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Case Details (Sorted by Age)

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VAERS ID:523885 (history)  Vaccinated:2013-11-11
Age:38.0  Onset:2013-11-11, Days after vaccination: 0
Gender:Female  Submitted:2013-11-25, Days after onset: 14
Location:California  Entered:2014-02-24, Days after submission: 91
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2013SE86905
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Underdose
SMQs:
Write-up: A report has been received from a Pharmacist concerning a 38 year old, female subject, who had been receiving FLUMIST. FLUMIST started on 11-Nov-2013. The reporter stated that the patient was administered only a half dose of FLUMIST in one nostril which started on 11-Nov-2013. The outcome of the event of administration of only a half dose of FLUMIST in one nostril is unknown. The report was considered to be non-serious.

VAERS ID:523950 (history)  Vaccinated:2013-11-11
Age:38.0  Onset:2013-11-11, Days after vaccination: 0
Gender:Female  Submitted:2013-11-25, Days after onset: 14
Location:California  Entered:2014-02-24, Days after submission: 91
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2013SE86889
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Underdose
SMQs:
Write-up: A report has been received from a Pharmacist concerning a 38 year old, female subject, who had been receiving FLUMIST. FLUMIST started on 11-Nov-2013. The patient experienced administration of only a half dose of FLUMIST in one nostril, which started on 11-Nov-2013. The outcome of the event of administration of only a half dose of FLUMIST in one nostril is unknown. The report was considered to be non-serious by the reporter.

VAERS ID:523680 (history)  Vaccinated:2011-02-01
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-02-25
Location:Unknown  Entered:2014-02-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1402USA010407
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abortion spontaneous, Exposure during pregnancy, Inappropriate schedule of drug administration, Wrong drug administered
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: This spontaneous retrospective pregnancy report as received from a consumer (patient''s sister) refers to a 38 year old female patient with allergy to sulfur products. The patient did not have a pertinent medical history. Approximately in February 2011 (reported as "about 3 years ago") the patient was vaccinated with a dose of ZOSTAVAX (one time vaccine) erroneously. Dose, route and lot number were not provided. There were no concomitant medications. It was reported that the patient was under age for ZOSTAVAX. The reporter further stated that her sister was to get the Malaria vaccine, but was accidentally given ZOSTAVAX instead. It was reported that the patient had experienced 3 miscarriages since taking the ZOSTAVAX vaccine. The adverse event onset date was reported as "late 2011". This report concerns one of the three miscarriages. The Last Menstrual Period (LMP) and Estimated Date of Delivery (EDD) is not known. The pregnancy outcome was spontaneous abortion. Reporter causality was not provided. The event "3 miscarriages since taking the ZOSTAVAX vaccine" was considered medically significant upon internal review. This case is linked to 1402USA011619 and 1402USA011620 (same patient). Additional information has been requested.

VAERS ID:524562 (history)  Vaccinated:2014-01-27
Age:38.0  Onset:2014-01-27, Days after vaccination: 0
Gender:Female  Submitted:2014-03-05, Days after onset: 37
Location:Texas  Entered:2014-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1401USA012775
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a patient of unknown age and gender. The pharmacist reported that the patient was administered a M-M-R II series on an unspecified dates when was younger (doses, route and lot numbers not provided); however they did not have documentation of these vaccinations. On 27-JAN-2014 the patient was at the pharmacy and the pharmacist would be administering a dose of M-M-R II (dose, route and lot number not provided). No adverse effects were reported. Follow up information as received from the pharmacist refers to the approximately 38 year old female patient. The patient was unsure whether or not she received M-M-R II in the past. She had immigrated and she did not have a vaccination record. The pharmacist administered one dose of M-M-R II on 27-JAN-2014. Additional information is not expected.

VAERS ID:525431 (history)  Vaccinated:2011-05-01
Age:38.0  Onset:2011-05-01, Days after vaccination: 0
Gender:Female  Submitted:2014-03-10, Days after onset: 1044
Location:Michigan  Entered:2014-03-10
Life Threatening? No
Died? Yes
   Date died: 2013-01-03
   Days after onset: 613
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses
Preexisting Conditions: No
Diagnostic Lab Data: Na
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNUN
Administered by: Unknown     Purchased by: Private
Symptoms: Cardiac disorder, Cerebrovascular accident, Death
SMQs:, Ischaemic cerebrovascular conditions (narrow), Haemorrhagic cerebrovascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow)
Write-up: I have to confirm the dates with her Nursing school, but approximately two weeks after receiving the shot my sister experienced stroke like symptoms, she went to the doctors and had to take off from school. Her heart was not checked, but had never been diagnosed with heart problems about a year later she died in her sleep from a heart problem that was misdiagnosed.

VAERS ID:525686 (history)  Vaccinated:2014-03-07
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-03-13
Location:Unknown  Entered:2014-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1403USA004911
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, No adverse event, Wrong drug administered
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This spontaneous prospective pregnancy report as received from a pharmacist refers to a 38 year old female patient. On 07-MAR-2014 the pregnant patient was inadvertently received a dose of GARDASIL (lot #, expiration date and dose unspecified), intramuscular instead of TDAP. No adverse effect was reported. The patient became pregnant with last Menstrual Period (LMP) of 09-AUG-2013 and Estimated date of delivery (EDD) of 16-MAY-2014. Initial exposure to GARDASIL was at 30 weeks. The pregnancy outcome was outcome pending. Additional information has been requested.

VAERS ID:525839 (history)  Vaccinated:2013-06-09
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2014-02-27
Location:Texas  Entered:2014-03-14, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hepatitis B Carrier
Preexisting Conditions: Hepatitis B; There were no other vaccinations administered on the same date.
Diagnostic Lab Data: UNK
CDC Split Type: A1031798A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB672AA UNLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Gait disturbance, Influenza like illness, Joint swelling, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: This case was reported by a physician and described the occurrence of fever in a 38-year-old male subject who was vaccinated with HAVRIX (GlaxoSmithKline). Relevant medical history included history of hepatitis b, hepatitis b carrier. On 9 June 2013 the subject received a dose of HAVRIX (1 ml, unknown route, left arm). In June 2013, less than one week after vaccination with HAVRIX, the subject presented to the physician having experienced fever, joint pain, joint swelling, rash, flu like symptoms and walking difficulty. At the time of reporting the events were unknown. The physician reported another case with HAVRIX. See case A1031781A for details on the other case.

VAERS ID:526176 (history)  Vaccinated:2014-03-05
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-03-19
Location:Michigan  Entered:2014-03-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall XR 20 MG
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSU4837AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad)
Write-up: Chills and skin discoloration.

VAERS ID:526280 (history)  Vaccinated:2014-03-06
Age:38.0  Onset:2014-03-07, Days after vaccination: 1
Gender:Female  Submitted:2014-03-20, Days after onset: 12
Location:Massachusetts  Entered:2014-03-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: Xray and MRI and Orthopedic Examination
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRRA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Joint range of motion decreased, Mobility decreased, Nuclear magnetic resonance imaging, X-ray
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Severe Pain in Left Shoulder radiating down through the upper arm region. Sharp and throbbing with decreased range of motion and mobility. Increasing pain daily.

VAERS ID:526826 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:2014-03-01
Gender:Female  Submitted:2014-03-27, Days after onset: 25
Location:Unknown  Entered:2014-03-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC; FLONASE
Current Illness: Rhinitis allergic
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1403USA012175
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0133450IMLA
Administered by: Other     Purchased by: Other
Symptoms: Influenza like illness, Pain in extremity
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a 38 years old female patient with allergic rhinitis. On 20-MAR-2014 the patient was vaccinated with PNEUMOVAX 23 (lot # J013345 exp date 11-JAN-2015) dose 1, .5ml, intramuscular in the left arm. Concomitant therapies included ZYRTEC and FLONASE. Medical assistant does not think the patient has received PNEUMOVAX in the past. In March 2014 the patient experienced flu-like symptoms and soreness of the left arm. The outcome of flu-like symptoms and soreness of the left arm was reported as recovering. The patient sought medical assistance at the office on 24-MAR-2014, none labs were performed and the patient was treated with acetaminophen/hydrocodone tablet. Additional information has been requested.

VAERS ID:527439 (history)  Vaccinated:2014-03-31
Age:38.0  Onset:2014-04-01, Days after vaccination: 1
Gender:Female  Submitted:2014-04-03, Days after onset: 2
Location:Maryland  Entered:2014-04-03
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: Codeine, Bactrim allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1SYRRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Fatigue, Injection site pain, Injection site swelling, Injection site warmth, Nasal congestion, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Felt achy, took alieve and went to work. Got progressively worse, extreme fatigue, nausea and aches by 2:30pm. Injection site hot, puffy and painful. Got home, took another Aleve and slept. Felt better next day, but still achy, nauseous and injection site still hot and sore. Took alieve all day but still felt weak and now slightly flu like soreness around eyes and body weakness, nauseous and nasal congestion. Injection site still hot and sore.

VAERS ID:527508 (history)  Vaccinated:2013-11-15
Age:38.0  Onset:2014-03-05, Days after vaccination: 110
Gender:Female  Submitted:2014-04-03, Days after onset: 28
Location:Massachusetts  Entered:2014-04-03
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Environmental allergies, asthma
Diagnostic Lab Data: Spinal tap
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS  UNLA
Administered by: Unknown     Purchased by: Other
Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Influenza, Lumbar puncture, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: I don''t know if there''s a link, but I got Guillain-Barre syndrome diagnosed in early March 2014. I also had a confirmed case of the flu in January, after getting the shot. Symptoms were typical GBS: numb hands, muscle weakness, etc.

VAERS ID:527514 (history)  Vaccinated:2014-04-02
Age:38.0  Onset:2014-04-03, Days after vaccination: 1
Gender:Female  Submitted:2014-04-03, Days after onset: 0
Location:Massachusetts  Entered:2014-04-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole; CELEXA; ZYRTEC; ORSYTHIA; Flunisolide
Current Illness: Sinusitis
Preexisting Conditions: Sulfa; Codeine; Eggs; PERCOCET
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURERJ0144011UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 3 red spots, warm to touch and sore arm.

VAERS ID:527660 (history)  Vaccinated:2014-04-03
Age:38.0  Onset:2014-04-03, Days after vaccination: 0
Gender:Female  Submitted:2014-04-04, Days after onset: 1
Location:Texas  Entered:2014-04-04
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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0111251UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: < 24 hrs after administering 2nd dose varicella, experienced itching and swelling, redness, 4" x 4".

VAERS ID:528045 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-04-04
Location:Unknown  Entered:2014-04-10, 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: Beclomethasone; Fluticasone propionate; Ketotifen; Albuterol; Corticosteroids
Current Illness: Conjunctivitis allergic with sensitization to tree, grass, dust mite, cat, alternaria species and perennial mold; Asthma
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHHY2014US039847
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Asthma, Condition aggravated, Impaired work ability, Influenza
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Case number PHHY2014US039847 is an initial literature report received on 01 Apr 2014. The author discussed about the effect of influenza vaccine in asthmatic patients. This report refers to a 38-year-old female patient. She was a mother to two children aged 5 and 3 years old. Her medical history included allergic rhinoconjunctivitis with sensitization to tree, grass, dust mite, cat, alternaria species and perennial mold in addition to well controlled asthma. She managed with 2 puffs of 40 mg of beclomethasone inhaled twice daily, 2 nasal squirts of 50 mg of fluticasone propionate daily and intermittent use of over-the-counter ketotifen ocular drops as needed. She used her Albuterol inhaler before exercise and intermittently (no more than once per week). It was reported that the previous few years, she averaged approximately 4 exacerbations per year and all required oral corticosteroid courses. The patient was vaccinated with influenza vaccine (manufacturer and batch number: not reported, so conservatively coded as influenza vaccine INN (seasonal or pandemic)) on an unknown dates in the past 2 years. On an unknown date, the patient contracted influenza and had an asthma exacerbation causing her to miss a day of work despite receiving the vaccine. She reported past asthma flared up within a month of vaccination, which in part has motivated her decision to defer influenza vaccination for some years. She expressed that she does not want to get sick from the vaccine and that some years she felt the vaccine does not work. The author concluded that influenza vaccine itself was linked to causing any asthma flares or contraction of influenza virus but it need to be discussed that vaccination might not prevent influenza-related asthma complications. In past years, the main circulating strain of influenza B has not been in the vaccine, validating the patient''s concern that vaccine efficacy might not be optimal in some years. However, vaccination is still the best recommendation to prevent her from contracting influenza and highlight that new quadrivalent vaccines are available that will hopefully provide more robust coverage against circulating influenza strains. It was reported that the patient was re-vaccinated with influenza vaccine (manufacturer and batch number: not reported) on an unknown date and this time she was without any issue and neither had any asthma-related complications during the influenza season.

VAERS ID:528231 (history)  Vaccinated:2014-02-11
Age:38.0  Onset:2014-02-28, Days after vaccination: 17
Gender:Female  Submitted:2014-04-13, Days after onset: 43
Location:North Carolina  Entered:2014-04-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Prenatal vitamins
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Exposure during pregnancy, Foetal death
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: I was 21 weeks pregnant when I received the Flu vaccine and in less than 2 weeks later my baby was dead. I believe the flu shot was poison to my baby.

VAERS ID:528413 (history)  Vaccinated:2014-04-08
Age:38.0  Onset:2014-04-09, Days after vaccination: 1
Gender:Male  Submitted:2014-04-10, Days after onset: 1
Location:Pennsylvania  Entered:2014-04-14, 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: WELLBUTRIN; EFFEXOR XR
Current Illness: None
Preexisting Conditions: Depression
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS2RY59 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Diarrhoea, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Nausea, vomiting, diarrhea, chills, headache. Sx began 12 hrs after vaccine given. Sx improved in 24 hrs. I was given the TDAP vaccine (0.5ml, Lot# U4329AA) on 5/30/2012 for having a metal wire pierce my foot. To this day I am experiencing: a dull pain, itching, prickly burning sensation in the area at the injection site. There is nothing visually seen in the area on the surface of the Lt deltoid where the vaccine was administered (no swelling, not hot with fever, and not red). There is just an uncomfortable feeling in the area of the dose administration constantly.

VAERS ID:528509 (history)  Vaccinated:2014-04-04
Age:38.0  Onset:2014-04-04, Days after vaccination: 0
Gender:Male  Submitted:2014-04-15, Days after onset: 11
Location:Unknown  Entered:2014-04-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1404USA004217
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0471AE0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to 38 year old male patient. On 04-APR-2014 (reported as today), the patient was vaccinated with the first dose of expired VARIVAX, lot # 0471AE, expiration date 02-APR-2014, 0.5 ml, subcutaneous. No adverse effects were reported. Additional information has been requested.

VAERS ID:528612 (history)  Vaccinated:2014-04-14
Age:38.0  Onset:2014-04-15, Days after vaccination: 1
Gender:Female  Submitted:2014-04-16, Days after onset: 1
Location:Kansas  Entered:2014-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, prenatal vitamin, other vitamins
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Feeling cold, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea, vomiting, headache, felt cold but did not check for a fever.

VAERS ID:528689 (history)  Vaccinated:2014-04-04
Age:38.0  Onset:2014-04-04, Days after vaccination: 0
Gender:Female  Submitted:2014-04-17, Days after onset: 13
Location:Unknown  Entered:2014-04-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1404USA008690
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.  SCUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse refers to a 38 year old female patient. On 04-APR-2014, the patient was vaccinated with a dose of PROQUAD (Merck), subcutaneous (lot # and expiration date were not provided). Other suspect therapies also administered on 04-APR-2014, included VARIVAX (Merck) (route, lot # and expiration date were not provided). On 04-APR-2014, when the patient was 38 years old, she received PROQUAD (Merck) and VARIVAX (Merck) in error. There were no known adverse effects. It was unknown if the patient sought medical attention. At the time of the report, the patient''s status was unknown. Additional information has been requested.

VAERS ID:528751 (history)  Vaccinated:2014-03-28
Age:38.0  Onset:2014-03-30, Days after vaccination: 2
Gender:Female  Submitted:2014-04-17, Days after onset: 18
Location:Minnesota  Entered:2014-04-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Topiramate, Pregabalin, Eletriptan, Rizatriptan, Acetaminophen, Ibuprofen
Current Illness: None reported
Preexisting Conditions: History of Fibromyalgia. Patient has excessive bruising but hasn''t identified a cause.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4668AA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 2 days after injection patient reported to urgent care with worsening and spreading pain and redness at the site of injection. She also had warmth and tenderness at the injection site. She was diagnosed with cellulitis and treated with Cephalexin.

VAERS ID:529171 (history)  Vaccinated:2014-01-17
Age:38.0  Onset:0000-00-00
Gender:Unknown  Submitted:2014-04-22
Location:Unknown  Entered:2014-04-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1404USA011296
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J005067 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a nurse refers to a 38 year old patient. Medical history and concurrent conditions were not reported. On 17-JAN-2014, the patient was vaccinated with PNEUMOVAX 23 lot # J005067; expiration date: 17-JAN-2015 (dose, strength and route were not reported). Secondary and concomitant therapies were not reported. Nurse called and stated that improperly stored PNEUMOVAX 23 was administered to patient. No adverse effects reported. On 13-JAN-2014, PNEUMOVAX 23 was stored outside of recommended temperatures for 2 hours (2 pm - 4 pm) the temperature recorded was 50 degrees F. On 18-JAN-2014, PNEUMOVAX 23 was stored outside of recommended temperatures for 2 hours (2 pm - 4 pm) the temperature recorded was 49.1 degrees F. On 10-FEB-2014, PNEUMOVAX 23 was stored outside of recommended temperatures for 6 hours (12 pm - 6 pm) the temperature recorded was 51.8 degrees F. On 16-FEB-2014, PNEUMOVAX 23 was stored of recommended temperatures for 5 hours (12 pm - 5 pm) the temperature recorded 51.8 degrees F. On 22-FEB-2014, PNEUMOVAX 23 was stored outside of recommended temperatures for 4 hours (2 pm - 6 pm) the temperature recorded was 52.7 degrees F. On 09-MAR-2014, PNEUMOVAX 23 was stored outside of recommended temperatures for 2 hours ((12 pm - 10 pm) the temperature recorded was 55.4 degrees F. On 15-MAR-2014, PNEUMOVAX 23 was stored outside of recommended temperatures for 6 hours (8 am - 2 pm) the temperature recorded was 50 degrees F. On 16-MAR-2014, PNEUMOVAX 23 was stored outside of recommended temperatures for 20 hours (2 am - 10 pm) the temperature recorded was 64.4 degrees F. On 17-MAR-2014, PNEUMOVAX 23 the temperature reading on the morning was 64.8 degrees F. The total of hours stored outside of recommended temperatures was 55 hours. This is one of several reports from the same reporter. Additional information has been requested.

VAERS ID:529590 (history)  Vaccinated:2014-04-23
Age:38.0  Onset:2014-04-23, Days after vaccination: 0
Gender:Female  Submitted:2014-04-23, Days after onset: 0
Location:Connecticut  Entered:2014-04-28, 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: Prenatal vitamins
Current Illness: None
Preexisting Conditions: Pregnancy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURCU328AA UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Exposure during pregnancy, Pruritus generalised, Rash
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow)
Write-up: Pt is 38 yo G4 P3 at 32 wks. Was given Tdap today as routine care. After 10-15 min, pt still at laboratory, she started to experience rash on arms and itchy on entire body. No difficulty breath or SOB or throat.

VAERS ID:530212 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:2014-04-01
Gender:Female  Submitted:2014-05-06, Days after onset: 35
Location:New York  Entered:2014-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ENPRESSE
Current Illness: Contraception
Preexisting Conditions:
Diagnostic Lab Data: Dermatologist obtained a biopsy of one of the lesions on 30-APR-2014. Result of biopsy was not available. 03/14/2014, Blood immunoglobulin G, less than 0.91 N/A
CDC Split Type: WAES1405USA001725
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Biopsy skin, Blood immunoglobulin G decreased, Pain, Papule, Skin lesion
SMQs:, Dementia (broad)
Write-up: This spontaneous report as received from a physician refers to a 38 year old female patient. The patient had no pertinent medical history or drug reactions/allergies. On 16-APR-2014 the patient was vaccinated with the first 0.5ml dose of VARIVAX (lot# unspecified) (subcutaneous, location unspecified) for "by lab patient was susceptible to varicella". Concomitant therapies included ENPRESSE for birth control. The reporter stated that on an unspecified date in April 2014 after the administration of VARIVAX the patient felt achy (described by physician "as a little bit of a prodrome") and on the next day on an unspecified date in April 2014 she had a lesion on her right wrist. On an unspecified date in April 2014 the patient then developed lesions on her left upper chest, stomach and legs which were itchy since an unspecified date. Patient had sought medical attention with a dermatologist on an unspecified date in April after the administration of VARIVAX. Dermatologist described lesions to physician, as papular and not vesicular which could possible be spider bites. Result of IGG (Blood immunoglobulin G) prior to administration of VARIVAX on 14-MAR-2014 was "less than 0.91". Dermatologist obtained a biopsy of one of the lesions on 30-APR-2014. Result of biopsy was not available. Treatment for lesions since an unspecified date was BENADRYL and ADVIL. Physician described patient as recovering and "back to work" since an unspecified date. Additional information has been requested.

