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Case Details (Sorted by Age)

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VAERS ID:358764 (history)  Vaccinated:2009-07-23
Age:26.0  Onset:2009-07-25, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Utah  Entered:2009-09-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 15 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: 10/20/09 Hospital records received for date of service 8/25-8/28. PMH: None. ALLERGIES: none. 10/20/2009 Electrophysiologic Diagnostic Consult and labs received for DOS 08/19-10/05.PMH: Lumbar and cervical problems
Diagnostic Lab Data: MRI, spinal tap, nerve conduction test. . 10/20/09 Hospital records received for date of service 8/25-8/28. LABS and DIAGNOSTICS: EMG abnormal. LP abnormal. 10/20/09 Hospital records received for date of service 8/25-8/28. LABS and DIAGNOSTICS: HCT 23.3 (l) HGB 8.8 (L) Platelets 463,000 (H) Electrophysiologic Diagnostic Consult and labs received for DOS 08/19-10/05. LABS/DIGNOSTICS: MONOCYTE % 9.9 (H) MONOCYTE # 0.9 (H) ,10 (L) RETICULOCYCTES 5.3 (H) SODIUM 134 (L) AST 136 (H) ALT 84 (H) TOTAL PROTEIN 8.7 (H) URINE BLOOD MODERATE URINE PROTEIN TRACE, MRI Mild degenerative changes C spine.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0381X0 LA
Administered by: Public     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Asthenia, Blood sodium decreased, Blood thyroid stimulating hormone normal, Blood urine, C-reactive protein, CSF protein increased, Computerised tomogram normal, Electromyogram abnormal, Epstein-Barr virus antibody, Full blood count abnormal, Guillain-Barre syndrome, Haematocrit decreased, Haematuria, Haemoglobin decreased, Haemolytic anaemia, Hypoaesthesia, Lumbar puncture abnormal, Lymphocyte count increased, Monocyte count increased, Neuralgia, Nuclear magnetic resonance imaging abnormal, Paraesthesia, Parvovirus B19 serology, Platelet count increased, Protein total increased, Pyrexia, Radiculopathy, Red blood cell sedimentation rate, Reticulocyte count increased, Ultrasound Doppler normal, Urine analysis abnormal, Urine protein, quantitative, Wheelchair user, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Haemolytic disorders (narrow), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Hyponatraemia/SIADH (narrow), Demyelination (narrow), Chronic kidney disease (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Guillian-barre syndrome from shot was down to the nerve coating and numbness. 10/20/09 Hospital records received for date of service 8/25-8/28. Discharge DX: Guillain-Barre syndrome. Records reveal patient presented in ER with progressive ascending weakness of LE approx. 3 days after receiving vaccine. Progressed to wheelchair bound. LP (+) isolated abnormality of elevated protein. EMG abnormal. IVIG x3 days with dramatic improvement. Discharged to inpatient rehab. 10/20/09 Hospital records received for date of service 8/28-9/05. Discharge DX: Acute inflammatory demyelinating polyradiculoneuropathy, neuropathic pain, hemolytic anemia secondary to IVIG. Records reveal account of inpatient rehab. Strength UE 4/5 bilaterally, LE 3/5-45. Developed neuropathic pain. Developed hemolytic anemia secondary to IVIG. No free circulating antibody. HCT stabilized at 23 and HGB at 8.8. INR and platelets stable at 463,000. Able to ambulate with supervision at discharge. To follow up with PCP and hematology. 10/20/2009 Electrophysiologic Diagnostic Consult and labs received for DOS 08/19-10/05. Diagnosis of GBS and/or AIDP confirmed. Notes patient had mild SX 1 week before admin of vaccine and SX increased thereafter.

VAERS ID:358892 (history)  Vaccinated:2008-01-09
Age:26.0  Onset:2009-09-17, Days after vaccination: 617
Gender:Male  Submitted:2009-09-22, Days after onset: 5
Location:North Carolina  Entered:2009-09-30, 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: none reported
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema, Rash papular, Rash pustular, Scab, Scar
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 27 y/o AD WM calls clinic on 17SEP09 concerned about "red, warm, tender area on my right upper arm "under my smallpox vaccination scar." There is no documentation of patients primary SPV date in DEERS or MEDPROS, but historically, the patient states he received his primary SPV just before he deployed over seas in JAN of 2008, the same day he got his AVA #1 (09JAN08) per DEERS. He has a scar on his right upper arm, which is now covered by an extensive, elaborate tattoo, which the patient has placed, in stages, over the past 6 weeks (deltoid of RUE). The patient reports a normal 2-3 week evolution of his primary SPV from papule to pustule to a scab, which dried and fell off without complications in JAN 2008. Thus, it appears that the current area of erythema, edema, and pus on his RUE represents a new infection, secondary to the patients recent tattoo placement on his RUE and is NOT in temporal association with the placement of his primary SPV in JAN of 2008. The patient was seen at the clinic on 17 Sept 09 by NP and Dr., who agreed with assessment. The patient was treated with KEFLEX 250 mg po qid x 10 days and given 800 mg ibuprofen tid po WF #30 prn pain. He was instructed to apply warm compresses 2-3 times a day over the affected area and to F/U with his PCP at clinic the next morning for TD booster, as his last TD was given on 12JUN2001. The patient did as instructed and saw seen by PA-c on SEP 18 09 at clinic and was given a TDAP and instructed to continue the compresses and KEFLEX. The PA-C who saw the patient felt that an I&D of the area was not necessary, as the patient reported that it ruptured spontaneously that evening before after applying the warm compress. NP f/u with patient by phone on 18 SE) 09 and he was doing better, applying the warm compresses and taking the KEFLEX. By second f/u call on 22SEP09, the SM reported that the area was no longer red or warm, but that he could feel a bump, perhaps from scar tissue. SM was in another state at the time. Advised to f/u prn at clinic.

VAERS ID:358998 (history)  Vaccinated:2009-09-28
Age:26.0  Onset:2009-09-29, Days after vaccination: 1
Gender:Female  Submitted:2009-09-29, Days after onset: 0
Location:Washington  Entered:2009-09-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED0594911A UNUN
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Area appears to be hard, firm & raised. Reddish surrounding area.

VAERS ID:359467 (history)  Vaccinated:2009-10-01
Age:26.0  Onset:2009-10-01, Days after vaccination: 0
Gender:Female  Submitted:2009-10-05, Days after onset: 4
Location:Texas  Entered:2009-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Necon 777 oral contraceptive
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0980Y1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Fatigue, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient received Gardasil vaccine dose #2 on 10/1/2009, and that evening she complained of chills, nausea, and several episodes of vomiting. She reports no fever, and her symptoms resolved that night. She does report feeling fatigued for the next 24 hours after the onset of her symptoms but reports no futher complaints.

VAERS ID:359595 (history)  Vaccinated:2009-09-24
Age:26.0  Onset:2009-10-03, Days after vaccination: 9
Gender:Female  Submitted:2009-10-06, Days after onset: 3
Location:California  Entered:2009-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Patient was placed on antibiotics and antihistamines and has a pending follow-up appointment. Overall I would rate this reaction as mild.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)SANOFI PASTEURU2937BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient reports that she began to have pain, swelling and redness on the morning of October 3, 2009. She denies any reaction to the vaccination prior to this date

VAERS ID:359627 (history)  Vaccinated:2009-09-22
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-10-05
Location:New Jersey  Entered:2009-10-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Asthma; Viral infection
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0909USA04052
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0507Y0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Injected limb mobility decreased, Injection site pain, Local reaction, Pain, Rash erythematous
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a nurse concerning a 26 year old female patient with asthma who on 22-SEP-2009 was vaccinated IM with 0.5 ml PNEUMOVAX 23 (Lot# 663486/0507Y). Subsequently the patient developed a severe local reaction. The patient experienced pain at the site and could barely move her arm. She had a pink speckled rash on both arms, neck and chest. Before receiving PNEUMOVAX 23 she had a mild virus. After the PNEUMOVAX 23 she was achy and short of breath, but they were not sure if those symptoms were related to the virus or vaccination. It was believed to be the first PNEUMOVAX 23 vaccine for this patient. It was the same lot as the other cases previously reported. A lot check was being done on 0507Y. The patient was taken to a local emergency room. Hospital name was not available. It was unknown if the patient was admitted or present status of the patient. Upon internal review, short of breath was determined to be an other important medical event. This is one of several reports for the same source. Additional information has been requested.

VAERS ID:360229 (history)  Vaccinated:2009-09-21
Age:26.0  Onset:2009-09-21, Days after vaccination: 0
Gender:Female  Submitted:2009-10-05, Days after onset: 14
Location:Unknown  Entered:2009-10-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: A0809107A
Vaccination
Manufacturer
Lot
Dose
Route
Site
RV1: ROTAVIRUS (ROTARIX)GLAXOSMITHKLINE BIOLOGICALSA41FA774A UNUN
Administered by: Other     Purchased by: Other
Symptoms: Accidental exposure, Chemical eye injury, Eye pruritus
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (narrow), Corneal disorders (broad), Medication errors (narrow)
Write-up: This case was reported by a sale representative and described the occurrence of eyes splashed with vaccine in a 26-year-old female subject who was administered ROTARIX (GlaxoSmithKline) to her child. A physician or other health care professional has not verified this report. On 21 September 2009 the subject was attempting to administer a dose of ROTARIX to her child and the vial did not puncture properly resulting in the vaccine getting in her eye. The subject experienced itching of the eye. The outcome of the event was not reported. It was the reporter''s opinion that this event was probably related to ROTARIX.

VAERS ID:359692 (history)  Vaccinated:2009-08-21
Age:26.0  Onset:2009-09-18, Days after vaccination: 28
Gender:Female  Submitted:2009-09-21, Days after onset: 3
Location:Texas  Entered:2009-10-07, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dysmenorrhea; Tension headache; Anemia; Menorrhagia
Preexisting Conditions: Delivery
Diagnostic Lab Data: Sonogram on 18-Sep-2009 uterus of 10.8 x 6.6 x 5.9 cm. The uterus contains a gestational sac. the right ovary is within normal limits at 31 x 15 x 11 mm. Doppler flow could not be confirmed; probably due to technical reasons rather than physiologic reasons. The left ovary cannot be seen either transabdominally or transvaginally. The adnexal regions are within limits. There is no pelvic free fluid. The age determination shows a gestational sac of 1.85 cm or six weeks two days, a crown-rump length is 1.27 cm or seven weeks three days. The average ultrasound age is six weeks six days. Fetal heart is confirmed at 152 beats per minute with M-mode scanning; serum pregnancy, 09/18/09, positive.
CDC Split Type: MEDI0008922
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Abortion spontaneous, Back pain, Blood human chorionic gonadotropin positive, Dehydration, Drug exposure during pregnancy, Foetal heart rate abnormal, Ultrasound scan normal, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: A serious clinical trial report of a Grade 3 miscarriage was received from an investigator concerning a 26 year-old female, who is enrolled in a study. The subject''s medical history included: dysmenorrhea (1994), tension headaches (2000), anemia (11/2008), and menorrhagia (10/2008 to 12/2008). Concomitant medications included acetaminophen: Rho (d) Immune Globulin (Human) Injection, naproxen sodium, and extra strength acetaminophen. Method of contraception used during the study by the subject was condoms and spermacide. The subject''s last menstrual period was 11-July-2009. On 21-August-2009, the subject received on 0.2ml dose of MEDI8662-BFS. This was the subject''s first and only dose as per the study protocol. On 18-Sep-2009, the subject went to the emergency room for abnormal vaginal bleeding. A serum pregnancy test was done and had a positive result. A sonogram of the uterus showed: size 10.8 X 6.6 X 5.9 cm. The uterus not be confirmed, probably due to technical reasons rather than physiologic reasons. The left ovary could not be seen either transabdominally or tranvaginally; and the adnexel regions were within limits; there was no pelvic free fluid. The age determination showed a gestational sac of 1.85 cm or six weeks two days, a crown-rump length is 1.27 cm or seven weeks three days. Fetal heart rate was confirmed at 152 beats per minute with M-node scanning. Intravenous saline was administered for dehydration prophylaxis and acetaminophen 650 mg was given for low back pain secondary to abnormal vaginal bleeding. Rho (D) Immune Globulin (Human) injection 50 mcg was also administered prophylactically to prevent fetal death. The subject was released from the emergency room and reported on 22-Sep-2009 that everything was fine. On 23-Sep-2009, the subject was again seen in the emergency room and had miscarriage. She was instructed to follow up with her gynecologist. Treatment for the event of miscarriage was not reported. The event of Grade 3 miscarrage resolved on 23-Sep-2009. Rechallenge is not applicable as in this clinical trial only one dose of study drug is given. The investigator assessed the relationship of the event miscarriage as possible. Analysis of similar events: a search of the safety database for the preferred term of miscarriage was performed on 28-Sep-2009 and noted only this case of miscarriage after the administration. Clinical trial case - patient was found not to be on FLUMIST when unblinded. 19-Feb-2010.

VAERS ID:359850 (history)  Vaccinated:2009-09-15
Age:26.0  Onset:2009-09-16, Days after vaccination: 1
Gender:Female  Submitted:2009-10-07, Days after onset: 21
Location:Ohio  Entered:2009-10-07
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) (AFLURIA)CSL LIMITED01949211A IMLA
Administered by: Private     Purchased by: Private
Symptoms: Malaise, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: malaise, urticaria, itching, rash

VAERS ID:360011 (history)  Vaccinated:2009-09-24
Age:26.0  Onset:2009-09-24, Days after vaccination: 0
Gender:Female  Submitted:2009-10-08, Days after onset: 14
Location:California  Entered:2009-10-08
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) (AFLURIA)CSL LIMITED 0 UN
Administered by: Public     Purchased by: Public
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Arm pain that resolved and then recurred after three weeks post vaccination

VAERS ID:360114 (history)  Vaccinated:2009-10-06
Age:26.0  Onset:2009-10-06, Days after vaccination: 0
Gender:Female  Submitted:2009-10-09, Days after onset: 3
Location:California  Entered:2009-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 200mg of Ibuprofen that morning
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Radiographs
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Chest X-ray, Chest discomfort, Chest pain, Cough, Dizziness, Dysphagia, Dyspnoea, Eye swelling, Fatigue, Gait disturbance, Impaired driving ability, Ocular hyperaemia
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (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), Glaucoma (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: I started coughing a lot around 3:00p.m. After about thirty minutes of constant coughing I had trouble swallowing and I felt like something hard was stuck in my throat. I was drinking plenty of water not knowing what was causing the problem. Soon after I was getting dizzy and was having a difficult time breathing. My chest felt very tight and it was painful when I would take a deep breath. At this point I was weak and my eyes were red and swollen. I contacted my primary physician and I was told to take 25mg of Benadryl per mouth and to go to the nearest emergency room. I was unable to drive, my co-worker transported me to the hospital. When we arrived at hospital at approximately 4:15p.m. I was very weak, had a lot of chest pain, difficulty breathing and I had a difficult time walking due to the weakness I felt. I was immediately checked in the emergency room and they gave me a cortisone injection intramuscular. They had me under observation and took two radiographs of my chest. After several hours of observation I was released that same night. I was very tired and felt weak, still unable to drive myself home.

VAERS ID:360337 (history)  Vaccinated:2009-10-08
Age:26.0  Onset:2009-10-08, Days after vaccination: 0
Gender:Female  Submitted:2009-10-11, Days after onset: 3
Location:Iowa  Entered:2009-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion 2x per day 200 mg; Lamictal 1x per day 150 mg; Ortho Evra patch
Current Illness: No
Preexisting Conditions: Depression (BiPolar II), Anxiety; Deviated Septum; Scoliosis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.UNKNOWN0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Headache, Nasal congestion, Rhinorrhoea, Sinus headache, Sinus operation, Sinusitis, Sneezing
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Nasal Congestion, runny nose, drainage into throat (slight congestion starting 10/8; worsened thru at least 10/11). Headache; sinus pressure / mild sinus pain: 10/10 starting approx. 12:30 p.m. Sneezing and Cough: Mainly started noticing 10/11 10 a.m. Suspected sinus infection starting afternoon of 10/10. Went to Urgent Clinic 7:45 p.m. on 10/10. Diagnosed with sinus infection and given amoxicillin prescription.

VAERS ID:360338 (history)  Vaccinated:2009-10-06
Age:26.0  Onset:2009-10-08, Days after vaccination: 2
Gender:Female  Submitted:2009-10-11, Days after onset: 3
Location:California  Entered:2009-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: fever, cough and etc~Influenza (H1N1) (Influenza A (H1N1) 2009 Monovalent, Intranasal Spray)~~26.83~Patient
Other Medications:
Current Illness: started on the evening of 10/08/2009
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3205CA IMUN
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500760P IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Influenza, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: I took the 2009 H1N1 influenza vaccine (LAIV which is sprayed into the nose). After taking the vaccine, I have fever, cough and other symptoms as H1N1 flu.

VAERS ID:360403 (history)  Vaccinated:2009-09-28
Age:26.0  Onset:2009-09-28, Days after vaccination: 0
Gender:Female  Submitted:2009-10-06, Days after onset: 8
Location:California  Entered:2009-10-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06649111A2IMRA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash to upper body bilat.

VAERS ID:360815 (history)  Vaccinated:2009-09-14
Age:26.0  Onset:2009-09-14, Days after vaccination: 0
Gender:Female  Submitted:2009-09-28, Days after onset: 14
Location:Ohio  Entered:2009-10-14, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPAMAX, LEVORA, FLONASE, AMBIEN, NAPROSYN
Current Illness: None
Preexisting Conditions: Fibromyalgia; allergy to quinilones
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3196AA IMUN
Administered by: Other     Purchased by: Unknown
Symptoms: Adenovirus infection, Adverse reaction, Body temperature increased, Cough, Nausea, Pain, Pain in extremity, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 9/14/09 - sore arm, achy feeling. 9/15/09 - nausea, sore arm, achy feeling; 100 temp. 9/16/09 - nausea, sore arm, achy, cough, chest congestion, went home sick. - P.A.C. dx adverse reaction & adeno virus systems persisted through 9/20/09 - chest congestion & cough remains.

VAERS ID:361055 (history)  Vaccinated:2009-10-15
Age:26.0  Onset:2009-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-10-15, Days after onset: 0
Location:Massachusetts  Entered:2009-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other meds
Current Illness: none
Preexisting Conditions: no health issues
Diagnostic Lab Data: cold pack given
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3188AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Feeling hot, Headache
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Suddenly hot Dizzy Headache

VAERS ID:361174 (history)  Vaccinated:2009-10-12
Age:26.0  Onset:2009-10-12, Days after vaccination: 0
Gender:Male  Submitted:2009-10-12, Days after onset: 0
Location:Ohio  Entered:2009-10-16, 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: None
Current Illness:
Preexisting Conditions: Hx HTN (no meds) and Panic attacks
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLVA458BA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Flushing, Hypertension, Pallor, Palpitations, Panic reaction, Tearfulness, Tremor, Vision blurred
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Hypertension (narrow), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Pt felt palpitations, panic feeling and blurred vision within 10 minutes of receiving influenza (seasonal) vaccination. Continued to have high BP 160/90, 184/90, 200/? after supine. Began shaking, tearful. Pale initially then flushed. Taken to ED for further evaluation.

