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Case Details (Sorted by Vaccination Date)

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VAERS ID:329005 (history)  Vaccinated:2008-10-15
Age:70.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Male  Submitted:2008-10-17, Days after onset: 2
Location:California  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Heart Meds and blood pressure meds, do not know the names
Current Illness: denies any
Preexisting Conditions: Hypertension, history of heart bypass 5 years ago.
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA178AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Fatigue, Headache, Pain, Stomach discomfort
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 4 hours after receiving the flu vaccination complained of bad chills, body aches, head ache, fatigue and upset stomach. (Did not take temperature.) The next day continued to have chills, upset stomach and fatigue but they were not as severe. Continued to feel tired and have an upset stomach the second day following the injection, but chills were gone.

VAERS ID:329011 (history)  Vaccinated:2008-10-15
Age:44.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 2
Location:D.C.  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERVO4.81, 906580UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Dizziness, Fatigue, Headache, Incontinence, Myalgia, No reaction on previous exposure to drug, Oropharyngeal pain, Pharyngeal oedema, Pyrexia, Tremor, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: It started with me feeling very tired and dizzy. So I went home and went to bed. Then I was shaking and chilled with my teeth chattering uncontrolably, even though I was completely (including my head) under two heavy blankets. Next I vomited so hard that I was also incontinent at the same time. The fever was making my head ache. The chills and shaking continued for the next six hours with me having to go to the bathroom every half hour. Because I was obviously losing a lot of fluid I tried to drink something but my throat was so swollen and sore that I could only trickle the fluid in. My muscles were aching. I am not allergic to eggs, latex, Thimerosal and I have never had Guillian Barre Syndrome. In fact, I have taken a flu shot every year for more than a decade because I work at a center and come in contact with 3000-10,000 people on any given night. I am not very young or very old and I am otherwise very healthy.

VAERS ID:329027 (history)  Vaccinated:2008-10-15
Age:65.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 2
Location:Michigan  Entered:2008-10-17
Life Threatening? Yes
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: Physician stated that a severe infection was present at the site of the injection causing the arm and under the arm to swell significantly.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 5UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Cellulitis, Chills, Fatigue, Headache, Infection, Injection site pain, Injection site swelling, Insomnia, Oedema peripheral, Pain in extremity, Pruritus, Rash, Skin warm, Sleep disorder
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: I received Pneumovax which was administered by the local pharmacy at approximately 3 pm. The injection was intensely painful. The pain continued to get worse which kept me awake the entire night with no sleep due to the intense pain in my arm left arm. My arm was hot to the touch. I had a headache and was weak and tired. My arm was severly swollen. My husband took me to our physician first thing the next morning. The physician took one look at all the swelling and hot tissue and said that I had a raging infection. He gave me some antibiotics and said if I was not better to call him after the weekend. Our total cost for the doctor was $125 and $25 for the antibiotic and was not covered by insurance. It is now 48 hours later and there is no improvement. 11/20/2008 Office records received from PCP for OV 10/16/08 with DX: Cellulitis. Insomnia. Pt presented with c/o rash, itching, ? chills, and sleep troubles. L shoulder warm and swollen and injection site. Tx with abx and Ambien

VAERS ID:329060 (history)  Vaccinated:2008-10-15
Age:33.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-16, Days after onset: 1
Location:Massachusetts  Entered:2008-10-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA207AA0UNRA
Administered by: Other     Purchased by: Other
Symptoms: Auricular swelling, Dyspnoea, Eye pruritus, Eye swelling, Stomach discomfort, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Upset stomach, difficulty breathing through nose, puffy, itchy eyes, hives, swollen eyes and ears - Benadryl and Zyrtec.

VAERS ID:329061 (history)  Vaccinated:2008-10-15
Age:48.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 2
Location:West Virginia  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2771AA0IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Headache - slight - only for few hours vomited 2 times same evening

VAERS ID:329635 (history)  Vaccinated:2008-10-15
Age:52.0  Onset:2008-10-16, Days after vaccination: 1
Gender:Female  Submitted:2008-10-22, Days after onset: 6
Location:Alabama  Entered:2008-10-22
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: back pain
Diagnostic Lab Data:
CDC Split Type: AL0827
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2829AA4IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Malaise, Musculoskeletal stiffness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Imm flu vaccine 10-15-2008 2pm. Pt. states awoke 8am with stiffness. Malaise, fever, aching all over. Temp. 99 @ 2:30p today. 10-17 phone call to following- o.k. after 24 hours pt. states.

VAERS ID:329641 (history)  Vaccinated:2008-10-15
Age:46.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-22, Days after onset: 7
Location:D.C.  Entered:2008-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: advair,albuterol,claritin
Current Illness: mild cold and cough,resolving
Preexisting Conditions: asthma, seasonal allergies, history of anaphylactic reaction to an allergy shot 5 years ago.
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS881320IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anaphylactic reaction, Palpitations, Pharyngeal oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal allergic conditions (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 40 minutes after vaccine,complained of throat swelling,palpitations. Diagnosed in ER as anaphylactic reaction. Treated with epinephrine,Benadryl and solumedrol.

VAERS ID:329684 (history)  Vaccinated:2008-10-15
Age:1.3  Onset:2008-10-16, Days after vaccination: 1
Gender:Female  Submitted:2008-10-21, Days after onset: 5
Location:Indiana  Entered:2008-10-22, 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: Runny nose
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2799AA3IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2828AA0IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF196AA2IMRL
Administered by: Private     Purchased by: Unknown
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient got shot (first ever) on 10/15/08 and next day broke out in hives. Face first, then whole body. Examined on 10/20/08, still has rash --$g given Prelone, Zyrtec.

VAERS ID:329698 (history)  Vaccinated:2008-10-15
Age:38.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-22, Days after onset: 7
Location:California  Entered:2008-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen-Codeine; CYMBALTA; desonide; MIRAPEX; mometasone furoate; oxycodone-acetaminophen; promethazine; ROBAXIN; TOPAMAX; trazodone
Current Illness: c/o sinus pressure & rhinorrhea; angular cheilitis; compression arthralgia of the knee/patella/tibia/fibula; hyperlipidemia; nic
Preexisting Conditions: Clindamycin; DILANTIN; IMITREX; influenza virus vaccine split; KEFLEX; morphine sulfate; penicillins; sulfa drugs; TORADOL; ZOFRAN; history of head injury; history of opioid dependence 10/23/08-records received-PMH:brain injury.
Diagnostic Lab Data: Lab work and IV fluid 10/23/2008-records received-CT normal, labs normal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2755AA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Cold sweat, Computerised tomogram normal, Crying, Depression, Dizziness, Headache, Laboratory test normal, Loss of consciousness, Nausea, Pain
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: 4-6 hrs. after administration of vaccine, pt. states she had bodyaches, clammy feeling, felt light headed, denies "passing out". Condition got worse, she was eventually taken to an urgent care on 10/19/08. While in UC, she claims she passed out, she was then transported to an ER via 911. 10/23/08-records received with report-presented to ED 10/19/08 with C/O weakness, nausea, body ache, headache since day after flu shot. Crying.Observed in ED no fevers or chills. Depressed recently and now ready to go home. DX: Headache resolved. Depression.

VAERS ID:329700 (history)  Vaccinated:2008-10-15
Age:70.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-18, Days after onset: 3
Location:Tennessee  Entered:2008-10-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: FOSAMAX, NASONEX, ESTRADIOL SYNTHROID, VESICARE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Erythema, Pain, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, Swelling, Warm to touch, achiness, Pt applied ice on Wednesday night- night of injection

VAERS ID:329734 (history)  Vaccinated:2008-10-15
Age:48.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-21, Days after onset: 6
Location:Oklahoma  Entered:2008-10-23, 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: Synthroid, Zyrtec
Current Illness:
Preexisting Conditions: Medical history included hypothyroidism and seasonal allergies. Childhood allergies included chocolate, peanuts, betadine, and feathers.
Diagnostic Lab Data:
CDC Split Type: 200803233
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2804A IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Chills, Cough, Dyspepsia, Dyspnoea, Eye discharge, Eye irritation, Nasal congestion, Ocular hyperaemia, Pain, Pain of skin, Postnasal drip, Pruritus, Pyrexia, Swollen tongue, Vulvovaginal burning sensation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific dysfunction (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Hypersensitivity (narrow)
Write-up: This serious case was received from a health professional on 16 October 2008. A 48-year-old female patient received an intramuscular left deltoid injection of FLUZONE (lot number U2804AA) on 15 October 2008. Medical history included hypothyroidism, seasonal allergies, and childhood allergies to chocolate, peanuts, Betadine, and feathers. Concomitant medications included Zyrtec and Synthroid. She was not ill at the time of vaccination, and had not experienced any adverse events following previous vaccinations. Approximately three hours after vaccination, the patient developed heartburn, cough, chills, burning eyes, generalized achiness, feverish sensation, vaginal burning, nasal congestion, and post-nasal drip. Approximately five hours after vaccination, she complained of difficulty breathing, chest tightness, shortness of breath, tongue swelling, itching, and that her "skin hurt". She self-treated her symptoms with Benadryl, and then went to bed. Upon awakening the next morning, she noted that her eyes were bloodshot, had drainage and were "stuck together". She had not sought medical attention, and at the time of the report the outcome was unknown. Documents held by sender: None. The reporter in this case also reported an event for another patient (radiating tingling and numbness), captured in case number 2008-03234.

VAERS ID:329737 (history)  Vaccinated:2008-10-15
Age:39.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-21, Days after onset: 6
Location:California  Entered:2008-10-23, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had a cough for one week prior to the vaccination. ''None reported'' was indicated for the following: additional pre-existing allergies/medical conditions; additional vaccinations within four weeks of 15 October 2008; concomitant medications prior to vaccine; adverse events following prior vaccinations.
Diagnostic Lab Data: Not reported
CDC Split Type: 200803244
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2745A IMLA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Initial report received from a healthcare professional on 17 October 2008. A 39-year-old female patient had received a left deltoid intramuscular injection of FLUZONE SV 2008-2009 (lot number U2745AA) on 15 October 2008 at 11:30 AM and that evening, she experienced fever (temperature unknown), chills, aches and vomiting. The patient had a history of cough for one week prior to the vaccination. She was hospitalized on 16 October 2008. At the time of the report, outcome was ''not recovered'' and the patient remained hospitalized. No additional details were provided. Documents held by sender: None.