VAERS ID:530631 (history)  Vaccinated:2014-05-08
Age:38.0  Onset:2014-05-12, Days after vaccination: 4
Gender:Female  Submitted:2014-05-12, Days after onset: 0
Location:Florida  Entered:2014-05-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: History of high Blood Pressure and shortness of breath.
Preexisting Conditions: History of high blood pressure and shortness of breath
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABA065A IMLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pain in extremity, Skin warm, Upper extremity mass
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Painful, warm, redness, and lump at left arm.

VAERS ID:531381 (history)  Vaccinated:2014-05-19
Age:38.0  Onset:2014-05-20, Days after vaccination: 1
Gender:Male  Submitted:2014-05-20, Days after onset: 0
Location:New York  Entered:2014-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: HEADACHE, NAUSEA, VOMITING, HEADACHE~Influenza (Seasonal) (no brand name)~~26.00~Patient
Other Medications: NONE
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0030740IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Diarrhoea, Headache, Induration, Local swelling, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: SEVERE HEADACHE, LOCAL SWELLING AND INDURATION, NAUSEA WITH VOMITING, DIARRHEA, WEAKNESS, FEVER.

VAERS ID:531515 (history)  Vaccinated:2014-04-27
Age:38.0  Onset:2014-04-29, Days after vaccination: 2
Gender:Male  Submitted:2014-05-20, Days after onset: 21
Location:Michigan  Entered:2014-05-21, 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
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS7734Y UNLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Joint range of motion decreased, Pain in extremity
SMQs:, Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: 2 days after Tdap - arm painful, decreased ROM, decreased strength.

VAERS ID:531822 (history)  Vaccinated:2014-05-22
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2014-05-22
Location:Wyoming  Entered:2014-05-22
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
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC199AA1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: None.

VAERS ID:531771 (history)  Vaccinated:2014-05-21
Age:38.0  Onset:2014-05-22, Days after vaccination: 1
Gender:Male  Submitted:2014-05-23, Days after onset: 1
Location:Minnesota  Entered:2014-05-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR  IMLA
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Fatigue, Pyrexia, Somnolence
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Significant fatigue, low fever, required 2 days away from work to sleep (have never had this type or degree of reaction before). Significantly impaired ability to perform normal daily tasks.

VAERS ID:532287 (history)  Vaccinated:2014-05-22
Age:38.0  Onset:2014-05-24, Days after vaccination: 2
Gender:Male  Submitted:2014-05-29, Days after onset: 5
Location:Maryland  Entered:2014-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazol (20)
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: n/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4344AB0IDLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Dysgeusia, Headache, Injection site pain, Toothache
SMQs:, Taste and smell disorders (narrow), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Headache, joint pain, tooth pain, metal taste in mouth, soreness at injection site.

VAERS ID:532582 (history)  Vaccinated:2014-05-15
Age:38.0  Onset:2014-05-15, Days after vaccination: 0
Gender:Female  Submitted:2014-06-01, Days after onset: 17
Location:New York  Entered:2014-06-01
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
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site urticaria, Local swelling, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: During the first week after the Tdap vaccine, my arm swelled up and became very hot in temperature. During the second week after the shot, I developed hives all over my body, especially concentrated in the arm where the shot was administered.

VAERS ID:532648 (history)  Vaccinated:2014-05-27
Age:38.0  Onset:2014-05-27, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:2014-06-01
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
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD 0PO 
Administered by: Other     Purchased by: Private
Symptoms: Oral administration complication, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient administered VIVOTIF - typhoid oral vaccine - experienced vomiting.

VAERS ID:532937 (history)  Vaccinated:2014-06-02
Age:38.0  Onset:2014-06-02, Days after vaccination: 0
Gender:Female  Submitted:2014-06-03, Days after onset: 1
Location:Florida  Entered:2014-06-03
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
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0119980UNLA
Administered by: Private     Purchased by: Other
Symptoms: Neck pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Patient received vaccine in the office on 6/2/14 around 10:30am, patient called the office on 6/3/14 at 1:36pm stating that she was having fevers of 102.0 degrees, arm and neck pain.

VAERS ID:534596 (history)  Vaccinated:2014-06-11
Age:38.0  Onset:2014-06-13, Days after vaccination: 2
Gender:Male  Submitted:2014-06-20, Days after onset: 7
Location:North Carolina  Entered:2014-06-20
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: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0119980IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSN59M30IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt called back and stated he chose to have both injections in the RD. Pt then called back and stated he was having chills, achy and one episode of nausea. Pt did not call back for 2 day with this information. Pt was advised to use TYLENOL for fever and if worsening needs visit.

VAERS ID:534694 (history)  Vaccinated:2014-05-27
Age:38.0  Onset:2014-05-27, Days after vaccination: 0
Gender:Female  Submitted:2014-06-19, Days after onset: 23
Location:Illinois  Entered:2014-06-23, 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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV1: JAPANESE ENCEPHALITIS (IXIARO)INTERCELL AGJEV13A32E0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ05130IMRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Immediate post-injection reaction, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Immediately following injection pt stated she felt pain at the site, tingling, and lightheadedness. Waited a few minutes and left. Stated pain x48 hours then OK.

VAERS ID:535084 (history)  Vaccinated:2013-09-16
Age:38.0  Onset:2013-09-16, Days after vaccination: 0
Gender:Female  Submitted:2014-06-06, Days after onset: 263
Location:North Carolina  Entered:2014-06-27, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: There were no concomitant vaccinations or medications and no relevant medical history. The subject had received flu shots in the past with no adverse events. The subject had not experienced adverse events following other previous vaccinations. The subject had received FLUARIX before
Diagnostic Lab Data: UNK
CDC Split Type: A1043132A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSTP225 UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Local reaction, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of pain in arm from flu shot in a 38-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). On 16 September 2013 (in the afternoon) the subject received a dose of FLUARIX (.5 cc, unknown route, left deltoid). On 16 September 2013, immediately after vaccination with FLUARIX, the subject experienced "shooting pain from injection site down to wrist". The event was reported as a local injection site reaction. On 17 September 2013, the event was resolved. The healthcare professional considered the event was probably related to vaccination with FLUARIX. On 11 October 2013, follow-up was received from the healthcare professional. It was reported that the ''pain in arm from flu shot'' resolved on 18 September 2013 (initial report indicated the event resolved on 17 September 2013). The reporter did not consider the event to be serious. It was indicated that this case was not reported to a regulatory agency. It was reported that no action was taken with the FLUARIX. The subject had received FLUARIX before. The subject had not experienced any adverse events following previous vaccinations.

VAERS ID:535130 (history)  Vaccinated:2013-09-27
Age:38.0  Onset:2013-09-30, Days after vaccination: 3
Gender:Female  Submitted:2014-06-06, Days after onset: 249
Location:West Virginia  Entered:2014-06-27, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; Chlorothiazide; Sertraline hydrochloride; ADDERALL
Current Illness: Unknown
Preexisting Conditions: There were no other vaccinations administered on the same date. At the time of reporting, there was no relevant medical history, including no cardiac problem history. There were no reported adverse reactions to previous vaccinations, including flu shots.
Diagnostic Lab Data: Holter monitoring normal, Oct2013, see text; On 10 October 2013, the subject visited the emergency and was placed on "a 24 hour Holter monitor; she was monitored and all cardiac testing came back negative."
CDC Split Type: A1046193A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  UNRA
Administered by: Private     Purchased by: Other
Symptoms: Anxiety, Asthenia, Cardiac function test normal, Dizziness, Electrocardiogram ambulatory normal, Eye swelling, Fatigue, Heart rate increased, Lip swelling, Local swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional (subject and nurse) and described the occurrence of lip swelling in a 38-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). Concurrent medications included lisinopril, chlorothiazide, ZOLOFT and ADDERALL. On 27 September 2013 the subject received a dose of influenza vaccine unspecified (.5 ml, unknown route, right arm). On 30 September 2013, 3 days after vaccination with influenza vaccine unspecified, the subject experienced lip swelling, swelling of eyes, swelling of hands and feet, swelling of face. These symptoms occurred when she woke up on 30 September 2013. The subject sought medical care at an emergency room and was treated with BENADRYL and an unknown intravenous treatment. The subject did not stay in the emergency room overnight. On 10 October 2013, 13 days after vaccination with FLUARIX, the subject had a sudden onset of heart rate high, felt like about to pass out. The subject sought medical attention from the emergency room. "She had a 24 hour Holter monitor; she was monitored and all cardiac testing came back negative." On 12 October 2013, 15 days after vaccination with FLUARIX, the subject "woke up again with the same symptoms as of 10 October 2013 and she had to go again to the emergency room" and also experienced a feeling of doom (described as a "feeling of impending doom"). In 2013, within the same month of vaccination with FLUARIX, the subject also experienced feeling weak and feeling tired. At the time of reporting the outcome of the events of lip swelling, swelling of eyes, swelling of hands and feet, swelling of face, heart rate high, felt like about to pass out, and feeling of doom were resolved. The subject reported still feeling weak and tired at the time of reporting.

VAERS ID:535264 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-06-06
Location:Unknown  Entered:2014-06-27, Days after submission: 21
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: A1054849A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Adverse reaction
SMQs:
Write-up: This case was reported by a consumer via sales representative and described the occurrence of adverse reaction in a currently 38-year-old female subject who was vaccinated with influenza vaccine (unspecified) (manufacturer unspecified). A physician or other health care professional has not verified this report. On an unspecified date the subject received a dose of influenza vaccine (unspecified) (unknown details). At an unspecified time after vaccination with influenza vaccine (unspecified), the subject experienced adverse reaction. Per the reporter, she "had an adverse reaction to the flu vaccine years ago." No other details were provided. At the time of reporting the outcome of the event was unspecified.

VAERS ID:535630 (history)  Vaccinated:2014-07-01
Age:38.0  Onset:2014-07-01, Days after vaccination: 0
Gender:Male  Submitted:2014-07-02, Days after onset: 1
Location:South Carolina  Entered:2014-07-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pt denies
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV371A9IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Feeling hot, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, warmth, tenderness, swelling, given steriods and will follow up with PCM 3 July 14 to monitor.

VAERS ID:537188 (history)  Vaccinated:2014-05-12
Age:38.0  Onset:2014-05-12, Days after vaccination: 0
Gender:Female  Submitted:2014-07-22, Days after onset: 71
Location:Pennsylvania  Entered:2014-07-22
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: Many Allergies per pt report: Latex--hives; Most fruits except strawberries and cherries; neosporin--local reaction; iron supplements; food dyes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS35F271IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Depressed level of consciousness, Dizziness, Feeling hot, Somnolence
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Within 2-3 minutes of vaccine administration c/o feeling hot/dizzy; placed in supine position w/ legs elevated; pt c/o feeling sleepy became difficult to arouse, sternal rub caused her to opens eyes and answer questions w/ 1-2 word answers; VSS BP 120-144/80, HR 96 & regular; Resp 16 & non-labored; no hives; no rash; lungs clear; Transported to ER via ambulance by 3:10 pm. Per ER physician, ? syncope. Symptoms resolved in ER and was discharged to home.

VAERS ID:537282 (history)  Vaccinated:2014-07-18
Age:38.0  Onset:2014-07-18, Days after vaccination: 0
Gender:Female  Submitted:2014-07-22, Days after onset: 4
Location:Virginia  Entered:2014-07-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir 400 mg once a day.
Current Illness: None
Preexisting Conditions: Allergy to sulfa and penicillin, high cholesterol, herpes
Diagnostic Lab Data: Unsure as doctor''s appointment is scheduled for later today.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Burning sensation, Feeling hot, Immediate post-injection reaction, Injection site pain, Insomnia, Muscular weakness, Myalgia, Pain, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: As soon as the needle entered my arm I felt a warm, burning, painful sensation that increased as the vaccine was injected. Within minutes it started to hurt at the site of the injection. The pain continued to increase as the hours passed. The pain was not typical post-vaccine pain of muscle soreness but rather a pain that felt/feels like it is under the muscle and slightly electric in nature yet sore as well. I have some weakness in my right arm and any movement of my arm significantly increases the pain. I have had great difficulty sleeping for the past four nights because of the pain in my arm. It is impossible to find a position when lying down that doesn''t make my arm hurt. When I''m up for the day, my arm has continued to hurt consistently with an increase in pain when I move it. I do not have any other symptoms. Just the pain in my arm and some perceived weakness in my arm/shoulder. It is now July 22, 2014 and I am still having pain and have made an appointment with my doctor today.

VAERS ID:538227 (history)  Vaccinated:2013-04-21
Age:38.0  Onset:2014-07-03, Days after vaccination: 438
Gender:Female  Submitted:2014-07-30, Days after onset: 27
Location:Unknown  Entered:2014-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Glucose tolerance impaired; Polycystic ovaries; Depression; Hypertension
Preexisting Conditions:
Diagnostic Lab Data: On 03-JUL-2014; Mumps antibody test: not reactive for mumps, negative; Measles antibody test: not reactive for measles, negative
CDC Split Type: WAES1407USA012167
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0412AE1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Measles antibody negative, Mumps antibody test negative, No adverse event
SMQs:
Write-up: This spontaneous report as received from a medical assistant refers to a 38 year old female patient with hypertension, depression, polycystic ovary disease and impaired glucose tolerance. After entering nursing school patient required M-M-R II series. On 21-APR-2013 the patient was vaccinated with the first dose of M-M-R II injection (dose and route not reported) lot # 0412AE, expired date 27-FEB-2014. On 21-APR-2013 the patient was vaccinated with the second dose of M-M-R II injection (dose, route and therapy type unknown, lot # 0412AE, expired date 27-FEB-2014). On 03-JUL-2014, titers were drawn. The patient was not reactive for measles and mumps. The patient did not seek medical attention and no treatment was given for the event. No adverse effects were noted. Outcome of the events was unknown. Additional information has been requested.

VAERS ID:538442 (history)  Vaccinated:2014-07-24
Age:38.0  Onset:2014-07-24, Days after vaccination: 0
Gender:Female  Submitted:2014-07-27, Days after onset: 3
Location:Arizona  Entered:2014-08-01, 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: ZOFRAN; PERCOCET
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14111010IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J005070IMRA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal pain upper, Chills, Erythema, Headache, Local swelling, Muscle spasms, Nausea, Paraesthesia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Within 15 to 30 minutes pt was throwing up, Thursday night had to call ambulance to take pt to emergency room. She was nauseous, had stomach pain, headache, muscle cramps, chills, and arm tingling. Pt came in to pharmacy on Sunday 7-27-14 about 5:30pm and arm is still visibly red and swollen.

VAERS ID:540036 (history)  Vaccinated:2014-08-14
Age:38.0  Onset:2014-08-14, Days after vaccination: 0
Gender:Female  Submitted:2014-08-15, Days after onset: 1
Location:Louisiana  Entered:2014-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergies: PCN, Sulfa, trees, weeds, grasses. HX of HTN, Asthma induced by allergies, Hypothyrodism, Bronchitis.
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3FZ742IMRA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Pruritus, Rash, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Symptoms rash, pruritus, scratchy throat, cough approximately 20 minutes after administration of Hepatitis B Vacccine. Treatment - Prednisone, Bendaryl, Zyrtec, Zantac.

VAERS ID:540249 (history)  Vaccinated:2014-07-30
Age:38.0  Onset:2014-07-30, Days after vaccination: 0
Gender:Female  Submitted:2014-08-02, Days after onset: 3
Location:North Carolina  Entered:2014-08-18, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSL5MN20IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: Metallic taste in mouth starting 10-15 minutes after vaccine was given. Went away after about 14 hours.

VAERS ID:541823 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:2013-12-05
Gender:Female  Submitted:2013-12-05, Days after onset: 0
Location:Unknown  Entered:2014-08-25, Days after submission: 262
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drugs not reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2013SE89271
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BJ2012 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered
SMQs:
Write-up: A report has been received from a Health Professional concerning a 38 year old, female subject, who had been receiving Nasal FLUMIST QUADRIVALENT. FLUMIST QUADRIVALENT started on unknown date. It was reported that four patients were inadvertently administered expired FLUMIST QUADRIVALENT (Preferred Term: Expired drug administered) which started on 05-Dec-2013. The outcome of the event of inadvertently administered expired FLUMIST QUADRAVALENT to four patients is unknown. The report was considered to be non-serious.

VAERS ID:542318 (history)  Vaccinated:2013-12-31
Age:38.0  Onset:2013-12-31, Days after vaccination: 0
Gender:Female  Submitted:2013-12-31, Days after onset: 0
Location:Missouri  Entered:2014-08-25, Days after submission: 236
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2014SE00366
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BJ2104 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered
SMQs:
Write-up: A report has been received from a Pharmacist concerning a 38 year old, Female subject, who had been receiving FLUMIST QUADRIVALENT (intranasal). FLUMIST QUADRIVALENT started on 31-Dec-2013. The pharmacist reported that the patient received expired FLUMIST QUADRIVALENT which started on 31-Dec-2013. The outcome of the event of patient received expired FLUMIST QUADRIVALENT is unknown. The report was considered to be non-serious.

VAERS ID:541780 (history)  Vaccinated:2014-08-27
Age:38.0  Onset:2014-08-27, Days after vaccination: 0
Gender:Female  Submitted:2014-08-29, Days after onset: 2
Location:Illinois  Entered:2014-08-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergic to DEMEROL and PHENERGAN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K000997 SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4875AA UNRA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Headache, Nausea, Pharyngeal oedema, Swelling face, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Approximately 20-30 min. after receiving vaccines felt nauseated. Then she cx of headache, weakness and vomiting. She called her father who took her to the hospital ER. States her face began to swell and throat too. Was given BENADRYL and ZOFRAN.

VAERS ID:542550 (history)  Vaccinated:2011-10-01
Age:38.0  Onset:2013-04-01, Days after vaccination: 548
Gender:Female  Submitted:2014-09-04, Days after onset: 521
Location:Michigan  Entered:2014-09-04
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NEURONTIN; NORCO
Current Illness: None
Preexisting Conditions: Hay fever
Diagnostic Lab Data: Paradelusional psychosis/anemic
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNUN
Administered by: Public     Purchased by: Private
Symptoms: Acarodermatitis, Anaemia, Arthralgia, Delusion, Psoriasis
SMQs:, Haematopoietic erythropenia (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)
Write-up: I.P.V. Joint pain monthly, possible herpes. Dx / psoriasis, chronic scabies on face.

VAERS ID:542719 (history)  Vaccinated:2014-09-02
Age:38.0  Onset:2014-09-04, Days after vaccination: 2
Gender:Female  Submitted:2014-09-05, Days after onset: 1
Location:Ohio  Entered:2014-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEUR  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site bruising, Injection site erythema
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Large area of redness and bruising at injection site.

VAERS ID:543070 (history)  Vaccinated:2014-09-04
Age:38.0  Onset:2014-09-05, Days after vaccination: 1
Gender:Female  Submitted:2014-09-09, Days after onset: 4
Location:Texas  Entered:2014-09-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GIVEN DEPO MEDROL 40MG IM IN OFFICE ON 9/4/14
Current Illness: WAS SEEN IN PRIMARY CARE C/O URINARY FREQUENCY, LEFT LEG PAIN AT KNEE AND RT HAND NUMBNESS WITH SHOULDER PAIN. URINE C&S WAS NEGATIVE
Preexisting Conditions: HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS5JRTT0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.5JR7T0SCRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA130470IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Headache, Nausea, Neck pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: NAUSEA, HEADACHE, FEVER, CHILLS AND NECK PAIN.

VAERS ID:543258 (history)  Vaccinated:2014-09-09
Age:38.0  Onset:2014-09-09, Days after vaccination: 0
Gender:Female  Submitted:2014-09-10, Days after onset: 1
Location:Massachusetts  Entered:2014-09-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED 0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Fatigue, Headache, Injection site pain, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Violent chills, fatigue, muscle aches, severe headache, nausea. Pain at injection site, soreness.