VAERS ID:361227 (history)  Vaccinated:2009-08-17
Age:26.0  Onset:2009-09-30, Days after vaccination: 44
Gender:Female  Submitted:2009-10-16, Days after onset: 16
Location:Texas  Entered:2009-10-16
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: YAZ
Current Illness: no
Preexisting Conditions: none 10/22/09 Hosp. records received for dates 10/1/09 to 10/18/09 PMH: anemia, previous smoker, family history of GBS.
Diagnostic Lab Data: 10/22/09 Hosp. records received for dates 10/1/09 to 10/18/09 Diagnostics/Labs: EKG sinus tachycardia, DVT(-), abdominal US(-), CXR abnormal-LLL infiltrates, CT chest(-), LP abnormal-CSF protein(H), CSF glucose(H), CSF WBC(H), CSF ALB 9(L), HGB 10.4(L), HCT 30(L), blood cult(-) initially, on 10/17 repeat blood culture(+) staph aureus. LDH 515(H), fibrinogen 917.8(H), urine culture (+)group B strep, sed rate 16(H), ALT 82(H), AST 80(H), CRP 27.8(H), CSF culture(-), CKMB 6.2(H), 10/16:WBC 13(H), RBC 3.3(L), platelets 670(H), 10/18: D-dimer 7(H).
CDC Split Type:
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0312Y3UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Albumin CSF decreased, Arachnoid cyst, Areflexia, Aspartate aminotransferase increased, Asthenia, Back pain, Blood creatine phosphokinase MB, Blood culture positive, Blood fibrinogen increased, Blood lactate dehydrogenase increased, Blood product transfusion, C-reactive protein increased, CSF culture negative, CSF glucose increased, CSF protein increased, CSF white blood cell count increased, Computerised tomogram normal, Culture urine positive, Echocardiogram normal, Electrocardiogram abnormal, Electromyogram abnormal, Endotracheal intubation, Fibrin D dimer increased, Guillain-Barre syndrome, Haematocrit decreased, Haemodialysis, Haemoglobin decreased, Haemothorax, Headache, Hypoaesthesia, Hypoaesthesia oral, Influenza like illness, Intensive care, Lumbar puncture abnormal, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Plasmapheresis, Platelet count increased, Pleural effusion, Pneumonia, Red blood cell count decreased, Red blood cell sedimentation rate increased, Reflex test abnormal, Respiratory failure, Sepsis, Staphylococcal infection, Tracheostomy, Ultrasound Doppler normal, Ultrasound abdomen normal, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Agranulocytosis (broad), Angioedema (broad), Haematopoietic erythropenia (narrow), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Demyelination (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: ascending paralysis, resp failure requiring intubation, IVIG x5 days followed by plasmapheresis x5 days. patient remains intubed and in ICU 10/22/09 Hosp. records received for dates 10/1/09 to 10/18/09. Current DX: GBS. Pt. presented to ER on 10/1/09 with c/o numbness in all extremities, pain, weakness in legs, back pain, numbness in mouth. Pt. was in ER 1 day prior and sent home, sx. Increased pt. returned to ER. Pt c/o flu like sx 10 days prior. pt received gardasil vax 8/17/09. Assessment: WNL except, absent knee reflexes, hypoflex of lower extremities. (+)intramuscular fluid around spine at the occipital cervical junction. DX at time of assessment: GBS vs. idiopathic polyneuropathy vs. MS. Pt. admitted to medical unit, sx. deteriorated transferred to ICU. Further assessments: absent deep tendon reflexes of upper and lower extremities, c/o pain throughout entire spine. MRI of spine (+)arachnoid cyst. 10/5/09 pt. intubated, tx IVIG with no response. Plasmapheresis. DX: GBS, respiratory failure, hemothorax. 10/15 tracheotomy placed.

VAERS ID:361417 (history)  Vaccinated:2009-10-15
Age:26.0  Onset:2009-10-18, Days after vaccination: 3
Gender:Female  Submitted:2009-10-18, Days after onset: 0
Location:Colorado  Entered:2009-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0823V0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Chest pain, Dyspnoea, Injection site pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Patient came into work today complaining of severe pain from injection site running into her chest. She complained of difficulty breathing and went to the ER.

VAERS ID:361409 (history)  Vaccinated:2009-10-14
Age:26.0  Onset:2009-10-14, Days after vaccination: 0
Gender:Male  Submitted:2009-10-19, Days after onset: 5
Location:Florida  Entered:2009-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3212AA0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Eye discharge, Eye swelling, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Puss in the yesm itchy throat, swollen eyes, cough, Shortness of Breath.

VAERS ID:361580 (history)  Vaccinated:2009-10-16
Age:26.0  Onset:2009-10-16, Days after vaccination: 0
Gender:Female  Submitted:2009-10-19, Days after onset: 3
Location:Tennessee  Entered:2009-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluconozole
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
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HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Asthenia, Decreased appetite, Diarrhoea, Headache, Hypokinesia, Muscle spasms, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow)
Write-up: Headache, severe nausea, loose stools, hand cramps, unable to move fingers, loss of appetite, weakness

VAERS ID:361685 (history)  Vaccinated:2009-09-16
Age:26.0  Onset:2009-09-16, Days after vaccination: 0
Gender:Female  Submitted:2009-10-20, Days after onset: 34
Location:North Carolina  Entered:2009-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B036BA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Injection site swelling, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Client received vaccine in right deltoid. Experienced swelling at injection site with tenderness. Client states enlarged axillary lymph nodes right side. Client instructed to take pain reliever and apply warm compresses to area.

VAERS ID:361821 (history)  Vaccinated:2009-10-13
Age:26.0  Onset:0000-00-00
Gender:Male  Submitted:2009-10-13
Location:Louisiana  Entered:2009-10-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0715Y2UNRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB252AA2UNLA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)SANOFI PASTEURU2865DA2UNLA
Administered by: Public     Purchased by: Other
Symptoms: No adverse event
SMQs:
Write-up: none

VAERS ID:361900 (history)  Vaccinated:2009-10-12
Age:26.0  Onset:2009-10-12, Days after vaccination: 0
Gender:Female  Submitted:2009-10-20, Days after onset: 8
Location:Florida  Entered:2009-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unable to supply the above information.
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Contact her Doctor for this information.
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Nausea, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Tingling/pins and needles sensation in feet that over the next 5-7 hours moved up legs to buttock when patient lied done. This sensation went away while sleeping, but sometime during the night a severe headache, nausea and vomiting started. These symptoms lasted approximately 6 days.

VAERS ID:362073 (history)  Vaccinated:2009-10-15
Age:26.0  Onset:2009-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-10-21, Days after onset: 6
Location:Michigan  Entered:2009-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500751P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Corneal abrasion, Eye irritation, Eye pain, Eye pruritus, Eye swelling, Headache, Ocular hyperaemia, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow), Glaucoma (broad), Corneal disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Eyes were very irritated and they hurt. Took out contacts and eyes continued to hurt. Next am, eyes slightly swollen and very red. She did not wear her contacts. She wore her glasses. While she was driving to work her eyes swelled shut. Had a severe HA and called her sister to get her and take her to urgent care. Was seen at Urgent care and was given Motrin 800 mg, and Nasocort nose spray. She had to have a patch because the itching was so intense that she scratched her cornea. By Oct 18th her symptoms subsided. She did say she had a fever of 101 in the urgent care. She did not have a fever before receiving the vaccine. The doctor she saw said she may have had the H1N1 virus in her system and the vaccine made it worse.

VAERS ID:362108 (history)  Vaccinated:2009-10-17
Age:26.0  Onset:2009-10-18, Days after vaccination: 1
Gender:Female  Submitted:2009-10-22, Days after onset: 4
Location:Arizona  Entered:2009-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Stomatitis of the mouth x 2 weeks prior to vaccination, no recent fever,
Preexisting Conditions: No diagnosed allergies or health conditions
Diagnostic Lab Data: Results known 10/22/09
CDC Split Type:
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500765P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Cough, Dyspnoea, Fatigue, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Began on 10/18 as normal side effects (cough, runny nose). Slowly progressed into more severe symptoms during the next few days. As of 10/21/09, symptoms include difficulty breathing accompanied by a cough as well as fatigue.

VAERS ID:362225 (history)  Vaccinated:2009-10-13
Age:26.0  Onset:2009-10-13, Days after vaccination: 0
Gender:Female  Submitted:2009-10-16, Days after onset: 3
Location:Wyoming  Entered:2009-10-22, 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: ZYRTEC; Atenolol; Amitriptyline
Current Illness:
Preexisting Conditions: Seasonal - mold, pollen -$g asthma like Rx
Diagnostic Lab Data: None
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP001AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthma, Chest discomfort, Pruritus
SMQs:, Anaphylactic reaction (narrow), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient received her H1N1 injection at approximately 3:15 on 10/13/09 and returned to work. At about 3:45 she began to experiencing itching, "felt like it was crawling under my skin" which began with her toes and moved upward to her face, where it was the most intense. She did not experience any rash or hives. At 4:15 she took 2 BENADRYL. At 5:00 she began to feel tightness in her chest, "asthma-like symptoms, which I have with my allergies". She finished her shift and went to the ER at 7:15, where she received a nebulizer treatment, breathing improved, itching improved. Also received a shot but is unsure what is. She was sent home, and was to continue with BENADRYL every 4 hours, and return in AM if not better. Itching improves, but then woke up about 2AM with intense itching. Returned to the ER and treated her with oral prednisone which she is continuing. States yesterday itching came and went, today itching gone and hasn''t needed to take BENADRYL. Was only to return to Dr. if needed.

VAERS ID:362232 (history)  Vaccinated:2009-08-27
Age:26.0  Onset:2009-09-15, Days after vaccination: 19
Gender:Male  Submitted:2009-10-20, Days after onset: 35
Location:Texas  Entered:2009-10-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: Metal allergy
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED070491116A UNRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHAVB302BA UNRA
Administered by: Military     Purchased by: Military
Symptoms: Dermatitis, Herpes zoster
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient developed unknown type of dermatitis in foot 2 wks after vaccine. Pt also developed shingles 2 weeks after dose.

VAERS ID:362263 (history)  Vaccinated:2009-10-16
Age:26.0  Onset:2009-10-16, Days after vaccination: 0
Gender:Female  Submitted:2009-10-22, Days after onset: 6
Location:Ohio  Entered:2009-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Pregnant
Diagnostic Lab Data:
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP001AA IM 
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Drug exposure during pregnancy, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives - Right upper trunk, vomiting, diarrhea

VAERS ID:362267 (history)  Vaccinated:2009-10-21
Age:26.0  Onset:2009-10-22, Days after vaccination: 1
Gender:Female  Submitted:2009-10-22, Days after onset: 0
Location:Georgia  Entered:2009-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Rheumatoid Arthritis
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3171AA IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Patient called and said she woke up this morning with numbness and loss of feeling in the hand and arm she was vaccinated in. Patient will contact personal physician.

VAERS ID:362347 (history)  Vaccinated:2009-10-20
Age:26.0  Onset:2009-10-20, Days after vaccination: 0
Gender:Female  Submitted:2009-10-22, Days after onset: 2
Location:Kansas  Entered:2009-10-22
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: None
Diagnostic Lab Data:
CDC Split Type:
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bedridden, Headache, Oropharyngeal pain, Pyrexia, Tonsillar hypertrophy
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swollen tonsils, sore throat, fever of 101 and higher throughout the night and next two days. Also, severe headache that prevent me from leaving the bed. I took Aleve and Tylenol alternating. Fever finally broke on 10/22/2009 around noon. However sore throat and swollen tonsils persist.

VAERS ID:362355 (history)  Vaccinated:2009-10-10
Age:26.0  Onset:2009-10-20, Days after vaccination: 10
Gender:Female  Submitted:2009-10-22, Days after onset: 2
Location:Kansas  Entered:2009-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None known (for allergies) per patient
Diagnostic Lab Data: None available to nurse.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500763P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Activated partial thromboplastin time, Blood product transfusion, Eye haemorrhage, Feeling abnormal, Full blood count, Haematoma, Idiopathic thrombocytopenic purpura, Immunoglobulin therapy, Influenza like illness, Intensive care, Malaise, Menorrhagia, Pain, Petechiae, Platelet count decreased, Prothrombin time normal, Pyrexia, Visual acuity reduced
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 10/20/09, patient reported that she had noted petechiae on her abdomen & upper chest while showering (before coming to work). She contacted facility & was advised to seek medical care from her physician. Saw patient on 10/21 & again told to pursue care through her physician. She works as RN on pediatric unit, received H1N1 vaccine as part of campaign for health care workers. Pt was admitted to ICU at health center on 10/22/09 with a platelet count of ZERO. She had two hemorrhages in her right eye per her local optometrist when she was having persistent visual chanes. She sought care from her optometrist on 10/22/09. She was referred by the opometrist toa local ophthalmologist, but before seeing the ophthalmologist, she sought care from her family physician who ordered a CBC and oagulation studies, and admitted her immediately to the ICU. Hematologist was immediately consulted. MD was told Pt and her family that she most likely had adult idiopathic thrombocytopenia purpura. MD explained this is that most likely caused by a virus and that it may never be known if it was the nasal spray H1N1 that caused it or it it was caaused by something else. She had a low grade fever and body aches and ''felt rough'' on 10/23/2009, but other than those symptoms, had felt ill. She was started on large doses of steroids and received IV gamma globulin on 10/22/09. Her platelet count on 10/23/09 is 8,00 according to her mother ( who also happens to be a nurse). She is to receive more gamma globulin today and mostly likely will be released from the hospital when her platelet count reaches 20,000-25,000. Pt wanted her mother to "Call reporter and let her know what''s going on. If it can help the CDC to know this, I don''t want anyone else going through the trauma of what we''ve been through. Reporter has my permission to review my chart, send infomatioin to the CDC or whatever would be helpful. I could hear Pt speaking in the background and Pt''s mother called me from her room in the ICU. I told them that I''d alreay filed the VAERS report, ut would send an update to VAERS today. I have not reviewed her meical records of laboratory reports at this time and explained that I would seek a written release in order to do so. The local health department has verbally been informed of this case also.

VAERS ID:362384 (history)  Vaccinated:2009-09-15
Age:26.0  Onset:2009-09-16, Days after vaccination: 1
Gender:Female  Submitted:2009-10-22, Days after onset: 36
Location:Montana  Entered:2009-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED02149211A0UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.09083X0UNRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Extensive swelling of vaccinated limb, Injection site erythema, Injection site swelling, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: R upper and lower arm very swollen and red. Painful. Was treated per PCP with antibiotics and BENADRYL. PNEUMOVAX given in R arm.

VAERS ID:362401 (history)  Vaccinated:2009-10-22
Age:26.0  Onset:2009-10-22, Days after vaccination: 0
Gender:Female  Submitted:2009-10-23, Days after onset: 1
Location:Kentucky  Entered:2009-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP0048AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood pressure increased, Diarrhoea, Dyspnoea, Feeling abnormal, Feeling hot, Heart rate increased, Impaired work ability, Local swelling, Muscle tightness, Rash, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Pseudomembranous colitis (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Around 5:00 AM noticed a rash on neck and abdomen, felt hot. Left work at 6:30 AM, went home took Benadryl. Went to bed at 8:00 AM. Woke up at 9:30, jumping out of skin. Noted golf ball sized welps all over. Had swollen neck, tight, couldn''t breathe; diarrhea. Went to ER at 9:45 AM. BP elevatetd, pulse rate elevated. At the ER, staff administered Epinephrine, Benadryl, Phenergan, zantac, prednisone and a dose of an antibiotic (possibly Keflex). Monitored her for about 2 hours and released home to be off work for 24 hours.

VAERS ID:362573 (history)  Vaccinated:2009-09-23
Age:26.0  Onset:2009-09-24, Days after vaccination: 1
Gender:Female  Submitted:2009-10-23, Days after onset: 29
Location:Texas  Entered:2009-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEUR 0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Myalgia, Pyrexia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever, muscle aches, runny nose, cough

VAERS ID:362609 (history)  Vaccinated:2009-10-19
Age:26.0  Onset:2009-10-19, Days after vaccination: 0
Gender:Female  Submitted:2009-10-23, Days after onset: 4
Location:California  Entered:2009-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500751P0IN 
Administered by: Unknown     Purchased by: Public
Symptoms: Headache, Lymphadenopathy, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: headache, rash on face/itching, Rt side lympnode below ear swelling. Pt. does not has history of egg allergy

VAERS ID:362737 (history)  Vaccinated:2009-10-22
Age:26.0  Onset:2009-10-22, Days after vaccination: 0
Gender:Female  Submitted:2009-10-23, Days after onset: 1
Location:California  Entered:2009-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98447P1 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Back pain, Dizziness, Injection site pain, Neck pain
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Patient stated that she felt dizzy and her right arm (vaccinated arm) hurt. She took TYLENOL but it still hurt. The pain in her arm started to spread toward her back and neck in the evening. She was advise to seek medical help. Called patient back in the morning and she was told by ER to take MOTRIN and to go back if pain is still there in 2 days.

VAERS ID:362748 (history)  Vaccinated:2009-10-20
Age:26.0  Onset:2009-10-20, Days after vaccination: 0
Gender:Female  Submitted:2009-10-20, Days after onset: 0
Location:Virginia  Entered:2009-10-23, 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: LITHIUM; ranitidine
Current Illness: light headed; nauseous; rapid heart rate
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98432P10IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Heart rate increased, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Patient became nauseous, lightheaded within 5 minutes, heart rate rose and patient mentioned difficulty breathing and pharmacist called 911.

VAERS ID:362627 (history)  Vaccinated:2009-10-23
Age:26.0  Onset:2009-10-23, Days after vaccination: 0
Gender:Female  Submitted:2009-10-24, Days after onset: 1
Location:Oregon  Entered:2009-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: oral contraceptive; lovastatin; multivitamin; topical
Current Illness: NO
Preexisting Conditions: Seasonal Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Public     Purchased by: Private
Symptoms: Headache, Visual impairment
SMQs:, Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)
Write-up: Visual disturbance for less than 1 minute. Headache that lasted several hours (can not directly correlate headache to vaccine - could have been limited caffeine intake that morning)

VAERS ID:362647 (history)  Vaccinated:2009-10-23
Age:26.0  Onset:2009-10-24, Days after vaccination: 1
Gender:Female  Submitted:2009-10-24, Days after onset: 0
Location:Ohio  Entered:2009-10-24
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
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0  
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Headache, Myalgia, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Headache, congestion, sore throat initially. Within 12 hours, experiencing muscle pain all over body and weakness.

VAERS ID:362780 (history)  Vaccinated:2009-10-21
Age:26.0  Onset:2009-10-21, Days after vaccination: 0
Gender:Female  Submitted:2009-10-26, Days after onset: 5
Location:Missouri  Entered:2009-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Client has multiple allergies has had allergy testing and has received allergy shots. Has had ill effects from this allergy testing and was aware of what to what for. Client has no allergies to eggs.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1007390IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Client reported Abdominal itching to her on-call OB provider. Was instructed to take Benadryl, which she did. She awakened at 3:00 AM to more itching and noticed 12 welps on abdomen. By 12:00 Noon on 10/22/2009 she had itching and welps on her legs and lower back. Client had received and seasonal flu vaccine in early Sept. this year and one other time a few years ago. 10/27/09 OB/GYN records received sevice dates 6/25/09 to 10/23/09. Assessment: Hives. Patient reports hives, itching, took benadryl.

