errors were caused by 1) customers not discarding product from the previous season and 2) product expiring during the peak of the flu season resulting in some medication errors that occurred shortly after the product expired. Additional information was received on 18-Mar-2009 that indicated no adverse events were reported through the medical clinic. Additional information was received on 12-May-2009; product investigation results.

VAERS ID:355994 (history)  Vaccinated:2009-01-12
Age:23.0  Onset:2009-01-12, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 119
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008207
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old male. Neither medical history nor concomitant medications were reported. On 12-Jan-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. As of 18-Mar-2009, there was no adverse events reported through the medical clinic associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the product expired. Additional information was received on 12-May-2009: product complaint investigation results.

VAERS ID:356013 (history)  Vaccinated:2009-01-26
Age:23.0  Onset:2009-01-26, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 105
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008213
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non - serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old male. Neither medical history nor concomitant medications were reported. On 26-Jan-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. As of 18-Mar-2009, there were no adverse events reported through the medical clinic associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from the previous season and 2) product expiring during the peak of the flu season resulting in some medication errors that occurred shortly after the product expired. Additional information was received on 12-May-2009 and incorporated into the narrative: Product complaint investigation results.

VAERS ID:356128 (history)  Vaccinated:2009-02-17
Age:23.0  Onset:2009-02-17, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 83
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008237
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old male. Neither medical history nor concomitant medications were reported. On 17-Feb-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. As of 18-Mar-2009, there was no adverse events associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause of the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the product expired. Additional information was received on 12-May-2009 and incorporated into the narrative: Product complaint investigation results.

VAERS ID:356147 (history)  Vaccinated:2009-02-18
Age:23.0  Onset:2009-02-18, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 82
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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': MEDI0008255
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 23-year-old male. Neither medical history nor concomitant medications were reported. On an unspecified date in Feb-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. As of 18-Mar-2009, there was no adverse event associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the product expired. Additional information was received on 12-May-2009 and incorporated into the narrative: Product complaint investigation results.

VAERS ID:354237 (history)  Vaccinated:2009-07-10
Age:23.0  Onset:2009-07-14, Days after vaccination: 4
Gender:Male  Submitted:2009-08-14, Days after onset: 31
Location:Missouri  Entered:2009-08-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known. Occasionally takes ibuprophen.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURUF484BA IM 
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Myalgia, Rash erythematous, Skin lesion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Complains of muscle soreness at injection site today which is over a month after receiving TDAp B. There is no redness or muscle induration. Complains of red lesions which appear on his hands and have now spread to his forearms after shaking hands or lifting a heavy object. They disappear in a few minutes and are not painful. There is no numbness or tingling associated with the lesions

VAERS ID:354508 (history)  Vaccinated:2003-01-13
Age:23.0  Onset:2007-09-01, Days after vaccination: 1692
Gender:Male  Submitted:2009-08-18, Days after onset: 717
Location:Unknown  Entered:2009-08-18
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: FACTOR V - NORMAL GENETIC MUTATION- NORMAL NO FAMILY HISTORY ALSO
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS   LA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Deep vein thrombosis, Fatigue, Gene mutation identification test negative, Pleural effusion, Pulmonary embolism, Pulmonary function test abnormal, Skin discolouration
SMQs:, Systemic lupus erythematosus (broad), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: 01/2003 SKIN DISCOLORATION 09/2007 - 3 PULMONARY EMBOLISM RIGHT LUNG THEN 9/2007 PLEURAL EFFUSION 7/2008 DVT IN RIGHT BICEP 2/2009 1 PULMONARY EMBOLISM. mY TREATMENT HAS BEEN COUMADIN AS OF RIGTH NOW I TAKE 10MG FRI-SUN 7.5MG MON-THU I HAVE HAS FACTOR V AND GENETIC MUTATION BLOOD WORK ALL CAME BACK NORMAL. I EXPERIENCE PAIN IN MY LUNGS FATIGUE HAD PULMONARY FUNCTIONS TEST FEV1 AT 70% OF PREDICTED LEVELS.

VAERS ID:354811 (history)  Vaccinated:2008-12-17
Age:23.0  Onset:2008-12-17, Days after vaccination: 0
Gender:Female  Submitted:2009-08-20, Days after onset: 245
Location:North Carolina  Entered:2009-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sprintec 28-day
Current Illness:
Preexisting Conditions: Epilepsy - age 4-8, then diagnosed with syncope. Allergic to erythromycin.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.UNKNOWN0UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Dizziness, Loss of consciousness, Nausea, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Within seconds of receiving vaccine, I felt like I was going to pass out, nurse instructed me to lie down on table, she left and I passed out. This occurred probably within 30 seconds total after receiving vaccine. Ambulance arrived and while being transported to hospital, I felt tingling in hands and fingers and also felt incredibly nauseous. Also felt I was going to pass out again, but didn''t. Arrived at hospital, still feeling nauseous and had many tests. Due to having a history of seizures and syncope, gynecologist and doctors at hospital dismissed symptoms as being anxious over having shot. I have given blood several times in the past few years and never passed out from that. It has been 8 months since vaccine and no other symptoms have occurred.

VAERS ID:355006 (history)  Vaccinated:2009-08-18
Age:23.0  Onset:2009-08-19, Days after vaccination: 1
Gender:Female  Submitted:2009-08-21, Days after onset: 2
Location:Minnesota  Entered:2009-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED02149211A0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1129X2IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0468X0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Developed fever, pain, redness & swelling at area of injection site day after immunization - treated with MOTRIN & antibiotic.

VAERS ID:355040 (history)  Vaccinated:2009-08-04
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-17
Location:Texas  Entered:2009-08-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Stop BC 2 weeks prior; Birth Control; MOTRIN PRN 1 week ago; OTC - since med PRN 3 weeks ago
Current Illness: at time unknown pregnancy
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0582Y0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Client going into nursing school, received varicella vaccine 8-4-09. On 8.15 and 16 took home pregnancy test which confirmed pregnancy. She had stopped her birth control pills 2 weeks prior vaccination due to menstrual period for entire month of July 2009. Will see Gyn/ob F.u.

VAERS ID:356501 (history)  Vaccinated:2009-06-17
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-06-17
Location:Georgia  Entered:2009-09-03, Days after submission: 78
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: (+) urine HCG (preg. test later performed after vaccine given)
CDC 'Split Type': GA09026
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0315Y2IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy, Urine human chorionic gonadotropin positive
SMQs:, Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: No adv s/sx.

VAERS ID:357058 (history)  Vaccinated:2009-09-09
Age:23.0  Onset:2009-09-10, Days after vaccination: 1
Gender:Female  Submitted:2009-09-11, Days after onset: 1
Location:California  Entered:2009-09-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Had PPD placed the same date and time of MMR vaccination.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1291X1SCLA
Administered by: Unknown     Purchased by: Public
Symptoms: Erythema, Induration, Pruritus, Tenderness
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Pt noted pruritis in the area 9/10/09, redness and tenderness noted soon afterwards. No history of other injury to the area. Exam reveals 70mm X 80mm area of erythema and slight insuration. No central lesion/bump

VAERS ID:357143 (history)  Vaccinated:2009-09-03
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-09-10
Location:California  Entered:2009-09-14, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: prenatal
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97839P1 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Drug exposure during pregnancy, Wrong drug administered
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Patient was injected with Fluvirin instead of Afluria. Patient is Pregnant.

VAERS ID:357163 (history)  Vaccinated:2009-06-15
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-25
Location:Missouri  Entered:2009-09-14, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1330X1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: Gardisil vaccine was stored at temperature that was out of normal range.

VAERS ID:357178 (history)  Vaccinated:2007-05-27
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-30
Location:Missouri  Entered:2009-09-14, 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: 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.1312X2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: GARDASIL vaccine was stored at temperature that was out of normal range.

VAERS ID:357180 (history)  Vaccinated:2009-06-01
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-20
Location:Missouri  Entered:2009-09-14, Days after submission: 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.1130Y1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: GARDASIL vaccine was stored at temperature that was out of normal range.

VAERS ID:357181 (history)  Vaccinated:2009-06-01
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-21
Location:Missouri  Entered:2009-09-14, Days after submission: 24
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.1130X2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: GARDASIL vaccine was stored at temperature that was out of normal range.

VAERS ID:357206 (history)  Vaccinated:2009-06-02
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-24
Location:Missouri  Entered:2009-09-14, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 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.1312X2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: GARDASIL vaccine was stored at temperature that was out of normal range.

VAERS ID:357210 (history)  Vaccinated:2009-09-01
Age:23.0  Onset:2009-09-02, Days after vaccination: 1
Gender:Female  Submitted:2009-09-14, Days after onset: 12
Location:Louisiana  Entered:2009-09-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none~ ()~NULL~~In Patient
Other Medications: Yaz
Current Illness: None
Preexisting Conditions: Allergic/Sensitive to penicillin and Bactrim
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0112Y4IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Pain in extremity, Pruritus, Rash, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: morning after receiving the Pneumovax vaccine, red & splotchy rash on upper arm away from injection site, pain, tenderness, warm skin. Next day redness had spread: called and visited doctor on 9/3/09 who diagnosed cellulitis and prescribed Clindamycin for 7 days. Indicated situation would be serious if infection reached the elbow or shoulder joint. Experienced patches of warm, red, itchy areas that would come and go only at the site of the cellulitis on day 2 of antibiotic. That resolved in 24 hours. Finished antibiotic 3 days ago, and SO FAR recovery OK and no apparent sequelae from Clindamycin to date.

VAERS ID:357222 (history)  Vaccinated:2009-06-03
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-08-24
Location:Missouri  Entered:2009-09-14, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 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.1312X2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: Gardisil vaccine was stored at temperature that was out of normal range.

VAERS ID:357273 (history)  Vaccinated:0000-00-00
Age:23.0  Onset:0000-00-00
Gender:Male  Submitted:2009-09-14
Location:New York  Entered:2009-09-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97839P20IMUN
Administered by: Other     Purchased by: Private
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt in few hour experienced numbness of the entire arm where he received the vaccine. The numbness went away in few hours.

VAERS ID:357378 (history)  Vaccinated:2009-09-15
Age:23.0  Onset:2009-09-15, Days after vaccination: 0
Gender:Female  Submitted:2009-09-15, Days after onset: 0
Location:Washington  Entered:2009-09-15
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: na
Preexisting Conditions: na
Diagnostic Lab Data: na
CDC 'Split Type':
Vaccination
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HEPA: HEP A (HAVRIX)SMITHKLINE BEECHAMAHAVB340AA0IMLA
TTOX: TETANUS TOXOID (NO BRAND NAME)SCLAVOU2590CA IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30015950PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Grand mal convulsion
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: After beng given a Hep A vaccination and the Tetanus Shot patient had a grand mal seizure. Has been very tired post seizure but no other symptoms. 9/21/09 Spoke with reporter, no treatment sought, pt not seen at any facility nor any MDs. Pt does not have insurance. Case closed

VAERS ID:357434 (history)  Vaccinated:2009-09-09
Age:23.0  Onset:2009-09-09, Days after vaccination: 0
Gender:Female  Submitted:2009-09-15, Days after onset: 6
Location:Maryland  Entered:2009-09-16, 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: Migraine; Eczema, atopic
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0670Y2IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Feeling abnormal, Headache, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: 9-9-09 - Pt received 3rd GARDASIL vaccination approximately equal to 1:10pm. Approx. 4 hours later, began to "feel funny" and was making "non-lucid statements" while at work. Went home to bed. Woke 9/10/09 approximately equal to 1:00am with headache, mild shortness of breath and low grade fever (100.9). Left arm sore. Advised to go to ER - Pt triaged at ER, waited "4.5 hr" and left prior to being seen by MD. 9-11-09 - Pt reports feeling better. 9-15-09 - Fu call to pt, states "feeling fine". No further complaints.