VAERS ID:543274 (history)  Vaccinated:2014-06-16
Age:38.0  Onset:2014-07-26, Days after vaccination: 40
Gender:Male  Submitted:2014-09-10, Days after onset: 46
Location:Virginia  Entered:2014-09-10
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: None
Current Illness: Presumed viral illness (URI)
Preexisting Conditions: Hypertension
Diagnostic Lab Data: 7/25/14: CBC wnl except neutrophils 35.10%L, eosinophils 11.3%H; CMP: wnl except CL 108H, CR 1.08H, Gluc 100H. 7/29/14: BNP: 677H. CKMB: 1.62, Troponin I 0.060H, CK 395H. 7/30/14: Cholesterol 210H, Triglycerides 182H, HCL 27L, LDL 147H; BMP: wnl except Glucose 108H, K+ 3.2L; CBC w/diff: wnl except WBC 11.2H, eosinophils 9.6%H, basophils 1.8%H; CK 1.38, Troponin I 0.068H, CK 328H; TSH 2.69; Mg 2.3. 8/2/14: Mg 2.5H; Phosphorus: 4.0; BMP wnl except Glucose 145H, Urea Nitrogen 28H, Cr 1.4H, Chloride 97L. 8/26/14: HSV 1+2 IgM: neg; HHSV6 Ab IgM <1:20, IgG 1:80H; Cytomegalovirus Ab IgM neg, IgG positive; Parvovirus B19 IgM 0.1, IgG 4.8H; Influenza A Ab: 1:16H, Influenza B Ab 1:8H; Coxsackie B1-6 Ab 1:16H. 6/25/14 CXR: Mild cardiomegaly; no airspa
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS007021A UNRA
Administered by: Military     Purchased by: Military
Symptoms: Basophil percentage increased, Blood chloride decreased, Blood chloride increased, Blood cholesterol increased, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase MB normal, Blood creatine phosphokinase increased, Blood creatinine increased, Blood glucose increased, Blood magnesium increased, Blood phosphorus normal, Blood potassium decreased, Blood thyroid stimulating hormone normal, Blood triglycerides increased, Blood urea increased, Brain natriuretic peptide increased, Cardiac failure, Cardiomegaly, Cardiomyopathy, Catheterisation cardiac abnormal, Chest X-ray abnormal, Coronary artery disease, Cough, Coxsackie virus test positive, Cytomegalovirus test positive, Differential white blood cell count abnormal, Dyspnoea, Dyspnoea paroxysmal nocturnal, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram abnormal, Eosinophil percentage increased, Herpes simplex serology negative, High density lipoprotein decreased, Human herpes virus 6 serology positive, Influenza A virus test positive, Influenza B virus test positive, Left ventricular dysfunction, Left ventricular hypertrophy, Low density lipoprotein normal, Metabolic function test normal, Mitral valve incompetence, Myocarditis, Neutrophil percentage decreased, Nuclear magnetic resonance imaging abnormal, Oedema peripheral, Orthopnoea, Parvovirus B19 test positive, Rhinorrhoea, Right ventricular systolic pressure increased, Roseolovirus test positive, Troponin I increased, Ventricular hypokinesia, Viral test negative, Weight increased, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Dyslipidaemia (narrow), Haematopoietic leukopenia (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Lipodystrophy (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad)
Write-up: The patient who has a history of poorly controlled hypertension received an Influenza vaccination (FLUCELVAX) on 6/16/14. At the time of vaccination the pt. reported that he had a 2-3 day history of a dry cough and rhinorrhea (with clear discharge). He denied fever, chills, sore throat, earache, diarrhea, nausea or vomiting. He also denied an increase of symptoms or local redness, swelling or pain at the injection site after the vaccination. He did not miss any work due to his symptoms nor did it interfere with his sleep pattern, ADLs or exercise regimen (daily treadmill and weight lifting). The pt. states that the cough and runny nose had completely resolved by 7/1/14. He remained asymptomatic until 7/26/14 when he became uncharacteristically dyspneic after a light swim and walking a few blocks. That night he had 3 pillows orthopnea. He denied chest pain, chest pressure palpitations or lightheadedness. On 7/29/14 after a third night of orthopnea the pt. reported to the clinic. At that time his weight was up about 20-25 pounds and the pt. noted that his ankles were edematous. The pt. was transported by ambulance to Hospital with new onset heart failure. The pt. was diuresed with LASIX over 1-2 days with significant improvement of his symptoms. The pt. was transferred to another facility for further evaluation. The pt. has had an echocardiogram, cardiac cath, and cardiac MRI and is currently being followed by the cardiology clinic. He was recently diagnosed with myocarditis and nonischemic cardiomyopathy. The pt. is wearing a Zoll life vest; the pt. denies any discharges. The patient''s current medications are: ASA 81mg qd, COREG 25mg bid, LIPITOR 40mg qd, MICARDIS 80mg qd and Spironolactone 25mg qd, LASIX 20mg qd and Potassium Chloride 20meq qd. He walks approx. 2 miles/day at a leisurely pace without symptoms. He does c/o occasional paroxysmal nocturnal dyspnea. The pt. denies chest pain/discomfort, dyspnea, palpitations, or syncope/presyncope.

VAERS ID:543714 (history)  Vaccinated:2014-09-08
Age:38.0  Onset:2014-09-09, Days after vaccination: 1
Gender:Female  Submitted:2014-09-10, Days after onset: 1
Location:New Mexico  Entered:2014-09-12, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14127011IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0091071IMRA
Administered by: Other     Purchased by: Other
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad)
Write-up: Pt had pain in arm and difficulty moving arm.

VAERS ID:543872 (history)  Vaccinated:2014-08-26
Age:38.0  Onset:2014-09-15, Days after vaccination: 20
Gender:Female  Submitted:2014-09-15, Days after onset: 0
Location:New York  Entered:2014-09-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pantoprazole; AMBIEN
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 DIAGNOSTICS145225 UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Hypoaesthesia, Injected limb mobility decreased, Insomnia, Musculoskeletal pain, Musculoskeletal stiffness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Pain in shoulder area, decrease of usage in deltoid and bicep and numbness. Sleeping is difficult. Believes neck muscle trying to compensate therefore stiff neck.

VAERS ID:543899 (history)  Vaccinated:2014-09-10
Age:38.0  Onset:2014-09-10, Days after vaccination: 0
Gender:Female  Submitted:2014-09-15, Days after onset: 5
Location:California  Entered:2014-09-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSX9HM33UNLA
Administered by: Public     Purchased by: Public
Symptoms: Muscular weakness, Paraesthesia, Radial nerve injury, Skin burning sensation
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow)
Write-up: (L) arm burning and tingling and weakness progressive since flu vaccine 5 days ago. Radial nerve distribution. Unresponsive to NSAIDs. Dropping objects.

VAERS ID:544431 (history)  Vaccinated:2014-09-09
Age:38.0  Onset:2014-09-09, Days after vaccination: 0
Gender:Male  Submitted:2014-09-09, Days after onset: 0
Location:Alabama  Entered:2014-09-17, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS141080 SYRLA
Administered by: Other     Purchased by: Unknown
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, swelling, itching. Ibuprofen.

VAERS ID:544555 (history)  Vaccinated:2014-09-18
Age:38.0  Onset:2014-09-18, Days after vaccination: 0
Gender:Female  Submitted:2014-09-21, Days after onset: 3
Location:California  Entered:2014-09-21
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: High blood pressure
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER   RA
Administered by: Public     Purchased by: Private
Symptoms: Abdominal pain upper, Chills, Erythema, Headache, Hyperhidrosis, Mobility decreased, Nausea, Pain, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pain, swelling, headache, stomach ache, nausea, chills, redness whole arm, sweating, can''t move arm as normal, skin very hot.

VAERS ID:544687 (history)  Vaccinated:2014-09-22
Age:38.0  Onset:2014-09-22, Days after vaccination: 0
Gender:Male  Submitted:2014-09-22, Days after onset: 0
Location:Virginia  Entered:2014-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: A cold with no fever.
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Lip swelling, Ocular hyperaemia, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Wheezing swollen lips red eyes.

VAERS ID:544930 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-09-22
Location:Unknown  Entered:2014-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity; Hypersensitivity; Immune system disorder; Colitis
Preexisting Conditions: Azithoprine, Hypersensitivity; FLAGYL, Hypersensitivity; sulfa, Drug hypersensitivity; amoxicillin, Drug hypersensitivity
Diagnostic Lab Data: Body temperature (date not provided): 102 (units reported as degree)
CDC Split Type: WAES1409USA004896
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1161X UNUN
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Fatigue, Influenza like illness, Pain, Pain in extremity, Vaccine positive rechallenge
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: This spontaneous report as received from a consumer refers to a 38 year old female patient with colitis, suppressed immune system, allergy to FLAGYL, allergy to azithoprine, allergy to amoxicillin, allergy to sulfa and allergy to REMICADE (MARRS # 1409USA009194). The concomitant medication was reported as flu shot in opposite arm, administered on the same day. In 2008, the patient was vaccinated with PNEUMOVAX 23, (lot number 661577/1161X expiry 06-DEC-2009) (dose, route were not reported). In 2013, the patient was vaccinated with PNEUMOVAX 23, (lot number J0007059 expiry 31-JUL-2014 date), (dose and route were not reported). In 2008 and also in 2013 (unspecified dates), the patient experienced an adverse reaction on the second day after receiving the PNEUMOVAX 23 on each occasion and the side effects included, body aches, 102 degree temperature, fatigue and general flu like symptoms that lasted for about a day. Her arm was very sore for two days. The patient experienced the same symptoms after each PNEUMOVAX 23. The outcome of 102 degree temperature, her arm was very sore, general flu like symptoms, fatigue and body aches was reported as recovered in 2008 (reported as lasted for two days). The outcome of 102 degree temperature, her arm was very sore, general flu like symptoms, fatigue, and body aches was reported as recovered in 2013 (reported as lasted for two days). Additional information has been requested.

VAERS ID:545139 (history)  Vaccinated:2014-09-24
Age:38.0  Onset:2014-09-24, Days after vaccination: 0
Gender:Female  Submitted:2014-09-25, Days after onset: 1
Location:Wisconsin  Entered:2014-09-25
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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CH20620IN 
Administered by: Private     Purchased by: Other
Symptoms: Intensive care, Uvulitis
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Went to hospital with severe uvulitis and is in ICU.

VAERS ID:545388 (history)  Vaccinated:2014-09-24
Age:38.0  Onset:2014-09-24, Days after vaccination: 0
Gender:Female  Submitted:2014-09-26, Days after onset: 2
Location:California  Entered:2014-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1) Effexor 2) Wellbutrin 3) Phenergan 4) Zofran
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Doctor visit on 09/25/14 with General Practitioner. Prescription for Acetaminophen w/ Codeine prescribed. Instructions for follow up in a few days. No tests performed.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Immediate post-injection reaction, Injected limb mobility decreased, Joint stiffness, Pain, Pain in extremity
SMQs:, Hypersensitivity (narrow), Arthritis (broad)
Write-up: 1) Received flu shot on left arm. 2) Localized pain was immediate. Pain was not consistent with prior flu shot administrations. 3) At approx. 5:40 PM on the day of the shot, I began to have a throbbing pain in the area surrounding the joint and severe pain & stiffness in the joint itself. 4) The morning of 09/25/14, my left arm was in severe pain, along with stiffness and the inability to move my left arm to any appreciable degree. 5) As of 09/26/14, the pain and lack of motion in my left arm has not subsided and is the same as it was on 09/25/14.

VAERS ID:545744 (history)  Vaccinated:2014-04-09
Age:38.0  Onset:2014-04-12, Days after vaccination: 3
Gender:Male  Submitted:2014-05-10, Days after onset: 28
Location:Illinois  Entered:2014-09-26, Days after submission: 139
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: NKDA; Medical conditions include anxiety, polysubstances dependence, osteoarthritis, COPD, pulmonary HTN, depression, and hyperlipidemia.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHG981341UNLA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis, Rash erythematous, Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient received PREVNAR vaccine (PCV13) on 4/9/14. On 4/12/14, he developed a raised itchy reddish rash all over his body. He sought care from the ED on 4/23/14. In the ED, patient reported use of a new soap starting on 4/11/14. Per ED doctor note, diagnosis was dermatitis- most likely reaction to new soap. Patient was instructed to stop new soap and was given prednisone 40mg x7 days and cetirizine 10mg PRN x20 days. Although rash was likely caused by new soap, there remains a possibility that PREVNAR could be the causative agent. Patient reported feeling a lot better during telephone follow-up on 4/24/14. Patient received PNEUMOVAX (PPSV23) on 5/7/14. As of 5/10/14, no reported signs of allergic reaction to vaccine, decreasing the likelihood patient had reaction to PCV13 vaccine.

VAERS ID:545775 (history)  Vaccinated:2014-09-19
Age:38.0  Onset:2014-09-19, Days after vaccination: 0
Gender:Female  Submitted:2014-09-22, Days after onset: 3
Location:Texas  Entered:2014-09-26, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TOPIMAX
Current Illness:
Preexisting Conditions: Migraines only
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS14031A0UNRA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Erythema, Injection site erythema, Injection site induration, Pain, Pyrexia, Sensory disturbance, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Vaccinated 3:45 pm 9/19/14. Noticed pain and swelling and redness within 2 hrs. Joint pain, fever, swells that evening. Took ALEVE. Seen on 9/22/14 reports decreased sensation (R) arm throughout, full strength, 3 cm induration and erythema at site. Tx CLARITIN, f/u 3 days.

VAERS ID:545912 (history)  Vaccinated:2014-09-24
Age:38.0  Onset:2014-09-26, Days after vaccination: 2
Gender:Female  Submitted:2014-09-29, Days after onset: 3
Location:Pennsylvania  Entered:2014-09-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT580060SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Reported arm - red, swollen and warm at injection site.

VAERS ID:546025 (history)  Vaccinated:2014-09-30
Age:38.0  Onset:2014-09-30, Days after vaccination: 0
Gender:Female  Submitted:2014-10-01, Days after onset: 1
Location:Illinois  Entered:2014-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins, fenugreek supplement
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Unknown
Symptoms: Chills, Dizziness, Feeling abnormal, Feeling cold, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: I got the flu shot in the morning, and by the evening, had a very strong reaction to the flu shot - in the evening, I felt strong body and muscle aches, chills (could not get warm enough until got a winter down blanket). I felt generally very itchy. I was also very dizzy the next morning.

VAERS ID:546723 (history)  Vaccinated:2014-10-01
Age:38.0  Onset:2014-10-01, Days after vaccination: 0
Gender:Female  Submitted:2014-10-01, Days after onset: 0
Location:Michigan  Entered:2014-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit B12; Vit D; TECFIDERA; Multivitamin
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI194AB IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Dyspnoea, Flushing, Injection site pain, Paraesthesia
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Within 5 minutes of administration, face flushed, spread to ears, neck, arms, chest with tingling sensation/"pins and needles" in B/L arms and hands - lasted approximately 1 hour followed by light SOB and weakness that lasted another hour. Injection site and upper arm sore.

VAERS ID:546297 (history)  Vaccinated:2014-10-02
Age:38.0  Onset:2014-10-03, Days after vaccination: 1
Gender:Female  Submitted:2014-10-03, Days after onset: 0
Location:Pennsylvania  Entered:2014-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1411601 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Back pain, Fatigue, Hyperhidrosis, Restlessness
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)
Write-up: Woke up sweaty. Ache in back, ankles and wrists. Restless but body exhausted.

VAERS ID:546554 (history)  Vaccinated:2014-10-04
Age:38.0  Onset:2014-10-04, Days after vaccination: 0
Gender:Male  Submitted:2014-10-05, Days after onset: 1
Location:Massachusetts  Entered:2014-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Humalog
Current Illness: None
Preexisting Conditions: Type 1 Diabetes Mellitus
Diagnostic Lab Data: Blood Sugar: 81; Urine Glucose: Negative; Urine Ketone: Negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT59507 IMRA
Administered by: Military     Purchased by: Military
Symptoms: Blood glucose increased, Fatigue, Glucose urine absent, Poor quality sleep, Urine ketone body absent
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Depression (excl suicide and self injury) (broad)
Write-up: During evening of 10/04/2014. Pt stated he had persistent elevated blood sugar after receiving flu injection requiring more than usual insulin injections. Pt was fatigued from poor sleep, but showed no lasting effects. He reported to clinic A+Ox3 with no significant clinical findings. Pt was sent home to convalesce.

VAERS ID:546618 (history)  Vaccinated:2014-10-02
Age:38.0  Onset:2014-10-02, Days after vaccination: 0
Gender:Female  Submitted:2014-10-06, Days after onset: 4
Location:Tennessee  Entered:2014-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec; Vitamin D
Current Illness: No
Preexisting Conditions: Shellfish allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Public     Purchased by: Other
Symptoms: Aphonia, Cough, Dysphonia, Headache, Malaise, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Coughing- caking and dry. Oct 3 fever 99.4, general body aches, headache, hoarseness, sore throat. General malaise, hacking cough, sore throat, and loss of voice persist today, Oct. 6. Trying to get appt with MD, but it''s a Monday..... Can''t get in.

VAERS ID:546642 (history)  Vaccinated:2014-09-25
Age:38.0  Onset:2014-09-26, Days after vaccination: 1
Gender:Female  Submitted:2014-10-06, Days after onset: 10
Location:California  Entered:2014-10-06
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: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Chills, Cough, Influenza like illness, Oropharyngeal pain, Pyrexia, Rhinorrhoea, Sinusitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Flu like symptoms-sore throat, fever, chills, runny nose, cough. Developed into a sinus infection.

VAERS ID:548279 (history)  Vaccinated:2014-10-03
Age:38.0  Onset:2014-10-03, Days after vaccination: 0
Gender:Female  Submitted:2014-10-08, Days after onset: 5
Location:Virginia  Entered:2014-10-08
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) (FLUZONE)SANOFI PASTEURUI197AC IMLA
Administered by: Private     Purchased by: Private
Symptoms: Incontinence, 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)
Write-up: Passed out, complete loss of consciousness for over a minute, loss of control of bodily functions, occurred while driving home.

VAERS ID:548448 (history)  Vaccinated:2014-10-04
Age:38.0  Onset:2014-10-04, Days after vaccination: 0
Gender:Female  Submitted:2014-10-08, Days after onset: 4
Location:California  Entered:2014-10-08
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI189AP IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Flu vaccine administered in left deltoid. Swelling around site about 100 mm with redness surrounding about 130 mm by evening. Sought opinion of PHN 10/6/14. Suggested icing swelling. Today definitely improving. No c/o of pain just itching.

VAERS ID:547435 (history)  Vaccinated:2014-10-10
Age:38.0  Onset:2014-10-10, Days after vaccination: 0
Gender:Female  Submitted:2014-10-10, Days after onset: 0
Location:Ohio  Entered:2014-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PNEUMOVAX 23 VIAL, IPRAT-ALBUT 0.5-3(2.5) MG/3 ML, AFLURIA 2014-2015 SYRINGE, FLUTICASONE PROP 50 MCG SPRAY, MONTELUKAST SOD 10 MG TABLET, RANITIDINE 150 MG TABLET, ALBUTEROL 2.5 MG/0.5 ML SOL,VENTOLIN HFA 90 MCG INHALER, IBUPROFEN 800 mg
Current Illness: No
Preexisting Conditions: Asthma
Diagnostic Lab Data: None yet....Was told if it continues to go to the hospital by the Pharmacists. Said it was an unusual side effect.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  SYRLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: I had a bad dizzy spell that lasted about 2 hours and horrible shaking that has been going on more then 5 hours now without improving.

VAERS ID:549544 (history)  Vaccinated:2014-10-06
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-10-10
Location:Kentucky  Entered:2014-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: GILDESS FE
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1464020IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0133450IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site erythema, Injection site swelling, Local swelling, Pain in extremity
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient states excruciating arm pain unrelieved by heat or ibuprofen. Pain continued and grew steadily worse. Area was red and swollen. Swelling grew worse to below elbow and patient could not straighten arm. Pt. went to MD and was given steroids and antihistamines. Pt much better and feels she got a bad vial.

VAERS ID:547729 (history)  Vaccinated:2013-11-04
Age:38.0  Onset:2013-11-04, Days after vaccination: 0
Gender:Female  Submitted:2014-09-03, Days after onset: 302
Location:Unknown  Entered:2014-10-13, Days after submission: 40
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject was not using contraception and the method of conception was intrauterine insemination. There was no evidence of defect from prenatal testing. There was no maternal and paternal history which may have an impact on the outcome of this pregnancy.
Diagnostic Lab Data: UNK
CDC Split Type: A1051514A
Vaccination
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Lot
Dose
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Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This prospective pregnancy case was reported by a consumer (subject) and described the occurrence of sore arm in a 38-year-old female subject who was vaccinated with BOOSTRIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. The subject was not using contraception and the method of conception was intrauterine insemination. There was no evidence of defect from prenatal testing. There was no maternal and paternal history which may have an impact on the outcome of this pregnancy. On 4 November 2013 the subject received a dose of BOOSTRIX (intramuscular, unknown details) and experienced vaccine exposure during the 3rd trimester of pregnancy. The gestational age was calculated to be 30 weeks. The date of last menstrual period was reported as 9 April 2013. The estimated date of delivery was reported as 13 January 2014 per the subject. At the time of reporting, the pregnancy was ongoing. On 4 November 2013, within hours of vaccination with BOOSTRIX, the subject experienced sore arm (injection site). At the time of reporting the events were resolved. The subject reported that the event was related to the BOOSTRIX. 12 March 2014: No further information provided; patient lost to follow-up.

VAERS ID:547998 (history)  Vaccinated:2014-10-13
Age:38.0  Onset:2014-10-13, Days after vaccination: 0
Gender:Female  Submitted:2014-10-14, Days after onset: 1
Location:Texas  Entered:2014-10-15, Days after submission: 1
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: MIRAPEX; NASONEX; SINGULAIR
Current Illness: None
Preexisting Conditions: PCN; Sulfonamides; CECLOR
Diagnostic Lab Data: Presently hospitalized
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI189AE IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0097230IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Injection site pain, Injection site swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt. presented to ER at 2200 on 10/13/14 for pain/swelling to left shoulder radiating to left elbow. Pt. treated with IV BENADRYL, DEMEROL 50mg and PHENERGAN 25mg. Pt. was discharged with oral pain medication received teaching and handouts on hypersensitivity reaction. Patient advised to follow up in clinic in A.M. Pt. was seen in clinic on 10/14/14 at 9:12 A.M. and advised to continue current medication regimen along with Prednisone 20mg TID #15. Patient returned to clinic at 4PM and was admitted to county hospital for allergic reaction.