VAERS ID:329754 (history)  Vaccinated:2008-10-15
Age:5.0  Onset:2008-10-16, Days after vaccination: 1
Gender:Female  Submitted:2008-10-21, Days after onset: 5
Location:Illinois  Entered:2008-10-23, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None diagnosed; has had hives x 2 with no known cause
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2790AA2UNLL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB259AA1UNRL
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Local reaction, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Local site reaction (erythema, swelling, itching) approximately 24 hrs after vaccination with flu vac. in left quad. At time of exam, redness and swelling was 12.5 cm in diameter.

VAERS ID:329757 (history)  Vaccinated:2008-10-15
Age:1.3  Onset:2008-10-16, Days after vaccination: 1
Gender:Female  Submitted:2008-10-17, Days after onset: 1
Location:Wisconsin  Entered:2008-10-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B192CA IMLL
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2790AA1IMRL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC683093IMRL
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Mild redness (urticarial wheal) at (R) thigh at site of immunization (PREVNAR) began within 24 hours - treated with oral BENADRYL - seen in clinic on 10/17/08

VAERS ID:329759 (history)  Vaccinated:2008-10-15
Age:36.0  Onset:2008-10-16, Days after vaccination: 1
Gender:Male  Submitted:2008-10-17, Days after onset: 1
Location:Wisconsin  Entered:2008-10-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Left forearm contusion
Preexisting Conditions: Allergies to PCN and Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3027BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Muscle spasms
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt. called c/o abd and bilateral bicep cramping since immunization.

VAERS ID:329772 (history)  Vaccinated:2008-10-15
Age:35.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-16, Days after onset: 1
Location:Alabama  Entered:2008-10-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA350BA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dizziness, Headache, Pain, Pyrexia, Respiratory tract congestion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Chills, fever (101.7), achy, headache, light headed/dizzy, congestion.

VAERS ID:329783 (history)  Vaccinated:2008-10-15
Age:43.0  Onset:2008-10-17, Days after vaccination: 2
Gender:Female  Submitted:2008-10-23, Days after onset: 6
Location:Georgia  Entered:2008-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS89973 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1382U0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site induration, Injection site swelling, Injection site warmth, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Patient reported swollen upper right arm with 2 large knots, injection site hot to the touch, and a sore neck. No fever. Symptoms began 2 days after receiving vaccination. All symptoms had resolved after an additional 2 days. Patient also received influenza vaccination in the left deltoid, but reported no adverse reactions at the site.

VAERS ID:331241 (history)  Vaccinated:2008-10-15
Age:10.0  Onset:2008-10-21, Days after vaccination: 6
Gender:Male  Submitted:2008-11-04, Days after onset: 14
Location:Illinois  Entered:2008-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concerta 36 & 54 mg
Current Illness: None
Preexisting Conditions: ADHD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1895U1SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Patient had the Varicella (chickenpox) injection on 10/15/08. Three bumps at injection site started a week later. Then progressed into a large area of rash from shoulder to elbow on right arm, arm of injection. Went back to doctor on 10/30/08 and received Desonide .05% cream. Patient has been using this since twice a day and is slowly looking somewhat better. We have noticed some extra bumps starting up higher on his shoulder and also have addressed them with the Desonide. This is patient''s second round of Varicella the first was when he was 10 months with no signs of an allergy.

VAERS ID:332164 (history)  Vaccinated:2008-10-15
Age:68.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-24, Days after onset: 9
Location:California  Entered:2008-11-12, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Pt saw a physician at urgent care; dx possible cellulitis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS89882 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.09614 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Red rash, swelling, itching and soreness of right arm from injection site to above (R) elbow after PNEUMOVAX (L) administration. Pt received PNEUMOVAX injection on 10/15/08 at about 5pm. Pt developed and experienced soreness, itching and rash at 10pm that night. Reported reaction 10/17/08

VAERS ID:332644 (history)  Vaccinated:2008-10-15
Age:58.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Male  Submitted:2008-10-24, Days after onset: 9
Location:Wisconsin  Entered:2008-11-17, 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
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.15410 UNRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Edema, warmth, tenderness at the injection site one hour post PNEUMOVAX.

VAERS ID:335015 (history)  Vaccinated:2008-10-15
Age:0.9  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-15, Days after onset: 0
Location:Texas  Entered:2008-11-17, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant not reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0007275
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.IN500560P  UN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: A non-serious, spontaneous report of administration of FLUMIST to a eleven-month-old female infant was received from a health professional. There was no adverse event associated with this medication error; treatment and reporter/sponsor causality assessments are not applicable and the event is considered resolved. This case is submitted in accordance with MedImmune''s post marketing. Commitment on accelerated reporting for the newly indicated population of 2 years to 59 months of age for FLUMIST.

VAERS ID:333278 (history)  Vaccinated:2008-10-15
Age:22.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-11-25, Days after onset: 41
Location:New York  Entered:2008-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clozapine, Lithium Carbonate, Zoloft, Provigil, Nexum
Current Illness: none
Preexisting Conditions: DX: Major Depression with Psychotic features, Personality Disorder, Acute Peptic Ulcer. Allergies: Cipro,PCN, tomatoes, milk
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS88117 3P0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Nasal congestion, No reaction on previous exposure to drug
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Red arms and stuffy nose appeared approximately 3 hours after administration of flu shot.Was seen at MD office. DX: ? Adverse Reaction Flu Shot. RX: Claritin 10 mg 1 po q day x 4. After administration of Claritin symptoms resolved. Patient has had influenza vaccine before without any adverse reaction.

VAERS ID:335620 (history)  Vaccinated:2008-10-15
Age:73.0  Onset:2008-10-18, Days after vaccination: 3
Gender:Male  Submitted:2008-12-18, Days after onset: 61
Location:New Hampshire  Entered:2008-12-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol,alendronate,amlodipine,B12 oral, gabapentin,hydrochlorothiazide,lorazepam,losartan,omeprazole,oxycodone/APAP,simvastatin,tiotropium
Current Illness: none
Preexisting Conditions: hyperlipidemia,hypertension,COPD,osteoporosis,obesity
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFFLA184AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Contusion, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (broad)
Write-up: complains of itching all over his body he has caused bruises on his arms He got flu shot three days ago.Hesays the itching strted soon after receiving the shot.

VAERS ID:336788 (history)  Vaccinated:2008-10-15
Age:63.0  Onset:2008-10-16, Days after vaccination: 1
Gender:Female  Submitted:2008-12-31, Days after onset: 76
Location:Pennsylvania  Entered:2009-01-08, Days after submission: 8
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
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA185AA IMUN
Administered by: Private     Purchased by: Private
Symptoms: Hypertension, Pruritus, Skin discolouration, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: 10/17/08 3:30 am Hives hospital ER. (10/18/08 9:22 am city hospital ER cover in hives- extreme itching-skin turning black and blue from top to bottom. BP 206/148). $ 585.81

VAERS ID:336793 (history)  Vaccinated:2008-10-15
Age:  Onset:2008-10-17, Days after vaccination: 2
Gender:Unknown  Submitted:0000-00-00
Location:Minnesota  Entered:2009-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Public
Symptoms: Pain in extremity
SMQs:
Write-up: Injected in left arm - net sore at first - but after 2 days very painful when lifting, putting on coat - etc. Lasted about 2 weeks. Daughter was injected as well.

VAERS ID:336832 (history)  Vaccinated:2008-10-15
Age:23.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-01-08, Days after onset: 85
Location:Texas  Entered:2009-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho Tri-Cyclen Lo oral contraceptives.
Current Illness: No.
Preexisting Conditions: None.
Diagnostic Lab Data: None done yet.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS89881 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain in extremity, Sleep disorder, Tenderness
SMQs:
Write-up: 23 year old female presented to Student Health Center at TAMU on 11/25/08 with complaint of right arm pain ever since she got her flu shot in mid october 2008. It hurts to lift her arm and it is tender to touch. She wakes up when she lies on it during the night.

VAERS ID:339761 (history)  Vaccinated:2008-10-15
Age:73.0  Onset:2008-10-22, Days after vaccination: 7
Gender:Female  Submitted:2009-01-29, Days after onset: 99
Location:Florida  Entered:2009-02-18, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? 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) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFFLA175AA UNUN
Administered by: Other     Purchased by: Unknown
Symptoms: Sensory loss
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad)
Write-up: Dead feeling in lower part of body.

VAERS ID:340848 (history)  Vaccinated:2008-10-15
Age:68.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-02-12, Days after onset: 120
Location:Minnesota  Entered:2009-02-27, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2765AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Body temperature increased, Chills, Dry skin, Gait disturbance, Nasopharyngitis, Nightmare, Pain in extremity, Pruritus, Sleep disorder, Tenderness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: On 2/12/2009 Pt. talked with PHN + and she stated she had a "reaction" to her Flu shot-stated she had "a temperature + chills, stated she could hardly walk to bathroom. Sore arm, "Ached so bad she had nightmares + wasn''t able to sleep. Stated her left side + Lt arm itched. Stated when she started to feel better, she got a bad cold. Later stated she thought may be the itching was from dry skin.

VAERS ID:347333 (history)  Vaccinated:2008-10-15
Age:11.0  Onset:2008-10-16, Days after vaccination: 1
Gender:Male  Submitted:2009-05-15, Days after onset: 211
Location:Unknown  Entered:2009-05-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0810USA03365
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy, Rash maculo-papular, Rash vesicular, Scab, Viral infection
SMQs:, Hypersensitivity (narrow)
Write-up: Information has been received from a physician concerning a 11 year old male with no past medical history of immunocompromise or immunosuppressive therapy and otherwise healthy who on 21-SEP-1998 was vaccinated with the first dose of VARIVAX (Oka/Merck). The patient received his second dose of VARIVAX (Oka/Merck) on 15-OCT-2008. The patient was also received BOOSTRIX and MENACTRA on 15-OCT-2008. Twenty-four hours later (the following day), the patient developed a maculopapular rash on the face with few lesions, two scabbed lesion on scalp, lesions behind ear, upper chest, torso and thighs. Lesions were maculopapular. Some with halo effect. Patient also had some post auricular lymphadenopathy on the left side. The mother of the patient called and stated that her son had more lesions and some "have water in them" on 17-OCT-2008. The patient sought medical attention at the physician''s office at 2PM on 17-OCT-2008. The physician noted a normal throat. The patient was afebrile and initially diagnosed with a viral illness. The physician also noted that the patient had exposure to a schoolmate who had a rash on the face. The school nurse could not role out Varicella. At the time of the reporting, the patient had not recovered from the adverse experiences. Additional information has been requested.