VAERS ID:357479 (history)  Vaccinated:2007-10-07
Age:23.0  Onset:2007-10-07, Days after vaccination: 0
Gender:Female  Submitted:2009-09-16, Days after onset: 710
Location:Florida  Entered:2009-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Depression, ADHD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Disorientation, Dizziness, Fatigue, Hyperhidrosis, Insomnia, Mobility decreased, Muscular weakness, Pyrexia, Skin warm, Thinking abnormal, Vision blurred, Visual impairment, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: I received the injection around 10 am and within an hour felt feverish- sweating, dizzy, blurred vision, fatigue. When I got home about 5 pm I was running a fever over 103, had started vomiting, my vision was spinning and I couldn''t see or think clearly. By 8 pm I had vomited everything on my stomach and couldn''t keep down water, I experienced severe fatigue and muscle weakness - couldn''t stand or walk without assistance and slept when possible. Family reported that I wasn''t fully aware of surroundings or others by about 10 pm. The next afternoon I started keeping down water and eventually other fluids, my fever went down to 102. Two days after the initial injection my fever broke and by the fourth day I was fully recovered. I took Tylenol and maintained a constant fluid intake when awake.

VAERS ID:357516 (history)  Vaccinated:2007-08-14
Age:23.0  Onset:2007-10-01, Days after vaccination: 48
Gender:Female  Submitted:2009-09-16, Days after onset: 716
Location:Massachusetts  Entered:2009-09-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None HPV#3 given 12/14/07, Lot# 0890F, RA
Diagnostic Lab Data: magnetic resonance, ?/?/07, no complications; vascular imaging, ?/?/07, no complications; diagnostic laboratory, negative; MRV, ?/?/07, no complications; Lyme disease assay, negative; von Willebrand factor, negative
CDC 'Split Type': WAES0907USA04940
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0469U1IMRA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Borrelia burgdorferi serology negative, Fatigue, Headache, Increased tendency to bruise, Infection, Laboratory test normal, Migraine, Myalgia, Nuclear magnetic resonance imaging normal, Vascular imaging, Von Willebrand's factor activity test
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Information has been received from a registered nurse concerning her daughter who had been vaccinated with three doses of GARDASIL and after the second dose began experiencing headaches. The patient was not hospitalized. The patient was seeing a rheumatologist. Follow-up information was received from a 23 year old female patient. She reported she in June 2007, August 2007 and December 2007 was vaccinated with the first, second and third dose of GARDASIL (lot numbers not reported) respectively. There was no illness at time of vaccination and there was no pre-existing allergies, birth defects or medical conditions either and "she was never a sick child or a sick adult". On 01-OCT-2007 morning the patient started to experience migraines. The patient reported she had constant migraine since then. She had seen a neurologist multiple times. She had an MRI, and MRV and and MRA done in late 2007 and they all showed no complications. She had been prescribed amitriptyline hydrochloride, ZOMIG, FROVA, FIORICET, TOPAMAX, INDERAL, lisinopril among others, not one of these medications helped her migraines. she saw her original primary care doctor and now being followed by her new primary care physician. She had multiple infections, many times getting tested for Lyme disease (negative) and other blood tests (negative). She was in constant crippling pain from her migraines, as well as muscle joint pain and weakness, and frequently getting infections. She had been bruising especially easily since October 2007 also. She was tested for VON WILLEBRAND''S Disease, but results were negative here as well. Her new primary doctor had recently diagnosed her with chronic fatigue and referred her to a Rheumatologist, which she had scheduled an appointment. The patient strongly believe her symptoms are side effects caused by the GARDASIL vaccine. She reported she had none of these symptoms prior to receiving the vaccine, and there was no medical explanation to her symptoms as of yet. The patient was not recovered. The patient''s events were co

VAERS ID:357517 (history)  Vaccinated:2008-08-24
Age:23.0  Onset:2009-07-28, Days after vaccination: 338
Gender:Female  Submitted:2009-09-16, Days after onset: 50
Location:Pennsylvania  Entered:2009-09-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Wart. Genital warts.
Preexisting Conditions: PMH: None Allergies: NKDA
Diagnostic Lab Data: Unknown Labs: CBC, wbc high, neutro high, lymphs and monos low, CMP, high glucose, potassium low, cardiac enzymes, Lyme titer norm, CPK, UA, Urine HCG, and urine drug screen all negative Dx studies: CT head, EKG, EEG wnl, MRI brain noted a Chiari malformation, CXR noted rt perihilar airspace disease
CDC 'Split Type': WAES0909USA01170
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0070X0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Amnesia, Anogenital warts, Antibody test negative, Blood creatine phosphokinase normal, Blood glucose increased, Blood potassium decreased, Borrelia burgdorferi serology negative, Cardiac enzymes normal, Chest X-ray abnormal, Computerised tomogram head, Computerised tomogram normal, Confusional state, Convulsion, Drug hypersensitivity, Drug screen negative, Electrocardiogram, Electrocardiogram normal, Electroencephalogram normal, Epilepsy, Full blood count, Headache, Lymphocyte count decreased, Metabolic function test, Monocyte count decreased, Neutrophil count increased, Nuclear magnetic resonance imaging brain abnormal, Oral contraception, Pregnancy test negative, Speech disorder, Tongue biting, Urine analysis normal, Urine human chorionic gonadotropin negative, White blood cell count, White blood cell count increased
SMQs:, Angioedema (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: Initial information from a consumer with follow up information from a secretary at a physician''s office, concerning a 24 year old female with warts and no known drug allergies who on 24-AUG-2008 was vaccinated with the first dose of GARDASIL (lot# 660553/0070X), 0.5 ml, I.M. and on 16-OCT-2008 was vaccinated with the second dose of GARDASIL (lot# 660612/0229X) 0.5 ml, I.M. Concomitant therapy included ALDARA for warts and "kapara" 500 mg daily. The patient had been off the birth control pill since January 2009. The physician noted in the chart for the 09-SEP-2009 visit, "The patient reported new onset of seizures since starting GARDASIL". Upon internal review seizures were considered to be an other important medical event. The health care professional contacted during telephone follow-up could not supply the following information: date of event, recovery status, hospital name (if applicable), primary practitioner contact information. Additional information has been requested. 9/28/09 PCP medical records received DOS 8/24/08 to 9/18/09. Patient experienced new onset seizure after Gardasil. Genital warts resolved. Reports Augmentin allergy. Oral contraception. 12/7/2009 and 12/14/2009 ED records for 7/28-7/29/2009 and neuro f/up visit for 7/31/2009. Patient with c/o''s confusion, biting the tongue, short term memory loss, headache and difficulty with speech after waking today. Patient had a similiar incident 4/2009 but did not seek tx. Neuro consult in hospital, started on Keppra. Dc Dx seizure disorder/Epilepsy

VAERS ID:357673 (history)  Vaccinated:2009-09-17
Age:23.0  Onset:2009-09-17, Days after vaccination: 0
Gender:Female  Submitted:2009-09-18, Days after onset: 1
Location:Minnesota  Entered:2009-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500713P IN 
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Nasal congestion, Oropharyngeal pain, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Itching, hives, headache, sore throat, nasal stuffiness after receiving LAIV. She took some Benadryl. Hives are gone, but itching still present as of 9/18/09 at 10am.

VAERS ID:357831 (history)  Vaccinated:2009-09-17
Age:23.0  Onset:2009-09-17, Days after vaccination: 0
Gender:Female  Submitted:2009-09-21, Days after onset: 4
Location:Florida  Entered:2009-09-21
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Isotretinoin
Current Illness: Unknown
Preexisting Conditions: The subject had previously received influenza vaccinations.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0808086A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA447BA UNLA
Administered by: Other     Purchased by: Private
Symptoms: Anaphylactic reaction, Pulse absent, Tachycardia, Tremor, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (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), Anaphylactic/anaphylactoid shock conditions (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of anaphylaxis in a 23-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). Concurrent medications included ACCUTANE. On 17 September 2009 at 15:00, the subject received a dose of FLUARIX (.5 ml, unknown, left arm). On 17 September 2009, 30 minutes after vaccination with FLUARIX, the subject experienced anaphylaxis, tachycardia, tremor, vomiting and absent pulse. "At one point she had no pulse. The subject was given epinephrine and taken to the emergency room." The healthcare professional considered the events were disabling, life threatening and clinically significant (or requiring intervention). The subject was treated with EPINEPHRINE. At the time of reporting the outcome of the events were unspecified. The healthcare professional considered the events were probably related to vaccination with FLUARIX.

VAERS ID:358036 (history)  Vaccinated:2009-09-10
Age:23.0  Onset:2009-09-10, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Michigan  Entered:2009-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BENADRYL 25 mg
Current Illness: Sinus drainage
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED069491114 UNLA
Administered by: Other     Purchased by: Private
Symptoms: Blood pressure decreased, Dizziness, Heart rate decreased, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad)
Write-up: Says shot did not hurt but 5-10 mins later he said he felt dizzy and his arm started to hurt (the arm which he received the injection in). His blood pressure and pulse rate dropped very low. 911 was called. By the time the EMTs arrived his BP and PR were normal.

VAERS ID:358085 (history)  Vaccinated:2008-10-31
Age:23.0  Onset:2008-10-31, Days after vaccination: 0
Gender:Female  Submitted:2009-09-22, Days after onset: 326
Location:Kansas  Entered:2009-09-23, 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: DIFLUCAN; omeprazole
Current Illness: Pregnancy NOS (LMP = Unknown)
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0909USA02430
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1448U1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Premature labour
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a office manager, for GARDASIL, a Pregnancy Registry Product, concerning a 23 year old female who on 11-SEP-2008 was vaccinated with the first dose of GARDASIL (0.5ml, IM). On 31-OCT-2008 the patient received the second dose of GARDASIL (0.5ml, IM, lot# 659653/1448U). Concomitant therapy included omeprazole and DIFLUCAN. Subsequently the patient got pregnant on an unspecified date. In April 2009, the baby girl was born prematurely and was on an incubator. The patient had a 2 month postpartum visit on 30-JUN-2009. A physician had a note in a chart saying the third dose of GARDASIL would hold off since the patient was breastfeeding. At the reporting time the outcome was unknown. Additional information has been requested.

VAERS ID:358447 (history)  Vaccinated:2009-09-06
Age:23.0  Onset:2009-09-06, Days after vaccination: 0
Gender:Female  Submitted:2009-09-27, Days after onset: 21
Location:Washington  Entered:2009-09-25, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: History of palpitations
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3196AA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Chest discomfort, Chest pain, Immediate post-injection reaction
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Chest ache/tightness x 10 min. immediately after vaccine admin.

VAERS ID:358163 (history)  Vaccinated:2009-09-26
Age:23.0  Onset:2009-09-26, Days after vaccination: 0
Gender:Female  Submitted:2009-09-26, Days after onset: 0
Location:California  Entered:2009-09-26
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97840P1 IMUN
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: After 3-4 minutes of receiving vaccine patient reported of dizziness. When try to help, patient refused any help to be given. Contacted patient''s doctor and doctor said they will try to contact patient. Patient was in the store for 20-25 minutes walking around.