VAERS ID:548067 (history)  Vaccinated:2014-10-09
Age:38.0  Onset:2014-10-11, Days after vaccination: 2
Gender:Male  Submitted:2014-10-15, Days after onset: 4
Location:Missouri  Entered:2014-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1412001 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cough, Headache, Malaise, Pain, Sinus congestion
SMQs:, Anaphylactic reaction (broad)
Write-up: Body aches, sinus congestion, headache, cough, general malaise.

VAERS ID:548068 (history)  Vaccinated:2014-10-13
Age:38.0  Onset:2014-10-14, Days after vaccination: 1
Gender:Female  Submitted:2014-10-15, Days after onset: 1
Location:Texas  Entered:2014-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Denied any medication usage at time of visit
Current Illness: None disclosed
Preexisting Conditions: None disclosed
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS7K344 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Patient stated that she experienced right shoulder & neck pain. Went to emergency room. Received pain medication. Followed up with PCP & received more pain medication & steroids.

VAERS ID:548175 (history)  Vaccinated:2014-10-14
Age:38.0  Onset:2014-10-14, Days after vaccination: 0
Gender:Male  Submitted:2014-10-16, Days after onset: 2
Location:New York  Entered:2014-10-16
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14107010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Back pain, Painful respiration
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: Pain in middle of back (both side affected), becomes more intense when inhaling deeply.

VAERS ID:548282 (history)  Vaccinated:2014-10-14
Age:38.0  Onset:2014-10-15, Days after vaccination: 1
Gender:Female  Submitted:2014-10-16, Days after onset: 1
Location:Georgia  Entered:2014-10-16
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: NKDA
Diagnostic Lab Data: Fluvirin/Trivalent Preservative Free given in the Right Arm 0.50ml - Novartis Vaccine- Lot # 145903 Vis date-8/19/14.
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS145903 IMRA
Administered by: Private     Purchased by: Military
Symptoms: Mobility decreased, Musculoskeletal stiffness, Neck pain, Torticollis
SMQs:, Dystonia (narrow), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Ocular motility disorders (broad), Arthritis (broad)
Write-up: Patient received Fluvirin/Trivalent Preservative Free given in the Right Arm 0.50ml - Novartis Vaccine- Lot # 145903 Vis date-8/19/14. On 10/14/2014 with some neck pain before bed. On 10/15/2014 began having worsening neck stiffness. She is unsure if she slept on it wrong. On 10/16/2014 had painful, rightward torticollis and unable to move to midline. It responded to OMT with moderate increase in mobility and decrease in pain. She was given Flexeril and steroid burst as an outpatient.

VAERS ID:548815 (history)  Vaccinated:2014-09-16
Age:38.0  Onset:2014-09-16, Days after vaccination: 0
Gender:Female  Submitted:2014-10-12, Days after onset: 26
Location:Indiana  Entered:2014-10-20, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion; HTZ; Hydroxyzine; Lamotrigine; Omeprazole; Prednisone; Sertraline; Simvastatin; Trazodone
Current Illness: Hospitalized for suicide ideation
Preexisting Conditions: IBS; BPD; Severe depression; Anxiety; Elevated BP; Acid Reflux; Elevated Chol; Poison ivy at time of hospital stay
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI158AB UNUN
Administered by: Private     Purchased by: Other
Symptoms: Immediate post-injection reaction, Mobility decreased, Musculoskeletal pain, Musculoskeletal stiffness, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Extreme pain at time of vaccine. 10x worse at least to any other flu shot I''ve ever gotten. Since then, without ceasing: extreme and crippling pain in shoulder/upper arm especially when moved certain ways; can barely do so at times and have loss of mobility, and stiffness (for over 3 wks now).

VAERS ID:549624 (history)  Vaccinated:2014-09-22
Age:38.0  Onset:2014-09-22, Days after vaccination: 0
Gender:Female  Submitted:2014-10-20, Days after onset: 28
Location:Massachusetts  Entered:2014-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN; KEFLEX; Cephalosporins; Sulfas; NSAIDS; morphine; adhesives; dx: hypothyroidism, hypoglycemia, anemia, insomnia, asthma, reflux, Raynaud''s, Vit D deficiency, ADHD, lumbar scoliosis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT59106 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Dizziness, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Dizziness, burning sensation (whole body), nausea, sweating -$g symptoms lasted 45 min-1 hour.

VAERS ID:549016 (history)  Vaccinated:2014-10-18
Age:38.0  Onset:2014-10-18, Days after vaccination: 0
Gender:Female  Submitted:2014-10-21, Days after onset: 3
Location:Missouri  Entered:2014-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: RITALIN 20MG; VITAMIN D 50,000 UNITS
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSXZ3SP0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site pruritus, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: PATIENT REPORTED TENDER, RED CIRCLE (1" WIDE) AROUND THE INJECTION SITE ACCOMPANIED BY ITCHING AND PAIN. PATIENT ALSO REPORTED 2 RED, SWOLLEN SPOTS WHICH WERE TENDER TO TOUCH AROUND THE WAIST THAT LOOKED LIKE BUG BITES. Patient reported this morning that spot is less red and tender today. Appears to be getting better at injection site and spots on waist.

VAERS ID:549072 (history)  Vaccinated:2014-10-17
Age:38.0  Onset:2014-10-17, Days after vaccination: 0
Gender:Female  Submitted:2014-10-21, Days after onset: 4
Location:Maryland  Entered:2014-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Chlorthalidone 12.5mg/day; Lisinopril 10mg/day; Klor-Con 20MEQ/day
Current Illness: None known
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Military     Purchased by: Other
Symptoms: Chills, Fatigue, Headache, Pain, Paranasal sinus hypersecretion, Tinnitus
SMQs:, Hearing impairment (narrow)
Write-up: Ringing in right ear began at approx 1630 on date of vaccination (approx 6 hours after vaccination). Headache and mild body aches upon waking at 0730 following day (18 OCT), along with continued ear ringing. Treated with 1000 mg Tylenol every 6 hours. Severe headache, fatigue, body aches, and chills upon waking at 0630 next day (19 OCT). Ringing ear had resolved. Continued treatment with Tylenol. Mild headache with fatigue and chills upon waking next day (20 OCT). Also developed sinus drainage. Continued treatment with Tylenol. Mild headache, sinus drainage and fatigue today (21 OCT). Continued treatment with Tylenol. Symptoms largely resolved by 1430 today.

VAERS ID:549675 (history)  Vaccinated:2014-10-12
Age:38.0  Onset:2014-10-18, Days after vaccination: 6
Gender:Female  Submitted:2014-10-19, Days after onset: 1
Location:Texas  Entered:2014-10-21, 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:
Preexisting Conditions: Ulcerative colitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUT4992AA IDRA
Administered by: Public     Purchased by: Public
Symptoms: Lymph node pain, Lymphadenopathy
SMQs:
Write-up: Lymph node in rt. axilla became swollen and tender.

VAERS ID:549156 (history)  Vaccinated:2014-10-17
Age:38.0  Onset:2014-10-17, Days after vaccination: 0
Gender:Female  Submitted:2014-10-22, Days after onset: 5
Location:Pennsylvania  Entered:2014-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: flu like symptoms, redness at site~Influenza (Seasonal) (no brand name)~1~19.00~Patient|flu like symptoms, pain in arm~Influenza
Other Medications: None
Current Illness: NO illness
Preexisting Conditions: No medical problems at time of visit. Healthy, active
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI187AB2IMRA
Administered by: Public     Purchased by: Other
Symptoms: Anxiety, Body temperature increased, Disturbance in attention, Dizziness, Dry mouth, Dysphagia, Erythema, Hypoaesthesia, Nausea, Skin warm, Swelling face, Tachycardia, Tremor, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: At approximately 12:30pm I developed tachycardia "felt like my heart was going to pound out of my chest", I also developed hives, reddness, and swelling on my face. I felt like my face was sunburned, I was shaky, anxious, and I have numbness in my fingers. I work in a surgical center, the nurse took me to the recovery room and alerted help. After resting for 20 minutes I felt symptoms resolving- received po Benadryl 25mg, however, within approx 10 minutes symptoms returned: dizzy, elevated temp. 38.0, difficulty swallowing, dry mouth, shaking, numbness in hands, hives on face and neck, anxiety and difficulty making a decision, and nausea. Treatment- IV epinephrine, IV Solu-Medrol, IV Benadryl 50mg, IV Zantac. Transferred by ambulance to the ER. Received IV Zofran and discharged after approx. 4 hours.

VAERS ID:549243 (history)  Vaccinated:2014-10-09
Age:38.0  Onset:2014-10-09, Days after vaccination: 0
Gender:Female  Submitted:2014-10-22, Days after onset: 13
Location:Alabama  Entered:2014-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho tri cyclin birth control
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Nerve testing abnormal 10/09/2014 Dr. Referred to Neurologist
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Burning sensation, Gait disturbance, Hypoaesthesia, Joint swelling, Local swelling, Lymphadenopathy, Mobility decreased, Nerve conduction studies abnormal, Pain in extremity, Paraesthesia, Paralysis
SMQs:, Angioedema (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad)
Write-up: Burning, tingling, swelling, pain in feet, hands, knees. Could not walk without assistance. Swollen lymphnode under right arm, right hand was completely asleep for 24 hours. As of today, 10/22/2014, I still do not have full mobility of my arms and legs and experience great pain in my joints. I have had two doctor visits, and my nerve testing for my arms came back abnormal as of yesterday. I am scheduled to see a neurologist on 11/08/2014. I was perfectly fine before I got the shot on 10/09/2014. Now I am suffering from partial paralysis and still do not have a diagnosis.

VAERS ID:553446 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2014-10-22
Location:Unknown  Entered:2014-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1410USA010008
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a pharmacist via company representative refers to a 38 year old male patient who was pharmacist family member. No pertinent medical history was reported. On an unknown date, the patient was vaccinated with VARIVAX (Merck) (dose, route, lot# were not reported). On an unknown date, the patient experienced rash all over his body and rash looked like mosquito bites. Patient was prescribed antibiotic, amoxicillin and AUGMENTIN by his physician. Patient sought medical attention by visiting physician. No Product Quality Complaint (PQC) was involved. The outcome of rash all over his body and rash looked like mosquito bites was unknown. Causality was not provided by the reporter. Additional information has been requested.

VAERS ID:549459 (history)  Vaccinated:2014-09-24
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2014-10-23
Location:Michigan  Entered:2014-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1410901 IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Underdose
SMQs:
Write-up: Under-dosage was given. Administered .05mL of Fluvirin instead of 0.5mL.

VAERS ID:549466 (history)  Vaccinated:2014-10-23
Age:38.0  Onset:2014-10-23, Days after vaccination: 0
Gender:Female  Submitted:2014-10-23, Days after onset: 0
Location:Missouri  Entered:2014-10-23
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
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS161207 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Had dizziness and ashen color within 30 minutes of vaccine. BP was stable 108/60 mmHg. She was observed for 30 minutes and given juice. She was nervous about the vaccination prior to receiving it. No allergy, shortness of breath, or hives. She felt fine when she left.

VAERS ID:549677 (history)  Vaccinated:2014-10-15
Age:38.0  Onset:2014-10-16, Days after vaccination: 1
Gender:Female  Submitted:2014-10-23, Days after onset: 7
Location:Unknown  Entered:2014-10-24, 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: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Diagnostic Lab Data: Diagnostic ultrasound, OCT2014, Unknown
CDC Split Type: 2014SA143513
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR  IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema, Injection site pain, Injection site warmth, Ultrasound scan
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Initial report received from a healthcare professional on 17 October 2014. A 38-year-old female patient, whose medical history was unknown, received an intramuscular right deltoid injection of ADACEL (lot number not reported) on 15 October 2014. One day post-vaccination, on 16 October 2014, the patient developed redness, pain, and heat at the injection site. She was sent for an ultrasound and diagnosed with cellulitis. The event subsequently resolved on an unspecified date. Documents held by sender: None.

VAERS ID:549752 (history)  Vaccinated:2014-10-22
Age:38.0  Onset:2014-10-23, Days after vaccination: 1
Gender:Female  Submitted:2014-10-24, Days after onset: 1
Location:Arkansas  Entered:2014-10-24
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: Cephalexin allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS145404 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0105221SCLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Feeling hot, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling, redness, and heat.

VAERS ID:549867 (history)  Vaccinated:2014-10-18
Age:38.0  Onset:2014-10-18, Days after vaccination: 0
Gender:Female  Submitted:2014-10-18, Days after onset: 0
Location:Ohio  Entered:2014-10-24, 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: Plaquenil
Current Illness: ?
Preexisting Conditions: Sjogrens syndrome; Sulfa allergy
Diagnostic Lab Data: Ptn claimed to be afraid of needles.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14124010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Dreamy state, Feeling hot, Immediate post-injection reaction, Loss of consciousness, Respiratory rate increased
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), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Patient appeared to pass out immediately after shot given. Eyes rolled back in head. She was taking rapid breaths. Said she did feel well after a few seconds. She says she felt hot, dizzy, and in a dream like state. Sat w/ptn. Gave OJ to drink. Took blood pressure. Was 84/55, pulse 71.

VAERS ID:549925 (history)  Vaccinated:2014-09-30
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-10-24
Location:Michigan  Entered:2014-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1309001 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Expired drug administered
SMQs:
Write-up: Expired vaccine administered to patient inadvertently.

VAERS ID:550381 (history)  Vaccinated:2014-10-01
Age:38.0  Onset:2014-10-01, Days after vaccination: 0
Gender:Female  Submitted:2014-10-28, Days after onset: 27
Location:Indiana  Entered:2014-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole; Loratadine
Current Illness: None
Preexisting Conditions: Allergic Rhinitis; GERD
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI191AB IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Continued pain at injection site for 3 weeks. Ice, heat, TYLENOL.

VAERS ID:550646 (history)  Vaccinated:2014-10-23
Age:38.0  Onset:2014-10-23, Days after vaccination: 0
Gender:Female  Submitted:2014-10-28, Days after onset: 5
Location:Arizona  Entered:2014-10-28
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: Allergies: latex, PCN, sulfa; Medical conditions: asthma, celiac disease, low IgG and IgA levels
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU5036BA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Back pain, Chest discomfort, Disorientation, Dysphagia, Dyspnoea, Headache, Neck pain, Pyrexia, Throat tightness, Tremor
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (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), Hypersensitivity (broad), Arthritis (broad)
Write-up: Radiating neck pain, severe headache, dysphagia/tightness of throat, chest heaviness, difficulty taking deep breath, lower back ache, disorentation, overall weakness, tremors, febrile (101-103 degrees).

VAERS ID:551278 (history)  Vaccinated:2014-10-27
Age:38.0  Onset:2014-10-27, Days after vaccination: 0
Gender:Male  Submitted:2014-10-29, Days after onset: 2
Location:Connecticut  Entered:2014-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT53909 IMUN
Administered by: Private     Purchased by: Private
Symptoms: Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fever, nausea, body aches.

VAERS ID:551294 (history)  Vaccinated:2014-10-08
Age:38.0  Onset:2014-10-08, Days after vaccination: 0
Gender:Female  Submitted:2014-10-29, Days after onset: 21
Location:Connecticut  Entered:2014-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLOFT
Current Illness: No
Preexisting Conditions: No; PCN allergy
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT56805 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Insomnia, Pain in extremity, Peripheral coldness
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain during injection process from site of fingers. Pain rated 8 on 1-10 scale for remainder of day and into day 3. Since the injection, pain is from upper arm to fingers. It is a continuous dull ache, with severe pain upon use. Unable to sleep on left side. Appt. with PCP on Oct 20, 2014 and was treated with ice and ibuprofen and has a follow up appt. 11/7/14. Left hand coldness.

VAERS ID:551332 (history)  Vaccinated:2014-10-30
Age:38.0  Onset:2014-10-30, Days after vaccination: 0
Gender:Female  Submitted:2014-10-30, Days after onset: 0
Location:New Jersey  Entered:2014-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1465030IMRA
Administered by: Other     Purchased by: Private
Symptoms: Immediate post-injection reaction, Local swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: As soon as injection was given IM to her right arm, it began to swell. An ice pack was applied a few minutes later.

VAERS ID:551200 (history)  Vaccinated:2014-10-30
Age:38.0  Onset:2014-10-30, Days after vaccination: 0
Gender:Male  Submitted:2014-10-31, Days after onset: 1
Location:Virginia  Entered:2014-10-31
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: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERXXXXX13IMLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURERXXXXX0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Decreased appetite, Fatigue, Headache, Injection site erythema, Injection site streaking, Injection site swelling, Myalgia, Night sweats, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Fatigue, Chills, Fever, Nightsweats, Muscle pain, Headache, Loss of appetite, Swelling at the site of injection, Red streaking local to site. Treatment: Motrin, Tylenol, Bedrest, Cool compresses to site.

VAERS ID:551431 (history)  Vaccinated:2014-10-31
Age:38.0  Onset:2014-10-31, Days after vaccination: 0
Gender:Female  Submitted:2014-11-02, Days after onset: 2
Location:Indiana  Entered:2014-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol 90mcg/actuation inhaler Flonase 50 mcg/actuation nasal spray Allegra omeprazole Paxil-cr 12.5mg
Current Illness: I had just recovered from the stomach flu with my youngest daughter. We had the flu with fever 10/28-10/29/2014.
Preexisting Conditions: I had allergy testing 10/22/2014 and I am strongly allergic to mold, trees and dust mites. I had pneumonia this fall from 8/15-9/15/2014. I also had just recovered from a sinus infection diagnosed on 10/14/2014 with Antibiotics ending on 10/24/2014.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERFLU VACCINE 3Q SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Chills, Dyspnoea, Headache, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Pain in back followed by vomiting and shortness of breath. I used the inhaler I had from pneumonia and that helped breathing a little. By midnight I had chills, fever, more vomiting. At 1am on 11/1/2014 I had sever muscle pain. 11/1/2014 during the day I had a bad headache, nausea, chills and muscle aches.

VAERS ID:554117 (history)  Vaccinated:2014-11-02
Age:38.0  Onset:2014-11-02, Days after vaccination: 0
Gender:Female  Submitted:2014-11-02, Days after onset: 0
Location:Massachusetts  Entered:2014-11-02
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
TDAP: TDAP (ADACEL)SANOFI PASTEURU4688BA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Throat irritation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Pt received TDAP and 30 minutes later c/o scratchy throat and hives face red. Pt stated she has allergies but not to TDAP. RN and another employee spoke with supervisor and had another member of pt''s team drive pt to urgent care for follow up. Pt has her own Epipen and brought with her in car to urgent care. Pt returned to facility at 3:30 but immediately drove home unable to get report from pt on what services she received from urgent care.

VAERS ID:551851 (history)  Vaccinated:2014-10-31
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-11-03
Location:Iowa  Entered:2014-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4992AA0IDLA
Administered by: Other     Purchased by: Other
Symptoms: Lymph node pain, Neck mass, Neck pain, Pain, Torticollis
SMQs:, Dystonia (narrow), Ocular motility disorders (broad), Arthritis (broad)
Write-up: X 4 days lump left lower neck, painful to move neck to left. Tender left supraclavicular lymph node, torticollis. Rx tramadol, OV needed for pain.

VAERS ID:551759 (history)  Vaccinated:2014-11-03
Age:38.0  Onset:2014-11-04, Days after vaccination: 1
Gender:Female  Submitted:2014-11-04, Days after onset: 0
Location:Illinois  Entered:2014-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Dizziness, Headache, Pyrexia, Temperature regulation disorder
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Woke up with chills, difficulty regulating body temperature, headache, light-headedness. 100.2 degree fever. Took Tylenol to reduce fever at 8:00 AM. Fever seems to be reducing. Was 99.4 by 9:15 AM.

VAERS ID:551774 (history)  Vaccinated:2014-10-13
Age:38.0  Onset:2014-10-13, Days after vaccination: 0
Gender:Female  Submitted:2014-11-04, Days after onset: 22
Location:Minnesota  Entered:2014-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fatigue had a head cold a couple days after vaccination
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI158AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Fatigue, Hypotonia, Injected limb mobility decreased, Injection site pain, Injection site reaction, Nasopharyngitis, Neuralgia, Pain
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: When raise arm above head, shooting pain down lt arm down through tricep/bicep seems to be nerve pain vs muscle pain. Arm gets limp and doesn''t function.

VAERS ID:551922 (history)  Vaccinated:2014-11-02
Age:38.0  Onset:2014-11-02, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Alabama  Entered:2014-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydroxychlorquine; Prednisone; Rayos: NEXIUM; Fluoxetine
Current Illness: Nausea and faint feeling
Preexisting Conditions: Lupus
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS146401 IMUN
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: The patient complained of being nauseated and feeling like she would faint. We had her to remain seated. She refused to put her head between for legs. No other symptoms were observed. The paramedics came, examined and released her.