VAERS ID:347373 (history)  Vaccinated:2008-10-15
Age:68.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Male  Submitted:2009-05-15, Days after onset: 212
Location:Arizona  Entered:2009-05-21, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0810USA04174
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Wrong drug administered
SMQs:
Write-up: Information has been received from a medical assistant concerning a 68 year old male who on 15-OCT-2008 was vaccinated with VARIVAX (Oka/Merck) 0.5ml IM. But the patient should have received ZOSTAVAX. No adverse effects noted. Medical assistant reported all VARIVAX (Oka/Merck) she administered were given IM. Telephone follow up information has been received from the medical assistant. She indicated that the person who orders the vaccines put the vaccines put the vaccine in the wrong place, leading to medication error. The office has taken measures to prevent this type of error in the future. Additional information is not expected.

VAERS ID:367164 (history)  Vaccinated:2008-10-15
Age:30.0  Onset:0000-00-00
Gender:Female  Submitted:2009-03-02
Location:Michigan  Entered:2009-11-12, Days after submission: 255
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: Not reported
Diagnostic Lab Data: Not Reported
CDC Split Type: 200900161
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2762A0IMAR
Administered by: Private     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Chills, Hyperhidrosis, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Dementia (broad)
Write-up: This non-serious event was reported by a health care professional on 13 January 2009. This patient is one of a cluster of 20 patient; the other 19 are captured in case numbers 2008-03509, 2009-00153 to 00160, and 2009-00162 to -00171. A female patient received an injection of FLUZONE SV 2008-2009 (lot number U2762AA; date administration details not reported). On 15 October 2008, the nurse was notified that the patient had complained of aches, chills, sweats, and called off; however the start date of the events were not provided. Outcome was not reported. Follow-up information was received from the health care professional on 13 February 2009. The patient was 30-years-old at the time of the event. On 15 October 2008, the patient received an intramuscular deltoid injection of FLUZONE. Symptoms began approximately 72 hours after vaccination, and she missed one day of work. The patient could not remember if she had taken any treatment medications. Symptoms lasted three days, and subsequently recovered. Documents held by sender: None

VAERS ID:367182 (history)  Vaccinated:2008-10-15
Age:43.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-03-02, Days after onset: 138
Location:Unknown  Entered:2009-11-12, Days after submission: 255
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: Not reported
Diagnostic Lab Data: not reported
CDC Split Type: 200900693
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR6714940 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Chest discomfort, Cough, Disorientation, Eye discharge, Eye irritation, Eye swelling, Feeling abnormal, Ocular hyperaemia, Pain, Pain in extremity, Pyrexia, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: This non serious case was received on 24 February 2009 from VAERS (reference number 328982) via a search of the QSCAN database. A 43 year old female patient received FLUZONE SV 2008-2009 (lot number 6714940) intramuscularly on 15 October 2008 at 1:00 PM. The patient began feeling a little disoriented and her arm ached. At 5:00 PM she developed a heavy, wheezing feeling in her chest with a cough. Her body was aching, her eyes became red and irritated. At approximately 3:00 AM she woke up and her eyes were swollen and almost matted shut. She went to the doctor''s at 10:30 AM the following day. The doctor did not think the patient''s symptoms were related to FLUZONE. She thought the patient had a virus. The patient was instructed to take TYLENOL cold medicine, BENADRYL, and rest. The patient continued to complain of aching and a very weak feeling, but her low grade fever resolved. The patient''s recovery status was not reported. No further information was reported. List of Documents held by Sender: none.

VAERS ID:367189 (history)  Vaccinated:2008-10-15
Age:39.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-02-27, Days after onset: 135
Location:Unknown  Entered:2009-11-12, Days after submission: 258
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: not reported
Diagnostic Lab Data: not reported
CDC Split Type: 200900705
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2740AA0IMAR
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Eye discharge, Eye pruritus, Fatigue, Headache, Pyrexia, Sensation of heaviness, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: This non serious case was received on 24 February 2009 from VAERS (reference number 329987) via a search of the QSCAN database. A 39 year old female received FLUZONE SV 2008-2009 (lot number U2740AA) intramuscular on 15 October 2008. One hour post vaccination the patient developed heaviness in the arm which was injected, redness, swelling, discharge, and itching in her eyes, fever, fatigue and head pressure. The patient was reported as recovered. No further information was received. List of Documents held by Sender: none.

VAERS ID:328923 (history)  Vaccinated:2008-10-16
Age:39.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 1
Location:Pennsylvania  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fall environmental allergy
Preexisting Conditions: Erythromycin - GI intolerance
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUF455BA IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU2754AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dysphagia, Dyspnoea, Sensation of foreign body, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Had immunization at 10 AM. At 2 PM, school nurse called reporting symptoms of wheezing, and feeling lump in throat. Advised to go to ER. ER report, said mild difficulty breathing and swallowing. Pt received SOLU-MEDROL and BENADRYL and PEPCID. Observed 3 hrs. Discharged on Prednisone and BENADRYL.

VAERS ID:328983 (history)  Vaccinated:2008-10-16
Age:62.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-17, Days after onset: 1
Location:Louisiana  Entered:2008-10-17
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
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2802AA4IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Feeling abnormal, No reaction on previous exposure to drug, Syncope, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Reports approx. 30 minutes after the flu shot was feeling bad and then when got home had difficulty breathing, syncope, vomited, dizziness. Had the flu shot before with no previous reactions in the past. Refused to go to hospital.

VAERS ID:328986 (history)  Vaccinated:2008-10-16
Age:58.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 1
Location:Illinois  Entered:2008-10-17
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: DIABETES HYPERTENSION
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED01349111A2IMLA
Administered by: Military     Purchased by: Private
Symptoms: Body temperature increased, Chills, Dry mouth, Erythema, Feeling of body temperature change, Flushing, Malaise, No reaction on previous exposure to drug, Pain, Tremor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad)
Write-up: Rec''d Afluria vaccine at 9am. Reports at 5pm began to feel flushed, aching, chilled. Reports during night had shaking chills and felt aching all over. Took Tylenol for complaints. At 9am reports still doesn''t feel well. Skin flushed. Cheeks reddened. Temp 99.2 otic. Hands cool to touch. c/o feeling hot/cold. c/o "dry mouth". Reports has had the flu vaccine before but never had a problem before. Reports felt "fine" prior to getting the vaccine and this is "not my usual" when I do get sick.

VAERS ID:328988 (history)  Vaccinated:2008-10-16
Age:  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-17, Days after onset: 0
Location:Michigan  Entered:2008-10-17
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: dwarfism
Diagnostic Lab Data: pt sent to emergency room via private car for further evaluation and labs.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB297BA0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2616AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0990X0SCLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Headache, Hypoaesthesia, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: PT PRESENTS WITH SHAKING, NUMBNESS IN ALL EXTREMITIES, HEADACHE, DIZZINESS, AND FEVER.

VAERS ID:328998 (history)  Vaccinated:2008-10-16
Age:77.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2008-10-17, Days after onset: 0
Location:Massachusetts  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: gemfibrozil, lisinpril, digoxin, alprazolam, celexa, atenolol, warfarin sodium
Current Illness: Admitted with rapid AF- in NSR at time of vaccination.
Preexisting Conditions: rheumatic heart disease, ascending TAA, HTN, HLD PMH: mechanical AVR/MVR on long term anticoagulation, HOH
Diagnostic Lab Data: Tmax 101.8 (PO) LABS: CBC WNL. Blood & urine c/s neg. CXR WNL. EKG abnormal. Cardiac enzymes neg.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA380AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0983X2IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Allergy to vaccine, Atrial fibrillation, Blood culture negative, Cardiac enzymes normal, Cardioversion, Chest X-ray normal, Chest discomfort, Culture urine negative, Dyspnoea, Electrocardiogram abnormal, Full blood count normal, Heart rate increased, Heart rate irregular, Hyperhidrosis, Malaise, Palpitations, Pyrexia, Urine analysis normal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypersensitivity (narrow)
Write-up: Pt developed red, swollen painful deltoid. Developed temp of 101.8 overnight following vaccine administration. UA neg, blood cultures sent. Pt receiving releif from tylenol, ice. Currently afebrile. 12/23/08 Reviewed hospital medical records of 10/14-10/18/2008. FINAL DX: atrial fibrillation; allergic reaction to influenza vaccine(injection site swelling & redness, fever 102). Records reveal patient experienced palpitations, rapid irregular heartbeat, chest heaviness, feeling unwell, SOB, diaphoretic. In ER, rapid atrial fib treated w/meds & cardioversion. received pneumovax right arm & influenza vax left arm. Same day developed swelling & redness over the left arm w/fever 102. Fever & swelling resolved by next day. D/C to home.

VAERS ID:329002 (history)  Vaccinated:2008-10-16
Age:46.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 1
Location:Maryland  Entered:2008-10-17
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: unknown
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED01449111A IMLA
Administered by: Military     Purchased by: Public
Symptoms: Conjunctivitis allergic, Eye pruritus, Ocular hyperaemia, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad), Conjunctival disorders (narrow), Hypersensitivity (narrow)
Write-up: Pt recieve flu vaccine and developed itchy red eyes within 24 hrs of vaccine, same problem occured the year before. Pt this year treated for allergic conjuctivitis with patonol prn; if

VAERS ID:329016 (history)  Vaccinated:2008-10-16
Age:46.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-17, Days after onset: 1
Location:Mississippi  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: SAME EVENT~Influenza (no brand name)~1~44~In Patient
Other Medications: CRESTOR AND INDOCIN
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURV2759A1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Body temperature increased, Oropharyngeal pain, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Within 4 hours of administration of Fluzone vaccine, pt had temperature of 103 degrees and body aches, weak and sore throat. All symptoms persisted for more than 24 hours.