VAERS ID:358407 (history)  Vaccinated:2009-08-03
Age:23.0  Onset:2009-08-05, Days after vaccination: 2
Gender:Female  Submitted:2009-09-26, Days after onset: 52
Location:Texas  Entered:2009-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None 10/2/09 Received medical records for date of service 8/10/09 to 8/12/09 PMH: MRSA, PMMD, multiple drug sensitivities. PMH: staph infection of face.
Diagnostic Lab Data: 10/2/09 Received medical records for date of service 8/10/09 to 8/12/09 Diagnostics/Labs: blood culture negative. CBC WNL.
CDC 'Split Type':
Vaccination
Manufacturer
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Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3058AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Blood culture negative, Blood sodium decreased, Blood urea decreased, Carbon dioxide decreased, Cellulitis, Eosinophil percentage increased, Erythema, Eye pain, Full blood count normal, Hordeolum, Hypoaesthesia, Induration, Injected limb mobility decreased, Joint swelling, Lymphocyte percentage increased, Oedema peripheral, Pain in extremity, Rash, Skin warm, Soft tissue infection
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Ocular infections (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Received vaccine through Employee Health at hospital on 8/3/09. Arm swelled about two to three times normal size and turned red and hot; 1st ER visit diagnosed with adverse reaction to Tdap as well as cellulitis. Given oral antibiotic and pain killer. Waited 3 days for improvement before returning to ER. 8-10-09 return to ER for dose of Vancomycin; diagnosed with staph infection from the shot; arm has swelled more and swelling has increased to shoulder, down the shoulder blade, and up the neck. 8-12-09 return to ER; admitted for 3 days worth of Vancomycin; continued redness; swelling decreasing; arm still numb and painful to touch. Infectious disease Dr clears me of staph yet placed me on vitamin B6 for nerve health. Still unable to lift weight in left arm and painful; refer to neurologist. Nerve test results are good; no permanent damage; still pain and unable to lift weight; unable to work bc of injury. 10/2/09 Received medical records for date of service 8/10/09 to 8/12/09. DX: Cellulitis left upper arm and forearm. Presenting SX: chief c/o left arm pain, swelling, erythema tracking up to her neck and back. Tetanus vaccine 5 days prior. PO abx given but pain, swelling and erythema got worse. Pt tx with IV abx. ICD9 codes: 682.3, 041.12, V0254

VAERS ID:358600 (history)  Vaccinated:2009-09-22
Age:23.0  Onset:2009-09-22, Days after vaccination: 0
Gender:Male  Submitted:2009-09-28, Days after onset: 6
Location:Kentucky  Entered:2009-09-28
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: Eggs
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURUF456AA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Axillary pain, Injection site erythema, Injection site rash, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Within 2 hours noted swelling and warmth. At 2 days, redness and rash progressively covering half of upper arm. Pain in axilla but no lymphadenopathy. Treated for possible cellulitis with KEFLEX.

VAERS ID:358630 (history)  Vaccinated:2009-05-28
Age:23.0  Onset:2009-07-14, Days after vaccination: 47
Gender:Female  Submitted:2009-09-24, Days after onset: 72
Location:New York  Entered:2009-09-29, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NUVARING
Current Illness: none
Preexisting Conditions: none 10/14/09 Hospital records received for dates 7/14/09 to 7/21/09 PMH: appendectomy, previous smoker.
Diagnostic Lab Data: CT scan 10/14/09 Hospital records received for dates 7/14/09 to 7/21/09 Diagnostics/Labs: D-dimer 844, CT(+)Bilateral pulmonary emboli. EKG-abnormal, cardiac echo WNL, CXR (-), Troponin WNL, UA(+)WBC and (+)Blood, HCT 34(L), platelets WNL,
CDC 'Split Type':
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0294Y1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Chest X-ray normal, Chest pain, Computerised tomogram, Computerised tomogram abnormal, Dizziness, Dyspnoea, Echocardiogram normal, Electrocardiogram abnormal, Fibrin D dimer increased, Lymphocyte count decreased, Mean platelet volume decreased, Neutrophil count increased, Platelet count normal, Pulmonary embolism, Troponin, Urinary tract infection, Urine analysis abnormal
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Myelodysplastic syndrome (broad)
Write-up: Bilateral pulmonary embolism. Coumadin/CT Scan. 10/14/09 Hospital records received for dates 7/14/09 to 7/21/09. DX: Bilateral Pulmonary embolism, UTI. Presenting SX: chest pain x1 week, shortness of breath, lightheadedness, "almost fainting" feeling. Assessment: relatively normal will perform labs/diagnostics. Pt has desk job, and 2 short flights within past week. Gardasil vax 5/08. Pt treated with anticoagulation therapy and dc. ICD9 codes: 599.0, 427.89, 415.19

VAERS ID:358649 (history)  Vaccinated:2009-09-24
Age:23.0  Onset:2009-09-24, Days after vaccination: 0
Gender:Female  Submitted:2009-09-29, Days after onset: 5
Location:Maryland  Entered:2009-09-29
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 (but similar reactions on 2 prior flu vaccines)
Diagnostic Lab Data: CBC, ESR, RF, ANA, CRP, C3D, C3/C4 CMP
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMLA
Administered by: Military     Purchased by: Military
Symptoms: Antinuclear antibody, C-reactive protein, Complement factor C3, Complement factor C4, Full blood count, Metabolic function test, Myalgia, Nausea, Pyrexia, Red blood cell sedimentation rate, Rheumatoid factor
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: muscle aches, fever to 101, nausua that started within 3hours of administration and lasted for 5 days+ (still resolving).

VAERS ID:358847 (history)  Vaccinated:2009-09-24
Age:23.0  Onset:2009-09-25, Days after vaccination: 1
Gender:Female  Submitted:2009-09-29, Days after onset: 4
Location:South Carolina  Entered:2009-09-29
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
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SCRA
Administered by: Private     Purchased by: Other
Symptoms: Lymph node pain, Lymphadenopathy, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen, extremely tender lymph node in R axillary region, with general aches to body. Node appears nickel to quarter size in diameter, raised area. Will see PCP tomorrow if ice and HYDROCORTISONE cream continues to not work.

VAERS ID:359006 (history)  Vaccinated:2009-09-18
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-09-29
Location:Kentucky  Entered:2009-09-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS88910 UNUN
Administered by: Private     Purchased by: Private
Symptoms: Expired drug administered, Unevaluable event
SMQs:
Write-up: Influenza virus vaccine (FLUVIRIN) 2008 - 2009 formula expiration date 6/30/2009 given instead of 2009-2010 formula. Vaccinated with influenza virus (FLUZONE) 2009-2010 formula after error discovered.

VAERS ID:359010 (history)  Vaccinated:2009-09-18
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-09-28
Location:Kentucky  Entered:2009-09-30, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: penicillin
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS88910 UNUN
Administered by: Private     Purchased by: Private
Symptoms: Expired drug administered, Unevaluable event
SMQs:
Write-up: Influenza virus vaccine (FLUVRIN) 2008-2009 formula expiration date 6/30/2009 given instead of 2009-2010 formula. Vaccinated with influenza virus vaccine(FLUZONE) 2009-2010 formula after error discovered.

VAERS ID:359226 (history)  Vaccinated:2009-10-02
Age:23.0  Onset:2009-10-02, Days after vaccination: 0
Gender:Male  Submitted:2009-10-02, Days after onset: 0
Location:Tennessee  Entered:2009-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen, nicotine,aspirin
Current Illness:
Preexisting Conditions: asthma
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97838P10IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: No reaction on previous exposure to drug, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed itching and rash on vaccination arm within 5 minutes of the shot. He has no known allergies.No previous reactions to vaccinations. The rash and itching intensified over the next 30 minutes. Benadryl was given (50mg) orally at 35 minutes post shot. Paramedics were called and arrived 5 minutes after giving benadryl. Patient''s was stable, BP was high but patient refused to be taken to hospital.

VAERS ID:359244 (history)  Vaccinated:2009-09-21
Age:23.0  Onset:2009-09-22, Days after vaccination: 1
Gender:Female  Submitted:2009-10-04, Days after onset: 12
Location:Texas  Entered:2009-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 2IJLA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Cyanosis, Feeling cold, Injection site urticaria, Migraine, Muscular weakness, Musculoskeletal stiffness, Oedema peripheral, Pain in extremity, Paraesthesia, Pruritus, Rash, Skin mass, Skin warm, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (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), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 9/22/2009: Broke out in hives around site of injection and at the same time around my lower right knee, accompanied by a rash. Intense itching. That night had extreme migraine (I never get migraines) to the point I couldn''t study and had to lay down. For two days later my head felt like I couldn''t think. Hives went away by morning of 9/23 but they continued to come back with extreme itching in various parts of my body including my arms, legs, and side of face. The most intense itching was on my lower legs, benadryl did not relieve the symptoms. This cycle of extreme itching continued for over a weeek. On 9/29/09 evening, while still experiencing the itching in my lower legs, I noticed my legs were becoming swollen and I had lumps under the skin of my legs, I could see from looking at my leg from the side. My legs felt funny to touch, like the sensation was different, the skin was more taunt, and muscles more stiff, the skin was warmer to touch than the rest of my body. I went to see my doctor on 9/30 and he said I was having an allergic reaction that was very rare. He put me on medrol pack, allegra (changed to zyrtec because insurance didn''t cover allegra) and bendryl every 4 hrs. I started the medrol Thursday Oct 1st. Oct 1st evening the swelling was still present, with weird sensation, taunt skin. My legs were sore below the knee and did feel weak toward the evening. The itching was still present in waves, but seeming to improve with the addition of zyrtec. By Friday I had noticed no improvement of my lower legs. I was waiting for the medrol to work. I worked Friday evening night shift and as the night progressed my lower legs felt tingling, even more decreased sensation to touch. It felt numb but I had no difficulty walking or moving. I became concerned with the worsening of my legs and called an on-call nurse at 4 AM Oct 3rd while I was at work. She decided that I should be re-evaluated that morning but I didn''t need to go to the ER. I was able to see a doctor by 9AM, by then my legs felt incredibly decreased

VAERS ID:359889 (history)  Vaccinated:2009-10-01
Age:23.0  Onset:2009-10-03, Days after vaccination: 2
Gender:Female  Submitted:2009-10-07, Days after onset: 4
Location:D.C.  Entered:2009-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: golf sized lymph nodes~Influenza (Seasonal) (no brand name)~~22.00~Patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960305P0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Lymphadenopathy, Night sweats
SMQs:
Write-up: night sweats, enlarged supraclavicular lymph node

VAERS ID:360146 (history)  Vaccinated:2009-10-08
Age:23.0  Onset:2009-10-08, Days after vaccination: 0
Gender:Female  Submitted:2009-10-08, Days after onset: 0
Location:Ohio  Entered:2009-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: YAZ
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97839P2 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Fall, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Patient receives FLUVIRIN flu shot. She said was not as bad as she thought. I told her to sit then she fainted sitting in chair then fell on floor. I proceed to do CPR but she became conscious and talking. She was not itching and no hives. Call 911. EMT''s came took vitals and took her to hospital.

VAERS ID:360245 (history)  Vaccinated:2009-10-01
Age:23.0  Onset:2009-10-04, Days after vaccination: 3
Gender:Male  Submitted:2009-10-09, Days after onset: 5
Location:California  Entered:2009-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: N/A
Diagnostic Lab Data: None
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97850P10UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Fatigue, Influenza, Nasopharyngitis, Oral herpes, Oropharyngeal pain, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: About 3 days after flu shot some cold/flu symptoms began. Runny nose/sneezing. The 4th and 5th day had heavy sneezing runny nose and sore throat. 6th and 7th day felt fatigue and coughing. About seven days later I began to recover, but still had some coughing and sore throat. Cold sores on lips.