VAERS ID:551964 (history)  Vaccinated:2014-10-24
Age:38.0  Onset:2014-10-24, Days after vaccination: 0
Gender:Female  Submitted:2014-10-24, Days after onset: 0
Location:Michigan  Entered:2014-11-04, 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: None presc. only on MTV - Women Day Formula
Current Illness: None
Preexisting Conditions: Allergy to ULTRAM (hives)
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS160984 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Local swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received annual Flu vac injection and developed localized swelling, redness and increased warmth over Lt deltoid and back area within 5 mins of injec. Tx with ice pack, BENADRYL IM, monitored with V/S.

VAERS ID:551971 (history)  Vaccinated:2014-10-20
Age:38.0  Onset:2014-10-20, Days after vaccination: 0
Gender:Female  Submitted:2014-10-24, Days after onset: 4
Location:Minnesota  Entered:2014-11-04, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI190AB2IMRA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Immediate post-injection reaction, Pain
SMQs:, Hypersensitivity (narrow)
Write-up: Pain set in immediately lasting 4 days. Headache occurred from evening of administration, continued for 4 more days, became severe on day 3, pt. took IBU for pain.

VAERS ID:552221 (history)  Vaccinated:2014-11-04
Age:38.0  Onset:2014-11-04, Days after vaccination: 0
Gender:Female  Submitted:2014-11-05, Days after onset: 1
Location:New York  Entered:2014-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lexapro, trazodone, Vyvanse, multivitamins
Current Illness: Mild post-nasal drip
Preexisting Conditions: Allergies - dust, tree pollen; Medication allergy - erythromycin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Other     Purchased by: Private
Symptoms: Axillary pain, Lymphadenopathy, Musculoskeletal pain, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (broad)
Write-up: Shot given in left arm. A few hours later, pain in the right shoulder and neck, then severe pain in right armpit. (NOT the arm in which shot was given.) 24 hours later, shoulder, neck, and arm pain remain, as well as pain and slightly swollen lymph nodes in armpit and neck. Right side only.

VAERS ID:552357 (history)  Vaccinated:2014-10-22
Age:38.0  Onset:2014-10-22, Days after vaccination: 0
Gender:Female  Submitted:2014-10-28, Days after onset: 6
Location:Arizona  Entered:2014-11-06, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None stated
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT4982AA5IDLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Received vax at 11 11 am. Shortly after, felt numbness on left side progressed to random sharp pains in chest with numbness in face/jaw area. No shortness of breath, muscular skeletal pain, lasted throughout day with same intensity. Numbness included in (L) leg, only on (L) side. Resolved on own about 21:00.

VAERS ID:552553 (history)  Vaccinated:2014-10-13
Age:38.0  Onset:2014-10-20, Days after vaccination: 7
Gender:Female  Submitted:2014-11-04, Days after onset: 15
Location:Missouri  Entered:2014-11-06, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site joint movement impairment, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Continued (L) shoulder and upper arm pain 2 weeks post vaccination - flu shot, pain and decreased ROM to (L) shoulder.

VAERS ID:552587 (history)  Vaccinated:2014-11-02
Age:38.0  Onset:2014-11-03, Days after vaccination: 1
Gender:Female  Submitted:2014-11-06, Days after onset: 3
Location:Missouri  Entered:2014-11-07, Days after submission: 1
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: Haloperidol; NORCO; amitriptyline; gabapentin; Vit D
Current Illness: None
Preexisting Conditions: Allergies: fluoxetine, olanzapine, morphine
Diagnostic Lab Data: WBC came back WNL -$g infection ruled out
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0098740IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Myalgia, Pain in extremity, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Patient rolled over on arm around 5am and was in extreme pain. She felt like her muscle was going to burst. Went to ER and was admitted. No temp, swelling, bruising, etc.

VAERS ID:552897 (history)  Vaccinated:2014-10-03
Age:38.0  Onset:2014-10-03, Days after vaccination: 0
Gender:Female  Submitted:2014-11-10, Days after onset: 38
Location:Pennsylvania  Entered:2014-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No.
Preexisting Conditions: No.
Diagnostic Lab Data: Xray shoulder; MRI shoulder
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 15IMLA
Administered by: Public     Purchased by: Other
Symptoms: Fluid retention, Joint stiffness, Musculoskeletal pain, Tendonitis, X-ray limb
SMQs:, Rhabdomyolysis/myopathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: FIRST NOTICED SHOULDER JOINT PAIN AND STIFFNESS ABOUT 1.5 hours after administration. This continues to worsen over next few days to the point where even minimal pressure on my extremity caused pain, and rom was significantly decreased despite attempts with anti-inflammatories and rom exercises. Saw occ health after 1week, started Aleve and tramadol and PT exercises, after still worsening symptoms had an xray and MRI on 10/15 revieled small fluid collection and tendonitis. Saw orthopedic on 10/22 recieved steroid injection. 48 hours later pain improved and rom improved. Began PT biweekly and at home. 11/6. Noticed pain worsening again. Today 11/10 pain is present, not debilitating but worse than yesterday and the day before. I am still on modified duty at work and see the orthopedic again on 11/12.

VAERS ID:552904 (history)  Vaccinated:2014-09-24
Age:38.0  Onset:2014-09-24, Days after vaccination: 0
Gender:Female  Submitted:2014-11-10, Days after onset: 47
Location:Indiana  Entered:2014-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: IBUPROFEN 600 MG TABS (IBUPROFEN) 1 tab po q 8 with food for headaches LORATADINE 10 MG TABS (LORATADINE) 1 tab daily for nasal congestion FLONASE 50 MCG/ACT SUSP (FLUTICASONE PROPIONATE) 2 sprays each nostril daily POLYETHYLENE GLYCOL 3
Current Illness: No
Preexisting Conditions: Headaches, allergic rhinitis, paresthesias, anxiety
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI158AA0IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Injected limb mobility decreased, Musculoskeletal pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Constant left shoulder pain with radiation down arm. Unable to raise arm over shoulder. Stinging sensation in hand.

VAERS ID:555500 (history)  Vaccinated:2014-10-20
Age:38.0  Onset:2014-10-21, Days after vaccination: 1
Gender:Female  Submitted:2014-11-10, Days after onset: 20
Location:Minnesota  Entered:2014-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ranitidine; QVAR; albuterol; loratadine; DESOGEN; FLONASE
Current Illness: Viral URI
Preexisting Conditions: Moderate persistent asthma, allergic rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0045420IMAR
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity
SMQs:, Angioedema (broad), Hypersensitivity (narrow)
Write-up: Localized allergic reaction, not systemic.

VAERS ID:553364 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2014-11-12
Location:Unknown  Entered:2014-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions: No adverse event, Per the reporter, the subject had no previous medical history.
Diagnostic Lab Data: Lab tests: There were no diagnostics tests performed.
CDC Split Type: A1054344A
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSA4K92 UNUN
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSB93490IMUN
TYP: TYPHOID LIVE ORAL TY21A (NO BRAND NAME)UNKNOWN MANUFACTURER  PO 
Administered by: Other     Purchased by: Other
Symptoms: Hyperhidrosis, Trance
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: This case was reported by a healthcare professional (office manager) via sales representative and described the occurrence of trance in a 38-year-old male subject who was vaccinated with TWINRIX (GlaxoSmithKline), FLULAVAL and typhoid (non-gsk). In 2013 the subject received 1st dose of TWINRIX (intramuscular, unknown details), a dose of FLULAVAL (unknown details), unspecified dose of typhoid (non-GSK) (oral). In 2013, within minutes of vaccination with FLULAVAL, oral typhoid vaccine (Non-GSK) and TWINRIX, the subject experienced trance and sweating. Per the reporter, the events occurred "shortly afterwards" when describing the onset of the events. Per the reporter, the subject "went into 2 to 3 minutes of a trance and was a little sweaty." Per the reporter, the subject stated that "he had never had before." The events were not the result of suspected transmission of an infectious agent via a medicinal product. At the time of reporting the events were resolved. Per the reporter, "after resolution he felt fine." The subject "did not come back for the next dose of TWINRIX." It was unclear from the report of the vaccination course with TWINRIX was discontinued. The reporter did not consider this case to be serious.

VAERS ID:553456 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-11-13
Location:Unknown  Entered:2014-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: DEJNJFOC20140809295
Vaccination
Manufacturer
Lot
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Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD  PO 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiac failure, Eosinophilic myocarditis
SMQs:, Cardiac failure (narrow), Cardiomyopathy (narrow)
Write-up: These case reports were previously actioned by Crucell (BERNA-2009-0209). The data was taken directly from the database repository and entered verbatim (including labeling and causality assessments) on to the safety database. Where labeling and causality assessments were absent, took the decision to assign according to company guidelines. This case was received from Novartis Vaccine, no.: 199501487BW on 28.May.2002. A 38-year old female took Typhoral-L (Batch no.: unknown) due to planned travelling to the tropics. She was tentatively diagnosed with eosinophilic myocarditis 2 months after vaccination. Further data was requested. No further data was available. Seriousness: serious (hospitalization). Causality: insufficient information. This case was found during archiving activities and has not previously been entered into the global safety database. The case was processed using procedural documents and current labelling documents. The subject was diagnosed with suspicion of eosinophilic myocarditis/heart failure, 2 months after vaccination with typhoid vaccine oral ty21a. This case was serious (hospitalization).

VAERS ID:553735 (history)  Vaccinated:2014-10-03
Age:38.0  Onset:2014-10-03, Days after vaccination: 0
Gender:Male  Submitted:2014-11-14, Days after onset: 42
Location:Pennsylvania  Entered:2014-11-14
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: No
Diagnostic Lab Data: Appointment to see shoulder orthopedist on 12/5/2014 after second visit to primary care doctor.
CDC Split Type:
Vaccination
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Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site pain, Insomnia
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Severe shoulder pain in area where flu shot was administered, limited range of motion, trouble sleeping (due to pain). Attempted to treat with periodic ibruprofen until visit to primary care doctor one week later, followed by 2-week course of prescription NSAID. Pain continues 6 weeks after vaccine administration.

VAERS ID:553846 (history)  Vaccinated:2014-10-07
Age:38.0  Onset:2014-10-12, Days after vaccination: 5
Gender:Male  Submitted:2014-11-16, Days after onset: 35
Location:Oklahoma  Entered:2014-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none~Influenza (Seasonal) (no brand name)~UN~0.00~Patient|none~Pneumo (no brand name)~UN~0.00~Patient
Other Medications: Topical, Norrir, Presista, Viread, Bactrim, Zithromax, omeprazole Prilosec.
Current Illness: None.
Preexisting Conditions: HIV positive
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 7IMLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Back pain, Blister, Musculoskeletal pain, Rash erythematous
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow)
Write-up: Woke up with severe back and shoulder pain. Then as the day grew older this red raised rash started to develop. By the evening it had popped up all these tiny blisters.

VAERS ID:553857 (history)  Vaccinated:2014-11-01
Age:38.0  Onset:2014-11-01, Days after vaccination: 0
Gender:Female  Submitted:2014-11-16, Days after onset: 15
Location:North Carolina  Entered:2014-11-16
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
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSXZ3SP0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site bruising
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Bruising at the injection site that lasted 2 weeks after administration.

VAERS ID:554182 (history)  Vaccinated:2014-10-20
Age:38.0  Onset:2014-10-20, Days after vaccination: 0
Gender:Male  Submitted:2014-11-12, Days after onset: 23
Location:Unknown  Entered:2014-11-17, Days after submission: 5
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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: First BP: 79/26 with pulse of 66 vitals before transport to ER: BP: 86/31, pulse 42, temp 97.9, O2 91% on room air
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia, Hypotension, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Approximately 10 to 20 minutes after receiving flu vaccine, patient complained of numbness, tingling, and pruritus to upper extremities; blood pressure was measured and was low (hypotensive). He was placed on O2 and given 400 ml NS but this did not provide much improvement. Patient remained awake, alert, and oriented x 3. Respirations were event an unlabored. MD was called; orders for epinephrine 1 mg provided and recommendation for patient to go to ER. Patient refused epinephrine but agreed to go to ER. Patient was transported to ER by transport.

VAERS ID:554957 (history)  Vaccinated:2014-11-18
Age:38.0  Onset:2014-11-18, Days after vaccination: 0
Gender:Female  Submitted:2014-11-20, Days after onset: 2
Location:Louisiana  Entered:2014-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient stated she was taking an antibiotic that had caused itching but had it discontinued on 11/18/2014 in the morning prior to getting her vaccine.
Current Illness: Newly diagnosed with Crohn''s disease
Preexisting Conditions: Allergy to penicillin and codeine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0135550IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site urticaria, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Rash, hives, intense itching, redness, pain at injection site (R arm, pain traveling down R arm.

VAERS ID:555022 (history)  Vaccinated:2014-10-31
Age:38.0  Onset:2014-11-01, Days after vaccination: 1
Gender:Male  Submitted:2014-11-20, Days after onset: 19
Location:Pennsylvania  Entered:2014-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol; enalepril; pantoprazole; VENTOLIN
Current Illness: No
Preexisting Conditions: Asthma; High blood pressure; Acetaminophen allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS146305 UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Patient has experienced "sharp persistent pain" in shoulder of the arm the shot was given. Stiffness occurs upon waking. The stiffness goes away after several hours but the pain stays. This has happened daily since 11/1/14.

VAERS ID:555212 (history)  Vaccinated:2014-11-19
Age:38.0  Onset:2014-11-20, Days after vaccination: 1
Gender:Female  Submitted:2014-11-22, Days after onset: 2
Location:Oregon  Entered:2014-11-22
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: Diabetic
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SYRLA
TDAP: TDAP (ADACEL)SANOFI PASTEUR  IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SYRRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Induration, Mass, Oedema, Pain, Pruritus, Skin warm, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Swelling, pain, edema, redness, hard lump, hot to touch, itching.

VAERS ID:555242 (history)  Vaccinated:2014-11-08
Age:38.0  Onset:2014-11-08, Days after vaccination: 0
Gender:Female  Submitted:2014-11-23, Days after onset: 15
Location:North Carolina  Entered:2014-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Escitaloptram - 5 mg/day
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Joint range of motion decreased, Musculoskeletal pain, Periarthritis
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (narrow)
Write-up: Extreme shoulder pain, frozen shoulder, ongoing pain and limited range of motion after two weeks.

VAERS ID:555412 (history)  Vaccinated:2014-11-06
Age:38.0  Onset:2014-11-06, Days after vaccination: 0
Gender:Female  Submitted:2014-11-24, Days after onset: 18
Location:North Carolina  Entered:2014-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI214AA1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Throat closing.

VAERS ID:555482 (history)  Vaccinated:2014-11-23
Age:38.0  Onset:2014-11-24, Days after vaccination: 1
Gender:Male  Submitted:2014-11-25, Days after onset: 1
Location:Indiana  Entered:2014-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: Ear Infection
Preexisting Conditions: Dairy Products
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI197AC IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Angioedema, Swollen tongue
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Tongue swelling, angioedema. EpiPen, Benadryl, Prednisone, Solumedrol, Pepcid.

VAERS ID:555631 (history)  Vaccinated:2014-11-04
Age:38.0  Onset:2014-11-04, Days after vaccination: 0
Gender:Female  Submitted:2014-11-18, Days after onset: 14
Location:Washington  Entered:2014-11-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Tramadol; AUGMENTIN; AMBIEN; VICODIN; TYLENOL; Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI198AE0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Shortly after flu vaccine, chest tightness and SOB began.

VAERS ID:557664 (history)  Vaccinated:2014-11-18
Age:38.0  Onset:2014-11-19, Days after vaccination: 1
Gender:Male  Submitted:2014-11-26, Days after onset: 7
Location:Indiana  Entered:2014-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin; Baclofen; Fluoxetine; HUMIRA; Meloxicam
Current Illness: Drug hypersensitivity; Ankylosing spondilitis
Preexisting Conditions: DEMEROL, Hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1411USA009869
Vaccination
Manufacturer
Lot
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Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K007262 IMAR
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site erythema, Injection site swelling, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a Licensed Practical Nurse refers to a 38 year old male patient with ankylosing spondylitis and DEMEROL allergy. On 18-NOV-2014 the patient was vaccinated with PNEUMOVAX 23 (0.5 ml, intramuscular, in the arm, lot # K007262 with expiry date: 25-NOV-2015). Concomitant therapies included atorvastatin, baclofen, fluoxetine, HUMIRA and meloxicam. On 19-NOV-2014, the patient experienced severe muscle weakness and pain in the arm, redness and swelling from injection site, across the anterior arm to the axilla and difficulty moving the injection site, after receiving PNEUMOVAX 23. The patient was treated with an ice to site, KEFLEX and hydroxyzine. None lab diagnostics studies were performed. The patient sought medical attention via seeing the physician. The outcome of events was not reported. The relatedness between events and PNEUMOVAX 23 was not reported. This is one of several reports from the same reporter. Additional information has been requested.

VAERS ID:556102 (history)  Vaccinated:2014-10-28
Age:38.0  Onset:2014-10-28, Days after vaccination: 0
Gender:Male  Submitted:2014-12-01, Days after onset: 34
Location:Michigan  Entered:2014-12-01
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1412501 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: No date or time onset for adverse reaction. Under-dose or possible second dose was given. Vaccination error.

VAERS ID:556103 (history)  Vaccinated:2014-11-25
Age:38.0  Onset:2014-11-25, Days after vaccination: 0
Gender:Female  Submitted:2014-12-01, Days after onset: 6
Location:Pennsylvania  Entered:2014-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: severe joint pain/stiffness, headache, throat tightness, hoarse voice~Influenza (Seasonal) (Flublok)~1~37.00~Patient
Other Medications: Benadryl 25mg PO was taken by the patient from 11/23/2014 through 11/25/2014.
Current Illness: No
Preexisting Conditions: Sulfa, zithromax, soy, dairy, eggs, gluten/wheat
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUR3: INFLUENZA (SEASONAL) (FLUBLOK)PROTEIN SCIENCES CORPORATION440553F1IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Anaphylactic reaction, Confusional state, Dyspnoea, Headache, Hypersensitivity, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Approximately 10:45 to 11:00 AM, beginning to feel tightness in throat and headache. Symptoms progressed to throat closing and shortness of breath, confusion by 12:00PM. Primary Care physician contacted via phone at 12:00PM and instructed patient to take Benadryl 50mg PO. Benadryl 50mg liquid PO was taken PO at 12:15PM (after being purchased) and continued Q6H around-the-clock until 11/30/2014. Patient also went to facility at 12:20 after Benadryl taken to discuss allergic/anaphylactic reaction with nurses who administered vaccine.

VAERS ID:556111 (history)  Vaccinated:2014-11-22
Age:38.0  Onset:2014-11-24, Days after vaccination: 2
Gender:Female  Submitted:2014-12-01, Days after onset: 7
Location:Indiana  Entered:2014-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE REPORTED
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CJ21293IN 
Administered by: Public     Purchased by: Private
Symptoms: Influenza, Influenza like illness
SMQs:
Write-up: HUSBAND STATED WIFE WAS "SEVERELY" ILL WITH THE FLU (AND FLU LIKE SYMPTOMS) FOR 4 DAYS. PATIENT AND 4 OTHER MEMBERS OF THE HOUSE HOLD REC. FLU MIST AND WERE ILL AS WELL. NONE OF THE PATIENTS WENT TO THE DOCTOR OR WERE DIAGNOSED OR TREATED WITH MEDICATION FOR THE FLU.

VAERS ID:556614 (history)  Vaccinated:2014-11-24
Age:38.0  Onset:2014-11-24, Days after vaccination: 0
Gender:Female  Submitted:2014-12-03, Days after onset: 9
Location:Arizona  Entered:2014-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Immediate sneezing
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CF2251 IN 
Administered by: Public     Purchased by: Private
Symptoms: Cough, Dry throat, Ear pain, Immediate post-injection reaction, Myalgia, Oropharyngeal pain, Sneezing, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (narrow)
Write-up: Immediate sneezing, then sore throat, ear ache, cough, sore muscles, dry throat, blurred vision, still continuing.

VAERS ID:556886 (history)  Vaccinated:2014-10-07
Age:38.0  Onset:2014-11-09, Days after vaccination: 33
Gender:Female  Submitted:2014-12-03, Days after onset: 24
Location:Pennsylvania  Entered:2014-12-04, Days after submission: 1
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: None
Preexisting Conditions: None
Diagnostic Lab Data: Guillain-Barre Syndrome
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI189AC0UNRA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Dysphagia, Facial paresis, Guillain-Barre syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow)
Write-up: Weakness, tingle in legs and arms, difficult swallowing, facial weakness.

VAERS ID:556969 (history)  Vaccinated:2014-12-03
Age:38.0  Onset:2014-12-03, Days after vaccination: 0
Gender:Female  Submitted:2014-12-04, Days after onset: 1
Location:Michigan  Entered:2014-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SERTRALINE, LEVOTHYROXINE
Current Illness: NO
Preexisting Conditions: ALLERGIC TO 4 ANTIBIOTICS
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
Administered by: Unknown     Purchased by: Public
Symptoms: Headache, Hypopnoea, Myalgia, Pyrexia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: LOW GRADE FEVER, HEADACHE, MUSCLE PAIN, SHALLOW BREATHING, HIVES ON NECK AND CHEST.