VAERS ID:329023 (history)  Vaccinated:2008-10-16
Age:0.5  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-17, Days after onset: 0
Location:Kentucky  Entered:2008-10-17
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
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX)GLAXOSMITHKLINE BIOLOGICALSAC21B192DA1IMLL
HIBV: HIB (ACTHIB)SANOFI PASTEURUF503AA1IMLL
PNC: PNEUMO (PREVNAR)PFIZER/WYETHC734461IMLL
RV5: ROTAVIRUS (ROTATEQ)MERCK & CO. INC.096641PO 
Administered by: Public     Purchased by: Public
Symptoms: Crying
SMQs:, Depression (excl suicide and self injury) (broad)
Write-up: Mother states child has been crying non-stop for 24 hours

VAERS ID:329026 (history)  Vaccinated:2008-10-16
Age:14.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2008-10-17, Days after onset: 0
Location:Minnesota  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin started 10-16-2008
Current Illness: Right elbow rash for 2 months
Preexisting Conditions: NKDA/Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1144X1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Lymphadenopathy, Mass, Neck pain
SMQs:, Arthritis (broad)
Write-up: pain in neck with a lump started at 2:30 patient was brought to clinic at 3:30 was asessed by PA and dx with lymphadneopathy on left side

VAERS ID:329073 (history)  Vaccinated:2008-10-16
Age:2.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-17, Days after onset: 1
Location:Alabama  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL; PULMICORT Neb Tx; Albuterol Neb Tx
Current Illness: Pharyngitis, prob. viral
Preexisting Conditions: BRAO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2829AA UNUN
Administered by: Private     Purchased by: Public
Symptoms: Cyanosis, Postictal state, Pyrexia, Staring
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: Child was seen in our office 10-16-08 and received the flu vaccine that evening. Mom states that she left our office and went to Wal-Mart. As she pulled into driveway @ home, less than 2 hrs later, child was staring and lips were blue, his O2 sat was 95. Ambulance was called and child taken to ER, dx - post-ictal. With febrile illness/child had low grade fever 101.4 degrees. No wheezing.

VAERS ID:329074 (history)  Vaccinated:2008-10-16
Age:68.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-17, Days after onset: 0
Location:California  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: (+) toenail fungus
Preexisting Conditions: Diabetes; HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR89975 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.066AX IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site cellulitis
SMQs:
Write-up: Pt developed cellulitis at the site of injection (R upper arm).

VAERS ID:329076 (history)  Vaccinated:2008-10-16
Age:12.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-16, Days after onset: 0
Location:Illinois  Entered:2008-10-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 08/2008~HPV (Gardasil)~~12~In Patient
Other Medications: LAMICTAL 100 mg bid
Current Illness: None
Preexisting Conditions: Cerebral Palsy and Seizure Disorder
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0575X0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2624AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Oral pruritus
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness warmth at GARDASIL injection site - Full tongue itchy HARDPALATE - NO SOB No Wheezing

VAERS ID:329091 (history)  Vaccinated:2008-10-16
Age:11.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-18, Days after onset: 1
Location:Utah  Entered:2008-10-17, 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: ALBUTEROL
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1153X1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Condition aggravated, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Redness/swelling/warmth at injection site about 20 degrees after vaccine. Also asthma flare - mild.

VAERS ID:329044 (history)  Vaccinated:2008-10-16
Age:66.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2008-10-19, Days after onset: 2
Location:New Jersey  Entered:2008-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: None~ ()~~0~Patient
Other Medications: Synthroid; Lipitor; Travatan; Aspirin
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2847AA16UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1005F1UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Contusion, Erythema, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (broad)
Write-up: Day of vaccination arm was so sore I could not lift it high enough to brush my teeth. The following morning the upper arm became violently red and hot to the touch. During the day it seemed to calm down but on Saturday morning the area was most of the upper arm and I went to ER at Community Hospital. The doctor gave me a perscription for an antibiotic and instructions to take them IF it worsened but did not think it was celulitis. I purchased the Rx but on Sunday the redness had mostly turned to yellow bruising so I did not take the Rx.

VAERS ID:329145 (history)  Vaccinated:2008-10-16
Age:53.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 1
Location:Kansas  Entered:2008-10-20, 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: Cortisone injection in foot 3 weeks ago
Current Illness: No
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2810AA3IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0867X1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Discomfort, Injection site erythema, Injection site oedema, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Redness, soreness, edema at injection site. fever, chills, Myalgia. Taking Advil for discomfort 10/20/2008 9:45am.

VAERS ID:329224 (history)  Vaccinated:2008-10-16
Age:47.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-20, Days after onset: 4
Location:California  Entered:2008-10-20
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
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED02649111A0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Dysphagia, Hypoaesthesia oral, Pain, Pharyngolaryngeal pain, Stomach discomfort, Swelling, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swollen tongue, numbness of tongue, sore throat, difficulty swallowing, body aches, stomach upset, puffiness,

VAERS ID:329227 (history)  Vaccinated:2008-10-16
Age:43.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-20, Days after onset: 3
Location:California  Entered:2008-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2808AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, No reaction on previous exposure to drug, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Patient returned day after vaccine with erythema at site of vaccine and also with urticaria on arms, legs, chest and neck. Patient had previous flu vaccine with no reaction.

VAERS ID:329251 (history)  Vaccinated:2008-10-16
Age:76.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:2008-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS89884 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0990U1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient presented to pharmacy on 10-18-08 stating he had cellulitis from his shot and wanted to know what we were going to do about it. Verified per VAR firm that it was the PNEUMOVAX-23 in the left arm. Arm was red, swollen and marked off with marker from the ER doctor. Filled prescription for generic Keflex 500mg and generic Bactrim DS. Patient paid for them.

VAERS ID:329322 (history)  Vaccinated:2008-10-16
Age:24.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-16, Days after onset: 0
Location:Hawaii  Entered:2008-10-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Hypothyroidism
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0070X0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Abnormal dreams, Dizziness, Moaning, Musculoskeletal stiffness, Syncope vasovagal, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: 11:40 am Injection given, 11:45 pt felt dizzy/faint. Then pt ? vaso-vagal response - (30-45s) mouth open/eyes open, stiffened, unresponsive to ammonia capsules x 3, moaning. Then pt awakes feeling dizzy, mentions weird dreams - is coherent. 13:00 pt d/c; A+O x3.

VAERS ID:329335 (history)  Vaccinated:2008-10-16
Age:46.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-16, Days after onset: 0
Location:Rhode Island  Entered:2008-10-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 150 mg, daily; Cytomil 5mg 2x day
Current Illness:
Preexisting Conditions: Thyroid dysfunction
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS89738 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness, Malaise, Pain, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad)
Write-up: 45 minutes after vaccine administered client c/o L side pain and not feeling well- dizzy and wanting to go to sleep

VAERS ID:329383 (history)  Vaccinated:2008-10-16
Age:0.2  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-21, Days after onset: 5
Location:Illinois  Entered:2008-10-21
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
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER?0IDRL
HIBV: HIB (NO BRAND NAME)UNKNOWN MANUFACTURER?0IDLL
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER?0IDLL
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER?0IDLL
Administered by: Private     Purchased by: Unknown
Symptoms: Crying, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (broad)
Write-up: Non-stop crying for 3 hours, fever 102

VAERS ID:329422 (history)  Vaccinated:2008-10-16
Age:4.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-21, Days after onset: 5
Location:Illinois  Entered:2008-10-21
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: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Diarrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Patient had a high temperature for 4 days (101-104 degrees throughout the four days). He also had had diarrhea.

VAERS ID:329423 (history)  Vaccinated:2008-10-16
Age:11.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-21, Days after onset: 4
Location:Illinois  Entered:2008-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: seiler had a high fever of 100- 103 degrees for 4 days. he also had severe diarea

VAERS ID:329657 (history)  Vaccinated:2008-10-16
Age:16.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-22, Days after onset: 6
Location:Texas  Entered:2008-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, birth control pills
Current Illness: none noted
Preexisting Conditions: none know
Diagnostic Lab Data: ct scan
CDC Split Type:
Vaccination
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0387U IMLA
Administered by: Public     Purchased by: Public
Symptoms: Computerised tomogram, Hypotension, Musculoskeletal stiffness, Syncope, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: immunization given, waited 10 min. left clinic,then fainted in car, was stiff and shaky. ambulance was called, transported to er via ambulance. was diagnosed with low blood pressure, had ct scan done at er

VAERS ID:329736 (history)  Vaccinated:2008-10-16
Age:62.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-21, Days after onset: 5
Location:Iowa  Entered:2008-10-23, 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:
Current Illness:
Preexisting Conditions: History of Sulfa allergy. ''None reported'' was indicated for the following: pre-existing medical conditions, concomitant medications, other vaccinations within four weeks of 16 October 2008. Illnesses at time of vaccination was not reported. The patient had not experienced any reactions to two previous doses of FLUZONE.
Diagnostic Lab Data: Unknown
CDC Split Type: 200803241
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2747A2IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)
Write-up: Initial report received from a health professional on 17 October 2008. A 62-year-old female patient received a right deltoid intramuscular injection of FLUZONE SV 2008-2009 (lot number U2747AA) on 16 October 2008 (reported as 16 October 2007) and three hours later, she complained of injection site redness and "hotness". The patient went to the emergency room later in the day due to shortness of breath. She received Prednisone for the injection site redness and was released. Outcome was reported as ''unknown''. Documents held by sender: None.

VAERS ID:329761 (history)  Vaccinated:2008-10-16
Age:55.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-20, Days after onset: 3
Location:Pennsylvania  Entered:2008-10-23, 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: BENICOR; TRICOR; LOVAZA; L-Thyroxine; Lovastatin
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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TDAP: TDAP (ADACEL)SANOFI PASTEURC3030AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Asthenia, Disorientation, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Extreme weakness. Body aches. Loss of appetite. 101 degrees fever. Some disorientation. Time course for event - 2 days. Treatment - after physician consult - (3) 325 mg TYLENOL.

VAERS ID:329865 (history)  Vaccinated:2008-10-16
Age:62.0  Onset:2008-10-22, Days after vaccination: 6
Gender:Female  Submitted:2008-10-23, Days after onset: 1
Location:Montana  Entered:2008-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Darvocet; Lasix; Ativan; Cozaar; Advil; Prilosec; Calcium with Vit D
Current Illness: Fish hook injury; tooth infection treated with PCN by dentist
Preexisting Conditions: Allergic to albuterol; Indocin; lisinopril; Norvasc; Percocet; giving dy stress incontinence; anxiety; depression; back pain; dyspepsia; abd pain; thygoiter
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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TD: TETANUS DIPHTHERIA (TENIVAC)SANOFI PASTEURU2332AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Red raised welt/rash area on left upper arm with itching developed 6 days after vaccine. Treated with Benadryl and if develops fever, chills, ha will treat with Keflex.