VAERS ID:360363 (history)  Vaccinated:2009-09-18
Age:23.0  Onset:2009-09-20, Days after vaccination: 2
Gender:Female  Submitted:2009-10-09, Days after onset: 19
Location:Texas  Entered:2009-10-09
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 PMH: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA456BA IMUN
Administered by: Military     Purchased by: Other
Symptoms: Dizziness, Ear pain, Facial palsy, Facial paresis, Headache, Hypoaesthesia facial, Influenza like illness, Muscle twitching, Neck pain, Paraesthesia oral, Pyrexia, Sensory loss
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Started with Flu like symptoms - fever, weakness, earache, tingling of tongue - then 2 days later - eye twitching - then HA; neck pain and eye twitching - left sided facial weakness-paralysis. Progress recovering. 12/9/09PCP records rec''d for DOS 9/29/09 with dx: Bell''s Palsy. Pt presented with 5 day hx of L-sided facial numbness/weakness. Also c/o L-sided earache, neck pain and frontal h/a. Dizziness 2'' to eyepatching. PE (+) for L facial droop with decreased sensation, otherwise neuro exam WNL with normal strength in upper and lower extremities. Tx: Pred and Acyclovir.

VAERS ID:360365 (history)  Vaccinated:2009-04-06
Age:23.0  Onset:2009-04-16, Days after vaccination: 10
Gender:Female  Submitted:2009-10-09, Days after onset: 176
Location:Unknown  Entered:2009-10-09
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 Behcets Disease PMH: Behcet''s disease Allergies: Sulfa, Augmentin and Trazadone
Diagnostic Lab Data: Labs: CBC lymphs low, neutrophils high, CMP,chloride, T bili and glucose all high, AST and ALT high, UA, ESR, CRP, ANA profile, celiac sprue panel, HLAB27 all negative Dx studies: ABd US wnl
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV141 UNUN
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURERB07062 IMUN
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Alanine aminotransferase increased, Antinuclear antibody negative, Arthralgia, Aspartate aminotransferase increased, Behcet's syndrome, Blood bilirubin increased, Blood chloride increased, Blood glucose increased, C-reactive protein normal, Full blood count, HLA marker study, Injection site pain, Injection site pruritus, Keloid scar, Lymphocyte count decreased, Metabolic function test, Neutrophil count increased, Odynophagia, Oesophageal pain, Oral discomfort, Oropharyngeal pain, Pleuritic pain, Rash erythematous, Red blood cell sedimentation rate normal, Subcutaneous nodule, Ultrasound abdomen normal, Urine analysis normal, Vision blurred
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Biliary system related investigations, signs and symptoms (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vasculitis (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pt reported that at the age of 12 she was diagnosed with Behcets disease and prior to her most recent flare in July 09 her last flare was severe, 4 yrs ago at age 19. From 12-19 she would have a mild flare every 2 yrs. She stated that about 10 days post immunization she had some abd discomfort, that became sever in Jul. She also reported blurred vision and burning in her mouth and esophagus. She reported that with each previous immunization a small keloid would form at the vaccination site. She also expressed concern re:the appearance of her SPV site. She described the skin over the site as raised, smooth, pink and shiny. She reports itching, tenderness to the site and that it appears to be getting larger. Symptoms: blurred vision, Odynophagia, Nodule, subcutaneous, Abdominal pain. 12/4/2009 MR and DC summary for 7/8-7/9/2009, patient with c/o''s arthralgias, pleural, pharyngeal, and abdominal pain. Tx: Rheumatology consult for Behcet''s disease, tx''d with IV Solu-Medrol and started on Colchicine.

VAERS ID:360327 (history)  Vaccinated:2009-10-10
Age:23.0  Onset:2009-10-10, Days after vaccination: 0
Gender:Female  Submitted:2009-10-11, Days after onset: 1
Location:Iowa  Entered:2009-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500759P   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain upper, Dyspnoea, Nausea, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Recieved h1n1 laiv around 12:15pm. At 4:30 I developed nausea and I vimitted four times. Nausea ended around 8pm. At around 8:30pm I noticed a sharp pain under right rib cage and I had difficulty breathing. This continued until 10:00pm

VAERS ID:360467 (history)  Vaccinated:2009-10-03
Age:23.0  Onset:2009-10-03, Days after vaccination: 0
Gender:Male  Submitted:2009-10-03, Days after onset: 0
Location:Connecticut  Entered:2009-10-12, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pt stated he had abdominal pain, but stated he was "ok"
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500725P0IN 
Administered by: Military     Purchased by: Other
Symptoms: Abdominal pain, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt stated that he vomitted 0.5 hr after receipt of FLUMIST. Pt stated that he had abdominal pain this morning and vomitted last evening. Pt came to clinic and said he was better.

VAERS ID:360532 (history)  Vaccinated:2009-10-01
Age:23.0  Onset:2009-10-01, Days after vaccination: 0
Gender:Female  Submitted:2009-10-05, Days after onset: 4
Location:Minnesota  Entered:2009-10-12, 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: Birth control pills
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: O2 sats=97%
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3201AA0IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Asthenia, Flushing, Urticaria, Vertigo
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (narrow), Hypersensitivity (narrow)
Write-up: Had vaccine at 15:00. Urticaria, flushing, vertigo, weakness at 15:15.

VAERS ID:360742 (history)  Vaccinated:2009-09-29
Age:23.0  Onset:2009-10-13, Days after vaccination: 14
Gender:Male  Submitted:2009-10-14, Days after onset: 1
Location:California  Entered:2009-10-14
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: None
Diagnostic Lab Data: None.
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 4IJLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 1 LA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Military     Purchased by: Military
Symptoms: Incorrect dose administered, Vaccination complication
SMQs:
Write-up: Vigorous reaction due to inappropriate dosing (15 jabs for immunologically naive patient), resulting in satellite lesions forming. Initiated antibiotic for bacterial prophylaxis and NSAID for analgesia.

VAERS ID:360791 (history)  Vaccinated:2009-10-02
Age:23.0  Onset:2009-10-04, Days after vaccination: 2
Gender:Female  Submitted:2009-10-07, Days after onset: 3
Location:Indiana  Entered:2009-10-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Acne; ADD; mild thyromegahy
Diagnostic Lab Data:
CDC 'Split Type':
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HPV4: HPV (GARDASIL)MERCK & CO. INC.1130X0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives. Advised to take BENADRYL. Prednisone.

VAERS ID:360832 (history)  Vaccinated:2009-10-07
Age:23.0  Onset:2009-10-07, Days after vaccination: 0
Gender:Male  Submitted:2009-10-07, Days after onset: 0
Location:Missouri  Entered:2009-10-14, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97840P1 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Muscular weakness, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient fainted, slumped in chair and seemed shaky. 911 was called immediately and pharmacist mentioned patient. Fire dept and EMS arrived monitored pt for 15+ minutes. Pt then was feeling well, refused ambulance and any more medical attention. Signed a release and walked out of store under his own free will.

VAERS ID:360924 (history)  Vaccinated:2009-10-07
Age:23.0  Onset:2009-10-08, Days after vaccination: 1
Gender:Male  Submitted:2009-10-09, Days after onset: 1
Location:Pennsylvania  Entered:2009-10-14, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1134Y0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Body temperature increased, Heart rate increased, Hypertension, Injection site erythema
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Hypertension (narrow)
Write-up: Red at site.- T high 102 degrees, Heart rate high 140- 160 - BP high 146/94 - TYLENOL ES tabs 2 po - SV started, BENADRYL 50 mg QV sent to ER

VAERS ID:361010 (history)  Vaccinated:2009-10-07
Age:23.0  Onset:2009-10-08, Days after vaccination: 1
Gender:Female  Submitted:2009-10-15, Days after onset: 7
Location:Arizona  Entered:2009-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3205CA,U3213AA IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Eye swelling, Facial pain, Lip swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow)
Write-up: PT WOKE UP WITH SWOLLEN RT EYE, CHEEK, AND LIP SWELLING, VERY PAINFUL. WENT TO PCP WHO PRESCRIBED A CREAM FOR THE PAIN, HAD FLU SHOT PREVIOUS DAY IN RT ARM. NOW RESOLVED.

VAERS ID:361012 (history)  Vaccinated:2009-10-14
Age:23.0  Onset:2009-10-14, Days after vaccination: 0
Gender:Male  Submitted:2009-10-15, Days after onset: 1
Location:Mississippi  Entered:2009-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: none known, given unknown medicine from emergency room with 24 hours bed rest, then returned to duty
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB302BA1IMRA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURFAV2170IDLA
Administered by: Military     Purchased by: Military
Symptoms: Bed rest, Headache, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Soldier complained of localized moderate edema to (unknown left or right) deltoid injection site and headache

VAERS ID:361116 (history)  Vaccinated:2009-10-06
Age:23.0  Onset:2009-10-07, Days after vaccination: 1
Gender:Male  Submitted:2009-10-15, Days after onset: 8
Location:Unknown  Entered:2009-10-16, 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:
Preexisting Conditions: Asthma
Diagnostic Lab Data: None
CDC 'Split Type': WAES0910USA01166
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1134Y IMRA
Administered by: Other     Purchased by: Other
Symptoms: Blood pressure increased, Body temperature increased, Chills, Electrocardiogram ST segment depression, Electrocardiogram abnormal, Erythema, Heart rate increased, Rash macular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypertension (narrow), Cardiomyopathy (broad), Other ischaemic heart disease (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 23 year old male employee with no drug reactions/allergies and a history of childhood asthma, who on 06-OCT-2009 was vaccinated intramuscularly in the right upper arm with a 0.5 ml dose of PNEUMOVAX 23 (lot # 662268/1134Y). On 05-OCT-2009 the patient was vaccinated with AFLURIA. The nurse reported that the employee returned on 08-OCT-2009 because of an adverse reaction. The patient had chills on 07-OCT-2009 ("the night before") and was taking TYLENOL. The nurse noted that his temperature was 102.6, heart rate was 130, right arm was red, his blood pressure was elevated at 148/94, his EKG was a little abnormal and there was a depression in his ST. He was given intravenously BENADRYL at Health Services, then he was sent to the emergency room because he was "starting to get blotchy". It was unspecified if the patient had had PNEUMOVAX 23 in the past. At the time of the report it was unknown if the patient recovered. No laboratory diagnostics studies were performed. The adverse experience was considered to be an other important medical event by the reporter. Additional information has been requested.

VAERS ID:361168 (history)  Vaccinated:2009-09-28
Age:23.0  Onset:2009-09-28, Days after vaccination: 0
Gender:Female  Submitted:2009-09-30, Days after onset: 2
Location:Unknown  Entered:2009-10-16, Days after submission: 16
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: All: Amoxicillin; Orange juice; No medical problems
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52BO41CA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0595Y0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Injection site erythema, Injection site swelling, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Developed red swollen area to left arm at site of varicella. Vomiting began 9-29-09; nausea and abd. pain.

VAERS ID:361307 (history)  Vaccinated:2009-10-14
Age:23.0  Onset:2009-10-14, Days after vaccination: 0
Gender:Female  Submitted:2009-10-17, Days after onset: 3
Location:Utah  Entered:2009-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Hyperhidrosis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Severe headache, all over head. Headache lasted until next morning. ALso, low-grade fever and sweats.

VAERS ID:361400 (history)  Vaccinated:2009-10-17
Age:23.0  Onset:2009-10-17, Days after vaccination: 0
Gender:Female  Submitted:2009-10-17, Days after onset: 0
Location:Alaska  Entered:2009-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED01649211A0UNLA
Administered by: Military     Purchased by: Military
Symptoms: Generalised erythema, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Left hip hive, red arm itching & redness itching throughout body. Treated with 50 mg Benadryl & closely monitored x 30 minutes. No breathing difficulty v/s stable!