VAERS ID:557209 (history)  Vaccinated:2014-11-09
Age:38.0  Onset:2014-11-13, Days after vaccination: 4
Gender:Male  Submitted:2014-12-06, Days after onset: 23
Location:Oregon  Entered:2014-12-06
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NONE
Diagnostic Lab Data: Spinal tap - elevated white count
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER 0IDLA
Administered by: Military     Purchased by: Military
Symptoms: CSF white blood cell count increased, Headache, Malaise, Meningitis, Spinal pain
SMQs:, Noninfectious meningitis (narrow), Arthritis (broad)
Write-up: Malaise, headache, spinal pain resulting in hospitalization and spinal tap consistent with meningitis.

VAERS ID:557349 (history)  Vaccinated:2014-10-29
Age:38.0  Onset:2014-10-29, Days after vaccination: 0
Gender:Female  Submitted:2014-12-08, Days after onset: 40
Location:North Carolina  Entered:2014-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nuva-ring
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEUR 1SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Contusion, Joint range of motion decreased, Local swelling, Pain in extremity
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Swelling, bruising, soreness in the arm, still do not have full range of motion left arm.

VAERS ID:557433 (history)  Vaccinated:2014-11-18
Age:38.0  Onset:2014-11-19, Days after vaccination: 1
Gender:Female  Submitted:2014-12-09, Days after onset: 20
Location:Washington  Entered:2014-12-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: same reaction~Influenza (Seasonal) (no brand name)~~24.00~Patient
Other Medications: None
Current Illness: None stated
Preexisting Conditions: None stated
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI173AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Injection site erythema, Injection site pain, Injection site swelling, Lymphadenopathy, Sternitis, Tenderness
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Erythema, swelling and tenderness at site. Temperature of 38 Celsius. Left axillary swelling and tenderness with motion. Numbness and swelling in sternal notch.

VAERS ID:557503 (history)  Vaccinated:2014-09-23
Age:38.0  Onset:2014-09-23, Days after vaccination: 0
Gender:Female  Submitted:2014-11-15, Days after onset: 53
Location:Texas  Entered:2014-12-09, Days after submission: 24
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: MRI and Xrays
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED1064922A0UNLA
Administered by: Unknown     Purchased by: Other
Symptoms: Joint range of motion decreased, Musculoskeletal pain, Nuclear magnetic resonance imaging, Periarthritis, Rotator cuff syndrome, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (narrow)
Write-up: Shoulder pain and immobility - Dx frozen shoulder and small tear in rotator cuff.

VAERS ID:557569 (history)  Vaccinated:2014-11-13
Age:38.0  Onset:2014-11-13, Days after vaccination: 0
Gender:Female  Submitted:2014-12-10, Days after onset: 27
Location:Kansas  Entered:2014-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zanaflex; Detrol; albuterol
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS58Z7H SYRLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Decreased appetite, Diarrhoea, Dizziness, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Headache, body ache and chills, dizziness and light headed did not eat or drink for two days with fever of 99.8. Husband to me to Hospital. Was put on 24 hour quarters after eating small amounts of food I then had diarrhea for 2 days and returned to Health Care where they gave me a shot in the butt and meds to take for the diarrhea.

VAERS ID:557836 (history)  Vaccinated:2014-10-24
Age:38.0  Onset:2014-10-27, Days after vaccination: 3
Gender:Unknown  Submitted:0000-00-00
Location:Delaware  Entered:2014-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dizziness
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI195AB IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Developed dizziness 3 days after take flu shot.

VAERS ID:558122 (history)  Vaccinated:2014-11-27
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-12-13
Location:Texas  Entered:2014-12-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Feeling cold, Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left severe arm pain at site of injection w/ cold like sensation.

VAERS ID:558147 (history)  Vaccinated:2014-12-04
Age:38.0  Onset:2014-12-06, Days after vaccination: 2
Gender:Female  Submitted:2014-12-14, Days after onset: 8
Location:Tennessee  Entered:2014-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Rx''d Claritin 25 mg daily.
Current Illness: None
Preexisting Conditions: Hx enviromental and shellfish allergies.
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5G9431IMLA
Administered by: Other     Purchased by: Private
Symptoms: Body temperature increased, Dysphonia, Injection site pruritus, Injection site rash, Oropharyngeal pain, Respiratory tract congestion, Sneezing, Throat irritation
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Sorethroat, sneezing, congestion, 99.9F temperature, scratchy throat, hoarseness, localized breakout L arm around vaccination site with itchiness, bump nickle size on L forearm. Signs and symptoms lasted for 6 days.

VAERS ID:558254 (history)  Vaccinated:2014-06-17
Age:38.0  Onset:2014-06-17, Days after vaccination: 0
Gender:Male  Submitted:2014-12-15, Days after onset: 181
Location:Connecticut  Entered:2014-12-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Bactrim, Doxycycline
Diagnostic Lab Data: CT scan
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3FZ741IMLA
Administered by: Public     Purchased by: Private
Symptoms: Computerised tomogram, Headache
SMQs:
Write-up: 45 minutes after receiving vaccine he started to have a headache which progressed to feeling like his head was going to "explode". Went to ER, referred to a neurologist who prescribed medication which helped minimally. Headache finally went away after 3 months.

VAERS ID:558440 (history)  Vaccinated:2014-10-16
Age:38.0  Onset:2014-10-16, Days after vaccination: 0
Gender:Female  Submitted:2014-12-15, Days after onset: 60
Location:New Jersey  Entered:2014-12-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: US2014009222
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS2L752 IMAR
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: This case was reported by a consumer and described the occurrence of rash in a 38-year-old female patient who received FLUARIX QUADRIVALENT (batch number 2L752, expiry date June 2015). On 16th October 2014 10:30, the patient received FLUARIX QUADRIVALENT (intramuscular). On an unknown date, the dose was an unknown dose. On 16th October 2014, 10 hrs after receiving FLUARIX QUADRIVALENT, the patient experienced rash and hives. The patient was treated with BENADRYL. On an unknown date, the outcome of the rash and hives were recovering/resolving. The reporter considered the rash and hives to be almost certainly related to FLUARIX QUADRIVALENT. Additional information: Caller reports that she received a FLUARIX QUADRIVALENT vaccine yesterday at her local pharmacy. Yesterday evening she started noticing a rash developing on her forearms. She woke up this morning and there were hives on both arms starting a little below her wrist to her elbow. The hives are red, elevated and flat, and they are worse on the arm where she received the injection. She spoke with her HCP and pharmacy, but has not had to go into the office. She took some BENADRYL this morning and the rash does seem to be doing better.

VAERS ID:559445 (history)  Vaccinated:2014-12-18
Age:38.0  Onset:2014-12-18, Days after vaccination: 0
Gender:Female  Submitted:2014-12-18, Days after onset: 0
Location:Ohio  Entered:2014-12-23, 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: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED10149221A IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site erythema, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: About 15 minutes after injection c/o bump and slight itching. Slight reddness around injection site (L) deltoid. Observed x 20 min B/P 128/83 at 845A and 120/82 at 905A. Applied ice x 10 min. States itching relieved. 12/19/14 reports feels better, arm only a little sore.

VAERS ID:559530 (history)  Vaccinated:2014-10-17
Age:38.0  Onset:2014-10-17, Days after vaccination: 0
Gender:Male  Submitted:2014-12-23, Days after onset: 67
Location:Michigan  Entered:2014-12-23
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1414001 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Pallor, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Patient got lightheaded and felt like her throat was closing up. Was lied down on the floor and lung sounds/pulse were checked. Patient stated that her coworkers stated that she looked pale. Patient''s first vaccinated. 1:15 pm, Pt placed on back with pink color with complaints of difficulty breathing. AOCx3, no wheezes heard upon observation. Pulse was 110 BPM. 1:20, Pt continued to explain of difficulty breathing with now complaint of tongue feeling t0o big. When offered grape juice. Call placed to 911. Epi given R arm 1:1000, # 682492. 0.5 given by lead RN. 1:30pm, pt remained stable with complaints of heavy chest lessened. Paramedics arrived 1:35pm, pt walked with help to stretcher.

VAERS ID:559613 (history)  Vaccinated:2014-11-13
Age:38.0  Onset:2014-11-13, Days after vaccination: 0
Gender:Female  Submitted:2014-12-24, Days after onset: 41
Location:Michigan  Entered:2014-12-24
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 spleen
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1414001 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Feeling hot, Local reaction, Local swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: (forearm/elbow) L arm redness/swelling not near injection site, c/o "felt hot". Benadryl provided per fellow employee, advised to apply ice pack, no c/o SOB. 10:00 AM- HR sent email to employee and employee states "she is feeling fine." 11:10 AM- per employee, "I feel fine," local reaction resolved with Benadryl and fluids.

VAERS ID:559778 (history)  Vaccinated:2014-12-17
Age:38.0  Onset:2014-12-18, Days after vaccination: 1
Gender:Female  Submitted:2014-12-18, Days after onset: 0
Location:Arizona  Entered:2014-12-24, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS995J52IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Body temperature increased, Headache, Injection site bruising, Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Noticed this am-site red and size of penny, felt like a bruise/hard, removed sweater this afternoon-site was bigger, reddened, warm to touch, painful with palpation. Reported to clinic-oral temp 99.1 and c/o H/A since yesterday, but has H/A frequently with weather change. Site marked.

VAERS ID:559876 (history)  Vaccinated:2014-11-05
Age:38.0  Onset:2014-11-05, Days after vaccination: 0
Gender:Female  Submitted:2014-12-29, Days after onset: 54
Location:Indiana  Entered:2014-12-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14621P0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Drug administered at inappropriate site, Hypoaesthesia, Mobility decreased, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: I feel that the injection was not in the deltoid muscle as intended. The injection was in the shoulder joint. I have had pain achiness, sharp pains and numbness and tingling. It has been approx. 6 weeks now and I cont. to have pain and decreased mobility requiring assistance taking off my shirt and coat.

VAERS ID:559939 (history)  Vaccinated:2014-12-20
Age:38.0  Onset:2014-12-20, Days after vaccination: 0
Gender:Female  Submitted:2014-12-29, Days after onset: 9
Location:Texas  Entered:2014-12-29
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: Cut finger
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4690BA SYRLA
Administered by: Public     Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site discolouration, Injection site pain, Weight bearing difficulty
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Soreness and discoloration around injection site developed shortly after the injection. Over the next day, soreness and discoloration spread from shoulder joint to half way down upper arm. Within several hours of injection, developed difficulty in lifting or preforming weight bearing activities with arm and restricted mobility of shoulder. Discoloration has diminished, but soreness and limited motion remain. Some ease of pain is received with Tylenol.

VAERS ID:560458 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-09-22
Location:Unknown  Entered:2015-01-02, Days after submission: 102
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLOFT; LOSEASONIQUE; Baclofen
Current Illness: BACTRIM, SOMA, melatonin, abnormal response to PAXIL, PROZAC, Drug hypersensitivity
Preexisting Conditions: Cerebral palsy; Endometriosis
Diagnostic Lab Data:
CDC Split Type: PHHY2013US122311
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Headache, Malaise
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Case number PHHY2013US122311, is an initial spontaneous report received from the Vaccine Adverse Event Reporting System (VAERS reference number 497409) web site on 15 Oct 2013. The report refers to a 38-year-old female patient. Her medical history included drug allergy to BACTRIM, SOMA, melatonin and abnormal response to PAXIL and PROZAC, cerebral palsy and endometriosis. Concomitant drugs included ZOLOFT, LOSEASONIQUE and baclofen. On an unknown date in 2009, the patient received H1N1 (manufacturer and batch number: not reported, so conservatively coded as Pandemic Influenza vaccine INN). On an unknown date, after vaccination she experienced headaches and general weakness with malaise. The outcome of the events was not reported. The seriousness and causality of the events were not reported.

VAERS ID:560478 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Unknown  Submitted:2014-04-11
Location:Unknown  Entered:2015-01-02, Days after submission: 266
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: UNK
Preexisting Conditions: Unknown
Diagnostic Lab Data: Lab tests unknown
CDC Split Type: 2013SA120191
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEUR  UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: Initial misuse report received from a nurse on 01 November 2013. The 38-year-old patient had received DAPTACEL (route, site not provided). Reporter stated that patient received DAPTACEL to 38 year old patient instead of ADACEL. (No information was provided regarding the patient). No adverse event was reported. List of documents held by sender: none.

VAERS ID:560449 (history)  Vaccinated:2014-08-25
Age:38.0  Onset:2014-09-10, Days after vaccination: 16
Gender:Female  Submitted:2015-01-04, Days after onset: 116
Location:Washington  Entered:2015-01-04
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Imitrex, Wellbutrin, spironolactone
Current Illness: No
Preexisting Conditions: Bactrim, chronic migraine
Diagnostic Lab Data: Going to Dr. ASAP to see if there is any way to halt the progress of this arthritis. Will forward report.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSL5MN20IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0001740IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Arthritis, Injection site hypoaesthesia, Injection site pruritus
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: Pain in knees and ankles every time I sit getting progressively worse as time passes. I had no knee or ankle pain before vaccination. Constant pain now. Just found out that this is from rubella vaccine. Numbness and deep crawling itch in location of vaccine. (deep itch has improved some over time and some sensation in shoulder has returned)

VAERS ID:564761 (history)  Vaccinated:2014-12-07
Age:38.0  Onset:2014-12-08, Days after vaccination: 1
Gender:Female  Submitted:2015-01-07, Days after onset: 30
Location:Pennsylvania  Entered:2015-01-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Local site reaction~Influenza (Seasonal) (no brand name)~UN~0.00~Patient
Other Medications: LYRICA; PRISTIQ; DILAUDID; naratriptan; VYVANSE
Current Illness: None
Preexisting Conditions: Complex chronic migraine; sulfa allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU5013AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Fatigue, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Patient described feeling weak/fatigue, having fever and joint pain starting approximately 1 day after receiving vaccination. Symptoms lasted approx 3 days. Patient did not self medicate or seek treatment.

VAERS ID:565135 (history)  Vaccinated:2014-11-26
Age:38.0  Onset:2014-12-01, Days after vaccination: 5
Gender:Female  Submitted:2015-01-14, Days after onset: 44
Location:Unknown  Entered:2015-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; omeprazole
Current Illness: Drug hypersensitivity; Gastrooesophageal reflux disease; Thyroid disorder
Preexisting Conditions: MACRODANTIN, Hypersensitivity
Diagnostic Lab Data: 12-NOV-2014: Titer level drawn: 0.46; 07-JAN-2015: Titer level drawn: 1.05
CDC Split Type: WAES1501USA004001
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0051780SCUN
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Rash pruritic, Rash pustular, Viral titre
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a nurse refers to a 38 year old female patient with thyroid disease, Gastroesophageal reflux disease (GERD) and allergy to MACRODANTIN. Medical history was not reported. On 12-NOV-2014 varicella titers were performed and the result was 0.46 (units not provided). On 26-NOV-2014 the patient was vaccinated with the first dose of VARIVAX (Merck) injection, 0.5 ml, subcutaneous, lot # K005178, expiration date 10-APR-2016, as a school requirement. Concomitant therapies included SYNTHROID and omeprazole. The nurse informed that 17-DEC-2014 the patient developed an itching and burning rash on an unspecified location on her body, also informed that on an unknown date in December 2014 (also reported as a couple days later) the patient developed pustules from head to toe on her body, the nurse stated that the patient was seen by a dermatologist on an unspecified date and also stated that on 17-JAN-2015 the patient had a titer level drawn for the varicella and the result on the titer was 1.05 (units not provided). The outcome of the events was recovered on an unspecified date. Additional information has been requested.

VAERS ID:565231 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2015-01-14
Location:Unknown  Entered:2015-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: US2014GSK039087
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS995J5 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This case was reported by a other health professional and described the occurrence of incorrect storage of drug in a 38-year-old male patient who received ENGERIX B (batch number 995J5, expiry date 6th February 2017). On an unknown date, the patient received ENGERIX B. On an unknown date, an unknown time after receiving ENGERIX B, the patient experienced incorrect storage of drug. On an unknown date, the outcome of the incorrect storage of drug was unknown. Office was sent a recall notification from their distributor regarding ENGERIX B and storage temperatures. The office has already administered the vaccine to 5 adults. Reporter is not certain what type of excursion took place (high or low temps). At this time, no reports to the office have been received from the patients following vaccination. Vaccines were given this week. Three female: 37, 62 and 52-year-old. Two male: 38 and 65-year-old. Follow-up received on 8 December 2014: Patient got ENGERIX B which was not stable. No adverse event reported.

VAERS ID:561617 (history)  Vaccinated:2015-01-02
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2015-01-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pregnant
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1466241UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS55MT7 UNLA
Administered by: Other     Purchased by: Private
Symptoms: Wrong drug administered
SMQs:
Write-up: Pt given incorrect vaccine. Wanted BOOSTRIX and was administered FLUVIRIN PF.

VAERS ID:561911 (history)  Vaccinated:2014-09-01
Age:38.0  Onset:2014-09-01, Days after vaccination: 0
Gender:Male  Submitted:2014-11-21, Days after onset: 81
Location:Unknown  Entered:2015-01-15, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2014US018299
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Cough, Fatigue, Influenza like illness, Muscle fatigue, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Guillain-Barre syndrome (broad)
Write-up: Case number PHEH2014US018299 is an initial spontaneous report received from consumer (who is the patient) on 10 Sep 2014, with a follow up consumer on 30 Oct 2014. This report refers to a 38 year old male patient. His medical history and concomitant medication were not reported. He was vaccinated with FLUVIRIN (batch number: not reported) intramuscularly on 01 Sep 2014. On the same day 04 hours after vaccination, he experienced flu like symptoms for 10 days. The symptoms were described as tiredness, weakness, tired muscle feeling, runny nose and cough. The first two days of the event were worst and after that he was a little better. The final outcome was reported as unknown. The seriousness and causality were not reported. Non-significant follow up received from consumer on 30 Oct 2014: updated nurse contact information only.

VAERS ID:561914 (history)  Vaccinated:2014-09-09
Age:38.0  Onset:2014-09-10, Days after vaccination: 1
Gender:Female  Submitted:2014-11-21, Days after onset: 72
Location:Unknown  Entered:2015-01-15, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2014US018695
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1412201 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Case number PHEH2014US018695, is an initial spontaneous report received from a consumer on 16 Sep 2014 and with a follow up information received from the physician on 10 Nov 2014. This report refers to a 38 years old female patient. Her medical history included allergic to neomycin. Her concomitant medications were not reported. She was vaccinated with FLUVIRIN (batch number: 1412201) intramuscularly at a dose of 0.5 ml in right deltoid on 09 Sep 2014 at 11.30 AM. On 10 Sep 2014, in morning she presented with two hives inferior to the injection site on either side lasted for 3 days. The physician reported that he had no information that the patient had reaction with vaccine. The final outcome of the event was reported as unknown. The seriousness and causality of the events were not reported. Follow up information received from the physician on 10 Nov 2014: Removed another suspect vaccine (FLUCELVAX). Updated batch number of FLUVIRIN, dose, and site of vaccination and physician comment in the narrative.

VAERS ID:561980 (history)  Vaccinated:2014-10-08
Age:38.0  Onset:2014-10-08, Days after vaccination: 0
Gender:Female  Submitted:2014-11-21, Days after onset: 44
Location:Unknown  Entered:2015-01-15, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2014US020259
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1411601 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Chills, Flushing, Headache, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Case number PHEH2014US020259 is an initial spontaneous report from the nurse received on 08 Oct 2014. This report refers to a 38-year-old female patient. She was vaccinated with FLUVIRIN (batch number: 1411601) intramuscularly on 08 Oct 2014 (at 09:00 am). On the same date, after vaccination she experienced general malaise, nausea, headache, chills and flushed cheeks. The outcome of the events was unknown. The seriousness and causality of the events were not reported.