VAERS ID:330034 (history)  Vaccinated:2008-10-16
Age:23.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2008-10-22, Days after onset: 5
Location:Massachusetts  Entered:2008-10-24, 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:
Current Illness:
Preexisting Conditions: none relevant; patient had bacterial vaginosis and was treated with local Rx; I don''t know if she filled the Rx. PMH: parathyroidectomy, breast reduction w/hypertrophic scars, umbilical hernia repair, smoker, migraines. Allergy: eggs.
Diagnostic Lab Data: pending from hospital LABS: H/H 11.7/33.4(L), neutros 90.5%(H), lymphs 6.1%(L), monos 0.9%(L). Sodium 135(L), potassium 2.9(L), magnesium 1.3(L). CXR WNL.
CDC Split Type:
Vaccination
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DT: DT ADSORBED (NO BRAND NAME)SANOFI PASTEURU202MBA IMUN
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR42847AA IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Blood magnesium decreased, Blood potassium decreased, Blood sodium decreased, Chest X-ray normal, Chills, Decreased appetite, Diarrhoea, Haematocrit decreased, Haemoglobin decreased, Headache, Hypokalaemia, Influenza like illness, Lymphocyte percentage decreased, Monocyte percentage decreased, Nausea, Neutrophil percentage increased, Pain, Pyrexia, Rhinorrhoea, Tachycardia, Vaccination complication
SMQs:, Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow)
Write-up: 33 year old woman was given flu vaccine during routine office visit. She was healthy at time of visit, with normal labs. She was also given dT. Flu: given 10/16/8 Vaccine manufacturer Sanofi: vaccine lot number 42847. dT: given 10/16/8 Vaccine manufacturer Sanofi U202MBA. Within 24 hours pt developed fever to 102, tachycardia to 148, and headache. She took OTC Motrin. She proceeded to hospital ER and was told she had a reaction to flu vaccine. She required IV fluids and was told that she was hypokalemic given oral K. She was D/C from ER to home. She was evaluated by me today 10/22/8 and still had minimal residual headache. 11/4/08 Reviewed PCP medical records & vaccine records of 10/16-10/22/2008. FINAL DX:flu shot reaction, fever. Records reveal patient experienced nasal drip, HA on 10/16. Seen in ER on 10/17 w/flu-like symptoms of fever, loose stool x 1, generalized aching, weakness, nausea, poor appetite, tachycardia & HA. Tx w/IVF & meds. Improved & d/c to home. RTC 10/22 felt chilled, HA resolving. Not to receive flu vax in future.

VAERS ID:330062 (history)  Vaccinated:2008-10-16
Age:16.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-16, Days after onset: 0
Location:Washington  Entered:2008-10-27, Days after submission: 11
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: Syncope/Acne
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB246AA1IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2665AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2768BA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1000X1SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Feeling hot, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient reported nausea and hot sensations within minutes following his immunizations - Pallor in color for several minutes.

VAERS ID:330100 (history)  Vaccinated:2008-10-16
Age:5.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-20, Days after onset: 3
Location:Utah  Entered:2008-10-27, 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: BENADRYL given
Current Illness: Healthy
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2752AA2UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 10X12cm area of induration and swelling at vaccination

VAERS ID:330101 (history)  Vaccinated:2008-10-16
Age:52.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-21, Days after onset: 5
Location:California  Entered:2008-10-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Med for high cholesterol
Current Illness: None
Preexisting Conditions: High Cholesterol
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2757AA2UNLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Cough, Eye irritation, Headache, Malaise, Nausea, Ocular hyperaemia, Pyrexia, Sensation of foreign body, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad)
Write-up: 330 PM had feeling of lump in throat; 630 PM not feeling well, lump in throat causing some coughing. Had increase nausea in the evening and his eye were "burning & turning red. " At 10 PM he vomited violently, repeatedly and his eyes "turned blood red." He had fever that night, malaise, HA & weakness 10/17 & 10/18; felt better 10/19.

VAERS ID:330105 (history)  Vaccinated:2008-10-16
Age:29.0  Onset:2008-10-19, Days after vaccination: 3
Gender:Male  Submitted:2008-10-21, Days after onset: 2
Location:Michigan  Entered:2008-10-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS879230UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0519X0UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness and swelling right upper arm and shoulder. Seen at office 4 days following vaccine. Treated with Medrol dose pack and Amoxil. Questionable early celluitis vs. immune system reaction to vaccine. No fever.

VAERS ID:330106 (history)  Vaccinated:2008-10-16
Age:35.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2008-10-20, Days after onset: 3
Location:New York  Entered:2008-10-27, 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: None
Preexisting Conditions: Sulfa, anemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P2IN 
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB584AA2IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3029AA1IMRA
Administered by: Military     Purchased by: Military
Symptoms: Burning sensation, Dizziness, Headache, Injection site pain, Muscle twitching, Musculoskeletal stiffness, Pyrexia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: headache, fever up to 102+, dizzy and light headedness, stiff neck, pain in arm (around injection site) L , burning in arm, muscle twitches in arm

VAERS ID:330109 (history)  Vaccinated:2008-10-16
Age:6.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-10-21, Days after onset: 4
Location:Ohio  Entered:2008-10-27, 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: No
Preexisting Conditions: Asthma / Seasonal Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2757AA3IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Left arm became red, a little swollen & hot to touch within 24 hours after vaccine. At 36 hours patient was red from shoulder to below elbow. Patient was seen in the office put on Benadryl every 6 hours and Keflex for cellulitis.

VAERS ID:330111 (history)  Vaccinated:2008-10-16
Age:51.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-31, Days after onset: 15
Location:Mississippi  Entered:2008-10-27, 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: THEODUR;CLONIDINE;Acropart and Albuterol Inhalers;VOLTARIN-prednisone; Atrovent Sol.; FOSAMAX
Current Illness: Bronchitis/asthma
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Asthenia, Chills, Ear discomfort, Eye irritation, Heart rate increased, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad)
Write-up: High fever 102.7 for 24 hrs then started to break. Chills almost to conuations for 6 hrs Elevated heart beat-burning ears and eyes vomiting and weakness

VAERS ID:330166 (history)  Vaccinated:2008-10-16
Age:65.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-27, Days after onset: 11
Location:Indiana  Entered:2008-10-27
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: At ER. Blood Work, EKG.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED02349111A IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amnesia, Asthenia, Blood glucose decreased, Blood test, Electrocardiogram
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: 4 hours after patient received vaccine she had symptoms of memory loss and weakness. She went to ER where they could find no problems, only that her blood sugar was a little low. The Dr there thought it was not related to vaccine and may be related to hypoglycemic episode.

VAERS ID:330532 (history)  Vaccinated:2008-10-16
Age:45.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-25, Days after onset: 9
Location:Michigan  Entered:2008-10-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Chills, Dyspnoea, Headache, Myalgia, Pallor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: A couple of hours after shot - difficulty breathing, paleness, chills, weakness, headache, sore muscles, symptoms lasted about a day + 1/2.

VAERS ID:330541 (history)  Vaccinated:2008-10-16
Age:6.0  Onset:2008-10-18, Days after vaccination: 2
Gender:Female  Submitted:2008-10-28, Days after onset: 10
Location:Texas  Entered:2008-10-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CBC; BMP; UA; PT/PTT; Immunoglobulin; Complement C3 12/9/09 Medical records received for date 10/24/08 to 11/17/08 Diag/Labs: UA (+)protein, leukocytes, urine culture(+), rapid strep(-).
CDC Split Type:
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500563P0IN 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain upper, Arthralgia, Complement factor C3, Cough, Culture urine positive, Full blood count, Henoch-Schonlein purpura, Immunology test, Metabolic function test, Oropharyngeal pain, Protein urine present, Prothrombin time, Purpura, Pyrexia, Streptococcus identification test, Urinary tract infection, Urine analysis abnormal
SMQs:, Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vasculitis (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Purpura Rash began 10/18/08 progressed to buttocks through the week; mild discomfort to knees, legs. Ultimately, diagnosed with Henoch-Schonlein Purpura. 12/9/09 Medical records received for date 10/24/08 to 11/17/08. DX: 10/24/08 purpuric rash suspect HSP. Parents c/o pt w/ rash on legs up to buttocks x1wk, fever. Parents state flumist x8days ago. Assessment: mild throat erythema, purpura. F/u appt 10/28/08 showing improvement. OV 10/29/08 DX: viral illness. Presented w/ fever, sore throat, cough. 11/5/08 f/u rash HSP. DX: HSP, UTI. Presented w/ new crop of rash on leg/knee, knee pain, stomach pain. Assessment: throat erythema, purpura rash. UA(+) protein, leukocytes. OV11/17/08 f/u appt for purpura. Assessment: WNL, no purpura, HSP resolving.

VAERS ID:330566 (history)  Vaccinated:2008-10-16
Age:11.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-28, Days after onset: 12
Location:Ohio  Entered:2008-10-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0072X0IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2666AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2927AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Pityriasis
SMQs:
Write-up: Pityriasis 2 hours after getting immunization.

VAERS ID:330632 (history)  Vaccinated:2008-10-16
Age:73.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Unknown  Submitted:2008-10-17, Days after onset: 1
Location:Michigan  Entered:2008-10-29, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS898810IMUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0551X0IMUN
Administered by: Other     Purchased by: Public
Symptoms: Back pain, Musculoskeletal pain, Neck pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Arthritis (broad)
Write-up: Severe pain in arm radiating to neck shoulder and back.

VAERS ID:331219 (history)  Vaccinated:2008-10-16
Age:11.0  Onset:2008-10-20, Days after vaccination: 4
Gender:Female  Submitted:2008-11-04, Days after onset: 15
Location:Texas  Entered:2008-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None except behavioral issues
Diagnostic Lab Data: Other labs unremarkable. Labs + for EBV and CMV. Ab IgG only.
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS0570X0UNRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.88635 UNLA
Administered by: Private     Purchased by: Private
Symptoms: Blood immunoglobulin A increased, Cytomegalovirus test positive, Epstein-Barr virus antibody positive, Lymphadenitis
SMQs:, Hypersensitivity (broad)
Write-up: Acute neck lymphadenitis x 1 week after the shot of HPV and FLUVIRIN. Given Augmentin after ENT consult and diagnosis of ? Cat scratch vs ? HPV shot allergy.

