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| VAERS ID: | 331493 | Vaccinated: | 2008-10-29 | | Age: | 1.3 | Onset: | 2008-10-30, Days after vaccination: 1 | | Gender: | Female | Submitted: | 2008-10-31, Days after onset: 1 | | Location: | Oregon | Entered: | 2008-11-06, Days after submission: 6 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: None | | CDC 'Split Type': OR200837 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTAP | GLAXOSMITHKLINE BIOLOGICALS | AC14B065AA | 1 | IM | LL | | FLU | SANOFI PASTEUR | U2808AA | 1 | IM | LL | | VARCEL | MERCK & CO. INC. | 1861U | 0 | SC | RL | |
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| VAERS ID: | 331495 | Vaccinated: | 2008-11-01 | | Age: | 10.0 | Onset: | 2008-11-01, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-11-03, Days after onset: 2 | | Location: | Oregon | Entered: | 2008-11-06, Days after submission: 3 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: Maybe getting viral illness- on ///// @ night | | Diagnostic Lab Data: We are checking for egg allergy but has had eggs in past and flu shots without any trouble. | | Previous Vaccinations: | | Other Medications: None | | Preexisting Conditions: sulfa | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | NOVARTIS VACCINES AND DIAGNOSTICS | 881176P | 5 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Allergy test, Eye swelling, Swelling face | | Write-up: Swelling around eyes 1 hour after the dose was given and then swelling in cheek and upper face. No trouble breathing. |
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| VAERS ID: | 331496 | Vaccinated: | 2008-10-17 | | Age: | 21.0 | Onset: | 2008-10-17, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-10-17, Days after onset: 0 | | Location: | North Carolina | Entered: | 2008-11-06, Days after submission: 20 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Birth Control | | Preexisting Conditions: Augmentin | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | NOVARTIS VACCINES AND DIAGNOSTICS | 89747 | 0 | UN | RA | |
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| VAERS ID: | 331497 | Vaccinated: | 2008-10-31 | | Age: | 53.0 | Onset: | 2008-10-31, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-10-31, Days after onset: 0 | | Location: | Pennsylvania | Entered: | 2008-11-06, Days after submission: 6 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: Advair, Spiriva, Seroquel, Benicar, Norvasc, Tubelin Purified Protein | | Preexisting Conditions: HTN/Depression/COPD | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | GLAXOSMITHKLINE BIOLOGICALS | AFLLA154AA | 0 | ID | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Incorrect route of drug administration | | Write-up: Maladministration of FLULAVOL vaccine, given interdermal 0.1 ml L forearm at 10:05 am on 10/31/08. Patient remained under observation for one hour after improper administration. |
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| VAERS ID: | 331498 | Vaccinated: | 2008-10-18 | | Age: | 48.0 | Onset: | 2008-10-19, Days after vaccination: 1 | | Gender: | Female | Submitted: | 2008-11-01, Days after onset: 13 | | Location: | Ohio | Entered: | 2008-11-06, Days after submission: 5 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | CSL LIMITED | 02049111A | 0 | IM | LA | |
| Administered by: Other Purchased by: Private | | Symptoms: Injection site erythema, Injection site pruritus | | Write-up: Area around injection site became red the next day after the injection. The site was still red and itchy 2 weeks later. Advised Benadryl and hydrocortisone cream to treat, and to see the doctor if symptoms persist. |
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| VAERS ID: | 331499 | Vaccinated: | 0000-00-00 | | Age: | 37.0 | Onset: | 2008-10-10 | | Gender: | Female | Submitted: | 0000-00-00 | | Location: | New Jersey | Entered: | 2008-11-06 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | GLAXOSMITHKLINE BIOLOGICALS | AFLLA197AA | | IM | RA | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Dizziness, Lip swelling, Swelling face | | Write-up: Dizziness, facial swollen lip swollen within 30 min of given vaccine. |
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| VAERS ID: | 331500 | Vaccinated: | 2008-10-18 | | Age: | 55.0 | Onset: | 2008-10-18, Days after vaccination: 0 | | Gender: | Male | Submitted: | 2008-10-24, Days after onset: 6 | | Location: | New Jersey | Entered: | 2008-11-06, Days after submission: 13 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: None | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2744AA | 0 | UN | LA | |
| Administered by: Public Purchased by: Public | | Symptoms: Malaise, Vomiting | | Write-up: Pt started to feel sick; ambulance was called by co-workers. Pt vomited x 3 in ambulance. Upon arrival at hospital, pt rec'd Benadryl po; said he felt better almost immediately. Pt observed, then dc'd. |
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| VAERS ID: | 331504 | Vaccinated: | 2008-10-23 | | Age: | 46.0 | Onset: | 2008-10-23, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-11-03, Days after onset: 11 | | Location: | California | Entered: | 2008-11-06, Days after submission: 3 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2948AA | | IM | UN | |
| Administered by: Unknown Purchased by: Private | | Symptoms: Chills, Headache, Hyperaesthesia, Nausea, Pain in extremity, Pyrexia, Sleep disorder | | Write-up: Sore arm by evening- hurt to touch. Sore arm by evening - hurt to touch. Woken several times during the night, shivering, feverish. Nausea and headache next day preventing me from going to work. Recovered by late afternoon the day following the vaccination. |
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| VAERS ID: | 331505 | Vaccinated: | 2008-10-27 | | Age: | 7.0 | Onset: | 2008-11-01, Days after vaccination: 5 | | Gender: | Female | Submitted: | 2008-11-03, Days after onset: 2 | | Location: | South Carolina | Entered: | 2008-11-06, Days after submission: 3 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2828AA | 3 | IM | LA | | VARCEL | MERCK & CO. INC. | 0792X | 1 | SC | RA | |
| Administered by: Private Purchased by: Public | | Symptoms: Urticaria | | Write-up: Received vaccine 10/27/08. Seen in ER with hives 11/01/08. Given Benadryl 25 mg PO. Epinephrine 1: 1000 0.3 mg SQ. Note - was around Cousin who was also seen with hives - no vaccine. |
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| VAERS ID: | 331507 | Vaccinated: | 2008-10-28 | | Age: | 44.0 | Onset: | 2008-10-28, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-10-30, Days after onset: 2 | | Location: | New Mexico | Entered: | 2008-11-06, Days after submission: 7 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: None | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | GLAXOSMITHKLINE BIOLOGICALS | AFLUA381CA | | UN | LA | |
| Administered by: Public Purchased by: Unknown | | Symptoms: Erythema, Nasal congestion, Postnasal drip | | Write-up: Erythema/redness 8x9 cm. T 97.6. Symptoms started 3-4 hrs after injection. Post-nasal drip with nasal congestion. |
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