VAERS ID:361334 (history)  Vaccinated:2009-10-17
Age:23.0  Onset:2009-10-18, Days after vaccination: 1
Gender:Female  Submitted:2009-10-18, Days after onset: 0
Location:Maryland  Entered:2009-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown. ED records received for date of service 10/18/09. Dx: Reaction to smallpox and anthrax vaccines. PMH: Renal infection, bladder infection, NKDA.
Diagnostic Lab Data: ED records received for date of service 10/18/09. Dx: Reaction to smallpox and anthrax vaccines. Labs and Diagnostics: None.
CDC 'Split Type':
Vaccination
Manufacturer
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2170IMRA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURW04003A0OTLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Burning sensation, Diplopia, Headache, Hypoaesthesia, Pain, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Ocular motility disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Member described having whole body aches, headache, blurred vision and faint. See was sent to local ER. 10/20/09: ED records received for date of service 10/18/09. Dx: Reaction to smallpox and anthrax vaccines. Assessment: Presents with c/o severe generalized pain, dizziness, whole body burning (especially joints), double vision, weakness and numb hands. Given IV hydration, Maalox and Motrin. Much improved after first liter of fluid. Discharged to home.

VAERS ID:361407 (history)  Vaccinated:2009-10-16
Age:23.0  Onset:2009-10-16, Days after vaccination: 0
Gender:Male  Submitted:2009-10-19, Days after onset: 3
Location:Texas  Entered:2009-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Monessa
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR03194AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia, Pain, Paraesthesia, Peripheral vascular disorder, Skin discolouration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Swelling and soreness, circulatory problems in the right arm, followed by tingling and color change to the affected arm, which has subsided. Numbness is slowling resolving over time (2 days since vaccine)

VAERS ID:361427 (history)  Vaccinated:2008-07-09
Age:23.0  Onset:0000-00-00
Gender:Female  Submitted:2009-10-19
Location:Massachusetts  Entered:2009-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE. PMH: ADD, Anxiety, Heart Murmur, tonsilectomy.
Diagnostic Lab Data: ENDOSCOPY, COLONOSCOPY, TONSILECTOMY, BLOOD WORK, SWALLOWED CAMERA.
CDC 'Split Type':
Vaccination
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0653X2IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anxiety, Asthenia, Attention deficit/hyperactivity disorder, Blood thyroid stimulating hormone decreased, Blood urea decreased, C-reactive protein increased, Chest pain, Colonoscopy, Colonoscopy normal, Cough, Culture stool negative, Diarrhoea, Echocardiogram normal, Electrocardiogram ambulatory abnormal, Endoscopy, Fatigue, Gastrointestinal disorder, Haematochezia, Laboratory test, Lymphadenopathy, Lymphocyte count decreased, Neutrophil count increased, Oropharyngeal pain, Pain, Pain in extremity, Pyrexia, Restless legs syndrome, Tonsillectomy, Weight decreased, White blood cell count decreased, X-ray normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Noninfectious diarrhoea (narrow)
Write-up: 09/2008 GASTROINTESINAL PROBLEMS 10/2008 WEIGHT LOSS 11/2008 SWOLLEN GLANDS LEG PAINS/RESTLESS LEGS LOST 30 LBS IN 3 MONTHS/TIRED FATIGUE/WEAKNESS -CONTINUED UNTIL PRESTENT DAY

VAERS ID:361432 (history)  Vaccinated:2008-02-19
Age:23.0  Onset:2008-02-21, Days after vaccination: 2
Gender:Female  Submitted:2009-10-16, Days after onset: 602
Location:Unknown  Entered:2009-10-19, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None PMH: None Allergies: NKDA
Diagnostic Lab Data: Unknown Labs: CBC WNL, CMP glucose 141 High Dx studies: Visual evoked response study to r/o optic neuropathy was negative studies mentioned but with no results: RA factor, ANA, IEP, RPR, TSH, UA, ESR, Folic acid, Vit B12 MRI Brain and EEG 11/2/09: Lab results for Influenza A & B by PCR received for date of service 10/13/09: Negative for Influenza A & B. Final.
CDC 'Split Type': WAES0910USA01159
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1267U0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Antinuclear antibody, Balance disorder, Blood glucose increased, Blood thyroid stimulating hormone, Dysarthria, Electroencephalogram, Full blood count, Hypoaesthesia, Laboratory test abnormal, Menstruation irregular, Multiple sclerosis, Nuclear magnetic resonance imaging, Paraesthesia, Paralysis, Reflex test abnormal, Rheumatoid factor, Urine analysis, Vision blurred, Visual evoked potentials normal, Vitamin B12
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vestibular disorders (broad), Fertility disorders (broad)
Write-up: Information has been received from a healthcare worker concerning a 25 year old female patient with no pertinent medical history and no known allergies who on an unspecified date was vaccinated with the first dose of GARDASIL (lot number not reported). The patient was new to the practice and the vaccine was not given in this practice. 2 days after the vaccination, the patient developed numbness to her left side. About 2 weeks after the onset of those symptoms, the patient was diagnosed with Multiple Sclerosis (MS). The patient saw family physician and neurologist (date unspecified). It was unknown if there were lab studies performed. At the time of the report, the outcome of the patient was not reported. Multiple sclerosis was considered to be disabling by the reporter. Follow-up information received from a medical assistant (MA) concerning the 23 year old (previously reported as 25 years old) female patient who on 19-FEB-2008 was vaccinated with the first dose of GARDASIL (lot number not reported). The MA did not know the physician''s name where the patient received the vaccine. On 05-FEB-2009, the patient was first seen in the office for irregular bleeding. On MAR-2009 the patient was seen again and the irregular bleeding had resolved. Additional infoformation has been requested. 10/23/2009 records from Neurologist, multiple visits 3/2008-7/2009. Patient''s sx started 2/2008 with numbness/tingling, inbalance, slurred speech, blurred vision and paralysis, LUE and LLE. PE noted hyperreflexia bilaterally, Romberg''s sign absent. Dx MS

VAERS ID:361640 (history)  Vaccinated:2009-10-15
Age:23.0  Onset:2009-10-16, Days after vaccination: 1
Gender:Female  Submitted:2009-10-20, Days after onset: 4
Location:Pennsylvania  Entered:2009-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None. Is pregnant
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA470BA0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Drug exposure during pregnancy, Injected limb mobility decreased, Injection site pain, Injection site swelling, Muscular weakness, Musculoskeletal pain, Musculoskeletal stiffness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (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), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Arthritis (broad)
Write-up: FLUVAX given 2pm 10/15/09; at 3pm on 10/16/09 - severe pain of entire arm left side where injection given pain and stiffness to L shoulder making movement difficult - no strength in arm. Upper arm swollen no redness. Also had burning sensation. 10/17/09 - swelling reduced, less pain 10/18/09 - resolved.

VAERS ID:361776 (history)  Vaccinated:2009-10-11
Age:23.0  Onset:2009-10-11, Days after vaccination: 0
Gender:Male  Submitted:2009-10-11, Days after onset: 0
Location:Arizona  Entered:2009-10-20, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97839P20IMLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling abnormal, Loss of consciousness, Muscle spasms, Tachycardia
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), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt was sitting in waiting room after administration. He blacked out/ became unconscious for 3-5 sec and had minor hand spasms. He was dazed, "stunned", reported tachycardia. He remained sitting for another 15-20 min, said he felt fire and went home.

VAERS ID:361966 (history)  Vaccinated:2009-09-10
Age:23.0  Onset:2009-09-10, Days after vaccination: 0
Gender:Male  Submitted:2009-10-15, Days after onset: 35
Location:Unknown  Entered:2009-10-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No known allergies; denies alcohol use, liver or kidney problems; No known past medical problems. Tolerated a flu shot in 2008.
Diagnostic Lab Data: None taken
CDC 'Split Type':
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Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3191AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Disturbance in attention, Hot flush, Injected limb mobility decreased, Pain, Pain in extremity
SMQs:, Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad)
Write-up: When administering FLUZONE 0.5ml to left deltoid muscle, the vaccine met some resistance, so I withdrew the needle and stuck it back in about 1 inch away and it went in fine. Today, he reports that his arm got sore 48 hours later, and continued to be sore to this day. Since it hurts to use it, he has been trying not to use it. When he pushes with the arm, he gets a sharp pain. Twenty four hours after the injection, he had to leave work because he "couldn''t think straight" and got chills followed by hot flashes.

VAERS ID:362439 (history)  Vaccinated:2009-10-23
Age:23.0  Onset:2009-10-23, Days after vaccination: 0
Gender:Female  Submitted:2009-10-23, Days after onset: 0
Location:Virginia  Entered:2009-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergies: singulair, phenergan, fenugreek Birth defects: none Medical conditions: none
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0381X0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: Pt reported salty taste in her mouth concurrently with Gardasil injection.

VAERS ID:362460 (history)  Vaccinated:2009-10-15
Age:23.0  Onset:0000-00-00
Gender:Male  Submitted:2009-10-15
Location:Unknown  Entered:2009-10-23, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1A98431 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:362478 (history)  Vaccinated:2009-10-01
Age:23.0  Onset:2009-10-01, Days after vaccination: 0
Gender:Male  Submitted:2009-10-01, Days after onset: 0
Location:Florida  Entered:2009-10-23, Days after submission: 22
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98434P1 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Fall, Loss of consciousness, Mouth injury
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), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt reported that he sometimes passes out when he gives blood, but thought that he should be fine with a flu shot. I administered vaccine and the pt said he felt fine. He and his wife were walking around the store. Pt started to feel lightheaded and they came back to the pharmacy. He tried to sit on the floor and just before reaching the seated position he fell and passed out briefly. When he fell he cut his lip on his braces. Within 30 seconds he was awake and instructed not to call 911. I raised his feet and rested them on a chair as he was laying on the ground. After he was feeling better, he sat in a chair for a few minutes. I checked his blood pressure and it was 128/78. He drank a Gatorade and when he was feeling ok I walked he and his wife out to their car and his wife drove him home.

VAERS ID:362496 (history)  Vaccinated:2009-10-12
Age:23.0  Onset:2009-10-12, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Louisiana  Entered:2009-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OCPs
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
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TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Diarrhoea, Feeling hot, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Same day felt chills, then felt hot - then next morning felt nausea & had diarrhea. Day after shot started having trouble focusing eyes, blurry vision symptoms persists. Referred patient to PMD.

VAERS ID:362578 (history)  Vaccinated:2009-10-22
Age:23.0  Onset:2009-10-22, Days after vaccination: 0
Gender:Female  Submitted:2009-10-23, Days after onset: 1
Location:Nevada  Entered:2009-10-23
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: allergic to sulfa
Diagnostic Lab Data:
CDC 'Split Type': up002aa
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA0UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Eye pruritus, Headache, Oropharyngeal pain, Pruritus generalised
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: sever itching all over including eyes. Hoarse Cough (therefore sore throat), slight trouble breathing, headache

VAERS ID:362815 (history)  Vaccinated:2009-10-21
Age:23.0  Onset:2009-10-21, Days after vaccination: 0
Gender:Female  Submitted:2009-10-23, Days after onset: 2
Location:Connecticut  Entered:2009-10-26, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Vomiting~Influenza (Seasonal) (no brand name)~~22.00~Patient
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08549111A0IM 
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Rash, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Vomiting and diarrhea approx 12 hours after vaccine administration. Hives and rash on stomach, chest and under arms.

VAERS ID:362920 (history)  Vaccinated:2009-10-21
Age:23.0  Onset:2009-10-22, Days after vaccination: 1
Gender:Female  Submitted:2009-10-26, Days after onset: 4
Location:Ohio  Entered:2009-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: infant lethargic and difficult to rouse for 36 hours after vaccine administration~DTP (no brand name)~1~2.00~Patient
Other Medications: Provigil, 200 mg/day Imitrex, 50 mg as needed
Current Illness: no
Preexisting Conditions: narcolepsy
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Public     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Body temperature increased, Decreased appetite, Dehydration, Diarrhoea, Fatigue, Haemorrhoids, Headache, Migraine, Occult blood, Pyrexia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Patient received nasal swine flu vaccine at 4pm Wednesday 10/21. On 10/22 and 10/23 patient noticed unusual fatigue considering she had slept 9 hours each night and was on 200 mg/day Provigil for narcolepsy and had not experienced daytime fatigue since beginning that medication several months ago. On Saturday 10/24, patient awoke at 8am with a basal body temperature of 98.9 (normal temp 97.8) which rose to 99.9 for the next 24 hours. Patient also experienced multiple loose stools, and by midafternoon patient experienced five hours of severe watery diarrhea, to the point of producing external hemorrhoids (and potentially internal as well since both bright and occult blood were noted in the stool for the next 24 hours). The diarrheal symptoms decreased in frequency after the first five hours from bowel movements every 10-15 minutes to every few hours. Patient also complained of appetite loss and severe headaches, though noted that dehydration is her usual migraine trigger. Fever, diarrhea, tiredness, and headaches resolved by the evening of 10/25. The patient lost 1.5 work days due to the severity of her GI symptoms.