VAERS ID:362789 (history)  Vaccinated:2009-10-20
Age:26.0  Onset:2009-10-23, Days after vaccination: 3
Gender:Female  Submitted:2009-10-26, Days after onset: 3
Location:Unknown  Entered:2009-10-26
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
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Erythema, Pain in extremity, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, cough, left arm pain, erythemia, swelling, s/p seasonal influenza vaccination. 3 days ago given GENADRYL 50mg IM x 1dose and EPINEHINRINE 0.3MG SC x 1dose w/ improvement in Sx. D/C w/ Rx for oral ABX and F/U in 2 days.

VAERS ID:363006 (history)  Vaccinated:2009-10-16
Age:26.0  Onset:2009-10-18, Days after vaccination: 2
Gender:Male  Submitted:2009-10-27, Days after onset: 9
Location:Pennsylvania  Entered:2009-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: PMH: Gilbert Syndrome. Sciatica.
Diagnostic Lab Data: EMG, CT Scan, MRI, blood work. LABS and DIAGNOSTICS: Urinalysis - Abnormal, ketones 1+, blood 1+, protein trace, bacteria rare, mucus moderate. CBC - Neutrophils 81.7% (H) Lymphocytes 11.8% (L) Basophils 2.5% (H) Neutrophils# 7.6 (H) Lymphocytes# 1.1 (L). Chem - Potassium 3.5 MMOL/L (L), Glucose 118 mg/dL (H) Bilirubin Total 3.0 mg/dL (H). Methemoglobin 1.2 g/dL (H). CT Head - WNL.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA0IJRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3216AA3IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anxiety, Bacteria urine identified, Basophil percentage increased, Blood bilirubin increased, Blood glucose increased, Blood methaemoglobin present, Blood potassium decreased, Blood test, Blood urine present, Computerised tomogram, Computerised tomogram normal, Decreased appetite, Diarrhoea, Dizziness, Dyspnoea, Dysstasia, Electromyogram, Facial paresis, Fatigue, Gait disturbance, Headache, Hypoaesthesia, Hypokalaemia, Hypokinesia, Lymphocyte count decreased, Lymphocyte percentage decreased, Migraine, Myalgia, Nausea, Nerve conduction studies normal, Neuropathy peripheral, Neutrophil count increased, Neutrophil percentage increased, Nuclear magnetic resonance imaging, Panic reaction, Paraesthesia, Photophobia, Protein urine present, Urine analysis abnormal, Urine ketone body present, Vertigo, Vomiting, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (narrow), Haematopoietic leukopenia (narrow), Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Proteinuria (narrow), Tubulointerstitial diseases (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Neuropathy, vomiting, migraine, loss of movement of legs for short period of time. 10/28/09 ED records received multiple service dates 10/19/09, 10/21/09, 10/24/09. Assessment: Neuropathy, hypokalemia, anxiety. Patient presents with tingling of both hands, feet, for 3 days. Returns to ED several days later with facial weakness, paresthesia, difficulty standing / walking. Dizziness, panic, trouble breathing, light-headedness, anxiety. Presents several days later with acute headache, sensitive to light, dizziness, nausea, vomiting. Nausea, (R) side numbness, ''spinning''.

VAERS ID:363059 (history)  Vaccinated:2009-10-20
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-10-22
Location:California  Entered:2009-10-27, 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: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500776P IN 
Administered by: Public     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: None

VAERS ID:363242 (history)  Vaccinated:2009-10-19
Age:26.0  Onset:2009-10-19, Days after vaccination: 0
Gender:Female  Submitted:2009-10-27, Days after onset: 8
Location:California  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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJRA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: i had a headache that lasted about 6 days. i also had muscle aches which lasted 2 days.

VAERS ID:363284 (history)  Vaccinated:2009-10-27
Age:26.0  Onset:2009-10-27, Days after vaccination: 0
Gender:Male  Submitted:2009-10-27, Days after onset: 0
Location:Arizona  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: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Dizziness, Flushing, Hypoaesthesia, Injection site pain
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Began with facial flushing followed pain down injection site arm followed by numbness to the hand. Feels like there is no strength in hand. Momentary dizziness.

VAERS ID:363387 (history)  Vaccinated:2009-10-20
Age:26.0  Onset:2009-10-22, Days after vaccination: 2
Gender:Female  Submitted:2009-10-22, Days after onset: 0
Location:Maryland  Entered:2009-10-28, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma; Allergic Rhinitis; ADD; Cavernous; Hemangioma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3214AA1 RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.06127Y0 LA
Administered by: Other     Purchased by: Other
Symptoms: Injection site induration, Injection site swelling, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Hives and swelling left deltoid over injection site induration 4"x3" started on BENADRYL po and ice.

VAERS ID:363403 (history)  Vaccinated:2009-10-15
Age:26.0  Onset:2009-10-28, Days after vaccination: 13
Gender:Female  Submitted:2009-10-28, Days after onset: 0
Location:Indiana  Entered:2009-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Referral to OB for further evaluation
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500763P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: No adverse reaction, patient received H1N1 flu mist and later found out she was pregnant 12/30/09 Prenatal recs received from 11/23/09 to 12/21/09. EDC 6/27/10. Normal IUP. Received H1N1 vax prior to knowledge of pregnancy.

VAERS ID:363490 (history)  Vaccinated:2009-10-23
Age:26.0  Onset:2009-10-23, Days after vaccination: 0
Gender:Female  Submitted:2009-10-28, Days after onset: 5
Location:New York  Entered:2009-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Patient reported that her right arm, the one which was vaccinated, become numb and weak soon after the innoculation. It persisted for more than 30 minutes so she came to my medical office for evaluation. the numbness and weakness persisted for at least 1 1/2 hours. Symptoms had resolved by the time she was evaluated 3 days later.

VAERS ID:363724 (history)  Vaccinated:2009-10-20
Age:26.0  Onset:2009-10-20, Days after vaccination: 0
Gender:Female  Submitted:2009-10-29, Days after onset: 9
Location:Illinois  Entered:2009-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Did influenza nasal swab for virus; ENT doctor did mirror diagnostic in pt throat to see if damaged negative
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU6547AA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Ear, nose and throat examination normal, Influenza serology negative, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)
Write-up: Pt was fine until 3 hrs after injection of Fluzone vaccine. She began coughing, earshot, heart racing. Gave BENADRAYL 25mg and Epifen sent pt to Dr. Dr checked pt for influenza virus (was negative). Pt not allergic to eggs so Dr assumes pt allergic to preservative gave Cortisone IM shot 10/20/09.

VAERS ID:363791 (history)  Vaccinated:2009-10-28
Age:26.0  Onset:2009-10-28, Days after vaccination: 0
Gender:Female  Submitted:2009-10-29, Days after onset: 1
Location:Michigan  Entered:2009-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasacort
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500797P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Chills, Cough, Hypoventilation, Oropharyngeal pain, Productive cough, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Within 30 minutes of recieving the H1N1 nasal vaccine I began feeling tightness in my throat. It became difficult to talk in a deep breath and my throat started to feel sore. Conditions worsened through the night and by morning I had developed a dry cough. At 9:30 am I started having chills and by 12:00 I started running a temperature and my cough became productive. At 12:00 noon my temperature was 102 degrees and Motrin was administered. It is 9pm on October 29th, 2009 and symptoms have not lessened.

VAERS ID:363921 (history)  Vaccinated:2009-10-05
Age:26.0  Onset:2009-10-28, Days after vaccination: 23
Gender:Male  Submitted:2009-10-30, Days after onset: 2
Location:New York  Entered:2009-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE. PMH: smoker, family h/o hepatitis and aids, cheek bone surgery, Head CT WBNL, CXR WNL Allergies: None
Diagnostic Lab Data: Labs & Diags: CFS: WBC 26 (H), RBC 2.0 (H), Lymph 72 (WNL), neutr 28 (H), protein 69 (H), Gram stain neg. CBC: RBC 4.09 (L), HGB, 12.1 (L), HCT 36.2 (L). Bld CX neg. Neg Flu A/B.
CDC Split Type:
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500619P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Blood culture negative, CSF test abnormal, Full blood count abnormal, Headache, Immunisation reaction, Influenza serology negative, Meningitis viral, Migraine, Myalgia, Nausea, Pain, Phonophobia, Photophobia, Pyrexia, Viral infection
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: PATIENT SEEN IN THE ER WITH POSSIBLE VIRAL MENINGITIS, ER REPORT STATES POSSIBLE CAUSE AS RECEIVING THE FLU-MIST VACCINE. 11/09/09 Medical records received for DOS 10/23. Final DX: Viral meningitis. Three s/p vaccine: C/O fever, HA, nausea, body aches, vomiting, flu-like sx. Muscle aches. Photo and phonophobia. CSF WBC increased. Viral syndrome w/meningitis. Migraine.

VAERS ID:364193 (history)  Vaccinated:2009-10-31
Age:26.0  Onset:2009-10-31, Days after vaccination: 0
Gender:Female  Submitted:2009-11-01, Days after onset: 1
Location:Florida  Entered:2009-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Doxycycline
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3226AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chest discomfort, Chills, Cough, Dyspnoea, Eye pruritus, Headache, Nausea, Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Constricted breathing, hard cough, heavy chest, itchy eyes, headache, fainting, nausea, chills, body aches. Required Benadryl to ease breathing.

VAERS ID:364277 (history)  Vaccinated:2009-10-29
Age:26.0  Onset:2009-10-30, Days after vaccination: 1
Gender:Female  Submitted:2009-11-02, Days after onset: 3
Location:Arizona  Entered:2009-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Bruising at injection site.

VAERS ID:364378 (history)  Vaccinated:2009-10-08
Age:26.0  Onset:2009-10-08, Days after vaccination: 0
Gender:Female  Submitted:2009-10-26, Days after onset: 18
Location:New York  Entered:2009-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3214AA0UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Cough, Flushing, Nausea, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Pt came to flu ped at 340 pm stating persistent cough, flushed, nausea. Pt vomitted shortly after receiving oral Benadryl. Pt was referred to nearest ED - coworker dropped her there.

VAERS ID:364381 (history)  Vaccinated:2009-10-27
Age:26.0  Onset:2009-10-27, Days after vaccination: 0
Gender:Female  Submitted:2009-10-27, Days after onset: 0
Location:Massachusetts  Entered:2009-11-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Allergies: TEGREATOL neurological disorder (? epilepsy)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS100738020IMUN
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Loss of consciousness, Muscle twitching, Pallor, Sensation of heaviness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Appro 25 min after rec''ing H1N1 vacc pt stated felt very hot, sat down looked pale. Pt passed out, eyes twitching, legs/arms felt felt heavy. Regained color, sat up, vitals ok. Felt syncopalagairc and passed out. Ambulance called. Spoke to pt - advised by ER = possible reaction to vacc.

VAERS ID:364387 (history)  Vaccinated:2009-10-19
Age:26.0  Onset:2009-10-20, Days after vaccination: 1
Gender:Female  Submitted:2009-10-26, Days after onset: 6
Location:Ohio  Entered:2009-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none. Pregnant. 11/4/09: Emergency Department Records received for date of service 10/19/09. PMH: Asthma.
Diagnostic Lab Data: none. 11/4/09: Emergency Department Records received for date of service 10/19/09. Labs and Diagnostics. None.
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA0UNRA
Administered by: Private     Purchased by: Public
Symptoms: Drug exposure during pregnancy, Injection site anaesthesia, Local reaction, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Fingers tingly and injection site was numb. To ER - local reaction on 10/20/09. 11/4/09: Emergency Department Records received for date of service 10/19/09. Dx: Left hand numbness Assessment: This 12 week pregnant female pesented the day after receiving the H1N1 vaccine in the left deltoid, with left arm and hand pain and numbness. No redness, swelling, SOB, rash or pain around the injection site. Pt. discharged to home.

VAERS ID:364408 (history)  Vaccinated:2009-08-31
Age:26.0  Onset:2009-08-31, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:2009-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Latex sensitivity; inappropriate sinus tachycardia; pregnancy 19 wk 12/02/09 PMH: Pregnancy.
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURB370UBA0UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest discomfort, Conjunctivitis, Cough, Drug exposure during pregnancy, Headache, Oculorespiratory syndrome, Oropharyngeal pain
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow)
Write-up: Chest tightness, sore throat, headaches, conjunctivitis, cough, oculo - respiratory 12/02/09 Medical record received for DOS 09/02/09. Telephone call from patient, reporting reaction to flu shot. Oculo-respiratory symptoms. Took Tylenol, feels better. DX: Allergic reaction to flu shot

VAERS ID:364413 (history)  Vaccinated:2009-10-28
Age:26.0  Onset:2009-10-28, Days after vaccination: 0
Gender:Female  Submitted:2009-11-02, Days after onset: 5
Location:Nevada  Entered:2009-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500765P1IN 
Administered by: Private     Purchased by: Other
Symptoms: Chills, Oropharyngeal pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt. has fever 100.5, chills, sore throat, vomiting. 10/31/09 started.

VAERS ID:364699 (history)  Vaccinated:2009-10-19
Age:26.0  Onset:2009-10-19, Days after vaccination: 0
Gender:Female  Submitted:2009-10-21, Days after onset: 2
Location:Arkansas  Entered:2009-11-03, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Headache after vaccine
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: AR0935
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED09149111A1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Feeling hot, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pain, swelling, itchy, hot to touch, ice pack, Ibuprofen.

VAERS ID:364937 (history)  Vaccinated:2009-10-30
Age:26.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Female  Submitted:2009-11-02, Days after onset: 3
Location:Massachusetts  Entered:2009-11-04, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC was 32 Hct; BS 117 at hospital
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS10081320UNLA
Administered by: Private     Purchased by: Private
Symptoms: Blood glucose increased, Drug exposure during pregnancy, Haematocrit decreased, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: After injection pt fainted - ?anxiety or hypoglycemia. No rash or shortness of breath. Pt was 30 wks preg. O2 given BP 60/40 Pulse 42. Pt recovered. Taken to hospital for fetal monitoring. 11/10/09 Medical records received for date 10/30/09. DX: syncope after H1N1 vax. Pt. sent to hosp. for fetal monitoring 30wks gestation. Assessment: FHR(+) WNL. Pt. denies and c/o. DC home.

VAERS ID:365009 (history)  Vaccinated:2009-10-19
Age:26.0  Onset:2009-10-19, Days after vaccination: 0
Gender:Female  Submitted:2009-10-30, Days after onset: 11
Location:California  Entered:2009-11-04, 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: Asthma; allergic Rhinitis; hx I RA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA261AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1337Y0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Blood test, Erythema, Hypoaesthesia, Injection site pain, Pain, Pyrexia, X-ray
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Per patient following injections R deltoid injection site pain, increasing in severity , fever, R upper extremity numbness, severe abdominal pain. Urgent care visit, ER visit, blood work, imaging studies & IV catheter with IV narcotic pain redness & IV antihistamine follows.

VAERS ID:365179 (history)  Vaccinated:2009-11-04
Age:26.0  Onset:2009-11-04, Days after vaccination: 0
Gender:Female  Submitted:2009-11-04, Days after onset: 0
Location:Missouri  Entered:2009-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NuvaRing
Current Illness: No
Preexisting Conditions: Allergic to Sulfa
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500803P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bradycardia, Dizziness, Erythema, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately 10 minutes after receiving the intranasal vaccine developed light headness (felt like she would pass out), bradycardia, generalized itching, "hot pink-bright red face.

VAERS ID:365337 (history)  Vaccinated:2009-09-21
Age:26.0  Onset:2009-09-21, Days after vaccination: 0
Gender:Female  Submitted:2009-11-05, Days after onset: 45
Location:Illinois  Entered:2009-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: No
Preexisting Conditions: Allergic to Sulfa medication, cat dander, mold, pollen
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3214AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Cough, Eye pruritus, Lacrimation increased, Pyrexia, Sneezing, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Itchy watery eyes, sneezing, coughing and wheezing and later on, fever. Took 2 benadryl and inhaler (albuterol)

VAERS ID:365350 (history)  Vaccinated:2009-10-30
Age:26.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Female  Submitted:2009-11-05, Days after onset: 6
Location:California  Entered:2009-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: PCOS
Diagnostic Lab Data: Lab tests showed abnormalities, and neurological testing showed abnormalities. Going for MRI''s tomorrow. More lab testing next week.
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP012990UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Back pain, Headache, Hemiplegia, Hypoaesthesia, Laboratory test abnormal, Muscle spasms, Muscular weakness, Nausea, Neurological examination abnormal, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow)
Write-up: Friday - Nausea, headache Friday night - Muscle cramping all over body Saturday - Right sided paralysis and tingling in feet Sunday - Feet tingling and paralysis Monday - Pain in back and feet tingling, muscle weakness, numbness, and also in my right hand Tuesday - Same Wednesday - Same, but more painful Today - Same, more painful

VAERS ID:365460 (history)  Vaccinated:2009-11-04
Age:26.0  Onset:2009-11-05, Days after vaccination: 1
Gender:Male  Submitted:2009-11-05, Days after onset: 0
Location:New York  Entered:2009-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: asthma. 11/13/09: Primary Care records received for date of service 11/6/09. PMH: Acne, asthma, ADHD, esophageal reflux, hypospadia, male erectile disorder due to physical condition, overweight.
Diagnostic Lab Data: 11/13/09: Primary Care records received for date of service 11/6/09. Labs and diagnostics: None.
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP0210IMRA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal distension, Rash, Rash generalised, Rash macular, Swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash all over the body. it is red dots mainly on the trunk of my body. puffiness in face. 11/13/09: Primary Care records received for date of service 11/6/09. Dx: Morbilliform eruption rash. Assessment: Underwent septoplasty surgery and finished perioperative antibiotics 5 to 6 days before visit. He received H1N1 vaccine two days before visit. The day before visit he woke up with a generalized body rash. He feels swollen all over and somewhat bloated. He denies fever, chills or asthma sx. Pt. to continue antihistamine and begin prednisone.

VAERS ID:365527 (history)  Vaccinated:2009-10-06
Age:26.0  Onset:2009-10-07, Days after vaccination: 1
Gender:Female  Submitted:2009-11-06, Days after onset: 30
Location:Pennsylvania  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA470AA IM 
Administered by: Public     Purchased by: Private
Symptoms: Injection site vesicles
SMQs:
Write-up: Blistering at site appears to be related to band aid.

VAERS ID:365556 (history)  Vaccinated:2009-10-26
Age:26.0  Onset:2009-10-26, Days after vaccination: 0
Gender:Female  Submitted:2009-11-06, Days after onset: 11
Location:Pennsylvania  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP007AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Migraine
SMQs:
Write-up: Migraines that lasted for several hours after the vaccine and still continue periodically. Treatment Motrin 600mg.