VAERS ID:331866 (history)  Vaccinated:2008-10-16
Age:60.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Male  Submitted:2008-11-05, Days after onset: 19
Location:D.C.  Entered:2008-11-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cellulitis @ injection site
Preexisting Conditions: HTN; Seizure DIS; PUD - all -$g Erythromycin and Chromotin
Diagnostic Lab Data: WBC on 10/18/2008 - 12.0, 86.4 segs ; WBC on 10/19/2008, 10.9, 79.0 segs; WBC 10/20/2008, 7.4, 72 segs
CDC Split Type: 2008001
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2752AA UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.080300UNRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Neutrophil percentage increased, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: 10/18/2008 presented to ED with cellulitis arm, put on followed up in ED 10/19 and 10/20/08.

VAERS ID:331942 (history)  Vaccinated:2008-10-16
Age:9.0  Onset:2008-11-02, Days after vaccination: 17
Gender:Male  Submitted:2008-11-11, Days after onset: 9
Location:Georgia  Entered:2008-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Synthoid 75mcg qd
Current Illness:
Preexisting Conditions: Congential Hypothyroidism. PMH: hypothyroid. ezcema. cough.
Diagnostic Lab Data: Chest X-ray Labs and diagnostics: CXR (+) for pneumomediastinum.
CDC Split Type:
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500567P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Chest X-ray abnormal, Chest pain, Cough, Crepitations, Local swelling, Oxygen supplementation, Pneumomediastinum, Pyrexia, Status asthmaticus, Subcutaneous emphysema, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 10-16-08 received FluMist, 11-02-08 developed Pnuemomediastinum & first time wheezing. No prior history of asthma. Admitted to hospital Dx: first time Unspecific Asthma with Status Asthmaticus, Pneumomediastinum with extensive bilateral subcutaneous emphysema. 12/16/2008 MR received for DOS 11/2-3/2008 with D/C DX: Pneumomediastinum. Unspecified asthma with status asthmaticus. Pt presented with fever, cough, neck swelling and chest pain. PE (+) for bilateral crepitus of the neck. Started on assthma protocol requiring O2 supplementation.

VAERS ID:332070 (history)  Vaccinated:2008-10-16
Age:59.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-11-07, Days after onset: 22
Location:Idaho  Entered:2008-11-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS0899730IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0224X0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Inflammation, Pain in extremity, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient experienced inflamed red welts all the way down her arm. Soreness for over a week. *Right arm only*

VAERS ID:332181 (history)  Vaccinated:2008-10-16
Age:  Onset:2008-10-29, Days after vaccination: 13
Gender:Male  Submitted:2008-10-31, Days after onset: 2
Location:Unknown  Entered:2008-11-12, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Myocardial infarction; Coronary artery disease; Premature ventricular contractions; Hypercholesterolemia; Seizures
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURERAC05441SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Troponin
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Admitted to hospital telemetry unit via ambulance late in the evening of 10/29/08. Patients chief complaint: chest pain. Troponin levels normal. No further information is available at this time.

VAERS ID:334191 (history)  Vaccinated:2008-10-16
Age:  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-11-14, Days after onset: 29
Location:Illinois  Entered:2008-11-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0810USA03355
Vaccination
Manufacturer
Lot
Dose
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Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Information has been received from a physician who was told that a female patient of another physician in the same practice, was vaccinated on 16-OCT-2008 with a dose of GARDASIL 0.5 mL IM. Subsequently, the patient fainted while in the office. The patient was unconscious for 20 minutes and was transported by ambulance to the Emergency Room. It was not known yet if the patient was admitted to the hospital or what treatment was given. Additional information has been requested.

VAERS ID:334790 (history)  Vaccinated:2008-10-16
Age:11.0  Onset:2008-10-20, Days after vaccination: 4
Gender:Female  Submitted:2008-11-14, Days after onset: 25
Location:Texas  Entered:2008-11-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0810USA03951
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Neck pain, Pharyngeal oedema, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Information has been received from a physician concerning a 11 year old female patient with no pertinent medical history and no drug reactions or allergies, who on 16-OCT-2008, was vaccinated, IM, with the first 0.5 ml dose of GARDASIL. Concomitant therapy included influenza virus vaccine administered on 16-OCT-2008. On 20-OCT-2008, the patient experienced left-side facial swelling, left neck pain and "a feeling like her throat is swollen". The patient was examined in the office on 21-OCT-2008, and a cervical x-ray has been ordered. The patient was scheduled for a consultation with an unspecified ENT specialist on the afternoon of 21-OCT-2008. At the time of reporting, the adverse events were ongoing. Additional information has been requested.

VAERS ID:332769 (history)  Vaccinated:2008-10-16
Age:73.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2008-11-19, Days after onset: 33
Location:D.C.  Entered:2008-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.08030 UNLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Fatigue, Headache, Injection site dryness, Oedema peripheral, Pain, Skin exfoliation
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient begin to feel tired, achey and had a headache, described her left arm as showing angry red band around her arm. Days later the injection site became flaky at the injection site. Arm swelling size of baseball

VAERS ID:332911 (history)  Vaccinated:2008-10-16
Age:84.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-11-20, Days after onset: 35
Location:Illinois  Entered:2008-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS89966 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0555U IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Oedema peripheral, Tenderness
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Sore, slightly swollen right arm. Approximately 3-4 hours later. Put cool compresses in evening then warm this a.m. Coordinator advised to continue cool compresses, Tylenol if able and needed. If feel the need you can call your physician. Patient stated she will be calling her physician or going to Emergency room is problem persists..

VAERS ID:335016 (history)  Vaccinated:2008-10-16
Age:  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-16, Days after onset: 0
Location:Missouri  Entered:2008-11-20, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0007280
Vaccination
Manufacturer
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Ear pain, Tinnitus
SMQs:, Hearing impairment (narrow)
Write-up: A non-serious spontaneous report of "ears hurting bad" has been received from a Pharmacist concerning a male child, subsequent to FLUMIST. This case is submitted in accordance with MedImmune''s post marketing commitment on accelerated reporting for the newly indicated population of 2 years to 59 months of age for FLUMIST. No medical history or concomitant medications were reported. The patient received one dose of FLUMIST on 16-Oct-2008. Thirty minutes after the patient received FLUMIST he returned to the pharmacy screaming stating that his ears hurt. The child stated that his, "ears are hurting bad." The Pharmacist described the event as tinnitus. The outcome of the event was not reported. The causality of the event was not reported.

VAERS ID:335017 (history)  Vaccinated:2008-10-16
Age:1.9  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2008-10-16, Days after onset: 0
Location:Kentucky  Entered:2008-11-20, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0007281
Vaccination
Manufacturer
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: A non serious spontaneous report of administration to a 21 month-old male was received from a pediatrician''s office. 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. This case is submitted in accordance with MedImmune''s post-marketing commitment on accelerated reporting for the newly indicated population of 2 years to 59 months of age for FLUMIST.

VAERS ID:333637 (history)  Vaccinated:2008-10-16
Age:58.0  Onset:2008-11-17, Days after vaccination: 32
Gender:Female  Submitted:2008-12-02, Days after onset: 15
Location:Pennsylvania  Entered:2008-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: None~ ()~NULL~~In Patient|None~ ()~NULL~~In Sibling1|None~ ()~NULL~~In Sibling2
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB525BA0IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB251AA1IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2997AA IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3001391 PO 
Administered by: Public     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed a rash on chest after taking Oral Typhoid Vaccine. Patient was given Oral Typhoid Vaccine On 10/28/2008 but did not take first dose until 11/16/08. Reaction occurred about 24 hours after taking vaccine.

VAERS ID:334266 (history)  Vaccinated:2008-10-16
Age:92.0  Onset:2008-10-23, Days after vaccination: 7
Gender:Male  Submitted:2008-11-01, Days after onset: 9
Location:California  Entered:2008-12-09, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Eye drops
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dysphonia, Dyspnoea, Hyperhidrosis, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Difficulty breathing, hoarseness, wheezing, weakness and sweats all night(one night). Continuing through Nov 1(today). Today feel 70%.

VAERS ID:334605 (history)  Vaccinated:2008-10-16
Age:48.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-12-09, Days after onset: 54
Location:Ohio  Entered:2008-12-09
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
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 24UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain similar to being "frogged" at the injection site. Constant ache that is always there. Intensifies when lift arm up or pressing on the site. Also hurts when lying on the arm. Only subsides with medication NAPROXEN 500 mg twice a day. This pain is very similar today as it was on the afternoon of the injection.

VAERS ID:334719 (history)  Vaccinated:2008-10-16
Age:34.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-11-14, Days after onset: 29
Location:Texas  Entered:2008-12-09, 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: Allergic to Sulfa Drugs
Diagnostic Lab Data: @ 2:33 pm client was injected with BENADRYL 50 mg/ we IM to LT. deltoid. @ 2:50 pm, Rash had dee red. No other signs & symptoms observed or noticed.
CDC Split Type:
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1837U IMRA
Administered by: Unknown     Purchased by: Public
Symptoms: Erythema, Paraesthesia oral, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: 2:15 pm client exhibited a well red mark under her chin area, neck area approximately 4 inches X 1 inch diameter well # 2 approximately 6 inches X 2 inches in diameter just below red area #1. Client complaints or exhibits no other signs or symptoms @ 2:30pm. Client c/o tingling to her upper lip. No swelling noted. V/s 98.9, P87, R20, B/P 134/86.