VAERS ID:362928 (history)  Vaccinated:2007-11-30
Age:23.0  Onset:2007-11-30, Days after vaccination: 0
Gender:Male  Submitted:2009-10-26, Days after onset: 695
Location:Minnesota  Entered:2009-10-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Large red welt with pruritis at the site of varicella vaccine injection (upper left arm), duration of 7 days post-administration.

VAERS ID:363359 (history)  Vaccinated:2009-03-18
Age:23.0  Onset:2009-03-18, Days after vaccination: 0
Gender:Female  Submitted:2009-10-28, Days after onset: 224
Location:Texas  Entered:2009-10-28
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: WILL BE NEEDING SPLEEN REMOVED.
Diagnostic Lab Data: NONE
CDC 'Split Type': TX090007PU
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MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2571AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0380U0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypersensitivity, Injection site erythema, Injection site pain, Injection site swelling, Pyrexia, Respiration abnormal, Vaccination complication
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: CLIENT CALLED ON 3/19/2009 TO REPORT A VACCINE REACTION. SHE STATED RIGHT ARM RED AND SWOLLEN FROM HER RIGHT ELBOW TO RIGHT SHOULDER. ALSO PAINFUL. SHE ALSO REPORTED SHE HAD FEVER ON 3/18/2009 AFTER THE INJECTION. ADVISED TO GO TO A PHYSICIAN. CALLED FOR FOLLOW-UP 3/23/2009. STATED SEEN IN ER AND GIVEN IV STERIOD ON 3/19/2009. ER PHYSICIAN TOLD HER IT WAS AN ALLERGIC REACTION. SHE ALSO STATED ER PHYSICIAN TOLD HER SHE HAD DIMINISHED RESPIRATION, BUT SHE STATED THAT SHE DID NOT NOTICE BREATHING PROBLEM. TODAY (3/23/09), CLIENT REPORTS SWELLING AND REDNESS TO RIGHT ARM HAS SUBSIDED. SHE ALSO REPORTED TO ME THAT SHE WILL BE HAVING HER SPLEEN REMOVED IN A FEW DAYS AND THAT IS THE REASON SHE NEEDED THE VACCINES, MENINGOCOCCAL AND PNEUMOCOCCAL VACCINE. SHE STATED THAT HER PHYSCIAN TOLD HER SHE WOULD NEED THESE VACCINES EVERY 5 YEARS. I EXPLAINED TO THE CLIENT NEEDED TO DISCUSS THIS REACTION WITH HER PHYSICIAN SINCE THE ER DOCTOR TOLD HER IT WAS AN ALLERGIC REACTION TO THE VACCINES.

VAERS ID:363498 (history)  Vaccinated:2009-10-22
Age:23.0  Onset:2009-10-23, Days after vaccination: 1
Gender:Male  Submitted:2009-10-28, Days after onset: 5
Location:Wisconsin  Entered:2009-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Cold symptoms, no fever
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP007AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on face, neck, bilateral arms, stomach, and lower extremeties

VAERS ID:363508 (history)  Vaccinated:2009-10-27
Age:23.0  Onset:2009-10-28, Days after vaccination: 1
Gender:Female  Submitted:2009-10-28, Days after onset: 0
Location:New York  Entered:2009-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain upper
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Terrible stomach cramping

VAERS ID:363514 (history)  Vaccinated:2009-10-28
Age:23.0  Onset:2009-10-29, Days after vaccination: 1
Gender:Male  Submitted:2009-10-29, Days after onset: 0
Location:Wisconsin  Entered:2009-10-29
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: No.
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Dizziness, Headache, Hyperhidrosis, Insomnia, Pallor, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Headache, Pale, Chills, Fever, Dizzy, Vomiting. Couldn''t sleep and soaked a couple sets of sheets in sweat. Eventually got to sleep and woke up feeling much better. Symptoms over in 8hrs.

VAERS ID:363678 (history)  Vaccinated:2009-10-28
Age:23.0  Onset:2009-10-28, Days after vaccination: 0
Gender:Female  Submitted:2009-10-28, Days after onset: 0
Location:Montana  Entered:2009-10-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dry/cracked feet
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP005AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt received the H1N1 shot at 5:15 pm 20 minutes later pt experienced hives on bilateral forearms, without respiratory distress. BENADRYL 50mg/1mL given. Pt tolerated well.

VAERS ID:364030 (history)  Vaccinated:2009-10-29
Age:23.0  Onset:2009-10-29, Days after vaccination: 0
Gender:Male  Submitted:2009-10-30, Days after onset: 1
Location:Michigan  Entered:2009-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pt denies
Preexisting Conditions: ALA-Dairy
Diagnostic Lab Data: None
CDC 'Split Type':
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500685P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Heart rate, Hyperhidrosis, Respiratory rate
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Pt received FLUMIST at 2:20. Pt (2:25p) became diaphoretic and complained of dizziness. O2 applied VS BP 80/62 P 90 Resp:20 Transported to hospital via ambulance.

VAERS ID:364129 (history)  Vaccinated:2009-10-28
Age:23.0  Onset:2009-10-28, Days after vaccination: 0
Gender:Female  Submitted:2009-10-30, Days after onset: 2
Location:Virginia  Entered:2009-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: keppra topiramate sprinkles lantus and novolog insulin claritan singulairre sprintek
Current Illness: mild conjunctivitis pneumonia two weeks ago probably over it allergic reaction Augmentin recent
Preexisting Conditions: cerebral palsy polymicrogyrea diabetes latex avelox suprax strawberries augmentin
Diagnostic Lab Data: urinanalysis blood work
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP018AA0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Blood test, Crying, Fear, Urine analysis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Crying complaining of abdominal pain and cramps fear

VAERS ID:364162 (history)  Vaccinated:2009-10-30
Age:23.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Female  Submitted:2009-10-31, Days after onset: 1
Location:Maryland  Entered:2009-10-31
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. Allergies: None.
Diagnostic Lab Data: Labs and Diags: WBC, BMP and UA WNL.
CDC 'Split Type':
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0381X0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal discomfort, Adverse drug reaction, Asthenia, Chills, Diarrhoea, Fatigue, Fluid replacement, Hot flush, Nausea, Syncope, Urine analysis normal, Vomiting, White blood cell count
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow)
Write-up: Tightness in abdomen, violent vomiting, diarreha, fainting, weakness, fatigue 11/03/09 Vaccine record received. 11/05/09 Medical records received for DOS 10/30/09. Patient developed nausea, diar and vomiting several hours s/p vaccine. Hot and cold flashes. ED visit. All bld wrk WNL. Fluid replacement and antiemetics. Felt better. D/c to home.

VAERS ID:364208 (history)  Vaccinated:1991-02-01
Age:23.0  Onset:1991-02-01, Days after vaccination: 0
Gender:Male  Submitted:2009-11-01, Days after onset: 6847
Location:Unknown  Entered:2009-11-01
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: have had diarrhea, body aches, hard time remembering things for the past 20 yrs.
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Muscle spasms, Pain
SMQs:, Pseudomembranous colitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea, cramps, aches.

VAERS ID:364281 (history)  Vaccinated:2009-10-27
Age:23.0  Onset:2009-10-27, Days after vaccination: 0
Gender:Female  Submitted:2009-11-02, Days after onset: 6
Location:Illinois  Entered:2009-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rocephin; Penicillin; Erythromycin; Tetracycline; Z-pack; Compazine
Current Illness: No
Preexisting Conditions: Rocephin--Anaphylactic shock; Penicillin--open sores; Erythromycin--Hives; Tetracycline--Hives; Z-pack--Hives; Compazine--Involuntary twitching, agitated and wheezing.
Diagnostic Lab Data:
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP005AA   
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on face, neck,abdomen, arms, and feets. Took Benadryl 50mg by mouth. 15 to 20 minutes later hives gone.

VAERS ID:364303 (history)  Vaccinated:2008-06-01
Age:23.0  Onset:2009-08-01, Days after vaccination: 426
Gender:Female  Submitted:2009-10-30, Days after onset: 90
Location:Pennsylvania  Entered:2009-11-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Pregnancy NOS (LMP = Unknown)
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0910USA03078
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HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Caesarean section, Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a licensed practical nurse, for GARDASIL, a Pregnancy Registry product, concerning a 23 year old female patient who in June 2008, was vaccinated with the first dose of GARDASIL (lot#, route and site of administration not reported) and she was not given any other doses of GARDASIL because she was pregnant. Unspecified medical attention was sought. In August 2009, the patient delivered a healthy baby via C-section. Upon internal review, delivered a baby via C-section was determined to be an other important medical event. No further information is available since the office nurse reported that they did not deliver the patient''s baby.

VAERS ID:364329 (history)  Vaccinated:2009-10-22
Age:23.0  Onset:2009-10-23, Days after vaccination: 1
Gender:Female  Submitted:2009-10-27, Days after onset: 4
Location:Wisconsin  Entered:2009-11-02, 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: None
Preexisting Conditions: Scoliosis
Diagnostic Lab Data: Unknown
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500756P0IN 
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Gait disturbance, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: Patient was given H1N1 LAIV nasal spray on 10/22/09. On 10/23/09 patient experienced dizzy spells, nausea, and inability to walk unassisted. Patient saw MD and was treated for vertigo. MD told patient that vaccine settled in her ear.

VAERS ID:364385 (history)  Vaccinated:2009-10-19
Age:23.0  Onset:2009-10-20, Days after vaccination: 1
Gender:Female  Submitted:2009-10-26, Days after onset: 6
Location:Ohio  Entered:2009-11-02, 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: None-pregnant
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA0IJAR
Administered by: Private     Purchased by: Public
Symptoms: Drug exposure during pregnancy, Injection site anaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: fingers tingly and injection site was numb

VAERS ID:364395 (history)  Vaccinated:2009-10-14
Age:23.0  Onset:2009-10-14, Days after vaccination: 0
Gender:Female  Submitted:2009-10-14, Days after onset: 0
Location:Florida  Entered:2009-11-02, Days after submission: 19
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 noted
Preexisting Conditions: None Noted
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98445P10IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: itching/redness along trunk area Loratadine 10mg PO x 1 - itching resolved after dose

VAERS ID:364587 (history)  Vaccinated:2009-10-30
Age:23.0  Onset:2009-10-31, Days after vaccination: 1
Gender:Female  Submitted:2009-11-03, Days after onset: 3
Location:Michigan  Entered:2009-11-03
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: Asthma
Diagnostic Lab Data: None
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJLA
Administered by: Public     Purchased by: Other
Symptoms: Cough, Dizziness, Dysphonia, Dyspnoea, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Hoarseness, dizziness, muscle aches, trouble breathing, coughing...10/30/2009 to present.

VAERS ID:364834 (history)  Vaccinated:2009-11-01
Age:23.0  Onset:2009-11-02, Days after vaccination: 1
Gender:Male  Submitted:2009-11-03, Days after onset: 1
Location:Michigan  Entered:2009-11-03
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, but still sick today
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 1IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Cough, Fatigue, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Fever, aches in knees and lesser aches over entire body. Tiredness, dry cough.