VAERS ID:365650 (history)  Vaccinated:2009-10-17
Age:26.0  Onset:2009-10-17, Days after vaccination: 0
Gender:Female  Submitted:2009-11-06, Days after onset: 20
Location:D.C.  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma
Diagnostic Lab Data: No testing
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP001AA UNLA
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA4790A UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1142Y UNLA
Administered by: Private     Purchased by: Public
Symptoms: Injected limb mobility decreased, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Tendinopathies and ligament disorders (broad)
Write-up: Vaccine received at 9 am on 10/17/2009 and at about 5 or 6 pm she had stiffness and soreness in the left shoulder to neck.

VAERS ID:365691 (history)  Vaccinated:2009-10-28
Age:26.0  Onset:2009-10-28, Days after vaccination: 0
Gender:Female  Submitted:2009-11-06, Days after onset: 9
Location:California  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: ALLERGIC TO PENICILLIN AND AMOXICILLIN
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest discomfort, Eye pruritus, Eye swelling, Fatigue, Feeling cold, Ocular hyperaemia, Oropharyngeal pain, Sensation of foreign body, Throat irritation, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: I got hives sporadically on my body. My eyes got swollen and red and were itchy. My throat felt sore and scratchy, and then it felt as if there was a lump in my throat. I felt heaviness in my chest, and I was wheezing. I felt very tired and I was cold. I didn''t receive medical attention because in the morning the symptoms had alleviated. I still had a little of heaviness on the chest, but it got better as the day progressed.

VAERS ID:365854 (history)  Vaccinated:2009-11-05
Age:26.0  Onset:2009-11-06, Days after vaccination: 1
Gender:Male  Submitted:2009-11-07, Days after onset: 1
Location:Illinois  Entered:2009-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Dizziness, Nausea, Excessive Sweating

VAERS ID:365878 (history)  Vaccinated:2009-10-08
Age:26.0  Onset:2009-10-10, Days after vaccination: 2
Gender:Female  Submitted:2009-11-08, Days after onset: 29
Location:Illinois  Entered:2009-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97842P20IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Joint stiffness, Pain
SMQs:, Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: starting day and a half after the shot was given on her left arm, She experiences Stiff arm -$g patient had hard time lifting her left arm over her head. Still painful to lift and it hurts to lay on bed with her left arm side down even till month later 11-8-09

VAERS ID:366085 (history)  Vaccinated:2009-11-04
Age:26.0  Onset:2009-11-06, Days after vaccination: 2
Gender:Unknown  Submitted:2009-11-09, Days after onset: 3
Location:New Hampshire  Entered:2009-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHOTRICYCLEN
Current Illness: None
Preexisting Conditions: Amoxicillin; ASA; Cetzine; Codeine; Morphine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
TDAP: TDAP (ADACEL)SANOFI PASTEURUF499BA IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: T/C from patient - seen 11/6/09 in ER at the hospital, for fever, swelling, reddness and pain (L) upper arm - Given IV antibiotics and fluids. Sent home with PO. KEFLEX - 11/9/09 - having reaction from medication and will see PCP today.

VAERS ID:366335 (history)  Vaccinated:2009-11-09
Age:26.0  Onset:2009-11-09, Days after vaccination: 0
Gender:Male  Submitted:2009-11-10, Days after onset: 1
Location:Louisiana  Entered:2009-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Decreased appetite, Headache, Lethargy, Oropharyngeal pain, Rhinorrhoea, Sinus headache
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: Runny nose beginning at 12:30 PM Nov 9, 2009 progressing to headache, lethargy, loss of appetite, paranasal sinus pressure, runny nose, and sore throat by 9:00 pm Nov 9, 2009. The severity of these symptoms increased over night and persist as of the time this adverse event report was submitted.

VAERS ID:366345 (history)  Vaccinated:2009-11-06
Age:26.0  Onset:2009-11-08, Days after vaccination: 2
Gender:Male  Submitted:2009-11-10, Days after onset: 2
Location:New Mexico  Entered:2009-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild URI
Preexisting Conditions: PMH: None Allergies: NKDA
Diagnostic Lab Data: Labs: CBC: neutrophils high, CMP: glucose and alkaline ph high, Influenza AB screen neg, strep test, UA norm, Blood cultures Dx studies: CXR 12/10/09 Labs: Rapid strep: negative.
CDC Split Type:
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500784P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood alkaline phosphatase increased, Blood culture, Blood glucose increased, Bronchitis, Chest X-ray, Cough, Diarrhoea, Dyspnoea, Full blood count, Hypoxia, Influenza serology negative, Metabolic function test, Nausea, Neutrophil percentage increased, Obesity, Oropharyngeal pain, Pyrexia, Rhinorrhoea, Streptococcus identification test, Urine analysis normal, Vomiting
SMQs:, Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Cough, sore throat, rhinorrhea, with hypoxia. Patient treated with Tamiflu, azithromycin, ceftriaxone, oxygen and admission to hospital. 11/10/2009 ED record for 11/8/2009, patient with c/o''s sore throat, SOB, cough, fever, nausea/vomiting and diarrhea. Tx: IV ABX and Tamiflu. 12/10/09 DC summary and medical records received for 11/08/09. Pt presented with cough x 1 1/2 weeksand c/o gasping for air in the middle of the night. Also has nausea, sore throat, diarrhea. Pt admitted for observation. Antibiotics and Tamiflu were withheld because of negative rapid strep. Discharged stable. DC DX: bronchitis, obesity

VAERS ID:366346 (history)  Vaccinated:2009-09-02
Age:26.0  Onset:2009-09-05, Days after vaccination: 3
Gender:Female  Submitted:2009-11-10, Days after onset: 66
Location:Florida  Entered:2009-11-10
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: ALLERGIES(DUST, MOLD, CATS) 11/13/09 Medical records received for dates 9/2/09 to 11/10/09 PMH: Anemia, HSV1
Diagnostic Lab Data: DOCTORS CAN''T FIND ANYTHING UNUSUAL IN BLOOD TESTING, BUT I WAS REFERRED TO A PULMONOLOGIST AND I''M CURRENTLY DOING SOME MORE TESTING. 11/13/09 Medical records received for dates 9/2/09 to 11/10/09 Diagnostics/Labs: EKG(-), CXR(-), CBC WNL
CDC Split Type:
Vaccination
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0313Y1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood test, Blood test normal, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Fatigue, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: BODY ACHES, MUSCLE WEAKNESS. FIRST THREE WEEKS FATIGUE, DIFFICULTY BREATHING SPECIALLY WHEN TALKING FOR MORE THAN 20 MINUTES. 11/13/09 Medical records received for dates 9/2/09 to 11/10/09. OV 9/2 received gardasil vax dose 1. OV 9/10 wellness exam visit pap WNL. OV 10/9 pt c/o body aches, muscle pain, dizziness, SOB. DX: fatigue, dyspnea, impacted cerumen. OV 10/13 c/o SOB, allergies, fatigue. Referral given cardio/pulm eval. 11/9 pt called MD stated left side muscle weakness where gardasil vax given, difficulty breathing. 11/10 pt called MD stated sx resolved. Declined further gardasil vax.

VAERS ID:366455 (history)  Vaccinated:2009-10-30
Age:26.0  Onset:2009-11-08, Days after vaccination: 9
Gender:Male  Submitted:2009-11-10, Days after onset: 2
Location:New Jersey  Entered:2009-11-10
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
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Dose
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Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURERVV04-003-A0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt describes a gradual onset of a pruitic rash starting on his neck, moving to his chest, abdomen, back , bilat arms and legs.

VAERS ID:366475 (history)  Vaccinated:2009-11-04
Age:26.0  Onset:0000-00-00
Gender:Male  Submitted:2009-11-04
Location:Illinois  Entered:2009-11-10, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB761AA SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: none stated

VAERS ID:366538 (history)  Vaccinated:2009-10-27
Age:26.0  Onset:2009-10-29, Days after vaccination: 2
Gender:Female  Submitted:2009-11-10, Days after onset: 12
Location:Kansas  Entered:2009-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Pregnant -- 1st trimester
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1008135P0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abortion spontaneous, Depression, Drug exposure during pregnancy, Haemorrhage, Muscle spasms, Pelvic pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Dystonia (broad), Depression (excl suicide and self injury) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Received H1N1 vaccine on 10/27/09. Started bleeding on 10/29/09 and miscarried on 11/1/09. 11/17/09 Medical records received from date 11/6/09. DX: SAB, depression. F/u appt from SAB past weekend.(+) bleeding/cramping. OV 11/9 c/o pelvic pain, bleeding. DX: SAB.

VAERS ID:366649 (history)  Vaccinated:2009-10-22
Age:26.0  Onset:2009-10-22, Days after vaccination: 0
Gender:Female  Submitted:2009-11-10, Days after onset: 19
Location:North Carolina  Entered:2009-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP010AA0IMAR
Administered by: Private     Purchased by: Unknown
Symptoms: Joint stiffness, Pain in jaw
SMQs:, Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Jaw stiffness, soreness.

VAERS ID:366722 (history)  Vaccinated:2009-10-22
Age:26.0  Onset:2009-11-01, Days after vaccination: 10
Gender:Male  Submitted:2009-11-06, Days after onset: 5
Location:West Virginia  Entered:2009-11-10, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP001AA IMRA
Administered by: Private     Purchased by: Public
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: H1N1 vaccine 1 1/2 wks ago-started breaking out with rash 2 days ago on arms-now all over body. Back, chest -arms and legs. See by doctor -11/3/09 -ZYRTEC 10mg qd to get allergy testing once rash resolved.

VAERS ID:366585 (history)  Vaccinated:2009-10-22
Age:26.0  Onset:2009-10-22, Days after vaccination: 0
Gender:Female  Submitted:2009-11-11, Days after onset: 20
Location:New York  Entered:2009-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97838P2 IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Flushing, Heart rate increased, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (broad)
Write-up: Returned to vaccine administrator approximately 15 minutes after receiving vaccine complaining of feeling flushed, rapid heartrate and chest congestion

VAERS ID:366653 (history)  Vaccinated:2009-11-10
Age:26.0  Onset:2009-11-10, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Missouri  Entered:2009-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pregnancy 12/08/09 PMH: NKDA, eye surgery, bladder surgery. SAB x2.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1009233P0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy, Musculoskeletal pain, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Soreness in arm and shoulder blade muscle tenderness in her chest. 12/08/09 Prenatal records received for DOS 10/19/09-12/01/09. G4 P1

VAERS ID:366908 (history)  Vaccinated:2009-11-10
Age:26.0  Onset:2009-11-10, Days after vaccination: 0
Gender:Female  Submitted:2009-11-12, Days after onset: 2
Location:Massachusetts  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP018AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Patient c/o sensation down L arm shortly after injection, also c/o lightheadedness. Patient''s mother had an anxiety reaction on 11/6/09.

VAERS ID:366975 (history)  Vaccinated:2009-11-12
Age:26.0  Onset:2009-11-12, Days after vaccination: 0
Gender:Female  Submitted:2009-11-12, Days after onset: 0
Location:Washington  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergies to cats; mold; trees
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500764P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Anxiety, Chest discomfort, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: One hour after administration of LAIV had onset of rash, itching mostly on chest, neck, face and arms. 2 hours after LAIV, developed anxious feeling, tight sensation in chest. No SOB.

VAERS ID:367040 (history)  Vaccinated:2009-11-11
Age:26.0  Onset:2009-11-11, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Nebraska  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: "Had a slight headache"
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500757P0IN 
Administered by: Public     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Spiked a fever one hour after receiving the H1N1 nasal mist. Temp. reached 101.7. It was 98 degrees prior to getting the vaccine. Temp. today is 102.3 degrees.

VAERS ID:367330 (history)  Vaccinated:2009-10-30
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-11-13
Location:California  Entered:2009-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: nausea/vomiting, dysuria and pelvic pain
Preexisting Conditions: PREGNANT (EDC = 11/25/2009) Pmh: pregnant Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA0IMRA
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98447PI0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Fluvirin w/ Thimerosal given to OB pt. LMP = 2/18/09. EDC = 11/25/09. Pt does NOT have an OBGYN. Pt NOT hospitalized after receiving H1N1 vaccine.11/17/2009 OB records for 10/30 and 11/13/2009, patient c/o''s nausea/vomiting, dysuria and pelvic pain on day of vaccine. Doing well next visit.

VAERS ID:367437 (history)  Vaccinated:2009-11-12
Age:26.0  Onset:2009-11-13, Days after vaccination: 1
Gender:Female  Submitted:2009-11-13, Days after onset: 0
Location:California  Entered:2009-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP012AA0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rashes noted left forearm with slight itching self treat with 50mg Benadryl.

VAERS ID:367366 (history)  Vaccinated:2009-11-02
Age:26.0  Onset:2009-11-02, Days after vaccination: 0
Gender:Male  Submitted:2009-11-14, Days after onset: 12
Location:New York  Entered:2009-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Recovering from sinus infection
Preexisting Conditions: Asthma
Diagnostic Lab Data: Neurological exam scheduled for 11/20/09
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Formication, Muscle spasms, Muscular weakness, Neurological examination, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: tingling in the feet, progressed to tingling in the hands, now 13 days later experiencing muscle cramping and slight weakness in the extremities in addition to tingling/crawling sensation.

VAERS ID:367423 (history)  Vaccinated:2009-11-11
Age:26.0  Onset:2009-11-13, Days after vaccination: 2
Gender:Female  Submitted:2009-11-15, Days after onset: 2
Location:Wyoming  Entered:2009-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus infections symptoms present
Preexisting Conditions: Hypothyroidism; 12/1/09 PMH: NKDA; hypothroid
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.9525U2IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysphagia, Dyspnoea, Headache, Muscle twitching, Palpitations, Pharyngeal oedema, Sinus headache, Sinusitis, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Twitching in back of legs, throat swelling, heart palpitations, difficulty swallowing, difficulty breathing, swelling of tongue 12/02/09 Medical record received for DOS 11/11/09. Presented with headache, sinus pressure x 3 weeks; requesting second gardasil injection. DX: Acute bacterial sinusitis

VAERS ID:367463 (history)  Vaccinated:2009-11-15
Age:26.0  Onset:2009-11-15, Days after vaccination: 0
Gender:Female  Submitted:2009-11-16, Days after onset: 1
Location:California  Entered:2009-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: I had no present illnesses at the time of the vaccine.
Preexisting Conditions: Mild Asthma.....no recent flare ups. Asthma due to allergies.
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP015AA0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Several hours after my H1N1 shot was given, I began to feel a tingling sensation trickle up and down my left arm, especially in my left hand. My left deltoid was the route of administration. Four hours have passed since I first started experiencing the tingling sensation and it still is occurring.

VAERS ID:367535 (history)  Vaccinated:2009-11-07
Age:26.0  Onset:2009-11-08, Days after vaccination: 1
Gender:Female  Submitted:2009-11-16, Days after onset: 8
Location:Florida  Entered:2009-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none~ ()~~0.00~Patient
Other Medications: do not take any medications, take fiorocet for migraines prn.
Current Illness: Joint pain in my left hand (the same arm I received vaccine) and nausea, chills, fatigue.
Preexisting Conditions: none
Diagnostic Lab Data: None at this time, informed that I should see a Neurologist and ophthalmologist.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP018AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye pain, Pain in extremity, Pain in jaw, Visual impairment
SMQs:, Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Osteonecrosis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Vision changes in left eye, vision field changes smaller view, pain in jaw, eye, and radiating down left arm.

VAERS ID:367630 (history)  Vaccinated:2009-11-04
Age:26.0  Onset:2009-11-04, Days after vaccination: 0
Gender:Female  Submitted:2009-11-04, Days after onset: 0
Location:Rhode Island  Entered:2009-11-16, Days after submission: 12
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: Allergies: seasonal and fruits PMH: none
Diagnostic Lab Data: Labs/Dx studies none noted
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1008136P0IMRL
Administered by: Private     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy, Injection site pruritus, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately 10 minutes after injection, patient complained of itchiness at injection site and itch face. She was given 25mg Benadryl by mouth. 5 minutes later patient complained of hives and was sent to ER for evaluation. Patient is 23 weeks pregnant. 11/18 and 11/20/2009 ED record for 11/4/2009 and OB-GYN records. Pregnant patient with c/o''s redness, itching and hives. Tx: IV benadryl. Dx allergic reaction

VAERS ID:367851 (history)  Vaccinated:2009-10-30
Age:26.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Female  Submitted:2009-11-16, Days after onset: 17
Location:California  Entered:2009-11-16
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: Pregnant EDC: 03/09/2010
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA IMLA
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98447P1 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Fluvirin with Thimerosal given to OB pt. LMP: 6/3/09. EDC: 03/09/2010. Pt does not have an ob/gyn. Pt notified on 11/06/2009. Denies any adverse effects. Pt not hospitalized after receiving H1N1 vaccine. 11/24/2009 MD records, vaccine given to pregnant patient, no side effects reported at this time.

VAERS ID:367899 (history)  Vaccinated:2009-05-18
Age:26.0  Onset:2009-05-18, Days after vaccination: 0
Gender:Female  Submitted:2009-11-16, Days after onset: 182
Location:New Mexico  Entered:2009-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho Evra Patch, Levoxyl.
Current Illness: None reported
Preexisting Conditions: Hypothyroidsm.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1130X0IMLL
Administered by: Private     Purchased by: Private
Symptoms: Headache, Pain
SMQs:
Write-up: Patient reported onset of headache same day vaccine (Gardasil) #1 was given. Pain lasted for one week, was relieved by taking OTC acetaminophen.

VAERS ID:368150 (history)  Vaccinated:2009-11-12
Age:26.0  Onset:2009-11-12, Days after vaccination: 0
Gender:Female  Submitted:2009-11-12, Days after onset: 0
Location:Massachusetts  Entered:2009-11-17, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP009AA IMLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Body temperature increased, Flushing, Hyperhidrosis, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Onset 35 min post injection-sweating. Vomiting-vitals 148/94 left sitting pulse = 100, temp 99.2-flushed. Joint pain-tingling over body. Saw MD-not a severe reaction-ER PRN.

VAERS ID:368164 (history)  Vaccinated:2009-10-08
Age:26.0  Onset:2009-10-09, Days after vaccination: 1
Gender:Female  Submitted:2009-11-10, Days after onset: 32
Location:Wisconsin  Entered:2009-11-17, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA456BA IMLL
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Injection site reaction, Pain, Palpitations, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)
Write-up: Left arm hurts at side of injection when lifted above should level only. Heart with palpation x2 wks but that has resolved. No bumps or bumps at side. No color changes. "Feels like something sticky there when I lift my arm."

VAERS ID:368264 (history)  Vaccinated:2009-10-29
Age:26.0  Onset:2009-10-30, Days after vaccination: 1
Gender:Female  Submitted:2009-11-17, Days after onset: 18
Location:California  Entered:2009-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site reaction
SMQs:
Write-up: Weakness in deltoid muscle at injection site worsening over past month. No deficit in strength but subjective weakness.