VAERS ID:335622 (history)  Vaccinated:2008-10-16
Age:73.0  Onset:2008-10-18, Days after vaccination: 2
Gender:Male  Submitted:2008-12-18, Days after onset: 61
Location:Kansas  Entered:2008-12-18
Life Threatening? No
Died? Yes
   Date died: 2008-12-11
   Days after onset: 54
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 34 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Albuterol-2 puffs QID, Flovent-1 puff QD, Avapro 150mg PO QD, Calcium Carbonate 1 tablet PO QD, Lasix 40mg PO QD, Asprin 81mg PO QD, Fish Oil 1000mg PO QD, Plavix 75mg PO QD, Prandin 2mg PO QD, Zocor 40mg PO QD.
Current Illness: None
Preexisting Conditions: COPD- well controlled, Diabetes Type 2, wel controlled. PMH: DM, Dyslipidemia, COPD, HTN, ? CHF, Allergies to sulfa, PCN, doxycycline, yellow dye #2.
Diagnostic Lab Data: 11/10/08 MRI: Acute Inflamatory process in both frontal lobes crossing the Corpus Callosum, consistent with encephalitis. On 11/24/08, open brain biopsy showed demyelination consistent with progressive multifocal leukoencephalopathy. On
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR2761AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abnormal behaviour, Basilar artery stenosis, Biopsy brain abnormal, Borrelia burgdorferi serology negative, CSF myelin basic protein increased, Cardiac failure congestive, Chest X-ray abnormal, Chronic obstructive pulmonary disease, Confusional state, Death, Demyelination, Depressed level of consciousness, Diabetes mellitus, Electroencephalogram abnormal, Encephalitis post immunisation, Gait disturbance, Hemiparesis, Hyperglycaemia, JC virus infection, Laboratory test abnormal, Lumbar puncture, Neuron-specific enolase increased, Nuclear magnetic resonance imaging brain abnormal, Progressive multifocal leukoencephalopathy, Psychomotor retardation, Respiratory distress, Speech disorder, Viral test negative
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Ischaemic cerebrovascular conditions (narrow), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (broad)
Write-up: Pt initally presented to hospital on 10/20-10/26/08 with gait instability, garbled speech and Left sided weakness. Pt was re-admitted to hospital on 11/20-11/23/08 with worsening weakness, increasingly garbled speech and severe gait instability. Pt. transferred to hospital on 11/23/08 for a brain biopsy. Brain Biopsy revealed demyelination consistent with progresive multifocal Leukoencephalopathy. Pt''s neurological status deteriorated until pt expired on 12/11/08. 11/22/2008 MR received for multiple admissions beginning ~10/20/2008. Pt expired 12/11/08 with COD Progressive Multifocal Leukoencephalopathy. Pt presented to local hospital 10/20-26/08 with respiratory distress and admitted for COPD exacerbation and CHF. Also having sx of L sided weakness attributed to possible TIA. Pt d/c but developed increasing L-sided weakness and hemineglect and readmitted 11/10/08 with D/C DX: Immunogenic encephalitis s/p vaccination, Diabetes with hyperglycemia on steroids, COPD. Pt was acting confused with abnormal behavior c/w encephalitis. Started on antiviral and steroids w/o improvement. Pt continued to progress with worsening psychomotor retardation. Pt transferred to rehab for several days and admitted agian 11/19/08 for brain biopsy. D/C DX: Infiltrative bilateral frontal lobe process, extending into the brain stem, possible postvaccinal encephalomyelitis. COPD, Dyslipidemia. Basilar artery stenosis, HTN, DM, DVT risk, morbid obesity. Brain bx (+) for JC virus which lead to dx of PML. Pt with decreasing LOC. Transferred to hospice care. Pt expired 12/11/2008. 2/5/09 Death Cert received. COD: Progressive Multifocal Leukoencephalopathy.

VAERS ID:336673 (history)  Vaccinated:2008-10-16
Age:51.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2009-01-05, Days after onset: 80
Location:North Carolina  Entered:2009-01-07, 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:
Current Illness:
Preexisting Conditions: The patient had no past medical history or use of other medications.
Diagnostic Lab Data: None reported.
CDC Split Type: 200803258
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2765A IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Initial information was received on 20 October 2008 from a health care professional. A 51 year old female patient received an intramuscular injection of FLUZONE (lot number U2765AA) on 16 October 2008. On 17 October 2008 the patient complained of itching with "welts" on the palms of her hands, axillary area, back, upper trunk, and abdomen approximately 24 hours post vaccination. The patient self medicated with Benadryl and had some relief. the patient continued to take the Benadryl and the symptoms persisted. The patient was not recovered at the time of the report. Follow-up information received on 31 December 2008 from a health care professional. The patient had no past medical history, or use of other medications at the time of vaccination on 16 October 2008. The adverse events of welts and itching were treated with Solu-Medrol injection and Prednisone tapering dose pack. No final overall diagnosis was made. The patient fully recovered on 24 October 2008, which was seven days after onset of first symptoms. Per this new information, this case was upgraded to serious. List of Documents held by Sender: None.

VAERS ID:337347 (history)  Vaccinated:2008-10-16
Age:6.0  Onset:2008-11-11, Days after vaccination: 26
Gender:Female  Submitted:2009-01-14, Days after onset: 64
Location:Georgia  Entered:2009-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NERVE CONDUCTION, MRI, BARIUM SWALLOW TEST, 1/16/09-records received-CSF: protein 77, glucose 52. NCV abnormal, F-wave. MRI normal. Nerve conduction studies and electromyelography: general acquired sensorimotor polyneuropathy, mixed. CBC, BMP, liver function tests, total protein and albumin level normal. Creatinine kinase slightly elevated.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500501P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Aphonia, Asthenia, Barium swallow, Blood albumin normal, Blood creatine phosphokinase increased, Blood product transfusion, CSF protein increased, Choking, Facial palsy, Fall, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Liver function test normal, Metabolic function test normal, Neck pain, Nerve conduction studies abnormal, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Polyneuropathy, Protein total normal, Pyrexia, Sensorimotor disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Demyelination (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: SHE RECEIVED THE FLU SHOT IN MID-OCTOBER AND DISPLAYED A FEVER DURING VETERAN''S DAY WEEKEND WITH NO OTHER SYMPTOMS. SHE FELL OFF THE MONKEY BARS AT SCHOOL ON NOV 13 AND STARTED TO COMPLAIN OF TINGLING AND LOSS OF ''CONTROL'' OF LIMBS ON RIGHT SIDE ON NOV 14. SHE STARTED LOSING HER VOICE NOV 30. SHE COMPLAINED OF HER HEAD TINGLING ON DEC 9 AND SUBSEQUENTLY WENT TO DOCTOR ON DEC 10 AND HAS HAD MRI''S, NERVE CONDUCTION TESTS, ETC AND WAS FINALLY DIAGNOSED WITH GBS ON/ABOUT DEC 12. 1/16/09-records received for DOS 12/10-12/13/08-DC DX: Guillain-Barre syndrome. Presented with C/O tingling all four extremities for about 4 weeks, back pain and leg pain. Day prior to hospitalization fell from monkey bar approximately 6 feet high. Subsequently C/O tingling in all 4 extremities. Seen by chiropractor. Few days later lost voice, whispery and hypophonic. DX: sciatica and recommended bedrest for 1 month. PE: reflexes absent ankle and knee jerk bilaerally. 12/29/08-follow-up visit with neurology, after 12/25/08 developed left facial palsy and at time of visit nearly resolved. Voice remains with whisper and occasionally chokes on liquids. Jerky gait. Mild weaknesses throughout. 1/9/09-admitted with multiple cranial nerve palsy. Began IVIG. Discharged 1/13/09. Follow-up 2/16/2010: Patient was down graded from GBS to CIDP and is getting monthly IVIG treatments.

VAERS ID:338969 (history)  Vaccinated:2008-10-16
Age:68.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2009-01-07, Days after onset: 82
Location:Tennessee  Entered:2009-01-30, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject had previously received influenza vaccinations and no adverse events were reported.
Diagnostic Lab Data: UNK
CDC Split Type: A0754849A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS  UNRA
Administered by: Private     Purchased by: Private
Symptoms: Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This case was reported by an allergy physician and described the occurrence of rash-pruritic in a 68-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). On 16 October 2008, the subject received a dose of FLULAVAL (unknown). On 17 October 2008, 1 day after vaccination with FLULAVAL, the subject experienced rash-pruritic. The subject was treated with steroid cream. The subject was received FLULAVAL dose at another office on 16 October 2008. On 17 October 2008, the developed a generalized rash all over. She has been using a steroid cream and the rash is getting better but it is still very pruritic. At the time of reporting the event was improved. Follow-up information was received on 15 December 2008, via healthcare professional, who reported the events resolved on an unknown date. The reporting healthcare professional considered the events possibly related to vaccination with FLULAVAL.

VAERS ID:338972 (history)  Vaccinated:2008-10-16
Age:58.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2009-01-07, Days after onset: 83
Location:Arizona  Entered:2009-01-30, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Esomeprazole; HYZAAR; (Hydrochlorothiazide+Losartan potassium+potassium salt); Diltiazem hydrochloride
Current Illness: Asthma; Food allergy
Preexisting Conditions: The subject has a history of numerous food allergies. It was reported that when she experiences a reaction, her ears clog, her throat becomes like sand paper, the roof of her mouth puckers and her tongue swells. The subject has not previously received any flu shots.
Diagnostic Lab Data: UNK
CDC Split Type: A0754692A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS  UNRA
Administered by: Private     Purchased by: Other
Symptoms: Dry mouth, Ear discomfort, Laryngitis
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: This case was reported by a consumer and described the occurrence of ears clogged in a 58-year-old female subject who was vaccinated with FLULAVAL. A physician or other healthcare professional has not verified this report. Concurrent medical conditions included asthma and food allergy. Concurrent medications included NEXIUM, ADVAIR and CARDIZEM. On 16 October 2008 at 13:30 the subject received unspecified dose of FLULAVAL at 0.5ml in the left arm. On 16 October 2008, 2 hours after vaccination with FLULAVAL, the subject''s ears began clogging. She took BENADRYL. Then the roof of her mouth, which is usually smooth, puckered. The subject also began to experience laryngitis on 16 October 2008. The subject began to recognize that she may be having an allergic reaction. At 20:00 the subject took another BENADRYL and went to the emergency room. In the emergency room she received a PREDNISONE burst and prescribed oral PREDNISONE, PEPCID and BENADRYL. The consumer stated that these medications only temporarily relieve the symptoms. At the time of reporting the outcome of the events was unspecified.

VAERS ID:340453 (history)  Vaccinated:2008-10-16
Age:14.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2009-02-13, Days after onset: 120
Location:Unknown  Entered:2009-02-18, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0901USA03550
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cardiac disorder
SMQs:
Write-up: Information has been received from a consumer concerning her 14 year old female daughter who on 16-OCT-2008 was vaccinated with the first dose of GARDASIL vaccine. On 16-OCT-2008, the patient had heart problems. It is unknown if the patient sought medical attention. At the time of reporting the patient had not recovered. Therapy with human papillomavirus vaccine was discontinued. This is one of two reports from the same source. The patient''s sibling experienced severe breathing problems after vaccination with GARDASIL vaccine (MSD WAES 0901USA03777). No further information is available. No further information is available.