VAERS ID:364873 (history)  Vaccinated:2009-09-23
Age:23.0  Onset:2009-09-23, Days after vaccination: 0
Gender:Female  Submitted:2009-11-03, Days after onset: 41
Location:North Carolina  Entered:2009-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: All : PCN
Diagnostic Lab Data:
CDC 'Split Type':
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB162BA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash on both arms - onset L upper arm 1 hr after TWINRIX #2 dose. Spread down L arm to hand then to R arm.

VAERS ID:365975 (history)  Vaccinated:2009-09-14
Age:23.0  Onset:2009-09-14, Days after vaccination: 0
Gender:Female  Submitted:2009-10-07, Days after onset: 23
Location:Montana  Entered:2009-11-03, Days after submission: 27
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: Concomitant medications and relevant medical history were unknown. It was unknown if adverse events were reported with previous vaccinations. The subject had previously received influenza vaccinations, adverse events associated with these vaccinations were unknown.
Diagnostic Lab Data:
CDC 'Split Type': A0807882A
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA261AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site pruritus
SMQs:, Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of itching in a subject of unspecified age and gender who was vaccinated with influenza vaccine trivalent (Flulaval, GlaxoSmithKline). On 14 September 2009, the subject received unspecified dose of Flulaval (unknown). On 14 September 2009, almost immediately after vaccination with Flulaval, the subject experienced itching. The reporter stated a subject experiended itching from the inside out which began almost immediately after the shot was given. Specific informaotin was not known. The reporter stated that the batch of vaccine for lot number AFLLA261AA might be defective which caused the adverse event. The reporter did not have specific information and is seeking advice on whether to continue giving injection with this lot. The reporter did not have an expiration date. At the time of reporting the outcome of the events were unspecified. The reporter stated three additional subjects experienced adverse events; see cases A0807879A, A0807883A, and A0807884A. Follow-up was received from 15 September 2009, via Quality Assurance (QA). QA stated thsi is an adverse Event only and it will not be recorded as a compliant. Follow-up was received on 18 September 2009, via sales representative, who reported the 23-year old female subject received FLuLaval on 14 September 2009. The onset of itchiness (described as skin crawling) at injection site was immediately following injection; symptoms were not long lasting. Subject feeling well prior to vaccine, no fever, no other medications, nor prior history of adverse events following flu vaccine. Subject was evaluated for rash and was negative. The events resolved on 14 September 2009 and was considered possibly related to Flulaval vaccination.

VAERS ID:364877 (history)  Vaccinated:2009-09-30
Age:23.0  Onset:2009-09-30, Days after vaccination: 0
Gender:Female  Submitted:2009-11-03, Days after onset: 34
Location:North Carolina  Entered:2009-11-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Condyloma acuminatum
Diagnostic Lab Data: Pregnancy confirmed by POSITIVE Beta Serum hCG (19OCT09). NEGATIVE Chlamydia trachomatis & Neisseria gonorrhoeae rRNA Panel (30Sep09) and PAP SMEAR 930SEP09) was NEGATIVE for Intraepithelial lesion or malignancy.
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HPV4: HPV (GARDASIL)MERCK & CO. INC.    
Administered by: Military     Purchased by: Military
Symptoms: Chlamydia identification test negative, Drug exposure during pregnancy, Pregnancy test positive, Smear cervix normal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: LPN calls FBVHC on 29OCT09 re 23 y/o AD female SM who inadvertently received GARDASIL vaccine on 30SEP09 and the Live Intranasal Flumist vaccine on 08OCT09 before the SM knew she was pregnant. As of 29OCT09, when the SM''s OB Intake/Registration was performed the SM was at 6 weeks, 3 days gestation / LMP 12SEP09 / EDC 19JUN2010. Age at first pregnancy: 20 years. Gravida 3, para 0 and 2 abortions/miscarrages one at 9 weeks and one at 5 months. No previous ectopic pregnancies. No h/o congenital malformations. No DES taken during pregnancy. Baby''s father is 24 y/o. The SM currently denies any evidence of adverse events following immunizations received no spotting, cramping, pelvic or abdominal pain reported. Denies N or V. NKDA. The SM is scheduled to be seen at OB-GYN on 07DEC09 for specialty consult s/p vaccine exposure as noted above. SM advised to notify PCM of any new onset of spotting, pelvic or abdominal cramping or pain. Intractable N or B fever $g 101F or any other changes in health status. FBVHC provided patient with online resources for MERCK GARDISIL PREGNANCY REGISTRY and will F/U with SM periodically throughout pregnancy to inquire re progress and reporting of any adverse events up through the delivery of the baby. Symptoms: Amenorthea.

VAERS ID:364933 (history)  Vaccinated:2009-09-15
Age:23.0  Onset:2009-09-15, Days after vaccination: 0
Gender:Female  Submitted:2009-10-28, Days after onset: 43
Location:Michigan  Entered:2009-11-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3195AA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Fatigue, Feeling cold, Malaise
SMQs:
Write-up: c/o "chills - really sick. Exhausted, run down, freezing" after vaccination. Not her first flu shot.

VAERS ID:365354 (history)  Vaccinated:2009-11-05
Age:23.0  Onset:2009-11-05, Days after vaccination: 0
Gender:Male  Submitted:2009-11-05, Days after onset: 0
Location:Missouri  Entered:2009-11-05
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':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dyspnoea, Eye pruritus, Haemoptysis, Heart rate increased
SMQs:, Anaphylactic reaction (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Severe itchy eyes, cough with blood in phlegm, rapid heartbeat, trouble breathing.

VAERS ID:365404 (history)  Vaccinated:2009-11-04
Age:23.0  Onset:2009-11-04, Days after vaccination: 0
Gender:Female  Submitted:2009-11-05, Days after onset: 1
Location:Rhode Island  Entered:2009-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Patient was 35 3/7 wks pregnant
Preexisting Conditions: Patient had a history of IUGR with previous pregnancy. She presented on 11/4 with preterm rupture of membranes to the hospital the same day that she got the vaccine at 10:30 pm. Rupture is more likely to current pregnancy''s IUGR as well. 1860 gm preterm female was born on 11/5 at 0630am with apgars of 8 at 1 min and 9 at 5 min. 11/10/09: Hospital Labor and Delivery Records and Prenatal records received for date of service 11/5/09. PMH: Term pregnancy with IUGR, NKDA. 11/9/09 Medical records received for dates 11/4/09 OB records Pt. is smoker, caffeine use.
Diagnostic Lab Data: + ferning upon admission to the hospital (confirming rupture of membranes) 11/10/09: Hospital Labor and Delivery Records and Prenatal records received for date of service 11/5/09. Labs and Diagnostics: HIV Neg, GBS +.
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS100813 6P1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Drug exposure during pregnancy, Premature labour, Premature rupture of membranes
SMQs:, Retroperitoneal fibrosis (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Patient had preterm rupture of membranes at 10:30 pm on the same day the vaccine was administered. She was preterm (35 3/7 wks) and weighed 1860. Mom has a history of IUGR with her first pregnancy. 11/10/09: Hospital Labor and Delivery Records and Prenatal records received for date of service 11/5/09. Dx: Premature delivery Assessment: Gravida 3 Para 1 at 35 3/7 weeks EGA presented to L&D with premature rupture of membranes on date of H1N1 vaccine administration. Baby had reassuring HR during labor. Apgar scores were 8 and 9 at 1 and 5 minutes respectively. Birth weight was 1860 gms. Placenta with 3 vessel cord. Estimated blood loss 100 ml. Abnormal placenta sent to pathology. 11/9/09 Medical records received for dates 11/4/09 OB records. 35wks exam WNL. c/o back pain lying down. FHR 140''s.

VAERS ID:365532 (history)  Vaccinated:2009-10-30
Age:23.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Female  Submitted:2009-11-05, Days after onset: 6
Location:South Dakota  Entered:2009-11-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1007393P0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Cough, Fatigue, Nasal congestion, Oropharyngeal pain, Pain, Pyrexia, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Sore throat, body aches, fatigue, cough, nasal/sinus congestion, fever-100. Some symptoms are still continuing today 11/6/09.

VAERS ID:365652 (history)  Vaccinated:2009-10-29
Age:23.0  Onset:2009-10-30, Days after vaccination: 1
Gender:Female  Submitted:2009-11-06, Days after onset: 7
Location:New Jersey  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control pills
Current Illness: None
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP015AA0UNRA
Administered by: Private     Purchased by: Other
Symptoms: Rash erythematous, Rash macular, Rash pruritic, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 10/29 - Red macular rash. Itchy, warm to touch. 11/01 - Red blotchy, itchy rash, warm to touch. Disappeared on own.

VAERS ID:365706 (history)  Vaccinated:2009-08-18
Age:23.0  Onset:2009-09-19, Days after vaccination: 32
Gender:Male  Submitted:2009-11-06, Days after onset: 48
Location:California  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: none
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA458BA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Headache, Vertigo
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (narrow)
Write-up: Patient received seasonal flu shot 9/18/09. Patient experienced dizziness. Vertigo associated with head movement and headache 24 hours after shot.

VAERS ID:365735 (history)  Vaccinated:2009-11-06
Age:23.0  Onset:2009-11-06, Days after vaccination: 0
Gender:Female  Submitted:2009-11-06, Days after onset: 0
Location:Massachusetts  Entered:2009-11-06
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: 25 days post partem
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500758P0IN 
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: Pt was given nasal (LAIV) H1N1 vaccine and shortly after pt started to have blurred vision and lightheadedness. Pt given water, fresh fruit and lied down over 20 min and her blood pressure and blood sugar went to normal range.

VAERS ID:365777 (history)  Vaccinated:2009-11-06
Age:23.0  Onset:2009-11-06, Days after vaccination: 0
Gender:Male  Submitted:2009-11-06, Days after onset: 0
Location:New York  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None stated
Preexisting Conditions: Allergy honey bee mixed vespid, asthma, ADHD,
Diagnostic Lab Data:
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Muscular weakness, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: States face tingle, legs weak, light headed. BP 138/80 AP 100 OT 97.8 given fluids monitored. 12:15 BP 130/80 AP 80 Lungs clear, not SOB, no swelling at site oriented X3. 12:40 Improved feeling of light headedness no SOB.