VAERS ID:368533 (history)  Vaccinated:2009-11-11
Age:26.0  Onset:2009-11-11, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2009-11-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0216Y1IMLA
Administered by: Other     Purchased by: Public
Symptoms: Facial pain, Injection site pain, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Tendinopathies and ligament disorders (broad)
Write-up: Aching sensation from injection site = LUA, radiating to face and entire (L) side of body, including lower extremities - Resolved 11/13/09.

VAERS ID:368627 (history)  Vaccinated:2009-11-18
Age:26.0  Onset:2009-11-18, Days after vaccination: 0
Gender:Female  Submitted:2009-11-18, Days after onset: 0
Location:Kansas  Entered:2009-11-18
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: PCN/ Sulfa/ Profen Forte
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP017AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient developed rash on upper chest and felt as if it was hard to breathe. SOLU MEDROL 125mg IVP given by doctor along with 2 tabs of CLARINEX.

VAERS ID:368565 (history)  Vaccinated:2009-11-12
Age:26.0  Onset:2009-11-12, Days after vaccination: 0
Gender:Female  Submitted:2009-11-19, Days after onset: 7
Location:California  Entered:2009-11-19
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Shortness of breath 30-40 minutes after vaccination. Went to Emergency room where I had a anaphylactic reaction. SOB, tongue and throat swelling. Was admitted to hospital overnight.
Preexisting Conditions: Thalessemia minor, depression/anxiety, allergies (cats, and unknown environmental allergies which cause sinus congestion), Eczema. PMH: pneumonia, thalassemia minor, allergy to clams, muscles.
Diagnostic Lab Data: Blood tests and chest x-ray was done. Diag/Labs: CXR(-), CBC abn,
CDC Split Type: CA
Vaccination
Manufacturer
Lot
Dose
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Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER102094P10UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood test, Chest X-ray, Chest X-ray abnormal, Dizziness, Dyspnoea, Full blood count abnormal, Heart rate increased, Paraesthesia, Pharyngeal oedema, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haematopoietic leukopenia (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Shortness of breath, swelling of tongue and throat, tingling of hands and arms, lightheadedness, dizziness, increased heart rate. 11/19/09 and 11/20/09 Medical records received for date 11/13/09. DX: Anaphylactic rx secondary to H1N1 vax vs. sushi. Pt. presented w/ c/o receiving H1N1 vax same day and later c/o SOB, tongue “fullness” after consuming sushi. Pt states allergic to clams and muscles. Assessment: pharyngeal swelling, SOB.

VAERS ID:368617 (history)  Vaccinated:2009-10-27
Age:26.0  Onset:2009-10-31, Days after vaccination: 4
Gender:Female  Submitted:2009-11-18, Days after onset: 18
Location:Virginia  Entered:2009-11-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: PCN; no known health problems
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP009AA0IMUN
Administered by: Private     Purchased by: Public
Symptoms: Oropharyngeal pain, Pruritus, Rash, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reports sore throat, congestion on 10/29/09. Developed rash with itching from chest to toes on 10/31/09. To PCP-treated with prednisone x 6 days. Returned to PCP 11/09/09-rash returned-advised to take ZYRTEC.

VAERS ID:368739 (history)  Vaccinated:2009-11-17
Age:26.0  Onset:2009-11-17, Days after vaccination: 0
Gender:Female  Submitted:2009-11-19, Days after onset: 2
Location:Washington  Entered:2009-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (CSL)CSL LIMITED00149611A0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Delivery, Drug exposure during pregnancy, Feeling abnormal, Flushing, Hyperhidrosis, Hypoaesthesia, Paraesthesia, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Patient c/o "feeling funny" with numbness & tingling bilateral hands and left side of face. She was flushed and slightly diaphoretic and breathing rapidly. She was 8 1/2 months pregnant and had expressed anxiety about receiving the vaccine. At 10:15 AM, she was taken back to the Tx room where she layed down under observation. Her facial features were even and symmetrical. B/P 120/70, pulse 112 and respirations 24. She denied any difficulty swallowing or breathing or any abdominal pain. 10:20 AM B/P 118/74, pulse 96 and respirations 18. She stated the numbness and tingling in hands and face had subsided; resting quietly. 10:40 AM, patient assisted to a sitting position where B/P 112/68, pulse 88 and respirations 18. She stated she felt much better and asked to go home. D/C''d at 10:40 without incident. 12/07/09, 12/08/09. Antenatal records received for DOS 04/14/09. Notation by MD on 11/28/09: pt delivered: mom and baby stable and healthy.

VAERS ID:368742 (history)  Vaccinated:2009-11-05
Age:26.0  Onset:2009-11-09, Days after vaccination: 4
Gender:Female  Submitted:2009-11-19, Days after onset: 10
Location:Colorado  Entered:2009-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pregnancy
Diagnostic Lab Data: HCG (HUMAN CHORIONIC GONADOTROPIN), SERUM, QUANTITATIVE 11/6/2009-6407 11/13/2009-8196 11/16/2009-2745
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP005AA0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abortion spontaneous, Blood human chorionic gonadotropin, Drug exposure during pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Spotting and Bleeding ended in miscarriage.

VAERS ID:368868 (history)  Vaccinated:2009-11-04
Age:26.0  Onset:2009-11-04, Days after vaccination: 0
Gender:Female  Submitted:2009-11-19, Days after onset: 15
Location:Virginia  Entered:2009-11-20, 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: LUNESTA prn
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.UP004AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Hypoaesthesia facial, Oral pruritus, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)
Write-up: C/O "foggy vision" 3-5 minutes after receiving injection. C/O "facial numbness-around mouth and upper cheek area." "Feels like you have been to the dentist." Complete resolution of symptoms in 20 minutes after injection. C/O "itching around mouth" as "numbness feeling was going away".

VAERS ID:368942 (history)  Vaccinated:2009-11-16
Age:26.0  Onset:2009-11-16, Days after vaccination: 0
Gender:Male  Submitted:2009-11-20, Days after onset: 4
Location:Ohio  Entered:2009-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: states was hospitalized as a child after a vaccine reaction, was told not to get whooping cough vaccine again.
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Was told by coworkers face looked red after vaccination, then itchy red raised rash on forearms; resolved next day; pt stated used Benadryl cream.

VAERS ID:369073 (history)  Vaccinated:2009-11-20
Age:26.0  Onset:2009-11-20, Days after vaccination: 0
Gender:Male  Submitted:2009-11-20, Days after onset: 0
Location:Texas  Entered:2009-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2197IMRA
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102040P1A0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Incorrect dose administered
SMQs:, Medication errors (narrow)
Write-up: During administration of vaccinations, patient was administered two doses of Anthrax vaccine.

VAERS ID:369214 (history)  Vaccinated:2009-11-09
Age:26.0  Onset:2009-11-16, Days after vaccination: 7
Gender:Female  Submitted:2009-11-20, Days after onset: 4
Location:Missouri  Entered:2009-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~Influenza (H1N1) (Influenza (H1N1) (UNKNOWN MANUFACTURER))~UN~0.00~
Other Medications: NOTHING BESIDES PRENATAL VITAMINS
Current Illness: NO
Preexisting Conditions: NO HEALTHY 26 YR OLD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy, Intra-uterine death
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Medication errors (broad)
Write-up: SHE JUST FOUND OUT SHE WAS PREGNANT, WORKS AT A HOSPITAL, WAS TOLD THAT PREG WOMEN ARE AT RISK. sHE GOT THIS SHOT TO PROTECT HER BABY NOT KNOWING THAT THERE HAS BEEN NO TESTING ON PREGNANT WOMEN OR FETUSES.WHAT SHE THOUGHT WAS A GOOD THING TURNED OUT TO B THE WORST. THE GOV KILLED HER BABY.

VAERS ID:369218 (history)  Vaccinated:2009-11-20
Age:26.0  Onset:2009-11-20, Days after vaccination: 0
Gender:Female  Submitted:2009-11-21, Days after onset: 1
Location:California  Entered:2009-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102123P10IJLA
Administered by: Public     Purchased by: Private
Symptoms: Abdominal pain upper, Dizziness, Fatigue, Hyperhidrosis, Hypoaesthesia facial, Injection site anaesthesia, Palpitations, Tremor
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Sweating, heart palpitations, shaky, dizzy, stomach cramping, numbness in injection arm, feeling of exhaustion, numbness periodically in face, especially around eyes and lips.

VAERS ID:369314 (history)  Vaccinated:2009-11-16
Age:26.0  Onset:2009-11-18, Days after vaccination: 2
Gender:Female  Submitted:2009-11-23, Days after onset: 5
Location:Virginia  Entered:2009-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RITALIN; DEPAKOTE; DEPO-PROVERA; ZYRTEC
Current Illness: Cough from recent URI
Preexisting Conditions: Autism; ADD; OCD; seizures; acne
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP013AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema nodosum, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 days after vaccine, rash developed on anterior lower legs consistent with erythema nodosum.

VAERS ID:369342 (history)  Vaccinated:2009-11-20
Age:26.0  Onset:2009-11-20, Days after vaccination: 0
Gender:Female  Submitted:2009-11-23, Days after onset: 3
Location:New York  Entered:2009-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS 0IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Enuresis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Syncope, enuresis. No loss of consciousness.

VAERS ID:369892 (history)  Vaccinated:2009-11-13
Age:26.0  Onset:2009-11-14, Days after vaccination: 1
Gender:Female  Submitted:2009-11-24, Days after onset: 10
Location:Connecticut  Entered:2009-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Flu vaccine given on 10/15/09. H1N1 given on 11/13/09. Pt symptomatic on 11/14/09
Preexisting Conditions:
Diagnostic Lab Data: MRI CSF analysis pending. 12/17/09 Hospital records, discharge summary received. Service dates 11/22/09 to 11/25/09. LABS and DIAGNOSTICS: CT Scan Brain - Abnormal area left frontal lobe. CHEM - Blood glucose 151 mg/dL (H) CO2 Total/Bloo
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102040P1 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Acute disseminated encephalomyelitis, Angiotensin converting enzyme decreased, Antinuclear antibody increased, Blood bicarbonate decreased, Blood glucose increased, CSF cell count abnormal, CSF oligoclonal band present, CSF test, Computerised tomogram abnormal, Demyelination, Dyskinesia, Dystonia, Electroencephalogram normal, Hemiparesis, Muscular weakness, Musculoskeletal stiffness, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain abnormal, Oral contraception, Red blood cells CSF positive, Scan brain
SMQs:, Rhabdomyolysis/myopathy (broad), Lactic acidosis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dyskinesia (narrow), Dystonia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Chronic kidney disease (broad), Arthritis (broad)
Write-up: Dystonia of left upper extremity. MRI brain on 11/22/2009 reveals multiple areas of demyelination. Concern for ADEM. Patient has had no prior symptoms. Patient does not meet criteria for multiple sclerosis. 11/25/09 Hospital neurological consultation received. Service date: 11/22/09. Assessment: Left upper extremity tonic activity. Patient presented with frequent intermittent left extremity stiffening spells. 5-10 second duration, tonic-like activity. Left upper and lower extremity weakness. 12/17/09 Hospital records, discharge summary received. Service dates 11/22/09 to 11/25/09. Assessment: Acute disseminated encephalomyelitis. Patient presented with frequent intermittent left extremity stiffening spells. Oral contraceptives.

VAERS ID:369910 (history)  Vaccinated:2009-11-16
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-11-19
Location:Michigan  Entered:2009-11-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB761AA2IMRA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Dizziness/lightheaded @ 2:30 - evening severe headache and weakness @ 7:30 am - 4:30 weakness continued through evening.

VAERS ID:369936 (history)  Vaccinated:2009-10-30
Age:26.0  Onset:2009-11-01, Days after vaccination: 2
Gender:Female  Submitted:2009-11-24, Days after onset: 23
Location:Massachusetts  Entered:2009-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 10 weeks pregnant
Preexisting Conditions: 12/01/09: PMH: hx arthritis 9 yrs ago, anxiety, thyroid disorder. Allergies: NKDA.
Diagnostic Lab Data: Lyme neg, Parvo IgG and IgM neg, Strep neg, HIV neg
CDC Split Type:
Vaccination
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEUR1008132P0IMRA
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEURU3265JA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthritis, Drug exposure during pregnancy, Erythema, Hypokinesia, Joint swelling, Joint warmth, Polyarthritis
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Asymmetric, oligoarthritis of the ankles, knees, and hands. 12/01/09 MR received for DOS 11/19. DX: Asymmetric mild arthritis On 11/01/09, Pt was seen in ED with c/o polyarthritis, joint swelling and warm, and decreased ROM. On 11/19/09, rheumatologic assessment: negative for infection, possibly temporal relationship to vaccines. Tx: APAP. Pt''s symptoms resolved spontaneously.

VAERS ID:370087 (history)  Vaccinated:2009-10-22
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-11-25
Location:New Hampshire  Entered:2009-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal Vitamins
Current Illness: no
Preexisting Conditions: Pregnant PMH: blighted ovum. G3P1 Allergies: unk
Diagnostic Lab Data: Labs & Diags: Cytology: Neg for intraepithelial lesion or malignancy.
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP009AA IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abortion missed, Drug exposure during pregnancy, Intra-uterine death, Ultrasound scan abnormal, Ultrasound uterus abnormal, Uterine dilation and curettage
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Went for normal prenatal ultrasound at 11weeks 4days pregnant at OB office and found that my baby was only measuring 8weeks 3days which is when i recieved my H1N1 vaccine!!! I suffered a missed miscarriage and had to have a d&c because of it. 12/1/09 medical records received for DOS 11/13-12/1/09 OB telephone notes. Final DX: Fetal demise, partial hydatidiform mole. On U/S fetal demise at approx 8 weeks. Previous ultrasound at initial visit showed fetal growth appropx 1 week behind. Molar pregnancy. D&C.

VAERS ID:370123 (history)  Vaccinated:2009-11-23
Age:26.0  Onset:2009-11-23, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Mexico  Entered:2009-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pt has asthma; ERYTHROMYCIN - vomiting; PROZAC - syncope; Perfume - diff breathing; Bleach cleaning supplies, diff breathing
Diagnostic Lab Data:
CDC Split Type:
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HPV4: HPV (GARDASIL)MERCK & CO. INC.081970IJLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: 4:50 20 minutes with GARDASIL injection #1, pt c/o Left leg hurting, stating "I know I received shot in my left arm, but my leg hurts like I had the shot in my leg." Pt also c/o dizziness. BP 110/60, P76, R20. Pt had not eaten or drank anything all day. H/o hypoglycemia. Provided juice and crackers Pt felt better. Dizziness gone. At 15:15 pt discharged per Dr - leg was still painful.

VAERS ID:370239 (history)  Vaccinated:2009-11-16
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-11-25
Location:Kansas  Entered:2009-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Pregnancy; 12/1/09 PMH Penicillin allergy;pituitary tumor; hyperprolactinemia.
Diagnostic Lab Data: Pregnancy 12/1/09 Labs: HGB 14.3 g/dL on 10/30/09
CDC Split Type:
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500828P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (broad)
Write-up: Client was given FLUMIST - MedImmune H1N1 live vaccine. Client is 10 wk pregnant. 12/01/09 Received prenatal Medical Records for DOS 11/16/09, 11/20/09, 11/25/09

VAERS ID:370398 (history)  Vaccinated:2009-11-23
Age:26.0  Onset:2009-11-24, Days after vaccination: 1
Gender:Female  Submitted:2009-11-28, Days after onset: 4
Location:California  Entered:2009-11-29, 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: Apidra, Spironalactone, Allegra D, Nuvaring
Current Illness: minor cough
Preexisting Conditions: Allergic to Ceclor, Type 1 Diabetic
Diagnostic Lab Data:
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP025AA1IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash, Skin burning sensation
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Burning itchy skin in upper arms and thighs. It is not constant burning itch accompanied by small bumps. It will switch back and forth from arms to thighs and is very uncomfortable. Not even Benadryl or aloe vera will make the itch stop.

VAERS ID:370588 (history)  Vaccinated:2009-11-16
Age:26.0  Onset:2009-11-16, Days after vaccination: 0
Gender:Female  Submitted:2009-11-30, Days after onset: 14
Location:North Carolina  Entered:2009-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
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HPV4: HPV (GARDASIL)MERCK & CO. INC.0981Y1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain
SMQs:
Write-up: Pt with severe body aches, sudden onset. Sx lasted through the night. Pt took 800mg of Ibuprofen at 8:00AM on 11/17/2009 and sx were better. Completely resolved by the afternoon of 11/17/09.

VAERS ID:370715 (history)  Vaccinated:2009-11-21
Age:26.0  Onset:2009-11-22, Days after vaccination: 1
Gender:Male  Submitted:2009-11-30, Days after onset: 8
Location:California  Entered:2009-11-30
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: Aspergers, Seizure Disorder
Diagnostic Lab Data: Labs were done for Anti seizure drug levels, all WNL however at low end of normal. Patient takes Carbatrol and Lamactil
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Condition aggravated, Convulsion, Laboratory test normal
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Seizure (no description of seizure was provided) Did not see physician until 48 hrs after incident

VAERS ID:370905 (history)  Vaccinated:2009-11-22
Age:26.0  Onset:2009-11-22, Days after vaccination: 0
Gender:Female  Submitted:2009-11-22, Days after onset: 0
Location:Ohio  Entered:2009-12-01, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN; CLARITIN; ORTHO-TRYCYCLIC
Current Illness: Denies
Preexisting Conditions: Sulfa; PCN; Codeine; Vicodin; Bee stings; nuts; latex; pollen
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3239AA0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Throat tightness, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Pt reports throat feels tight. Reports h/o "rxn" after GARDASIL. Taken BENADRYL 50 mg x 1. Observed x 45 min. Vitals stable. Pt returned home. Called pt 2 hours later - doing better. No resp/skin issues. Sister vaccinated (latex allergy as well) without incident.

VAERS ID:370915 (history)  Vaccinated:2009-11-18
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-11-18
Location:California  Entered:2009-12-01, Days after submission: 13
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
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP019AA UNLA
Administered by: Private     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: None Stated

VAERS ID:370989 (history)  Vaccinated:2009-11-03
Age:26.0  Onset:2009-11-10, Days after vaccination: 7
Gender:Female  Submitted:2009-11-24, Days after onset: 14
Location:Oregon  Entered:2009-12-01, Days after submission: 7
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:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP015AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Headache, Injection site rash, Pruritus, Sinus congestion, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash started in afternoon. H1N1 vaccine given 11/3/09 0.5mL IM (L) deltoid patient is pregnant 17 wks 5 days at time of vaccination patient developed hive type rash on arm immunization administered in (L) deltoid. C/o sinus congestion headache rash spread to abdomen. Given Benadryl 50mg po q 6 hours prn.

VAERS ID:371075 (history)  Vaccinated:2009-11-11
Age:26.0  Onset:2009-11-12, Days after vaccination: 1
Gender:Female  Submitted:2009-11-23, Days after onset: 11
Location:Unknown  Entered:2009-12-02, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions:
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500800P IN 
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Metatarsalgia, Rash erythematous, Serum sickness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Serum sickness developed day after H1N1 mist. Diffuse arthralgics wrists/elbows/carpals, tarsals (MTP''s), knees, ankles, diffuse rash - hypopig center with erythema tous rings.