VAERS ID:562829 (history)  Vaccinated:2013-10-31
Age:38.0  Onset:2013-10-31, Days after vaccination: 0
Gender:Female  Submitted:2014-10-31, Days after onset: 365
Location:Unknown  Entered:2015-01-21, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Hypertension; Migraines; chills; Vertigo; Nausea
Preexisting Conditions: The patient had no illness at time of vaccination and had a medical history of hypertension and migraines. Follow up information received on 06 January 2014. The patient had a history of chills/rigors, vertigo, nausea and headache. The patient had taken flu shot before. The patient was currently married and had 2 sons. The patient smokes every day. The patient had a surgery of dilation and curettage. The patient did not have any severe life threatening allergy to eggs, had no Guillain-Barre Syndrome (within 6 weeks of previous flu vaccine), the patient never had a severe reaction to the flu vaccine and the patient was not ill with a fever greater than 100 degree. The patient''s father had a medical history of Alzheimer''s disease and cerebrov
Diagnostic Lab Data: Follow up information received on January 2014. On an unspecified date the patient physical examination was done that includes: The patient constitutional was normal (well developed), ear: normal, respiratory was normal (inspection, efforts and auscultation was normal), Cardiovascular was normal (regular rate and rhythm, no murmurs, gallops or rubs), Vascular was normal (pulses, Dorsalis pedis was normal), Abdomen was normal (inspection, auscultation was normal and no abdominal tenderness), skin was red diffuse, patch slightly raised across abd and extremity was normal (no edema). Blood pressure, unknown, 128/86 mmhg, nl; Pulse rate, 60 beats/min, nl; Weight, 89.811 kg, nl
CDC Split Type: 2013SA113926
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH895AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Muscular weakness, Rash, Rash pruritic, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow)
Write-up: Initial report received from a healthcare professional on 01 November 2013. A 38-year-old female patient had intramuscularly received a dose of FLUZONE (batch number: UH895AA, dose in series was not reported) in the left deltoid on 30 October 2013. The patient had no illness at time of vaccination and had a medical history of hypertension and migraines. Concomitant medication were not reported. On 31 October 2013, few hours after vaccination the patient developed rash that developed into hives and was very itchy. No laboratory tests were done and the patient had received Medrol dose pack as corrective treatment. At the time of this report, the patient was not recovered. It was reported the patient was not recovered. It was reported the patient required ER/doctor visit. List of documents held by sender: None. Follow information received on 06 January 2014. The patient rash was resolving and had developed headache and weakness in arm on an unspecified date. The FLUZONE vaccine expiry date was 30 June 2014. The patient had a history of chills/rigors, vertigo, nausea and headache. The patient had taken flu shot before. The patient was currently married and had 2 sons. The patient smokes every day. The patient had a surgery of dilation and curettage. The patient did not have any severe life threatening allergy to eggs, had no Guillain-Barre Syndrome (within 6 weeks of previous flu vaccine), the patient never had a severe reaction to the flu vaccine and the patient was not ill with a fever greater than 100 degree. The patient''s father had a medical history of Alzheimer''s disease and cerebrovascular accident CVA (stroke). The patient'' mother had a medical history of Diabetes and CAD Coronary artery disease. On an unspecified date the patient''s physical examination was done that included: The patient constitutional was normal (well developed), ear: normal, respiratory was normal (inspection, efforts and auscultation was normal), cardiovascular was normal (regular rate and rhythm, no murmurs, gallops or rubs), vascular was normal (pulses, Dorsalis pedis was normal), Abdomen was normal (inspection, auscultation was normal and no abdominal tenderness), skin was red diffuse, patch slightly raised across abd and extremity was normal (no edema). Vital signs included: The patient was 89.811 kg, blood pressure was 128/86 mm/hg and pulse was 60beats/min. The patient received orally Prednisone (0.5mg/kg) 20mg, every day for 4 days, metoprolol tartrate (orally 100mg tablet 1 times every day with meal), Hydrochlorothiazide (orally 25 mg tablet every day), Lisinopril (orally 40 mg 2 tablet every day), Triamcinolone Aceonide (thin film of 0.1% was applied to the affected skin areas 1 to 2 times every day), ZYRTEC (orally 10 mg tablet every morning), FIORICET (50mg-325mg-40mg, one tablet by oral route every 4 hours as needed not to exceed 6 tablets per 24 hours) and BENADRYL. Follow up information received on 07 February 2014. The event of rash was resolved on 06 November 2013 and the reporter had no record of weakness in arm.

VAERS ID:562068 (history)  Vaccinated:2015-01-14
Age:38.0  Onset:2015-01-15, Days after vaccination: 1
Gender:Male  Submitted:2015-01-22, Days after onset: 7
Location:Nevada  Entered:2015-01-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AMBIEN, NORCO, CELEBREX, PROZAC
Current Illness: NO
Preexisting Conditions: SMOKER, RHEUMATOID ARTHRITIS
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K010523 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Contusion, Erythema, Inflammation, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (broad)
Write-up: MILD INFLAMMATION AND REDNESS IN SHOULDER AND ARM. SOME BRUISING REMAINS. PATIENT CLAIMS SHE GOT AN UPPER RESPIRATORY INFECTION, ALTHOUGH RELATIONSHIP TO VACCINE IS UNLIKELY.

VAERS ID:562074 (history)  Vaccinated:2014-09-19
Age:38.0  Onset:2014-09-22, Days after vaccination: 3
Gender:Female  Submitted:2015-01-22, Days after onset: 122
Location:Florida  Entered:2015-01-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown On no routine prescription meds
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT579062IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Acne, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Small pinple to side of injection site. Progressed into non-raised red rash on arms, trunk and Left side of face. Went to PCP given Steriod injection X1 and po meds. Immediately improved and rash gone before finished 7 day course of steriods po.

VAERS ID:565849 (history)  Vaccinated:2014-12-12
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2015-01-22
Location:Unknown  Entered:2015-01-23, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: US2014GSK041120
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS4T7E4 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This is a prospective pregnancy case. This 38-year-old female subject was enrolled in a study. The subject received BOOSTRIX (intramuscular) .5 ml on 12th December 2014. The subject''s last menstrual period was on 18th April 2014 and estimated date of delivery was 23rd January 2015. The subject received BOOSTRIX at week 34 of the pregnancy and during the third trimester of pregnancy. On an unknown date, an unknown time after receiving BOOSTRIX the subject developed vaccine exposure during pregnancy (Non-serious). The outcome of vaccine exposure during pregnancy was unknown. The pregnancy was ongoing. Additional information received on 12 December 2014: The last menstrual period was not reported but was calculated with the due date. The type of conception was not reported.

VAERS ID:563918 (history)  Vaccinated:2014-01-20
Age:38.0  Onset:2014-01-20, Days after vaccination: 0
Gender:Female  Submitted:2014-10-31, Days after onset: 283
Location:California  Entered:2015-01-26, Days after submission: 87
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: UNK
Preexisting Conditions: None
Diagnostic Lab Data: Lab tests unknown
CDC Split Type: 2014SA009445
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4722AA0IDRA
Administered by: Private     Purchased by: Private
Symptoms: Exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Initial pregnancy report received from a healthcare professional on 21 January 2014. A 38-year-old female patient, had received an intradermal first dose of FLUZONE ID (batch number: UT4722AA, expiry date 10 April 2014, anatomical site of vaccination was not reported) on 20 January 2014. The patient had neither allergies nor any medical history. The patient received vaccine during pregnancy. The patients last menstrual period date was not reported and the estimated date of delivery is 01 April 2014. As of this report, the patient had not experienced any adverse events. Laboratory investigations were not reported. Follow-up pregnancy report received from a healthcare professional on 29 July 2014. It was reported that patient was vaccinated at private hospital and vaccine purchased with private fund. Mother''s health status (relevant ongoing illness) was reported as healthy. No family history of congenital abnormality was reported. Pregnancy information: Estimated date of delivery was reported as 12 April 2014. No previous pregnancy was reported. Route of vaccination was reported as intradermal right deltoid (arm). Mother did not receive any drug during pregnancy. It was reported that mother did not experience any relevant non serious adverse events. Pregnancy outcome was reported as healthy baby girl without any pregnancy complications. Child outcome: (healthy baby girl born). Apgar score was reported as ''4, 5 and 8'' in 10 minutes, week of gestation was reported as 42. Height of the baby child was reported as 150 inches. Weight: 2.96 kg.

VAERS ID:564090 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-11-03
Location:Indiana  Entered:2015-01-26, Days after submission: 84
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Not reported
Diagnostic Lab Data: Not reported
CDC Split Type: 201309789
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: This case is linked to a serious case 2013-08799 (same patient, different adverse events). Initial report received from a patient who is a healthcare professional on 20 September 2013. A 38-year-old female patient, whose medical history and concomitant medications were not reported had received a dose of Influenza vaccine (manufacturer: unknown, lot number, dose in series, route and site of administration was not reported) on an unspecified date. On an unspecified date, post vaccination, the patient developed hives. Laboratory tests and corrective treatments were not reported. At the time of this report, the outcome of the event was not reported. List of documents held by the sender: None.

VAERS ID:566135 (history)  Vaccinated:2013-08-12
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-04-17
Location:South Carolina  Entered:2015-01-28, Days after submission: 286
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: The patient''s health during pregnancy and risk factors (e.g.: alconol, tobacco or recreational drugs) were reported as "NA". Concomitant medications were not reported.
Diagnostic Lab Data: Not reported
CDC Split Type: 201308651
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4313AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Initial report received from a healthcare professional on 13 August 2013. A 38-year-old female patient had received an intramuscular dose 1 of ADACEL vaccine (batch number: U4313AA and site of administration was not reported) on 12 August 2013. The patent''s health during pregnancy and risk factors were reported as "N/A". Concomitant medications and past medical history were not reported. Treatment for infertility was reported as "N/A". The patient was pregnant at the time of vaccination. The patient''s last menstrual period date was 08 January 2013. The estimated dose of delivery was 08 October 2013. At the time of the report, the patient had not experienced any adverse events. Documents held by sender: none.

VAERS ID:566486 (history)  Vaccinated:2013-07-23
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2014-04-17
Location:South Carolina  Entered:2015-01-28, Days after submission: 286
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Not reported
Diagnostic Lab Data: Not reported
CDC Split Type: 201308074
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4586AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Initial report received from a healthcare professional on 23 July 2013. A 38-year-old female patient, had received first intramuscular dose of ADACEL vaccine (Lot number: U4586AA and site of administration was not reported) on 23 July 2013. The patient was pregnant at the time of vaccination. The patient''s last menstrual period was on 14 November 2012. The patient''s estimated date of delivery was reported as 21 August 2013. At the time of this report, the patient had not experienced any adverse events. The patient''s health during pregnancy, concomitant medications, medical history and specific risk factors (e.g.: alcohol, tobacco or recreational drugs) were not reported. At the time of this report, the patient''s outcome was unknown. Documents held by sender: none.

VAERS ID:566741 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:2015-01-15
Gender:Female  Submitted:2015-01-29, Days after onset: 14
Location:Unknown  Entered:2015-01-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 15-JAN-2015, the patient had a titer drawn and the results showed that the patient was negative for mumps.
CDC Split Type: WAES1501USA008520
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, Mumps antibody test negative
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: This spontaneous prospective pregnancy report was received from a nurse practitioner refers to a 38 year old female patient without pertinent medical history and allergies. On an unknown date in 1983, the patient was vaccinated with one dose of M-M-R II, (strength, dose, frequency, route, anatomical location, lot number and expiration date were not reported) when the patient was 7 years old. No concomitant therapy. The reporter stated that the patient was "about 12 weeks" pregnant (Maternal exposure before pregnancy). The patient became pregnant with and estimated last menstrual period (LMP) of 29-OCT-2014 and estimated date of delivery (EDD) of 05-AUG-2015. On 15-JAN-2015, the patient had a titer drawn an d the result of it was mumps antibody test negative described as the patient was negative for mumps. The reporter stated that the patient who is also a physician had a titer drawn because she was going to start a new job at a hospital. It was reported that the patient did not seek medical attention and treatment was not given for the event. The pregnancy outcome was outcome pending. Th outcome of mumps antibody test negative was unknown. The relatedness between mumps antibody test negative and therpay with M-M-R II was not reported. Additional information has been requested.

VAERS ID:563163 (history)  Vaccinated:2015-01-15
Age:38.0  Onset:2015-01-16, Days after vaccination: 1
Gender:Female  Submitted:2015-01-30, Days after onset: 14
Location:Kansas  Entered:2015-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa, Spironolactone
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CBC, ESR nl
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS5JR7T2IMRA
Administered by: Military     Purchased by: Military
Symptoms: Ecchymosis, Full blood count normal, Pruritus, Purpura, Red blood cell sedimentation rate normal, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: Hives, itching, ecchymosis, purpura.

VAERS ID:564547 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2013-11-27
Location:Unknown  Entered:2015-01-30, Days after submission: 429
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Allergy to chemicals
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2012US024362
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Case number PHEH2012US024362 is an initial spontaneous report received from a pharmacist on 06 Dec 2012. This report refers to a 38-years-old male patient. He had an allergy to thiomersal. He was vaccinated with seasonal influenza vaccine (manufacturer and batch number: not reported) on an unknown date. It was reported that he had fever for three days after receiving the flu vaccine. The outcome of the event was not reported. He was further vaccinated with FLUVIRIN (batch number: not reported) on 28 Oct 2012 (see related case: PHEH2012US024660).

VAERS ID:567192 (history)  Vaccinated:2015-01-21
Age:38.0  Onset:2015-01-22, Days after vaccination: 1
Gender:Male  Submitted:0000-00-00
Location:Kansas  Entered:2015-02-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Non stop crying, sore leg~DTP (no brand name)~1~0.30~Sibling
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Test for influenza, labwork, O2 level
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.K0065032UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4870BA0UNLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Diarrhoea, Dyspnoea, Impaired work ability, Influenza virus test, Lymphadenopathy, Mass, Pain in extremity, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: Sore arm and hugely swollen lymph nodes under arm1st then neck, and groin. Lumps appeared on 1/22/15. On 1/23/15 came home from work-node under arm bigger than fist. On 1/4 started vomiting, diarrhea, chills, SOB, fever, finally went to ER. Sat eve. at 10:00- Did breathing tx, IV, BENADRYL, steroid (Prednisone) and something for stomach. Still off work 1/26 and 1/27. O2 level still down to 91.

VAERS ID:567198 (history)  Vaccinated:2013-08-17
Age:38.0  Onset:2013-08-17, Days after vaccination: 0
Gender:Female  Submitted:2014-04-24, Days after onset: 250
Location:Massachusetts  Entered:2015-02-02, Days after submission: 284
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: The patient had no illness at time of vaccination. The patient had medical history of gall stones, varicose veins and sensitivities. Concomitant medications were not reported.
Diagnostic Lab Data: On an unspecified date, EKG (Electrocardiography) was done, the results of which was reported as ''ok''.
CDC Split Type: 201309060
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEUR  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Electrocardiogram normal, Feeling cold, Heart rate increased, Myalgia, Peripheral coldness, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad)
Write-up: Initial report received from a consumer (the patient) on 22 August 2013. A 38-year-old female patient had received a dose of Rabies vaccine (manufacturer unknown) (batch number, route of administration was not reported) in the left deltoid on 17 August 2013. On 17 August 2013, the patient had received first dose of IMOGAM vaccine (batch number, route and site of administration not reported). The patient had no illness at the time of vaccination. The patient had medical history of gall stones, varicose veins and sensitivities. Concomitant medications were not reported. On 17 August 2013, after vaccination the patient developed cold sensation up her arm, spread to across chest and teeth was chattering, heart was beating fast, achy muscles in legs and felt more sleepy. On an unspecified date, EKG (Electrocardiography) was done, the results of which was reported as ''ok''. Corrective treatment was not reported. On an unspecified date, the patient had recovered from the events. Documents held by sender: none.

VAERS ID:563585 (history)  Vaccinated:2013-11-01
Age:38.0  Onset:2013-11-01, Days after vaccination: 0
Gender:Female  Submitted:2015-02-03, Days after onset: 459
Location:Texas  Entered:2015-02-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium, Spironolactone, Metformin, Concerta
Current Illness: NA
Preexisting Conditions: PCOS, GERD
Diagnostic Lab Data: MRI-bursitis, shoulder impingement; Surgery revealed partial tear to rotator cuff
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 6SYRRA
Administered by: Unknown     Purchased by: Other
Symptoms: Bursitis, Immediate post-injection reaction, Injection site pain, Nuclear magnetic resonance imaging abnormal, Pain, Rotator cuff syndrome, Shoulder operation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Very painful injection. Shoulder very stiff and sore immediately following injection. Increasing pain in following weeks. Range of motion not very good. Given steroid pack 11/18/2013. Had a little relief for the week of steroid pack. Pain came back after completion of steroid pack. Referred to orthopedic surgeon. Was given a cortisone injection 12/3/2013 and started physical therapy. Some pain relief but not complete. Surgery performed 3/18/2014 followed by physical therapy.

VAERS ID:564297 (history)  Vaccinated:2014-11-15
Age:38.0  Onset:2014-11-16, Days after vaccination: 1
Gender:Female  Submitted:2015-02-08, Days after onset: 84
Location:New York  Entered:2015-02-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: tendonitis~Influenza (Seasonal) (AFLURIA)~UN~0.00~Patient
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Examined by physician who prescribed physical therapy due to tendonitis/bursitis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT59208 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Bursitis, Injected limb mobility decreased, Injection site pain, Tendonitis
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Muscular/Shoulder pain on administered arm, lack of strength and flexibility resulting in tendonitis/bursitis. Physical therapy prescribed by physician.

VAERS ID:565315 (history)  Vaccinated:2013-09-23
Age:38.0  Onset:2013-09-23, Days after vaccination: 0
Gender:Female  Submitted:2015-02-13, Days after onset: 508
Location:Maryland  Entered:2015-02-16, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI. x-rays x2 after injury
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13383P0UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Injection site pain, Injury, Nuclear magnetic resonance imaging, X-ray
SMQs:, Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Hostility/aggression (broad)
Write-up: Vaccine was given in right arm at approx. 10:00 am. Positive pain onset 1-2 hours later, in right shoulder and radiating down front of right bicep. KENALOG injections in right shoulder x4, numerous ortho appts, not resolved. Continued pain and ROM. Surgery scheduled.

VAERS ID:569546 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2015-02-16
Location:Unknown  Entered:2015-02-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 2013, Vital titre decreased, Negative
CDC Split Type: WAES1502USA006163
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Viral titre decreased
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a 38 year old female patient. Patient medical history and current condition was not reported. On an unknown date the patient was vaccinated with MMR II for immunization as a child. Also reported that the patient was unsure if she had one or two doses of MMR II, live as a child. Reporter stated that on an unknown date and month in 2013 the patient has unspecified titers done, and the titers were negative. Pharmacist also reported that on an unknown date in SEPTEMBER-2013 the patient had one dose (unspecified) of MMR II, live cancer and overdose was not reported. The outcome of the events was unknown. Causality for the event ''titers were negative'' was unknown. Additional information has been requested.

VAERS ID:565488 (history)  Vaccinated:2015-02-05
Age:38.0  Onset:2015-02-05, Days after vaccination: 0
Gender:Male  Submitted:2015-02-17, Days after onset: 12
Location:Illinois  Entered:2015-02-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Enbrel; Xanax; Mobic
Current Illness: None
Preexisting Conditions: Penicillin Allergy; Methotrexate Allergy; Tesalon Pearles Allergy; Patient has psoriatic arthritis
Diagnostic Lab Data: Tested for flu and it was negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthritis, Chills, Headache, Inflammation, Influenza virus test negative, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arthritis (narrow)
Write-up: Chills, body aches, headache, fever, arthritis inflammation.

VAERS ID:565534 (history)  Vaccinated:2014-10-28
Age:38.0  Onset:2014-10-28, Days after vaccination: 0
Gender:Female  Submitted:2015-02-17, Days after onset: 112
Location:Maryland  Entered:2015-02-17
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: Xray was negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1411501  LA
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site pain, Pain in extremity, X-ray normal
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Flu shot administered in left shoulder felt pain which never went away. The pain grew more and more intense and pain went down my left arm. I began to lose range of motion in arm. Went to see doctor on 11/13/2014 at that time had xray and was referred to a physiatrist. Appointment was 12/5/2014 received a cortisone shot and prescribed PT. Still in PT as of 2/17/2015.

VAERS ID:565625 (history)  Vaccinated:2015-02-08
Age:38.0  Onset:2015-02-08, Days after vaccination: 0
Gender:Female  Submitted:2015-02-17, Days after onset: 9
Location:California  Entered:2015-02-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses at time of vaccination
Preexisting Conditions: No known conditions/allergies/birth defects/medical conditions at time of vaccination
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT513080IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAG7KY0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Joint range of motion decreased, Joint stiffness, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Soreness/tightness in arm, difficulty lifting arm, limited range of motion, and tingling sensation in middle and ring finger in affected arm.

VAERS ID:569989 (history)  Vaccinated:2015-02-13
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2015-02-17
Location:Pennsylvania  Entered:2015-02-23, 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: Clonazepam; Fluoxetine HCl; Metformin HCl ER; Vitamin D3
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0181492IMRA
Administered by: Private     Purchased by: Private
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: None.

VAERS ID:566968 (history)  Vaccinated:2015-01-14
Age:38.0  Onset:2015-01-14, Days after vaccination: 0
Gender:Female  Submitted:2015-02-25, Days after onset: 42
Location:New York  Entered:2015-02-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: Adverse effects from shots, saw doctor for medication.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS9954H UNLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3FZ742UNLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Eye irritation, Fatigue, Lacrimation increased
SMQs:, Guillain-Barre syndrome (broad), Corneal disorders (broad), Lacrimal disorders (narrow)
Write-up: Eyes started to burn and tear. Also feeling of fatigue and weakness for weeks following.

VAERS ID:567247 (history)  Vaccinated:2015-02-23
Age:38.0  Onset:2015-02-25, Days after vaccination: 2
Gender:Male  Submitted:2015-02-26, Days after onset: 1
Location:California  Entered:2015-02-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No but also blood drawn for yearly checkup
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Blood test, Headache, Injection site pain, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Headache, Body Aches, Moderate pain and swelling where shot given.