VAERS ID:365796 (history)  Vaccinated:2009-10-23
Age:23.0  Onset:2009-10-23, Days after vaccination: 0
Gender:Female  Submitted:2009-11-06, Days after onset: 14
Location:Ohio  Entered:2009-11-06
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: n/a LMP 10/11/09.
Diagnostic Lab Data: None ran
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP0006AASP1 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dermatitis allergic, Diarrhoea, Headache, Ocular hyperaemia, Rash generalised, Rash pruritic, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Itching all over Hives on face

VAERS ID:365840 (history)  Vaccinated:2009-11-07
Age:23.0  Onset:2009-11-07, Days after vaccination: 0
Gender:Female  Submitted:2009-11-07, Days after onset: 0
Location:Florida  Entered:2009-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: THROAT RESTRICTION AND HIVES ON THE CHEST
Preexisting Conditions: BEE-STINGS, SULFA, LATEX, ASPRIN AND PCN
Diagnostic Lab Data: UNKNOWN
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500743P OT 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: PATIENT HAD RESTRICTION IN BREATHING AND HAD HIVES ON HER CHEST

VAERS ID:365909 (history)  Vaccinated:2009-10-13
Age:23.0  Onset:2009-10-13, Days after vaccination: 0
Gender:Female  Submitted:2009-11-08, Days after onset: 26
Location:Illinois  Entered:2009-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth Control (Seasonique), Asmanex, Albuteral, Mobic
Current Illness: no
Preexisting Conditions: asthma PMH: Asthma Allergies: Keflex
Diagnostic Lab Data: Dx studies: US of the neck impression lymph node
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HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Dizziness, Fatigue, Lymphadenopathy, Neck mass, Presyncope, Swelling, Ultrasound scan normal
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Lymph node in neck became swollen. Feeling tried and exhausted and dizzy all day. Cannot perform normal daily functions because of tiredness and near syncope.11/12/2009 MD records for 10/20/2009, patient with c/o''s lump lt side of neck. PE noted a small, mobile, 1cm mass. Tx: observation Dx neck mass ICD-9 code 784.2

VAERS ID:366046 (history)  Vaccinated:2009-10-06
Age:23.0  Onset:2009-10-07, Days after vaccination: 1
Gender:Female  Submitted:2009-10-28, Days after onset: 21
Location:Connecticut  Entered:2009-11-09, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: AMOXICILLIN - last dose 10/5/09 10 AM; Oral contraceptive
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3175AA0IMRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB731AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Hypersensitivity, Mechanical urticaria, Rash macular, Rash pruritic, Somnolence, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow)
Write-up: The employee c/o hives which began about 36 hours after receiving a HEPATITIS B vaccine and a seasonal inactivated influenza vaccine on 10/6/09 about 9 am. The hives began the evening of 10/7/09 at approximately 8-9 PM. The hives were predominately located on her back. She states that the rash was itchy. She denies any associated difficulty breathing, shortness of breath, mouth or tongue swelling. She denies any new foods, soaps, detergents. She has been taking BENADRYL 2-4 X a day (denies drowsiness other than on the first day), PREDNISONE 60 mg - tapering doses that was prescribed by a PA and ZYRTEC. She was also evaluated by Dr. - she denies any prior h/o hives. Allergies - none known. PE - very faint erythematous macular rash upper abdomen, chest arms and back - the rash is not diffuse. There is slight facial erythema. No urticaria is visible. Imp - / allergic reaction to hepatitis B vaccine and/ or inactivated seasonal influenza vaccine. Plan - continue present medications - taper PREDNISONE. File VAERS Observe. The employee returns stating that after completing her course of PREDNISONE on 10/18, she had almost complete resolution of the hives. However, since 10/25, the hives have returned. The symptoms come and go and are not associated with any particular food or activity although she did have a few episodes in the evening while sitting on the couch and a few times while in bed during sexual activity. However, the hives also occur sporadically during the day. She has been self-medicating with ZYRTEC and BENADRYL and recently tried CLARITIN with no relief. She does have cats and dogs, but has always been around pets. She is unable to identify any new food, medication, soaps, etc. She does not eat shellfish. She has not had any oral swelling, shortness of breath, or respiratory difficulty during these episodes. Meds- birth control pill. PE- alert, NAD, no respiratory distress. VS BP 130/86 P-87 T-99 po pulse oximter 99% on room air. Skin - there are scattered areas of urticaria on t

VAERS ID:366080 (history)  Vaccinated:2009-10-08
Age:23.0  Onset:2009-10-08, Days after vaccination: 0
Gender:Female  Submitted:2009-10-19, Days after onset: 11
Location:Colorado  Entered:2009-11-09, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: rash~Influenza (Seasonal) (no brand name)~UN~21.00~Patient
Other Medications: Nuvaring
Current Illness: None
Preexisting Conditions: Endometriosis
Diagnostic Lab Data: None
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA468BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash face, arms, torso. Given steroids, Benadryl & Cimetadine.

VAERS ID:366169 (history)  Vaccinated:2009-11-02
Age:23.0  Onset:2009-11-02, Days after vaccination: 0
Gender:Female  Submitted:2009-11-09, Days after onset: 7
Location:Michigan  Entered:2009-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No Known Illnesses
Preexisting Conditions: No Known Dx PMH: None Allergies: NKDA
Diagnostic Lab Data: Client was confirmed positive for pregnancy at the hospital. Client was not aware that she was pregnant at time of reciving the H1N1 FLU Mist. Labs: ua culture neg, tsh, rpr, hep a antigen pap smear all normal/negative cbc, neutrophils high, lymphocytes low Labs: CBC and CMP wnl, pregnancy test + Dx studies: US abd + for pregnancy
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500783P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Blood thyroid stimulating hormone normal, Culture urine negative, Dizziness, Drug exposure during pregnancy, Full blood count, Hepatitis A antibody negative, Hypotension, Lymphocyte count decreased, Metabolic function test, Neutrophil count increased, Pregnancy test positive, Smear cervix normal, Syphilis test negative, Ultrasound antenatal screen normal
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Client was given the H1N1 Flu mist after being screened. Client indicated that she was not pregnant at this time. Client waited her 15 minutes as instructed and then went to the public restrooms. Client was found conscious on bathroom floor by an RN who assisted client to a sitting position. EMS was present at H1N1 Flu Community Clinic and took over care for the client. Client complained of being lightheaded and weak. Client''s BP was slightly low per EMS, client was assisted to the floor and legs were elevated. This action assisted with client''s BP returning to normal. Client''s children and her mother were present. EMS offered to tranport client to local hospital. Client agreed and was transfered. Client has a pregnancy test at the hospital and was confirmed postive for pregnancy. 12/16/2009 ED visit 11/2/2009 patient with c/o''s lightheadedness and dizziness 12/16/2009 OB-GYN visit for 11/6/09 initial visit

VAERS ID:366199 (history)  Vaccinated:2009-10-28
Age:23.0  Onset:2009-10-30, Days after vaccination: 2
Gender:Female  Submitted:2009-11-09, Days after onset: 10
Location:California  Entered:2009-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yaz Indrin
Current Illness: None
Preexisting Conditions: Migraines
Diagnostic Lab Data: None
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 2 days after vaccine administered 10/28/09, reaction at site of administered muscle L deltoid, red, swollen, pain, induration, warm compress. Seen 11/6/09 with all except slight induration resolved.

VAERS ID:366212 (history)  Vaccinated:2009-11-03
Age:23.0  Onset:2009-11-06, Days after vaccination: 3
Gender:Male  Submitted:2009-11-09, Days after onset: 3
Location:Ohio  Entered:2009-11-09
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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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Dose
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500764P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: RED, BUMPY, ITCHY RASH APPEARED FIRST ON ARMS, HAS THEN SPREAD TO FACE, TRUNK, BACK.

VAERS ID:366518 (history)  Vaccinated:2009-11-04
Age:23.0  Onset:2009-11-08, Days after vaccination: 4
Gender:Female  Submitted:2009-11-10, Days after onset: 2
Location:Illinois  Entered:2009-11-10
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
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500782P0IN 
Administered by: Public     Purchased by: Unknown
Symptoms: Epistaxis, Eye swelling, Haemoptysis, Sinus headache
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: 11/08/2009, I got up from laying down to go to bed and experienced a chronic nose bleed out of both nostrils and was coughing up blood (from nose bleed) for 25 minutes. I called 911 and the Paramedics told me to pinch nose and apply ice. After 40 minutes it stopped. Today, 11/11/2009 I have a swollen left eye and soreness all around my left sinus region. I am taking an anti-immflammatory drug for the swelling.

VAERS ID:366631 (history)  Vaccinated:2009-10-21
Age:23.0  Onset:2009-10-26, Days after vaccination: 5
Gender:Female  Submitted:2009-11-11, Days after onset: 16
Location:Iowa  Entered:2009-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none PMH: None Allergies: NKDA
Diagnostic Lab Data: CT, MRI, Lumbar Puncture, Blood Work Labs: CBC, BMP, LFT''s, TSH, Vit B12, ANA, CRP, Lyme titer, CSF normal, ASO titer normal Dx studies: CT head and MRI Brain WNL
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500783P IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Antinuclear antibody, Asthenia, Blood test normal, Blood thyroid stimulating hormone, Borrelia burgdorferi serology, CSF cell count normal, Computerised tomogram normal, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia facial, Liver function test normal, Lumbar puncture normal, Metabolic function test normal, Metamorphopsia, Muscle tightness, Neurological symptom, Nuclear magnetic resonance imaging normal, Paraesthesia, Speech disorder, Streptococcus identification test, Streptococcus identification test negative, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (narrow)
Write-up: Symptoms began with headache, blurred/distorted vision, tingling sensation on left side of body, numbness in face. Proceeded to tightening of muscles on right side of body. Speech was impaired. Exhibited stroke like symptoms. Went to ER, CT scan was done. Was admitted to hospital. MRI was done following morning. Approx. 5:00 pm, was discharged and went to Medical Center. Had lumbar puncture. All tests came back fine. Was referred to another Medical Center for further testing. Still do not know what happened, no diagnosis. Nothing has come back on any of the testing.11/12 and 11/13/2009 ED, MR for DOS 10/27-10/28/2009, Pt c/o headache, blurred vision, tingling, weakness of extremities, slow speech and unsteady gait. Neuro exam abnormal. Impression: Neurological spell. 12/1/2009 Lab test results: ASO titer: 211 IU/ml: normal. 01/12/10 MR received for DOS 10/28/09. Pt c/o numbness of L side of body and weakness, peripheral vision problems, confused, difficulty ambulating, headache, slow speech. On neurological exam: normal. Dr. considered this event as possible underlying seizure. Pt scheduled for EEG to evaluate possible sz.

VAERS ID:366888 (history)  Vaccinated:2009-11-11
Age:23.0  Onset:2009-11-12, Days after vaccination: 1
Gender:Female  Submitted:2009-11-12, Days after onset: 0
Location:California  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None. States she used hospital provided hand lotion with olivamine for first time. Has sensitive skin and previous allergy testing.
Current Illness: None
Preexisting Conditions: Has sensitive skin and has had previous allergy testing. Allergic to Nickel. Also states she used hopital provided hand lotion for the first time last night. "Remedy" skin repair cream with Olivamine.
Diagnostic Lab Data: Referred to occupational health facility for evaluation.
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1013261P0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Hypoaesthesia, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Numbness and tingling in both arms more on left side, up back of neck and to left eye. Redness on both wrists but not at injection site.

VAERS ID:366927 (history)  Vaccinated:2009-11-11
Age:23.0  Onset:2009-11-11, Days after vaccination: 0
Gender:Female  Submitted:2009-11-12, Days after onset: 1
Location:South Carolina  Entered:2009-11-12
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: ulcerative colitis
Diagnostic Lab Data: employee was given IV Benadryl and Atarax to use at home if needed
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1008136P0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus generalised, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Started itching all over, a red rash appeared on back, chest, stomach, neck.

VAERS ID:366990 (history)  Vaccinated:1999-10-30
Age:23.0  Onset:1999-10-30, Days after vaccination: 0
Gender:Male  Submitted:2009-11-12, Days after onset: 3666
Location:New York  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Before vaccination no illness
Preexisting Conditions: eczema, allergy to latex
Diagnostic Lab Data: detoxification
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERUKN1IJRA
Administered by: Military     Purchased by: Military
Symptoms: Lymphadenopathy
SMQs:
Write-up: swollen lymph node

VAERS ID:367034 (history)  Vaccinated:2009-11-10
Age:23.0  Onset:2009-11-10, Days after vaccination: 0
Gender:Female  Submitted:2009-11-12, Days after onset: 2
Location:Unknown  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500760P0IN 
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Pruritus, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Received LAIV at 11:30 and at 16:05 chest/torso "felt itchy". Next morning, woke up and red blotches on chest/torso. Seen MD on 11/12/09 and rx of "ALLEGRA and steroid cream".

VAERS ID:367242 (history)  Vaccinated:2009-11-12
Age:23.0  Onset:2009-11-12, Days after vaccination: 0
Gender:Female  Submitted:2009-11-13, Days after onset: 1
Location:Kentucky  Entered:2009-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no illness at time of vaccination
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (CSL)CSL LIMITED00349611A0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Headache,