VAERS ID:371116 (history)  Vaccinated:2009-12-01
Age:26.0  Onset:2009-12-01, Days after vaccination: 0
Gender:Female  Submitted:2009-12-02, Days after onset: 1
Location:Minnesota  Entered:2009-12-02
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: Allergies to BIAXIN; pine nuts; food dye
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102041P10IMRA
Administered by: Public     Purchased by: Other
Symptoms: Anxiety, Hypersensitivity, Injection site erythema, Pharyngeal oedema, Pruritus, Skin warm, Swollen tongue, Tongue disorder, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 5:30 PM received H1N1 flu vaccine. Palms started itching shortly after. 7:00 PM - hives on left side of body, red at injection site. 7:16 PM - tongue/ throat swelling, took oral BENADRYL. Went to ER and given PREDNISONE & TAGAMET. Currently taking oral BENADRYL every 4 hours and PREDNISONE for 4 days. Symptoms have resolved.

VAERS ID:371202 (history)  Vaccinated:2009-11-17
Age:26.0  Onset:2009-11-17, Days after vaccination: 0
Gender:Female  Submitted:2009-12-02, Days after onset: 15
Location:Texas  Entered:2009-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: TX090085PU
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUPO10AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Facial palsy, Feeling abnormal
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: ABOUT SIX HOURS AFTER RECEIVING VACCINE, FELT UPPER LIP DROOPING AND FELT LIKE SHE WAS "SPACING OUT." SYMPTOMS LASTED ABOUT 48 HOURS THEN RESOLVED SPONTANEOUSLY. DID NOT SEEK MEDICAL ATTENTION.

VAERS ID:371203 (history)  Vaccinated:2009-12-01
Age:26.0  Onset:2009-12-01, Days after vaccination: 0
Gender:Female  Submitted:2009-12-02, Days after onset: 1
Location:Virginia  Entered:2009-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none PMH: hypoglycemia, panic attacks Allergies: Monistat
Diagnostic Lab Data: On antibiotics for 9 days Labs/Dx studies none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102123P11IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest discomfort, Dizziness, Dysphagia, Dyspnoea, Hypersensitivity, Nausea, Palpitations, Pyrexia, Rash, Skin warm, Swelling, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (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 (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, Nausea, Hives, Not able to swallow, Chest Tightness, Hot to the touch, Dizziness, Swelling 12/11/2009 ED records for 12/1/2009, patient with c/o''s red itchy rash, facial swelling, SOB, heart racing, tx''d with IV Solu-Medrol and Benadryl, DC DX Allergic reaction

VAERS ID:371214 (history)  Vaccinated:2009-05-04
Age:26.0  Onset:2009-05-06, Days after vaccination: 2
Gender:Female  Submitted:2009-12-02, Days after onset: 210
Location:Colorado  Entered:2009-12-02
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:
Current Illness: No
Preexisting Conditions: None. 12/4/09: Discharge summary and hospital records received for dates of service 5/7/09 to 5/8/09. PMH: SLE, hypothyroidism, endometriosis, laparotomy. Allergies: Naproxen.
Diagnostic Lab Data: 12/4/09: Discharge summary and hospital records received for dates of service 5/7/09 to 5/8/09. Labs and diagnostics: CK 1170 (H).
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC3028BA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase increased, Chills, Headache, Hypersensitivity, Hypothyroidism, Insomnia, Myalgia, Pain, Rhabdomyolysis, Systemic lupus erythematosus
SMQs:, Rhabdomyolysis/myopathy (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (broad), Eosinophilic pneumonia (broad), Hypothyroidism (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Body and Muscle pain, elevated CK. 12/4/09: Discharge summary and hospital records received for dates of service 5/7/09 to 5/8/09. Dx: Allergic reaction to pertussis vaccine, rhabdomyolysis, hypothyroid, SLE. Presented experiencing upper body aches, pain in UE''s with active ROM, pain in neck, headache and chills, myalgias and trouble sleeping.

VAERS ID:371233 (history)  Vaccinated:2009-12-01
Age:26.0  Onset:2009-12-01, Days after vaccination: 0
Gender:Female  Submitted:2009-12-02, Days after onset: 1
Location:Missouri  Entered:2009-12-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102124P10IMRA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3175BA1IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Rash generalised, Rash papular, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Within 90 minutes of receiving vaccinations - developed pruritus bilateral arms. Within 2 hours - rash spread to chest, trunk and bilateral lower extremities papules, pruritus. BENADRYL 25 mg given with relief @ 1200N took another BENADRYL 25mg at 130P symptoms resolved.

VAERS ID:371307 (history)  Vaccinated:2009-12-01
Age:26.0  Onset:2009-12-01, Days after vaccination: 0
Gender:Female  Submitted:2009-12-03, Days after onset: 2
Location:Missouri  Entered:2009-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Diabetes since age 9
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102124P10UNLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received vaccine H1N1 at 1300 12-1-09. 1600 began itching on hips. 1900 hives on hips, Abd. 2030 Hives on buttocks- Applied HYDROCORTISONE oint. BENADRYL 25mg PO. 12-2-09 Hives to hips and stomach -$g ZYRTEC 1 tab daily per MD.

VAERS ID:371362 (history)  Vaccinated:2009-11-14
Age:26.0  Onset:2009-11-14, Days after vaccination: 0
Gender:Female  Submitted:2009-12-03, Days after onset: 19
Location:New York  Entered:2009-12-03
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: BP 100/80, P 96
CDC Split Type: NYC09
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500805P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Nasal discomfort
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: 11:17 complaining of inside of nose itching (had nasal vaccine) 11:30 stated no itching itching inside of nose anymore 11:40 difficulty breathing EMS called and patient taken to ER

VAERS ID:371363 (history)  Vaccinated:2009-11-14
Age:26.0  Onset:2009-11-14, Days after vaccination: 0
Gender:Male  Submitted:2009-12-03, Days after onset: 19
Location:New York  Entered:2009-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: C/o dizziness
Preexisting Conditions: Hx frequent migraines, VP shunt, H/o Fetal alcohol syndrome, allergic to PCN
Diagnostic Lab Data:
CDC Split Type: NYC09
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102044P1 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Presyncope
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Dizzy pre-syncopal given Epi Pen 911 called.

VAERS ID:371393 (history)  Vaccinated:2009-11-30
Age:26.0  Onset:2009-11-30, Days after vaccination: 0
Gender:Female  Submitted:2009-12-03, Days after onset: 3
Location:Tennessee  Entered:2009-12-03
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 Known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP044AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Nausea, Pain, Photophobia
SMQs:, Acute pancreatitis (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad)
Write-up: Headache with onset of about 30 minutes after vaccine administration. Moderate pain not relieved by Aleve. Headache progressed to more severe pain with nausea and sensitivity to light.

VAERS ID:371420 (history)  Vaccinated:2009-10-21
Age:26.0  Onset:2009-10-21, Days after vaccination: 0
Gender:Female  Submitted:2009-12-03, Days after onset: 43
Location:Tennessee  Entered:2009-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: LATEX ALLERGY
Preexisting Conditions: Relevant medical conditions included reaction to shrimp. Concomitant medications were unknown. The subject had not experienced any adverse events following previous vaccinations PMH: None Allergies: Latex, shrimp
Diagnostic Lab Data: UNK None
CDC Split Type: A0814573A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA275AA UNLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Discomfort, Drug hypersensitivity, Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of itching in a 26-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). Concurrent medical conditions included latex allergy. On 21 October 2009 at approximately 16:00 the subject received unspecified dose of FLULAVAL (.5 cc, unknown, unknown arm). On 21 October 2009, 20 minutes after vaccination with FLULAVAL, the subject experienced itching, burning (nos), discomfort and erythema. The subject experienced itching, burning, redness and discomfort of the arms, chest and neck within 20 minutes of receiving FLULAVAL, subject took 50 mg of BENADRYL by mouth. She returned to yhe physician''s office and was administered 8/10th of a cc of adrenaline. The subject was treated with BENADRYL and adrenaline. On 21 October 2009, the itching, burning, redness and discomfort of the arms, chest and neck were resolved. The healthcare professional considered the events were possibly related to vaccination with FLULAVAL. Follow up information was received on 23 November 2009 via the reporting healthcare professional. The healthcare professional reported that the subject received a dose of FLULAVAL in her left arm. The subject was diagnosed with a drug hypersensitivity. The healthcare professional considered the itching, burning (nos), discomfort, erythema and drug hypersensitivity were clinically significant (or requiring intervention). On 21 October 2009, the events were resolved. The healthcare professional considered the events were probably related to vaccination with FLULAVAL. 12/10/2009 records from MD for 10/21/2009, patient with c/o''s severe itching and burning on arms chest and neck, given benadryl and then adrenaline when sx did not subside, given Rx for epi pens

VAERS ID:371493 (history)  Vaccinated:2009-12-03
Age:26.0  Onset:2009-12-03, Days after vaccination: 0
Gender:Female  Submitted:2009-12-04, Days after onset: 1
Location:Minnesota  Entered:2009-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None PMH: pregnant Allergies: NKDA
Diagnostic Lab Data: Baby Died! Labs: None Dx studies: Transvaginal US abnormal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP019AA0 LA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3264DASP0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug exposure during pregnancy, Intra-uterine death, Ultrasound scan abnormal
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: I went in for my 12 week appointment and the doctor said the baby''s heart had stopped. She said it didn''t grow and must have stopped right after my 8 week appt. I got the H1N1 shot at my 8 week appointment. The baby was perfectly healthy, perfect size, and perfect heartbeat at 8 weeks. And from hours to days later it died? 12/7 and 12/9/2009 OB records for ov 12/3/2009 , Dx missed abortion patient for 12 wk f/up visit, Transvaginal US noted no fetal heart rate, had D&C on 12/4/2009,

VAERS ID:371572 (history)  Vaccinated:0000-00-00
Age:26.0  Onset:2008-05-05
Gender:Female  Submitted:2009-12-03, Days after onset: 577
Location:Illinois  Entered:2009-12-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy NOS (LMP = 5/5/2008); Diabetes
Preexisting Conditions:
Diagnostic Lab Data: Ultrasound, 07/21/08, identified a "missed AB"; beta-human chorionic, 06/07/08, positive
CDC Split Type: WAES0806USA02864
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1060U2IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abortion missed, Drug exposure during pregnancy, Pregnancy test positive, Ultrasound scan abnormal
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a specially trained medical technician for the Pregnancy Registry for GARDASIL vaccine, concerning a 26 year old female with diabetes and no drug reaction/allergies, who on 21-Jun-2007, 25-Aug-2007 and 28-May-2008 was vaccinated intramuscularly with 0.5 ml of first (lot# 660389/1968U), second (lot# 658100/0525U) and third (lot# 658556/1060U) doses, respectively, of GARDASIL vaccine and is pregnant. Concomitant therapy included NOVOLOG. On 07-Jun-2008 the patient took home pregnancy test that tested positive (LMP = 05-May-2008). Unspecified medical attention was sought, the patient was seen in office. No adverse event reported. At the time of this report the outcome is unknown. Follow-up information has been received from a person in the physician''s office on 24-NOV-2009 who reported that on 21-JUL-2008 the patient had an ultrasound performed which identified a "missed AB", which was dated at 11 weeks gestation by LMP. The patient did "fine" after that, recovered. Upon internal review, "missed AB" was determined to be an other important medical event. This is one of two reports concerning the same patient (WAES#0911USA04901). A lot check has been initiated. No further information is available.

VAERS ID:371809 (history)  Vaccinated:2009-11-25
Age:26.0  Onset:2009-11-27, Days after vaccination: 2
Gender:Female  Submitted:2009-11-28, Days after onset: 1
Location:Minnesota  Entered:2009-12-07, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CELEXA 10 mg QD
Current Illness: no
Preexisting Conditions: depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU2972BA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Rec''d 5 ml tetanus toxoid injection 11/25/09 - noted 11/27/09 (lt) deltoid with 5 x 4 cm round, red, warm to touch area - ROM WNL - Radial pulse present - c/o (lt) arm "sore" @ injection site.

VAERS ID:372227 (history)  Vaccinated:2009-12-08
Age:26.0  Onset:2009-12-08, Days after vaccination: 0
Gender:Male  Submitted:2009-12-08, Days after onset: 0
Location:Mississippi  Entered:2009-12-08
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: Patient received IV fluids and an unknown Lab test.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102134P11IMLA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain upper, Asthenia, Chills, Dyspnoea, Fluid replacement, Hyperhidrosis, Laboratory test, Nausea, Pallor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Weakness, Diaphoretic, Chills, Paleness, Slight Stomach Pain, Little nausea, shortness of breath.

VAERS ID:372275 (history)  Vaccinated:2009-11-23
Age:26.0  Onset:2009-11-23, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2009-12-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Recovering from URI
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102124P10IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Shortness of breath dizzy.

VAERS ID:372302 (history)  Vaccinated:2009-11-03
Age:26.0  Onset:2009-11-11, Days after vaccination: 8
Gender:Female  Submitted:2009-12-03, Days after onset: 22
Location:Louisiana  Entered:2009-12-09, 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: No
Preexisting Conditions: No
Diagnostic Lab Data: 11/13/09 MRI brain, optic nerve, optic tract and eye with and without contrast - normal. 11/17/09 MRI - neck and carotid - neg. 11/18 see attached 11/20/09 spinal tap - neg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP017AA0IMRA
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA476BA0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Blindness, Blood albumin increased, C-reactive protein increased, Eye pain, Lumbar puncture normal, Nuclear magnetic resonance imaging brain normal, Nuclear magnetic resonance imaging normal, Optic neuritis, Red blood cell sedimentation rate increased
SMQs:, Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Retinal disorders (broad), Ocular infections (broad)
Write-up: 11/11/09 am started having pain and vision loss in R eye. 11/12/09 saw eye doctor. 11/12/09 saw ophthalmologist 11/17/09 saw ophthalmologist and neurologist 12/2/09 saw neurologist - looks better 12/3/09 doc - vision better may not come back 100%. Getting better, not 100%

VAERS ID:372453 (history)  Vaccinated:2009-12-08
Age:26.0  Onset:2009-12-08, Days after vaccination: 0
Gender:Female  Submitted:2009-12-09, Days after onset: 1
Location:Washington  Entered:2009-12-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions: No.
Diagnostic Lab Data: None
CDC Split Type: UP02AASP
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURERUP026AASP1IJLA
Administered by: Public     Purchased by: Unknown
Symptoms: Cough, Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Sudden onset of shortness of breath, weazie, difficulty breathing. This caused lots of coughing. This lasted until 11:40 pm that night. I tried taking a hot shower to help with my breathing, but that did not help. Then the symptoms then went away rather suddenly. I did have some peppermint tea to help sooth my throat. I did not call the doctor since it was so late.

VAERS ID:372631 (history)  Vaccinated:2009-12-02
Age:26.0  Onset:2009-12-03, Days after vaccination: 1
Gender:Female  Submitted:2009-12-10, Days after onset: 7
Location:Massachusetts  Entered:2009-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin XL Effexor NuvaRing Multi-vitamin
Current Illness: Low-grade fever, unknown cause.
Preexisting Conditions: Celiac Disease, chronic sinusitis, allergy to Penicillins and several other antibiotics, allergy to Benadryl, asthma related to sinus infections.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0 LA
Administered by: Public     Purchased by: Private
Symptoms: Dyspnoea, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives on arms and lower back. Difficulty breathing. Generally itchy skin.

VAERS ID:372812 (history)  Vaccinated:2008-05-19
Age:26.0  Onset:2009-03-01, Days after vaccination: 286
Gender:Female  Submitted:2009-12-10, Days after onset: 284
Location:Unknown  Entered:2009-12-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Pregnancy NOS (LMP = 5/19/2008)
Preexisting Conditions:
Diagnostic Lab Data: diagnostic laboratory; urine beta-human, positive
CDC Split Type: WAES0807USA02901
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Blood test, Caesarean section, Drug exposure during pregnancy, Labour complication, Urine human chorionic gonadotropin positive
SMQs:, Tumour markers (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a nurse practitioner and a 26 year old female consumer for the Pregnancy Registry for GARDASIL concerning herself who on 19-MAY-2008 was vaccinated intramuscularly in the deltoid with her first dose of GARDASIL (lot# not reported) and became pregnant. There was no concomitant medication. The patient''s LMP was 19-MAY-2008 and EDD was 23-FEB-2009. Subsequently the patient experienced no adverse symptoms. The patient sought medical attention with an office visit on an unspecified date. The patient had blood work and a urine pregnancy test to confirm the pregnancy. The patient''s outcome was not reported. Follow-up information was received from the consumer who stated that she had a baby boy who is now nine months old; healthy and normal with no problems. She also said her pregnancy was "very good", and she was one week overdue when she went into labor. Additionally she reported an "emergency" cesarean section during labor because the baby "wasn''t coming down" and had the umbilical cord wrapped around his arm and after a while" he couldn''t take it any more". The reporter stated the baby was fine after he was born and she recovered very well from the surgery. Upon internal review, umbilical cord abnormality was considered an other important medical event. Additional information is not expected.

VAERS ID:373284 (history)  Vaccinated:2009-11-13
Age:26.0  Onset:2009-11-13, Days after vaccination: 0
Gender:Female  Submitted:2009-11-18, Days after onset: 5
Location:Wisconsin  Entered:2009-12-15, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pregnant (7th week)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500828P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (broad)
Write-up: None stated.

VAERS ID:373470 (history)  Vaccinated:2009-09-15
Age:26.0  Onset:2009-09-15, Days after vaccination: 0
Gender:Female  Submitted:2009-12-16, Days after onset: 92
Location:Pennsylvania  Entered:2009-12-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nicotine Patch
Current Illness: NO
Preexisting Conditions: Amoxicillin
Diagnostic Lab Data: Vital Signs
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3184AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)
Write-up: Heart starting racing (sitting at the time) and could feel it in her neck. lasting less than a minute

VAERS ID:373689 (history)  Vaccinated:2009-12-03
Age:26.0  Onset:2009-12-04, Days after vaccination: 1
Gender:Male  Submitted:2009-12-16, Days after onset: 12
Location:Rhode Island  Entered:2009-12-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1333Y2IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Injection site pain, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: site painfule immediate after injection, pain has persisted; no throbbing or redness, pain with movement; developed right trapezius pain, still present on 12/15/09

VAERS ID:373746 (history)  Vaccinated:2009-12-14
Age:26.0  Onset:2009-12-15, Days after vaccination: 1
Gender:Female  Submitted:2009-12-16, Days after onset: 1
Location:Ohio  Entered:2009-12-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: neurocardiogenic syncope, mitrovalve prolapse
Diagnostic Lab Data: MRI will be done by neurologist once seen on dec. 28th
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS101329-4P1 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Corneal reflex decreased, Dyskinesia, Ear pain, Facial palsy, Hypoaesthesia, Hypoaesthesia facial, Lacrimation increased, Neck pain, Nuclear magnetic resonance imaging brain normal, Ophthalmoplegia
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Corneal disorders (narrow), Hearing impairment (broad), Lacrimal disorders (narrow), Ocular motility disorders (narrow), Arthritis (broad)
Write-up: Bells Palsy, numbness and paralysis on left side of face, unable to close left eye, use left side of mouth, smile, wrinkle forehead, blink, wink, pain in left ear and down neck, started at about 10 am with a watery eye then numbness then inablity to move left side of face. occurred in about 30 min. have appointment with neurologist to determine treatment on dec 28th

VAERS ID:373928 (history)  Vaccinated:2009-11-23
Age:26.0  Onset:2009-11-23, Days after vaccination: 0
Gender:Female  Submitted:2009-12-17, Days after onset: 24
Location:Pennsylvania  Entered:2009-12-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: eczema
Preexisting Conditions: allergic rhinitis, allergy to penicillin, hyperthyroidism
Diagnostic Lab Data: not applicable
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA285AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: Tingling in feet and legs that lasted x 15 minutes later in the day after receiving the vaccine. Also had tingling in left arm where she received vaccine. Experienced aching in legs and fatigue for several days after receiving vaccine.