VAERS ID:567442 (history)  Vaccinated:2014-10-10
Age:38.0  Onset:2014-10-10, Days after vaccination: 0
Gender:Female  Submitted:2014-10-10, Days after onset: 0
Location:Nevada  Entered:2015-02-26, Days after submission: 139
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug (s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2014SE78735
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CH2064 IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug administration error
SMQs:
Write-up: A spontaneous report has been received from a pharmacist concerning a 38 year old, female patient. No information regarding relevant medical history, concomitant disease or concomitant medication was provided. The patient was receiving Nasal FLUMIST (Intranasal) started on 10-Oct-2014. The reporter administered almost the full dose of FLUMIST into one nostril of the patient which started on 10-Oct-2014. The outcome of the event of patient received FLUMIST full dose in one nostril was unknown. The reporter considered the event patient received FLUMIST full dose in one nostril as non-serious.

VAERS ID:567530 (history)  Vaccinated:2015-02-25
Age:38.0  Onset:2015-02-27, Days after vaccination: 2
Gender:Female  Submitted:2015-02-27, Days after onset: 0
Location:Michigan  Entered:2015-02-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, 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: Arm red, hot, swollen, hard to touch and painful where shot was given.

VAERS ID:567541 (history)  Vaccinated:1999-09-01
Age:38.0  Onset:1999-09-01, Days after vaccination: 0
Gender:Female  Submitted:2015-02-28, Days after onset: 5659
Location:Virginia  Entered:2015-02-28
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Hypersensitivity, Hypoaesthesia oral, Hypotension
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Lips numb, hypotension with dizziness. Placed as allergy in medical record.

VAERS ID:567545 (history)  Vaccinated:2015-02-26
Age:38.0  Onset:2015-02-28, Days after vaccination: 2
Gender:Male  Submitted:2015-02-28, Days after onset: 0
Location:California  Entered:2015-02-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin D
Current Illness: Getting over a cold, eye infection
Preexisting Conditions: None
Diagnostic Lab Data: None yet
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Unknown     Purchased by: Other
Symptoms: Axillary mass
SMQs:
Write-up: 2"-3" Lump in my left arm pit.

VAERS ID:568024 (history)  Vaccinated:2015-03-02
Age:38.0  Onset:2015-03-04, Days after vaccination: 2
Gender:Female  Submitted:2015-03-04, Days after onset: 0
Location:Oregon  Entered:2015-03-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medications reported
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS7S29F1IMRA
Administered by: Public     Purchased by: Other
Symptoms: Blister, Pruritus, Urticaria
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Blisters, pruritis, urticaria on palms of hands. Primarily on right hand, scant on left hand. Pt reports self treating with cortisone cream with minimal relief. Will continue to monitor and assess. Instructed pt to f/u with PCP if the condition does not resolve or gets worse.

VAERS ID:571355 (history)  Vaccinated:2014-09-24
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2015-03-17
Location:Unknown  Entered:2015-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Drug hypersensitivity
Preexisting Conditions: Penicillin, Hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1503USA006666
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J014876 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Mumps antibody test negative
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 38 year old adult female patient. The patient''s concurrent condition included allergy to penicillin. On 18-FEB-2010, the patient was vaccinated with M-M-R II (lot #, expiry date, route of administration not reported) (0.5 ml dose) as she was health care worker. No concomitant medication was reported. The physician reported that the patient''s titer drawn on 12-SEP-2014 showed that the patient was not immune to mumps. On 24-SEP-2014, the patient was administered another 0.5ml dose of M-M-R II (Lot# J014876, unspecified expiry date). The patient sought medical attention and consulted the physician. The outcome of event was unknown. No further information was reported. Additional information has been requested.

VAERS ID:571964 (history)  Vaccinated:2015-01-26
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:2015-03-11
Location:Washington  Entered:2015-03-19, 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.K0099021IMLA
Administered by: Other     Purchased by: Private
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: No adverse event.

VAERS ID:570812 (history)  Vaccinated:2015-03-19
Age:38.0  Onset:2015-03-19, Days after vaccination: 0
Gender:Female  Submitted:2015-03-20, Days after onset: 1
Location:California  Entered:2015-03-20
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Dog bite on right knee
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC488AA UNLA
Administered by: Private     Purchased by: Private
Symptoms: Hallucination, Memory impairment, Pharyngeal oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal allergic conditions (narrow), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: Patient experienced "crazy hallucinations" and didn''t remember certain events throughout the evening. She had broken out in hives. Also had swelling of the throat.

VAERS ID:572198 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2015-03-24
Location:Unknown  Entered:2015-03-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1502USA010060
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Adverse reaction
SMQs:
Write-up: This spontaneous report received from a market research program from a consumer refers to a 38 year old male patient. On an unknown date the patient was vaccinated with PPV23 (manufacturer unknown) (dose, lot no. unknown). On an unknown date the patient reported bad experience. The outcome of event was unknown. The causality of event was not reported. Additional information is not expected because the patient did not give consent for follow up.

VAERS ID:571293 (history)  Vaccinated:2015-03-24
Age:38.0  Onset:2015-03-24, Days after vaccination: 0
Gender:Male  Submitted:2015-03-25, Days after onset: 1
Location:Utah  Entered:2015-03-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levemir; Novolin r.; Truvada; Norvir; Prezista
Current Illness: None at time of vaccine
Preexisting Conditions: HIV; diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 1IMRA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Decreased appetite, Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Side effects are pain, redness, swelling at my injection site, on the left arm my limitation of arm movement in injunction site, muscle pain, decreased appetite, chills.

VAERS ID:572950 (history)  Vaccinated:2012-01-11
Age:38.0  Onset:2012-02-02, Days after vaccination: 22
Gender:Female  Submitted:2015-03-09, Days after onset: 1130
Location:Unknown  Entered:2015-04-06, Days after submission: 28
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
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Agitation
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad)
Write-up: Agitation.

VAERS ID:574113 (history)  Vaccinated:2015-04-11
Age:38.0  Onset:2015-04-12, Days after vaccination: 1
Gender:Male  Submitted:2015-04-16, Days after onset: 4
Location:Puerto Rico  Entered:2015-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ranitidine HCL 150MG
Current Illness: No illness at time of vaccination.
Preexisting Conditions: No previous allergies reaction of anthrax.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV407A5IMRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Back pain, Dizziness, Fatigue, Headache, Injection site pain, Lacrimation increased, Myalgia, Ocular hyperaemia, Pallor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Eyes redness and tearful eyes, joint and muscle pain, pain in the injected arm, pale skin, severe lower back pain, feeling extremely tired and weak, headache, and dizziness.

VAERS ID:574203 (history)  Vaccinated:2015-04-14
Age:38.0  Onset:2015-04-15, Days after vaccination: 1
Gender:Male  Submitted:2015-04-16, Days after onset: 1
Location:Texas  Entered:2015-04-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient denies taking any medications at this time.
Current Illness: Patient denies any illnesses at time of vaccination.
Preexisting Conditions: Patient denies any allergies. Patient states he received the Polio vaccine approximately 1 month ago.
Diagnostic Lab Data: N/A. Pt will be referred to provider.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV392A4IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0148332SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0118021SCLA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Injection site erythema, Injection site swelling, Injection site warmth, Skin tightness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left deltoid is red, swollen, skin is warm to touch and tight. Pt denies any nausea/vomiting/diarrhea. Pt states he started feeling a "low headache in the background" starting today (4/16/2015).

VAERS ID:574309 (history)  Vaccinated:2015-01-16
Age:38.0  Onset:2015-01-16, Days after vaccination: 0
Gender:Unknown  Submitted:2015-04-16, Days after onset: 89
Location:Unknown  Entered:2015-04-16
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
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Wrong drug administered
SMQs:
Write-up: Patient was supposed to receive the PCV13 vaccination but incorrectly received the PPSV 23 vaccine. The patient had previously received the PPSV 23 vaccine on 1/24.24.

VAERS ID:575123 (history)  Vaccinated:0000-00-00
Age:38.0  Onset:0000-00-00
Gender:Male  Submitted:2015-04-23
Location:Unknown  Entered:2015-04-23
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: Losartan potassium; Metoprolol; Aspirin
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 02/17/2015, Measles antibody, low
CDC Split Type: WAES1504USA020241
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Measles antibody negative, Mitral valve repair
SMQs:
Write-up: This spontaneous report was received from a physician and refers to an approximately 38 year old male patient with no pertinent medical history and no drug reaction/allergy. Concomitant therapies included losartan potassium (manufacturer unknown), metoprolol and aspirin. On an unknown date, when he was a child, the patient was vaccinated with M-M-R II (therapy type: HSA, dose, route of administration, lot number and expiry date were not reported). On an unspecified date in 2003, the patient had a mitral valve repairment due to an unknown event. In approximately 2003, the patient was hospitalized in the reporting physician''s hospital. the outcome of an unknown event that led to mitral valve repairment was not reported. On 17-FEB-2015, the patient''s measles titers were drawn and were low. The patient sought medical attention (saw a physician). The outcome of low measles titer was not reported. The relatedness between the vaccination and the adverse events was not reported. Under internal review the an unknown event that led to mitral valve repairment was considered to be medically significant. Additional information has been requested.

VAERS ID:575797 (history)  Vaccinated:2015-04-23
Age:38.0  Onset:2015-04-23, Days after vaccination: 0
Gender:Female  Submitted:2015-04-28, Days after onset: 5
Location:North Carolina  Entered:2015-04-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Enbrel, Ortho-Tri-Cyclen Lo, tramadol, lorazepam, quetiapine, amitzia, guaifenesin/pseudoephedrine, albuterol
Current Illness: No known illness
Preexisting Conditions: No physician diagnosed allergies
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Erythema, Fatigue, Feeling hot, Injection site erythema, Injection site pain, Injection site pruritus, Malaise, Nausea, Pain in extremity, Peripheral swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Pain in affected arm. Injection site pain, redness, burning, itching, feeling hot at 4:00 PM. Swelling of the arm 5:00 PM. On 04/24/2015 low grade fever redness, swelling and pain spread up and down arm (6" x 3") defined area, nausea, dizziness, fatigue, malaise which continued to worsen. Visited Urgent Care on 04/26/2015 and was treated for possible allergic reaction/cellulitis. Medications prescribed were Zyrtec 10mg Tablets daily and Cipro 500mg Tablets twice daily for 7 days. Swelling improved but not resolved 04/28/2015. Itchiness, redness, pain, burning, nausea, fatigue, dizziness and malaise still on-going.

VAERS ID:576733 (history)  Vaccinated:2015-03-23
Age:38.0  Onset:2015-03-25, Days after vaccination: 2
Gender:Female  Submitted:2015-05-04, Days after onset: 40
Location:Missouri  Entered:2015-05-04
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 Reported
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K005183 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Vaccination site swelling, Vaccination site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Client States she noticed hotness, redness and swelling at the vacination site.

VAERS ID:576785 (history)  Vaccinated:2015-04-14
Age:38.0  Onset:2015-04-17, Days after vaccination: 3
Gender:Female  Submitted:2015-05-05, Days after onset: 18
Location:Texas  Entered:2015-05-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC; FLOVENT; DYMISTA
Current Illness: Drug hypersensitivity; Rhinitis; Asthma
Preexisting Conditions: Clarithromycin, drug hypersensitivity; Azithromycin, Hypersensitivity; Ceddinir, Hypersensitivity; Penicillin (unspecified), drug hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1504USA020088
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K020215 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Myalgia, Swollen tongue
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a physician referring to a 38 year old female patient with asthma, rhinitis, allergic to penicillin, cefdinir, azithromycin and clarithromycin. On 14-APR-2015, the patient was vaccinated with a dose of PNEUMOVAX 23, 0.5 ml, lot# K020215, expiration date 15-MAR-2016, due to "having low protective strept pneumo titers". Concomitant therapies included FLOVENT, azelastine hydrochloride, DYMISTA and ZYRTEC. On 16-APR-2015, the patient experienced "diffused" myalgia. On 17-APR-2015, the patient experienced shortness of breath. On 18-APR-2015 the patient experienced "possible" tongue swelling. No lab diagnostics studies were performed. The patient was seen by the physician on 20-APR-2015. The physician prescribed the patient a "5 day course" of prednisone and increased the patient''s FLOVENT to an unspecified amount due to the shortness of breath. The outcome of the events was reported as recovering. Additional information has been requested.

VAERS ID:576813 (history)  Vaccinated:2011-10-01
Age:38.0  Onset:2013-06-01, Days after vaccination: 609
Gender:Male  Submitted:2015-04-24, Days after onset: 692
Location:Unknown  Entered:2015-05-05, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2015US007728
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1103001 IMAR
Administered by: Other     Purchased by: Other
Symptoms: Bacterial test positive, Blood testosterone decreased, Fatigue, Gastrointestinal bacterial infection, Gastrointestinal inflammation, Hair colour changes, Immune system disorder, Local swelling, Memory impairment, Pain, Rectal haemorrhage, Tinnitus, Weight increased
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific inflammation (broad), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Noninfectious diarrhoea (broad)
Write-up: Case number PHEH2015US007728, is an initial spontaneous report from a consumer (also patient) received on 20 Apr 2015. This report refers to a 42-year-old male patient. Historical conditions were not reported. No concomitant medication was reported. Prior to vaccination the patient was healthy. The patient was vaccinated with FLUVIRIN (batch number: 1103001) intramuscularly in his shoulder in Oct 2011. The patient does not remember needle breaking skin and no band aid was needed after vaccination. In Oct 2011 after vaccination, the patient went to the emergency room with aching pain all over the body. The patient reported that after the vaccination he had weakened immune system. Further, the patient had experienced fatigue problems, memory problems, tinnitus, weight gain and gray hair. In Jun 2013, the patient was admitted to the hospital for 10 days due to rectal bleeding, swollen colon and inflamed small intestine. The patient''s lab results revealed bacteria in intestine. The patient was treated with cefadroxil and minocycline. The patient was also treated for low testosterone. The final outcome of the events was unknown. Causality was not reported.

VAERS ID:578390 (history)  Vaccinated:2015-05-08
Age:38.0  Onset:2015-05-08, Days after vaccination: 0
Gender:Female  Submitted:2015-05-15, Days after onset: 7
Location:Unknown  Entered:2015-05-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1505USA003765
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K008621 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Injection site extravasation
SMQs:, Extravasation events (injections, infusions and implants) (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 38 year old female patient. None concurrent conditions, pertinent medical history, drug reaction or allergies were reported. On 08-MAY-2015 the patient was vaccinated with GARDASIL 0.5 ml, once, intramuscular, lot # K008621, expiration date 04-MAR-2017, (dose number and anatomical location were unspecified), which was considered an inappropriate schedule of drug administration, and experienced an injection site leaking as an unspecified amount of GARDASIL leaked out of the injection site onto the patient''s skin. No treatment was given for the adverse event and no laboratory diagnostic studies were performed. The patient did not seek medical attention. The outcome of injection site leaking and inappropriate schedule of drug administration was unknown. The relatedness between injection site leaking and GARDASIL was not reported. Additional information has been requested.

VAERS ID:578532 (history)  Vaccinated:2015-05-15
Age:38.0  Onset:2015-05-15, Days after vaccination: 0
Gender:Female  Submitted:2015-05-18, Days after onset: 3
Location:Puerto Rico  Entered:2015-05-18
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:
Diagnostic Lab Data: Allergic Reaction
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSGUX2D0UNUN
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Lymph node palpable, Muscle spasms, Pain in extremity
SMQs:, Angioedema (broad), Dystonia (broad), Hypersensitivity (narrow)
Write-up: Pain on the left arm. Palpable submandibular nodes. Supraclavicular nodes. Muscle spasms. Everything on the left side.

VAERS ID:579315 (history)  Vaccinated:2015-05-15
Age:38.0  Onset:2015-05-17, Days after vaccination: 2
Gender:Female  Submitted:2015-05-26, Days after onset: 9
Location:Kansas  Entered:2015-05-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall, levothyroxine, Vitamin D3, MVI, and PRN - Protonix, Maxalt, and antiemetic
Current Illness: 05/15/15 Pre-employment health review reported: chronic musculoskeletal/tension "recurrent neck pain," L4 - L5 laminectomy partial dislectomry; IT band, SI joint tendonitis/bursitis; arthritis ankles feet "s/p sprain and fracture," latex intolerance skin rash respiratory irritation; a dn kenitosis (?sp skin trouble, rash, or disease).
Preexisting Conditions: Erythromycin, vancomycin, keteck, Omnicef (due to c-diff)
Diagnostic Lab Data: Sling for right arm "protection" reported being provided. Soreness and several joints remain sore; however, is dissipating.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4714AA2IMRA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Injection site pain, Musculoskeletal pain, Musculoskeletal stiffness
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Reported initially experiencing right deltoid soreness and shoulder stiffness beginning Sunday, May 17 which progressively became worse and radiated to: neck stiffness, elbow and hand joint pain and swelling, and to pain radiating to the ankle joints. “I counted 17 joints that have been affected. My right shoulder hurt so much; it was as if I had a major shoulder injury… I didn't have any arm involvement that appeared resemble an infection, but I think I have developed vaccine syndrome. Each year I have a worse reaction to the flu shot. I am a proponent of vaccinations, but if a patient came to me like this, I would not recommend vaccinations.”

VAERS ID:579421 (history)  Vaccinated:2015-05-22
Age:38.0  Onset:2015-05-23, Days after vaccination: 1
Gender:Female  Submitted:2015-05-26, Days after onset: 3
Location:D.C.  Entered:2015-05-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None - wellness visit
Preexisting Conditions: Ulcerative colitis, BCC
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL53938 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Hypersensitivity
SMQs:, Angioedema (broad), Hypersensitivity (narrow)
Write-up: Vaccine given 5/22/15. 5/24/15 pt given Rx BACTRIM secondary to allergic reaction vs. cellulitis. In office 5/26/15 improved symptoms noted. Advised complete BACTRIM, BENADRYL, OTC.

VAERS ID:579611 (history)  Vaccinated:2014-10-22
Age:38.0  Onset:2014-10-24, Days after vaccination: 2
Gender:Female  Submitted:2015-05-27, Days after onset: 215
Location:Pennsylvania  Entered:2015-05-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Welbutrin 300mg; Lamictal
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 6IMLA
Administered by: Other     Purchased by: Private
Symptoms: Activities of daily living impaired, Insomnia, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad)
Write-up: Extreme arm pain in the shoulder. Interferes with sleep, showering, cleaning etc. Pain since vaccination. Went to doctor and was prescribed Naproxen (2 refills). Suggested that I go to orthopedic surgeon or get X-ray but did not pursue do to finances.

VAERS ID:579787 (history)  Vaccinated:2015-05-28
Age:38.0  Onset:2015-05-28, Days after vaccination: 0
Gender:Female  Submitted:2015-05-30, Days after onset: 2
Location:Louisiana  Entered:2015-05-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol/Chlorthalidone 50/25 mg; Clonazepam 0.5 mg
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS2SNF20IMLA
Administered by: Other     Purchased by: Private
Symptoms: Wrong drug administered
SMQs:
Write-up: Patient was given Engerix B instead of Boostrix.

VAERS ID:580935 (history)  Vaccinated:2015-05-21
Age:38.0  Onset:2015-05-22, Days after vaccination: 1
Gender:Female  Submitted:2015-06-08, Days after onset: 17
Location:Tennessee  Entered:2015-06-08
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) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1412201 UNRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5G943 UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K021030 UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSB7PC3 UNLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt. received 4 vaccines on 5/21/15. Patient presented to health dept. on 5/22 stating that her left arm was very swollen. I observed the swelling from the shoulder to elbow area. Pt had previously asked a ER nurse to look at the area and advised cold compresses and ibuprufen. Same treatment recommend at HD.

VAERS ID:25710 (history)  Vaccinated:1989-09-25
Age:38.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Foreign  Entered:1990-08-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: EBWWMA011125
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM    
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: PT vaccinated with Engerix-B and developed joint pains, fever, rash after the first dose; the second dose symptoms lasted many months was prescribed non-steroidals; vaccination course was interrupted afte the second dose.

VAERS ID:79927 (history)  Vaccinated:1995-10-02
Age:38.1  Onset:1995-10-26, Days after vaccination: 24
Gender:Male  Submitted:1995-12-06, Days after onset: 41
Location:Foreign  Entered:1995-12-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: surg for cerebral aneurism in 1988 followed by Gardenal (phenobarbital) tx which was stopped in 1994;
Diagnostic Lab Data: OCT95 Blood cultures neg;CSF analysis nl (proteins-glucose-cells);Cerebral CT scan nl;EEG nl; serologies neg;24JAN96-f/u: GGTP increased.
CDC Split Type: 950130821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)SMITHKLINE BEECHAM1715B6 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Convulsion, Cough, Dysphagia, Influenza, Laboratory test abnormal, Meningism, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: pt recvd vax 23OCT95-exp fever,coughing,fever to 39C w/h/a,dysphagia,rx w/atb;hosp for meningeal synd w/convuls;CSF analysis, cerebral CT scan & EEG were nl;24JAN96-f/u: also had flu s/sx 12d p/vax.

VAERS ID:81267 (history)  Vaccinated:1995-10-02
Age:38.0  Onset:1995-10-22, Days after vaccination: 20
Gender:Male  Submitted:1996-01-15, Days after onset: 85
Location:Foreign  Entered:1996-01-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE reported
Current Illness:
Preexisting Conditions: epilepsy
Diagnostic Lab Data:
CDC Split Type: 960001161
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)