VAERS ID:342921 (history)  Vaccinated:2008-10-16
Age:73.0  Onset:2009-03-05, Days after vaccination: 140
Gender:Female  Submitted:2009-03-26, Days after onset: 20
Location:Tennessee  Entered:2009-03-30, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Not reported. From information received 17 March 2009, the patient had no past medical history and she had not been ill at the time of vaccination. She had not received any other vaccines within four weeks of FLUZONE.
Diagnostic Lab Data: 09/Mar/2009: Influenza virus A&B IgG, IgM and IgA ABS, Influenza A: IgG, (4.94), IgM (1.09), IgA (1.4); Influenza B: IgG (3.38), IgM (<8.80), IgA (<0.80), Reference ranges - (<0.80 - negative); (0.80 - 1.20 = Equivocal); ($g1.20 = positive).
CDC Split Type: 200901066
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  IMRA
Administered by: Private     Purchased by: Private
Symptoms: Culture throat negative, Eye pain, Flushing, Haematocrit normal, Haemoglobin normal, Influenza, Influenza serology positive, Pharyngeal erythema, Platelet count normal, Sinus congestion, White blood cell count decreased
SMQs:, Anaphylactic reaction (broad), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Hypersensitivity (broad)
Write-up: Initial report received from a health care professional on 13 March 2009. The reporter stated that two of his patients "got the Flu" after receiving FLUZONE; however information was received for only one patient. An elderly female patient had received FLUZONE SV 2008-2009 (lot number, route/site of administration not reported) on 16 October 2008 and an unspecified amount time later she developed the "flu". On 09 March 2009, the patient had laboratory testing performed for Influenza virus A & B IGG, IGM, and IGA ABS with the following results: Influenza A: IgG (4.94), IgM (1.09), IgA (1.4) and Influenza B: IgG (3.38), IgM (<0.80), IgA (<0.80). Reference ranges - (<0.80 = negative); (0.80 - 1.20 = Equivocal); ($g1.20 - positive). According to the laboratory report received, "This test(s) was performed using a kit that has not been cleared or approved by the FDA. The analytical performance characteristics of this test have been determined by (the laboratory). This test should not be used for diagnosis without confirmation by other medically established means." The patient''s recovery status was not reported. No additional information was provided at the time of the report. Follow-up information received 17 March 2009 from a health care professional. The reporter confirmed that patient had been 74-years-old at the time of the event. The patient had received an intramuscular right deltoid injection of FLUZONE on 16 October 2008 and 140 days later, she developed sinus congestion; aching behind eyes, red pharynx and her face was flushed. She had no adenopathy and her lungs were clear. Laboratory test results had been positive for influenza A and B and additional labs revealed Hgb (14.1), Hct (42), WBC (3,300) and platelets (151,000); Diff: PMN (70.3), Lymph (23), Prolymphs (6.3). A throat culture grew normal flora. The patient had no pre-existing illnesses or medical conditions and no illness at the time of vaccination. She had not received any other vaccines within four weeks of receiving FLUZONE. The patient was recover

VAERS ID:348334 (history)  Vaccinated:2008-10-16
Age:1.0  Onset:2009-05-25, Days after vaccination: 221
Gender:Female  Submitted:2009-05-27, Days after onset: 2
Location:Florida  Entered:2009-06-02, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0917X0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1002X0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster
SMQs:
Write-up: Typical shingles of L chest and arm 7 months after vaccine. Zoster/Shingles.

VAERS ID:359853 (history)  Vaccinated:2008-10-16
Age:76.0  Onset:2008-12-11, Days after vaccination: 56
Gender:Female  Submitted:2009-10-06, Days after onset: 298
Location:Unknown  Entered:2009-10-07, Days after submission: 1
Life Threatening? No
Died? Yes
   Date died: 2009-01-01
   Days after onset: 21
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Lymphoma
Preexisting Conditions: Chemotherapy; Radiotherapy 10/13/09 Hospital records and DC summary received for dates 12/11/08 to 12/23/08. PMH: Thrombocytopenia, non-Hodgkin''s lymphoma, pacemaker, myelodysplastic syndrome, hyponatremia. 10/15/09 Medical records received for date of service 10/9/08. PMH: None.
Diagnostic Lab Data: Unknown 10/13/09 Hospital records and DC summary received for dates 12/11/08 to 12/23/08. Diagnostics/Labs: CT abdomen and pelvis-RUQ mass, bilateral pleural effusion. CXR-decreased inspiration w/ basilar effusion/atelectasis. US RUQ - cholecystitis. EKG WNL. Platelet 13(L), HGB 9.8(L), HCT 30.8(L), BUN 28(H), urine culture(+) E-coli.10/15/09 Medical records received for date of service 10/9/08. Diagnostics and Labs: None.
CDC Split Type: WAES0910USA00329
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA184AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal mass, Acute myeloid leukaemia, Anaemia, Arthralgia, Atelectasis, Back pain, Blood urea increased, Chest X-ray abnormal, Cholecystitis, Computerised tomogram abnormal, Condition aggravated, Culture urine positive, Death, Electrocardiogram normal, Haematocrit decreased, Haemoglobin decreased, Inspiratory capacity decreased, Leukaemia, Lymphadenitis, Lymphadenopathy, Lymphoma, Malnutrition, Myelodysplastic syndrome, Platelet count decreased, Pleural effusion, Positron emission tomogram abnormal, Pyrexia, Soft tissue neoplasm, Tooth abscess, Ultrasound abdomen abnormal, Urinary tract infection
SMQs:, Acute renal failure (broad), Haematopoietic cytopenias affecting more than one type of blood cell (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Blood premalignant disorders (narrow), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Osteonecrosis (broad), Malignant tumours (narrow), Tumours of unspecified malignancy (narrow), Chronic kidney disease (broad), Malignant lymphomas (narrow), Arthritis (broad), Myelodysplastic syndrome (narrow), Tumour lysis syndrome (broad)
Write-up: Information has been received from a consumer concerning his approximately 78 year old wife with lymphoma diagnosed in February 2007. The patient was underwent chemotherapy and radiation. In December 2007 she experienced a recurrent lymphoma and was prescribed oral chemotherapy from January 2008 to May 2008. In October 2008 she was vaccinated with a dose of ZOSTAVAX (Merck) (lot # not reported). Several weeks later, she was diagnosed with leukemia and experienced recurrence of lymphoma. On an unspecified date she was hospitalized. She received unspecified treatment which was unsuccessful. The patient died on 01-JAN-2009. The cause of death were Lymphoma and leukemia. No further information is available. 10/13/09 Hospital records and DC summary received for dates 12/11/08 to 12/23/08. DC DX: Lower back pain-resolved, fever-resolved, UTI-resolved, dental abscess, malnutrition. Presenting SX: pt c/o pain in back and both hips. Assessment: Pt found to have fever. Pt treated for current medical conditions and acute conditions and DC to rehab facility. 10/15/09 Medical records received for date of service 10/9/08. Shingles (Zostavax) vaccine administered on 10/9/08. Physician reports that pt. did not call office to report an adverse reaction. 10/21/09 Death Certificate DOD 1/1/2009. Myelodysplastic syndrome. Acute myelogenous leukemia. Anemia.

VAERS ID:362998 (history)  Vaccinated:2008-10-16
Age:41.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2009-10-27, Days after onset: 376
Location:Illinois  Entered:2009-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Never really seen by doctor. Called and was told to stay home from work.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500563P3IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Impaired work ability, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Felt lightheaded and dizzy in the bathroom before passing out.

VAERS ID:367195 (history)  Vaccinated:2008-10-16
Age:52.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Male  Submitted:2009-02-27, Days after onset: 134
Location:Unknown  Entered:2009-11-12, Days after submission: 258
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: 200900710
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2757AA0 NS
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Condition aggravated, Cough, Eye irritation, Headache, Malaise, Nausea, Ocular hyperaemia, Pyrexia, Sensation of foreign body
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad)
Write-up: This non serious case was received on 24 February 2009 via a search of the VAERS database (reference number 330101). A 52 year old male received FLUZONE SV 2008-2009 (lot number U2757AA) on 16 October 2008. At 3:30 pm post vaccination, the patient had a feeling of a lump in their throat. At 6:30 pm the patient was not feeling well and the lump in their throat caused coughing. The patient had an increase in nausea in the evening and his eyes were burning and had turned red. At 10 pm the patient had an increased in nausea in the evening and his eyes turned blood red. That night he developed a fever, malaise, headache, and weakness. His symptoms continued through 17 October 2008. He felt better on 19 October 2008 and was reported as recovered. No further information was reported. List of Documents held by sender: None.

VAERS ID:392199 (history)  Vaccinated:2008-10-16
Age:63.0  Onset:2008-10-17, Days after vaccination: 1
Gender:Female  Submitted:2010-06-14, Days after onset: 605
Location:Unknown  Entered:2010-07-02, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Breast cancer; The subject had not previously received any flu shots. In 1975, the subject declined Td (tetanus and diphtheria vaccine) due to known reaction. The subject was a non-smoker.
Diagnostic Lab Data: PPD in August 2007 and on 14 October 2009 was negative.
CDC Split Type: A0766172A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA373BA0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Tinnitus, Tuberculin test negative
SMQs:, Hearing impairment (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of tinnitus-bilateral in a 63-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). The subject had not previously received any flu shots. The subject''s medical history included breast cancer. In 1975, the subject declined Td (tetanus and diphtheria vaccine) due to known reaction. "PPD" in August 2007 and was negative on 14 October 2008. Concurrent medications included FOSAMAX, PAXIL, FEMARA and XANAX. On 16 October 2008 the subject received 1st dose of FLUARIX (.5 ml, unknown, left arm). On 17 October 2008, 24 hours after vaccination with FLUARIX, the subject experienced tinnitus-bilateral. The physician''s assistant reported that the subject developed the tinnitus greater in the left ear than the right ear and it was more annoying at night when things are quiet. At the time of reporting the events was unresolved. Follow-up information received on 13 February 2009 indicated that the event was still unresolved as of 27 January 2009. In the reporter''s opinion, the event was possibly related to treatment with FLUARIX.

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