VAERS ID:374021 (history)  Vaccinated:2009-12-15
Age:26.0  Onset:2009-12-15, Days after vaccination: 0
Gender:Female  Submitted:2009-12-17, Days after onset: 2
Location:California  Entered:2009-12-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: None noticed~HPV (Gardasil)~1~0.00~Patient|None noticed~HPV (Gardasil)~2~0.00~Patient
Other Medications: Currently taking Ocella, have been since April 2007
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2IJLA
Administered by: Public     Purchased by: Private
Symptoms: Headache
SMQs:
Write-up: Extreme headache on my whole head. Not a sharp pain. Just a constant pain, not throbbing. When I bent my head down it would hurt a little more for a minute. Just a painful and very annoying headache that lasted through 12-17-2009 (today). When I took 2 Excedrin it helped a lot.

VAERS ID:374184 (history)  Vaccinated:2009-12-17
Age:26.0  Onset:2009-12-18, Days after vaccination: 1
Gender:Female  Submitted:2009-12-18, Days after onset: 0
Location:Wisconsin  Entered:2009-12-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102044P10IMLA
Administered by: Private     Purchased by: Public
Symptoms: Facial palsy, Facial paresis, Head deformity, Musculoskeletal pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Tendinopathies and ligament disorders (broad)
Write-up: Bells palsy to right side of face.

VAERS ID:374835 (history)  Vaccinated:2009-12-14
Age:26.0  Onset:2009-12-15, Days after vaccination: 1
Gender:Male  Submitted:2009-12-16, Days after onset: 1
Location:Indiana  Entered:2009-12-23, Days after submission: 7
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: NKMA- no problems
Diagnostic Lab Data: Chest x-ray, clear
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102132P1 UNLA
Administered by: Other     Purchased by: Public
Symptoms: Chest X-ray normal, Cough, Rhinorrhoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: C/O sudden onset cough and runny nose and wheezing no medicine taken @ 12:00 midnight. Tuesday 12-15-09 during the day symptoms were less. Wednesday 12-16-09 @ midnight, cough, runny nose and wheezing returned over.

VAERS ID:374926 (history)  Vaccinated:2009-12-08
Age:26.0  Onset:0000-00-00
Gender:Female  Submitted:2009-12-21
Location:Virginia  Entered:2009-12-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pregnant LMP 7/30/2009
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500832P0IN 
Administered by: Public     Purchased by: Unknown
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy, Ultrasound antenatal screen normal
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow), Medication errors (broad)
Write-up: Client received H1N1 intranasal - client states she crossed out pregnancy on medical screening questionnaire and checked no pertaining to question about pregnancy.

VAERS ID:374967 (history)  Vaccinated:2009-10-13
Age:26.0  Onset:2009-11-28, Days after vaccination: 46
Gender:Male  Submitted:2009-12-24, Days after onset: 26
Location:Arizona  Entered:2009-12-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type: IHS858834
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500760P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Aphthous stomatitis, Chills, Cough, Dry eye, Eyelid function disorder, Facial palsy, Facial paresis, Headache, Hypoaesthesia, Hypoaesthesia facial, Muscular weakness, Nasal congestion, Oropharyngeal pain, Pain, Paraesthesia, Rhinorrhoea, Sinusitis, Tongue biting, Tongue ulceration
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Hearing impairment (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Generalised convulsive seizures following immunisation (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: no PMH presents with 2 days of progressive R facial numbness, tingling, and weakness and N/T in R arm for 2 days. Denies pain or loss of sensation. R eye not blinking well, and increased R eye dryness. This is the first time this has happened. Denies fever, recent illness, HA, N/V/D/C, dysphagia, loss of bladder or bowel fxn, loss of coordination, or change in mentation. No change in hearing, visual acuity or sense of taste. No sick contacts. No oral contraceptive use.

VAERS ID:374993 (history)  Vaccinated:2009-11-16
Age:26.0  Onset:2009-12-09, Days after vaccination: 23
Gender:Female  Submitted:2009-12-26, Days after onset: 17
Location:Kentucky  Entered:2009-12-26
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1008133P0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Abdominal pain, Abortion missed, Crying, Drug exposure during pregnancy, Foetal heart rate abnormal, Insomnia, Intra-uterine death, Laboratory test normal, Ultrasound antenatal screen abnormal, Uterine dilation and curettage
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: unborn fetus of 14 weeks and 5 days died. no other explanable cause.

VAERS ID:375020 (history)  Vaccinated:2009-12-27
Age:26.0  Onset:2009-12-27, Days after vaccination: 0
Gender:Male  Submitted:2009-12-27, Days after onset: 0
Location:Colorado  Entered:2009-12-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: Declined being sick
Preexisting Conditions: He fainted when he was 12 years old after 4 shots
Diagnostic Lab Data: BP 127/113
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102133P10IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Suspected light headedness from H1N1 flu shot. He sat & put head between his knees in waiting area. He said he was afraid of shots but his aunt & uncle talked him into getting the shot after they got theirs. His uncle bought him candy & Gatorade. Broke ammonia inhalant at patient request & he said it really helped x 3 whiffs. He walked out with his uncle - did not want me to call 911 - time about 15 minutes.

VAERS ID:375177 (history)  Vaccinated:2009-11-04
Age:26.0  Onset:2009-11-04, Days after vaccination: 0
Gender:Female  Submitted:2009-12-29, Days after onset: 55
Location:Florida  Entered:2009-12-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diazide 25mg qday; Potassium 20Meq qday; Birth Control (Demulen); Singulair 10mg qday; Symbicort 160/4.5 2puffs BID; Nasonex 50mcg qday; VFend 200mg BID; Xolair injection once a month; Xopenex MDI/ Nebulizer PRN
Current Illness: Sputum culture taken 2 days after vaccine was given grew out Strep. Pneumoni; stenotrophomonas maltophilia and pseudomonas. Did
Preexisting Conditions: Allergies: Seasonal (outdoor pollens/ dust/ animal dander); Penicillin Other Conditions: Chronic Sinusitis, Asthma, chronic bacterial/fungal growth of opportunistic infections.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Erythema, Injection site erythema, Injection site nodule, Injection site swelling, Injection site warmth, Pruritus, Upper respiratory tract congestion, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The injection site swelled into a 3inch by 3inch knot that was bright red and hot. Head, neck, chest and arms became very red. This turned into patchy hives all over and severe itchiness. I became short of breath and very congested. This worsened for 24hrs before treatment was seeked out. After treatment, the syptoms went away in about 5 days.

VAERS ID:375220 (history)  Vaccinated:2009-12-22
Age:26.0  Onset:2009-12-22, Days after vaccination: 0
Gender:Female  Submitted:2009-12-22, Days after onset: 0
Location:Virginia  Entered:2009-12-29, Days after submission: 7
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP063AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Blood pressure normal, Dizziness, Feeling hot, Vision blurred, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Adverse Event: (1) Hot feeling (2) Dizzy, blurry vision (3) Vomiting. Treatment: B.P. checked (normal), cold drink, ice pack.

VAERS ID:375461 (history)  Vaccinated:2009-12-29
Age:26.0  Onset:2009-12-29, Days after vaccination: 0
Gender:Male  Submitted:2009-12-30, Days after onset: 1
Location:New York  Entered:2009-12-30
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: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102149P10IMLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR113351DA0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Chest discomfort, Chills, Cough, Headache, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tightness in chest cough, Achy arms, legs. At 1AM chills, achy arms, legs, head ache low grade fever. 6AM low grade fever, and head ache. 10am fever was gone still had head ache

VAERS ID:375671 (history)  Vaccinated:2009-12-28
Age:26.0  Onset:2009-12-28, Days after vaccination: 0
Gender:Female  Submitted:2009-12-31, Days after onset: 3
Location:Georgia  Entered:2009-12-31
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102145P10IMLA
Administered by: Other     Purchased by: Public
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: All over body rash lasting approx. 30-45mins $g treatment: 50mg BENADRYL.

VAERS ID:375773 (history)  Vaccinated:2009-12-17
Age:26.0  Onset:2009-12-17, Days after vaccination: 0
Gender:Male  Submitted:2010-01-04, Days after onset: 18
Location:New York  Entered:2010-01-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: asthma, no known allergies to medications
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102132P1 IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Chills, Pyrexia, Stomatitis
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 6 hours after vaccination, patient developed fever and chills, sores inside mouth

VAERS ID:375785 (history)  Vaccinated:2009-12-08
Age:26.0  Onset:2009-12-17, Days after vaccination: 9
Gender:Female  Submitted:2009-12-31, Days after onset: 14
Location:Texas  Entered:2010-01-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: recent HSV infection (lip)
Preexisting Conditions: None
Diagnostic Lab Data: 12/18/2009 viral culture: positive HSV; bacterial culture: negative; vaccinia PCR: negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV219   
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR    
Administered by: Military     Purchased by: Military
Symptoms: Bacterial culture, Blister, Erythema, Herpes simplex serology positive, Paraesthesia, Pyrexia, Rash macular, Rash papular, Skin lesion, Tenderness
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 25 y/o USAF AD female developed facial skin lesions onset approximately 9 days following receipt primary SPV & AVA#2 given on 12/8/2009. Pt first noticed redness over her nose & cheeks, followed by tingling grouped papular eruptions around upper & lower lip borders; by next day, a few more isolated eruptions appeared on forehead, right cheek & left outer ear. No oral lesions or painful swallowing; by day 10, papules increased around lips. Lesions remained tingly, otherwise non............. covering SPV site until after day 5 or so when she noted a vesicle at site; pt denied scratching/rubbing site & has kept it covered since. She was well day of vaccination but reported a fever blister left lower lip that lasted 3 days & just resolved the day before vaccination. She had childhood history VZ; no prior vaccine-related reactions. Immunization record indicated positive titers to MMR, VZV, & HBV. Initial medical evaluation by PCM was on 12/17/2009 at which time pt was afebrile & other than skin lesions, was well-appearing. She was evaluated by derm on 12/18/2009, at which time lesions were as follows: multiple grouped papules distributed around upper & lower lips borders, some on erythematous bases, some mildly coalesced; 2-2 papules above upper lip, 1 on left outer ear; 1 one vesicle on right cheek; 2 papules on forehead; shiny macular plaque across nose & both cheeks; SPV site appeared c/w robust take reaction with reported mild tenderness left axillary area. No other cutaneous findings. Preliminary diagnosis was possible autoinoculation; Valtrex was prescribed. Symptoms: Lesions, papule, Lesions, macule, Lesions, Vesicle.

VAERS ID:376048 (history)  Vaccinated:2010-01-04
Age:26.0  Onset:2010-01-05, Days after vaccination: 1
Gender:Male  Submitted:2010-01-06, Days after onset: 1
Location:D.C.  Entered:2010-01-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER   RA
Administered by: Public     Purchased by: Private
Symptoms: Chest pain, Dizziness, Fatigue, Pain
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Throughout the day I had mild chest pains, felt tired, and achy. A little light headed. I left work early, and got a good night''s rest. Today (1/6/2010) I feel much better.

VAERS ID:376060 (history)  Vaccinated:2010-01-04
Age:26.0  Onset:2010-01-04, Days after vaccination: 0
Gender:Male  Submitted:2010-01-06, Days after onset: 2
Location:Kentucky  Entered:2010-01-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP057AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Influenza like illness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: @ 1630 on 4 Jan I felt extreme fatigue and other flu-like symptoms. Slept until 1030 on 5 Jan, waking up periodically to use bathroom. Muscle-aches and a minor fever also accompanied the symptoms.

VAERS ID:376232 (history)  Vaccinated:2009-12-23
Age:26.0  Onset:2009-12-23, Days after vaccination: 0
Gender:Male  Submitted:2010-01-08, Days after onset: 16
Location:Maryland  Entered:2010-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: mild asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP048DA0IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB373A70IMLA
Administered by: Private     Purchased by: Private
Symptoms: Euphoric mood, Hearing impaired, Visual impairment
SMQs:, Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hearing impairment (narrow), Hypoglycaemia (broad)
Write-up: Pt reported feeling "euphoric" about 30 minutes after had vaccines. "Vision seemed cloudy and hearing was fuzzy". Episode lasted perhaps thirty minutes and symptoms resolved after drinking some fluid and taking a snack. Follow up call on 12/24: pt felt fine. No further trouble.

VAERS ID:376253 (history)  Vaccinated:2010-01-01
Age:26.0  Onset:2010-01-01, Days after vaccination: 0
Gender:Female  Submitted:2010-01-07, Days after onset: 6
Location:Missouri  Entered:2010-01-08, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 0 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity; Migraine; Vocal cord disorder; Asthma; Alpha-1 anti-trypsin deficiency
Preexisting Conditions:
Diagnostic Lab Data: electroencephalography 01/01/2010, results normal; computed axial, 01/01/2010, results not reported
CDC Split Type: WAES1001USA00034
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abnormal behaviour, Computerised tomogram, Dizziness, Dyspnoea, Electroencephalogram normal, Gaze palsy, Intensive care, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Information has been received from a consumer concerning her 26 year old daughter who is a respiratory therapist with allergy to theophylline, XOLAIR and one other medication that the mother could not remember name of, basal migraine, vocal cord dysfunction, possibly asthma and alpha-1 anti-trypsin deficiency who was vaccinated with a dose of PNEUMOVAX (Lot number unspecified). The mother thought that her daughter''s first vaccination with PNEUMOVAX was on 01-Jan-2010 at 13:00 but she was not sure. Concomitant therapy included SYMBICORT, TOPAMAX and MSD. The patient''s relevant past drug history included vaccinations against influenza virus A (antigen type unspecified) vaccine (H1N1) and regular influenza virus vaccine (unspecified) in approximately November 2009, about 2 months ago. The mother stated that on 01-Jan-2010 about 1 hour after vaccination, she began to experience behavioral changes, dizziness and passed out. The mother reports that her daughter described a feeling like she was coming out of her skin, and after that her feet start moving and her eyes rolled back. The patient also had some difficulty to breathing but she was not on a respirator. On 01-Jan-2010, she was admitted to an Intensive care unit at a local hospital and electroencephalography (EEG) was performed and the results were normal and a computed tomography (CAT scan) and the results was being performed at the time of reporting, results were not known. At the time of the report the patient was on oxygen and treated with albuterol (dose not reported) for her difficulty breathing. The patient continued to experience all of her symptoms. This was originally reported by a consumer. Additional information has been requested.

VAERS ID:376297 (history)  Vaccinated:2009-08-13
Age:26.0  Onset:2009-08-13, Days after vaccination: 0
Gender:Female  Submitted:2009-12-31, Days after onset: 140
Location:Florida  Entered:2010-01-08, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none mentioned
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3030AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypokinesia, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: C/o "extreme pain" @ injection site, limited ROM in left arm, and tingling in fingers of left hand which began approx. 2 hours after Tdap shot. Denies symptoms when shot received. Recommended massage and ice pack and ibuprofen. Spoke with employee 8/18-stated arm is fine now, symptoms were gone by Sat. 8/15.

VAERS ID:376340 (history)  Vaccinated:2010-01-06
Age:26.0  Onset:2010-01-07, Days after vaccination: 1
Gender:Male  Submitted:2010-01-08, Days after onset: 1
Location:California  Entered:2010-01-08
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: ARTHRITIS OF BACK/KNEE/HIP
Diagnostic Lab Data: none-called doctor and NP said that it was normal and to take Motrin and Tylenol. Also recommended a flu medication that she said was not advised by the CDC after receiving H1N1 vaccine
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Dysphonia, Pallor, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: mild hoarseness--wheezing for about 2 hrs when lying down, paleness in hands, slight weakness (difficulty holding my 1 year old son of 30lbs and completing my physical fitness exam for work), heartbeat of 88 bpm (not sure if this is fast or not)

VAERS ID:376443 (history)  Vaccinated:2009-03-31
Age:26.0  Onset:2009-03-31, Days after vaccination: 0
Gender:Female  Submitted:2009-06-21, Days after onset: 82
Location:Unknown  Entered:2010-01-08, Days after submission: 201
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Alcohol abuse; GERD; panic d/o
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1163X IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Symptoms: 1. Rash. 2. swelling at injection site. Treatment Drugs Used: 1-CEPHALEXIN Dose: 500 Units: MG Freq: QID Route: PO.

VAERS ID:376564 (history)  Vaccinated:2010-01-11
Age:26.0  Onset:2010-01-11, Days after vaccination: 0
Gender:Female  Submitted:2010-01-12, Days after onset: 1
Location:Connecticut  Entered:2010-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (CSL)CSL LIMITEDL30111 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Cough, Dysphagia, Dyspnoea, Insomnia, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: difficulty breathing, difficulty swallowing, closing of throat, wheezing, coughing

VAERS ID:376586 (history)  Vaccinated:2009-10-01
Age:26.0  Onset:2009-10-03, Days after vaccination: 2
Gender:Female  Submitted:2010-01-04, Days after onset: 93
Location:Florida  Entered:2010-01-12, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0087Y0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Flushing, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed rash on arms and torso two (2) days after injection; rash lasted ''couple more days''. Pt felt "flush and achy".

VAERS ID:376591 (history)  Vaccinated:2009-12-12
Age:26.0  Onset:2009-12-12, Days after vaccination: 0
Gender:Female  Submitted:2009-12-23, Days after onset: 11
Location:New Jersey  Entered:2010-01-12, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: ZOFRAN ODT 4 mg 3 tabs./1 tblt every 6 hrs. prn N
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2210UNUN
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS101716P10UNUN
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB767AA0UNUN
Administered by: Military     Purchased by: Military
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: During immunization of ANTHRAX/HEP B/H1N1-pt passed out-sent to ER-observed-released.

VAERS ID:376699 (history)  Vaccinated:2009-12-03
Age:26.0  Onset:2010-01-03, Days after vaccination: 31
Gender:Male  Submitted:2010-01-12, Days after onset: 9
Location:Arizona  Entered:2010-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type: IHS808512
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA1IMLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3237AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Facial palsy
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: Bell''s Palsy affecting the right side of the face.

VAERS ID:376790 (history)  Vaccinated:2009-12-29
Age:26.0  Onset:2010-01-08, Days after vaccination: 10
Gender:Male  Submitted:2010-01-13, Days after onset: 5
Location:Nevada  Entered:2010-01-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient states he may have been sick with a mild flu like symptoms.
Preexisting Conditions: No
Diagnostic Lab Data: Still recovering, lesions are still present.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04-003A0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Post vaccination autoinoculation
SMQs:
Write-up: Small Pox lesions on left side of face below the eye and esion on right temple.

VAERS ID:376885 (history)  Vaccinated:2010-01-06
Age:26.0  Onset:2010-01-06, Days after vaccination: 0
Gender:Male  Submitted:2010-01-08, Days after onset: 2
Location:California  Entered:2010-01-14, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS104045P11UNLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3240AA1UNRA
Administered by: Other     Purchased by: Public
Symptoms: Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient states he noted swelling to both wrists, knees, and ankles 1.5 hours after receiving both seasonal and H1N1.

VAERS ID:376887 (history)  Vaccinated:2010-01-07
Age:26.0  Onset:2010-01-09, Days after vaccination: 2
Gender:Female  Submitted:2010-01-11, Days after onset: 2
Location:New York  Entered:2010-01-14, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Known Asthmatic
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS00349611A IMRA
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED0594911A IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0623Y IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site induration, Injection site swelling, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 2 vaccines left arm patient reported "Hives" around injection site, swollen, hard, hot to touch left deltoid 1/9/10 (AVAC. given 1/7/10) 1/9/10 patient tx''d at hospital ER. Give antibiotic and anti inflammatory med. (Patient states ER MD -said didn''t appear to be infection).

VAERS ID:376902 (history)  Vaccinated:2009-12-12
Age:26.0  Onset:2009-12-12, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Alaska  Entered:2010-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU2591AA UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Induration, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 6cm x 10cm anular erythematous indurated and warm reactions spreading x 4 days.

VAERS ID:376930 (history)  Vaccinated:2009-12-07
Age:26.0  Onset:2009-12-10, Days after vaccination: 3
Gender:Female  Submitted:2009-12-14, Days after onset: 4
Location:Arkansas  Entered:2010-01-14, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3264CA0IMUN
Administered by: Other     Purchased by: Private
Symptoms: Aphthous stomatitis, Arthralgia, Pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Arthritis (broad)
Write-up: Sever body aches, sever joint aches, 10+ canker sores.

VAERS ID:376959 (history)  Vaccinated:2009-10-20
Age:26.0  Onset:2009-10-20, Days after vaccination: 0
Gender:Male  Submitted:2010-01-14, Days after onset: 86
Location:Maryland  Entered:2010-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.UNK1IN 
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 20 October 2009, I received the Seasonal Flu Mist. Following it, I went into work. I experienced no symptoms until later in the evening. I went to bed approximately 1030pm. Soon after, my head and hands began to itch terribly. I took some Benadryl and it stopped the itching and I went to sleep. The next morning I woke up and had welts on my hands with itching. I put some cortisone ointment on them and he helped for a short period of time. Later that day, my unit had training in the same location that the mist was given. While at training, I reviewed the reactions part of the brochure that was given with the vaccine. Upon seeing that my reaction was similar, I immediately went to the individuals giving the vaccine. They informed me to go the closest medical facility. I was given Benadryl and cortisone and sent home. The following morning, I awoke with hives all over my face and they continuously itched. I called medical, and was informed to put cortisone on and to come in. The cortisone relieved the itching and helped with the swelling. This continued on and off for about 3 weeks. The symptoms finally went away.

VAERS ID:377043 (history)  Vaccinated:2010-01-15
Age:26.0  Onset:2010-01-15, Days after vaccination: 0
Gender:Female  Submitted:2010-01-15, Days after onset: 0
Location:New York  Entered:2010-01-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: pregnancy- 11 weeks
Diagnostic Lab Data: n/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500854P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (broad)
Write-up: No adverse reaction. Patient wanted nasal vaccine due to injection available containing thimerasol.

VAERS ID:377254 (history)  Vaccinated:2010-01-11
Age:26.0  Onset:2010-01-12, Days after vaccination: 1
Gender:Female  Submitted:2010-01-18, Days after onset: 6
Location:Connecticut  Entered:2010-01-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: allergic to sulfonamide and gluten
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Corneal reflex decreased, Eye swelling, Eyelid disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Corneal disorders (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: problems with eyes: pressure within the eyes, nervous blinking of eyelids, swellings around the eyes, hanging eyelid (right)

VAERS ID:377433 (history)  Vaccinated:2009-12-29
Age:26.0  Onset:2009-12-31, Days after vaccination: 2
Gender:Female  Submitted:2010-01-19, Days after onset: 19
Location:Iowa  Entered:2010-01-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus infection
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Public     Purchased by: Other
Symptoms: Pain, Rash erythematous, Swelling, Viral rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Viral rash began behind ears on 12/31. Over next 3 days, spread to neck, shoulders, upper chest, and upper arms. Area behind ears was most affected - very red and swollen with bumps merging together, but not itchy. Rash began to spread onto earlobes and into the outer ear by 1/4. Physician prescribed topical fluocinonide cream (0.05%), which reduced the rash over 5 days. Skin remains sensitive as of 1/19.

VAERS ID:377615 (history)  Vaccinated:2010-01-15
Age:26.0  Onset:2010-01-15, Days after vaccination: 0
Gender:Female  Submitted:2010-01-20, Days after onset: 5
Location:Illinois  Entered:2010-01-20
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) (FLUZONE)SANOFI PASTEURU3226AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC324AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Itchy hives along chin area for about 3-4 hrs.

VAERS ID:377642 (history)  Vaccinated:2010-01-20
Age:26.0  Onset:2010-01-20, Days after vaccination: 0
Gender:Male  Submitted:2010-01-20, Days after onset: 0
Location:California  Entered:2010-01-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: PT STATES THAT HE HAD GASTROENTERITIS TWO DAYS PRIOR VACCINATION
Preexisting Conditions: NONE
Diagnostic Lab Data: EKG
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500892P0IN 
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB719AA0IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2843AA3IMLA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Dizziness, Dyspnoea, Electrocardiogram
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: PT COMPLAINT OF CHEST PAIN, DIFFICULTY TO BREATH AND DIZZINESS

VAERS ID:377768 (history)  Vaccinated:2010-01-15
Age:26.0  Onset:2010-01-15, Days after vaccination: 0
Gender:Female  Submitted:2010-01-21, Days after onset: 6
Location:Indiana  Entered:2010-01-21
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP001AA0UNRA
Administered by: Private     Purchased by: Other
Symptoms: Drug exposure during pregnancy, Wrong drug administered
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (narrow)
Write-up: OB pt given 2 H1N1 vaccines instead of 1 seasonal & 1 H1N1 vaccine pt had no adverse reaction.

VAERS ID:378593 (history)  Vaccinated:2010-01-14
Age:26.0  Onset:2010-01-15, Days after vaccination: 1
Gender:Female  Submitted:2010-01-21, Days after onset: 6
Location:California  Entered:2010-01-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: peripheral neuropathy
Preexisting Conditions: hydromorphone HCL; sulfa antibiotics and penicillins
Diagnostic Lab Data: MRI of left shoulder, doppler study of left arm; and labs showing abnormal CBC (WBC 21.6)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3252BA2IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1190Y0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Cellulitis, Chills, Full blood count abnormal, Injection site pain, Injection site rash, Pain in extremity, Pyrexia, Thrombosis, White blood cell count increased
SMQs:, Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Post vaccinations on 1/14/10, patient developed fever of 102, chills and pain in left deltoid and arm. Was seen on 1/15 at which time a rash had developed on her upper left arm. She was admitted to hospital on 1/17/10 for cellulitis. A doppler study revealed a clot in the anterior brachial vein. She was placed on IV antibiotics and started on LEVONOX.

VAERS ID:378807 (history)  Vaccinated:2010-01-15
Age:26.0  Onset:2010-01-22, Days after vaccination: 7
Gender:Female  Submitted:2010-01-28, Days after onset: 6
Location:Massachusetts  Entered:2010-01-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Pain in leg
Preexisting Conditions: Asthma.
Diagnostic Lab Data: Magnetic resonance, mild bilateral fascitis of the lower extremities; Serum creatine kinase, mild elevated; erythrocyte, elevated; serum C-reactive, elevated.
CDC Split Type: WAES1001USA02983
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abasia, Blood creatine phosphokinase increased, C-reactive protein increased, Condition aggravated, Fasciitis, Nuclear magnetic resonance imaging abnormal, Pain in extremity, Red blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: Information has been received from a physician concerning a 26 year old female patient with a history of asthma and no drug reactions/allergies, who "last week" on approximately 15-JAN-2010 was vaccinated with the first dose of GARDASIL. Concomitant medications included unspecified birth control. On 22-JAN-2010 the patient had sudden onset and worsening of lower extremity leg pain to a point that the patient would not walk and was admitted to the hospital. Creatine kinase was mildly elevated. Sedimentation rate was performed (results not provided). At the time of the report the patient had not recovered. Follow up information has been received from the physician who reported that the patient''s MRI revealed mild bilateral fasciitis of the lower extremities. The patient had elevated ESR and CRP level. The patient was treated with Non-steroidal anti-inflammatory drugs (not specified). The patient was referred to a Rheumatologist, Neurologist and infectious Disease specialist. The physician stated that the patient was able to walk at the time of her discharge from the hospital. "Lower extremity leg pain to a point that the patient would not walk" was considered to be disabling. Additional information has been requested.

VAERS ID:378824 (history)  Vaccinated:2009-11-03
Age:26.0  Onset:2009-12-31, Days after vaccination: 58
Gender:Female  Submitted:2010-01-29, Days after onset: 29
Location:Colorado  Entered:2010-01-29
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: Pregnancy @ 21 weeks. Class B Diabetes.
Diagnostic Lab Data: Serial ultrasounds
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA276AA IMLA
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER1007390IMRA
Administered by: Private     Purchased by: Public
Symptoms: Foetal growth retardation, Ultrasound scan
SMQs:, Foetal disorders (narrow)
Write-up: Intrauterine growth retardation (IUGR)

VAERS ID:378869 (history)  Vaccinated:2010-01-27
Age:26.0  Onset:2010-01-29, Days after vaccination: 2
Gender:Female  Submitted:2010-01-30, Days after onset: 1
Location:Michigan  Entered:2010-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Raised red rash at injection site as well as around neck and spots on trunk and back.

VAERS ID:378952 (history)  Vaccinated:2010-01-19
Age:26.0  Onset:2010-01-19, Days after vaccination: 0
Gender:Female  Submitted:2010-01-21, Days after onset: 2
Location:Ohio  Entered:2010-02-01, 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:
Preexisting Conditions: Allergies pcn, cedar, MACROBID, DEMEROL - environmental allergies
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP101AA0IMAR
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Reported today a local reaction at injection site. Described 5" swelling, painful & warm to touch. Taking BENEDRYL po. Today reports less swelling - 2" - less discomfort. 1-22-2010 Reported fever 100.8 degrees.

VAERS ID:379157 (history)  Vaccinated:2009-10-04
Age:26.0  Onset:2009-10-04, Days after vaccination: 0
Gender:Female  Submitted:2010-02-02, Days after onset: 121
Location:Florida  Entered:2010-02-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic pain. Anxiety. Had "stomach flu" day before injections with vomiting and diarrhea.
Preexisting Conditions: None known
Diagnostic Lab Data: none known
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97845P1 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0632Y0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Generalised erythema, Heart rate irregular, Myalgia, Pruritus generalised, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Cardiac arrhythmia terms, nonspecific (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Got influenza shot, then the pneumonia. Immediately after the pneumonia shot got redness and itching all over body, faintness, then hives developed, erratic pulse, muscle aches. Given epinephrine sq with some relief of symptoms.

VAERS ID:379200 (history)  Vaccinated:2009-12-30
Age:26.0  Onset:2010-01-06, Days after vaccination: 7
Gender:Male  Submitted:2010-01-22, Days after onset: 16
Location:Washington  Entered:2010-02-03, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Food poisoning; seasonal allergies, head cold & stomach flu
Preexisting Conditions: Adult A.D.H.D.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Public     Purchased by: Public
Symptoms: Influenza, Nasopharyngitis
SMQs:
Write-up: ~2.5 - 3+ weeks & counting of all cold & all Flu Symptoms! EXEDRIN MAX STRENGTH & ROBITUSSIN DM MAX.

VAERS ID:379264 (history)  Vaccinated:2010-01-22
Age:26.0  Onset:2010-02-01, Days after vaccination: 10
Gender:Female  Submitted:2010-02-03, Days after onset: 2
Location:California  Entered:2010-02-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER 3 LA
Administered by: Military     Purchased by: Military
Symptoms: Dyskinesia, Injection site induration, Injection site pain, Injection site swelling
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Usual pain at inj site shortly after receiving inj which lasted 2d and then completely resolved. 10d later, some painful "twinges" were noticed near the inj site. Evening of 2FEB, noticed that segment of deltoid that had been injected was now indurated and protruding. The affected area runs from the origin to the insertion of that segment of the R deltoid only. After the muscle is flexed, it remains notably sore afterward. I asked my fellow fligt surgeons about the rxn this morning - none had heard of such rxn.

VAERS ID:379287 (history)  Vaccinated:2010-01-12
Age:26.0  Onset:2010-01-12, Days after vaccination: 0
Gender:Female  Submitted:2010-02-03, Days after onset: 22
Location:California  Entered:2010-02-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP032AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain at site with weakness in arm d/t pain, continued for 2 weeks

VAERS ID:379625 (history)  Vaccinated:2010-02-06
Age:26.0  Onset:2010-02-07, Days after vaccination: 1
Gender:Male  Submitted:2010-02-07, Days after onset: 0
Location:California  Entered:2010-02-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None, pt denies concurrent illness.
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS105050P10IMRA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Oropharyngeal pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Low grade fevers (99.9 - 100.2), cough, & sore throat.

VAERS ID:379649 (history)  Vaccinated:2010-01-06
Age:26.0  Onset:2010-01-20, Days after vaccination: 14
Gender:Male  Submitted:2010-02-08, Days after onset: 19
Location:Virginia  Entered:2010-02-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: denies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV214 UNUN
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS104040P1 UNUN
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURERVV04003A  UN
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURERE02131 IMUN
Administered by: Military     Purchased by: Military
Symptoms: Eye discharge, Ocular hyperaemia, Photosensitivity reaction
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Glaucoma (broad), Hypersensitivity (broad)
Write-up: Stated he was vaccinated on 06 Jan and keep the site covered at all times and practiced frequent handwashing. The area on arm is almost healed and he had very little drainage. He noticed that his rt eye was starting to turn red with clear drainage last Wed - 20 Jan, inc redness and drainage on 21 Jan, then during the weekend it spread to left eye. He denies eye pain but reports photosensitivity. No problems with vision and drainage has remained clear. No other sx. Did see ophtho - and placed him on a steroid eye drop and anbx. Is feeling better this pm.

VAERS ID:379784 (history)  Vaccinated:2010-01-12
Age:26.0  Onset:2010-01-19, Days after vaccination: 7
Gender:Male  Submitted:2010-02-08, Days after onset: 20
Location:Kansas  Entered:2010-02-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Denies
Preexisting Conditions: Denies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV223 UNUN
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A IDUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B049AA UNUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURB09802 IMUN
Administered by: Military     Purchased by: Military
Symptoms: Chills, Malaise, Migraine, Pain, Rhinorrhoea
SMQs:
Write-up: On Day 7 he began to notice runny nose, chills and aching. Since the 21st he has been waking up with migraines (no hx of headaches), extreme hangover type feeling and just not feeling right. No Medical attention.

VAERS ID:379788 (history)  Vaccinated:2010-01-27
Age:26.0  Onset:2010-01-27, Days after vaccination: 0
Gender:Female  Submitted:2010-01-28, Days after onset: 1
Location:Washington  Entered:2010-02-08, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3224BB IMRA
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Private
Symptoms: Eye inflammation, Eye pain, Eye pruritus
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad), Corneal disorders (broad)
Write-up: Right eye inflamed and itchy and painful. Unknown if symptoms are related to vaccine. Pt only received seasonal flu. Galyna did not get the H1N1 F/U.

VAERS ID:380079 (history)  Vaccinated:2009-11-10
Age:26.0  Onset:2009-11-12, Days after vaccination: 2
Gender:Male  Submitted:2010-02-12, Days after onset: 92
Location:South Carolina  Entered:2010-02-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 17 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Pt denies
Preexisting Conditions: NKDA
Diagnostic Lab Data: 13 Nov 2009, CT, Head w/o contrast: The ventricles, sulci, and subarachnoid cisterns are normal in size and configuration. No abnormal areas of attenuation are present within the brain parenchyma. No subarachnoid hemorrhage or abnormal extra-axial fluid collections are present. There is no evidence for intracranial mass or herniation. The calvarium, skull base, orbits, and paranasal sinuses are unremarkable. No acute intracranial bleed, mass or fracture.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.102040P1A UNUN
Administered by: Military     Purchased by: Military
Symptoms: Areflexia, Ataxia, Balance disorder, Computerised tomogram normal, Diplopia, Dizziness, Gait disturbance, Haematuria, Headache, Hypoaesthesia, Hyporeflexia, Impaired work ability, Miller Fisher syndrome, Ophthalmoplegia, Pyrexia, Sinus headache, VIth nerve paralysis, Visual impairment, Vitamin B1 decreased, Vitamin B12 decreased
SMQs:, Peripheral neuropathy (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 22 Oct 2009 - SM received his 2nd TWINRIX vaccine. He does not recall any unusual or prolonged local reactions or systemic symptoms following vaccine receipt. He specifically denied any symptoms of upper respiratory or gastrointestinal symptoms during weeks prior to or on the day of vaccine receipt. 10 Nov 2009 - SM received H1N1 vaccine (IM). Following administration of the H1N1 vaccine, SM does not recall any unusual reactions at the vaccination site. He denies being sick at the time he received this vaccine. He specifically denies upper respiratory or gastrointestinal symptoms during weeks prior to or on day of vaccine receipt. 12 Nov 2009 - SM sought evaluation for lightheadedness, double vision, problems with equilibrium, and numbness in his extremities. He was treated with IVF and placed on quarters x 24 hours. 13 Nov 2009 - SM returned to the clinic for evaluation of double vision, problems with balance, headache and tingling sensation in his extremities and across his upper chest. He had a normal CT of his head, On exam, his DTRs were diminished and SM had an ataxic gait. He was evaluated by Optometry, who assessed his diplopia as EOM palsy/6th nerve with other neurological symptoms not of ocular origin. SM was also referred to Internal Medicine, who after examination consulted with Neurology. Neurology felt SM had Miller-Fisher Syndrome and should recover spontaneously. 20 Nov 2009 - SM was evaluated by Neurology. It was noted that SM reported about a 2 week history of URI symptoms, with ongoing headache and sinus pressure. At time of evaluation, reported symptoms had stabilized, but SM continued to have diplopia, tingling in his feet and fingers and difficulty walking. Neurology Assessment: Trial of opthalmoparesis, areflexia, ataxia is consistent with Miller Fisher syndrome, particularly in the absence of evidence of brain lesion on imaging. The onset 2 days after that H1N1 vaccine would be relatively quick but cannot rule out this as an etiology. His prior upper respiratory symptoms indicate likely viral infection a