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Case Details (Sorted by Age)

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VAERS ID:474204 (history)  Vaccinated:2012-11-09
Age:25.0  Onset:2012-11-09, Days after vaccination: 0
Gender:Male  Submitted:2012-11-13, Days after onset: 4
Location:Massachusetts  Entered:2012-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None known
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA716BA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vaccinated at flu clinic held at hospital infection prevention office. Complained of vomiting one hour after getting vaccination. BP 113/61 Pulse 59. No further vomiting - only once. Stated he had a GI bug one week prior. ED at 1154. Left without instructions 1513.

VAERS ID:476875 (history)  Vaccinated:2012-10-19
Age:25.0  Onset:2012-10-20, Days after vaccination: 1
Gender:Male  Submitted:2012-11-06, Days after onset: 17
Location:Illinois  Entered:2012-11-14, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0117800IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt has pneumonia vaccine on 10/19/12. Pt went to ED on 10/21/12 after redness/swelling of arm and fever of 103.2.

VAERS ID:474270 (history)  Vaccinated:2012-11-13
Age:25.0  Onset:2012-11-13, Days after vaccination: 0
Gender:Female  Submitted:2012-11-15, Days after onset: 2
Location:Wisconsin  Entered:2012-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Unknown     Purchased by: Other
Symptoms: Dyspnoea, Hypoaesthesia, Injection site swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives on Chest and Right Side of Face, Numbness in Right Cheek, Some Difficulty Breathing, Raised injection site, Itchiness on Right side of neck and arm -- Took 50 mg Benadryl at home and in the ER received Prednisone and Claritin.

VAERS ID:474289 (history)  Vaccinated:2012-11-05
Age:25.0  Onset:2012-11-06, Days after vaccination: 1
Gender:Female  Submitted:2012-11-15, Days after onset: 9
Location:Virginia  Entered:2012-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Mild sinus discomfort (afebrile)
Preexisting Conditions: 21 weeks'' pregnant, hypertension per client
Diagnostic Lab Data: Patient reports blood drawn by doctor to determine problem.
CDC Split Type: VA12008
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1224SP0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC528079CA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Blood test, Erythema, Maternal exposure during pregnancy, Oedema peripheral, Pruritus generalised
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Client reports the day after receiving vaccines, one became itchy all over, with mild swelling and redness on left forearm & right elbow up to mid part of arm. Client is 21 weeks pregnant and let her OB see the areas at her visit. Reports some improvement. Reports Dr unsure if reaction or something else.

VAERS ID:474634 (history)  Vaccinated:2012-10-06
Age:25.0  Onset:2012-11-13, Days after vaccination: 38
Gender:Female  Submitted:2012-11-17, Days after onset: 4
Location:Wisconsin  Entered:2012-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: None Known
Diagnostic Lab Data: Patient tested positive for typhoid fever after receiving typhoid fever vaccine. It is unknown if the positive test is related to vaccination or development of illness, patient hospitalized for vomiting.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURG1541 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Laboratory test abnormal, Pyrexia, Typhoid fever, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Daughter has been diagnosed with Typhoid. She has been hospitalized and is on antibiotics and fluids. Fever of 104.

VAERS ID:474654 (history)  Vaccinated:2012-11-16
Age:25.0  Onset:2012-11-17, Days after vaccination: 1
Gender:Male  Submitted:2012-11-18, Days after onset: 1
Location:Maryland  Entered:2012-11-18
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: PMH: Migraine headaches (last one occurring about 9 months ago), Yeast infections, Eczema
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 3IMLA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal discomfort, Condition aggravated, Malaise, Migraine, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Migraine headache, neck muscles sore, upset stomach, malaise lasting through night into next day.

VAERS ID:477059 (history)  Vaccinated:2012-11-07
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-19
Location:Unknown  Entered:2012-11-19
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: WAES1211USA004504
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect route of drug administration, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)
Write-up: This spontaneous report as received from a healthcare worker refers to a 25 years old female medical assistant. The patient was vaccinated with her first dose of GARDASIL (lot number not provided) subcutaneously instead of intramuscularly on 07-NOV-2012. No other co-suspects were reported. No concomitant medications were reported. The patient reported pain, redness and swelling at injection site. No treatment was given for adverse events. The outcome of adverse events was unknown. The patient did not seek medical attention. Additional information is not expected.

VAERS ID:477464 (history)  Vaccinated:2012-10-31
Age:25.0  Onset:2012-11-01, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Illinois  Entered:2012-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DILERA; SINGULAIR; FLONASE; ABREVA; Colchicine; ZYRTEC
Current Illness: None
Preexisting Conditions: Asthma; Allergic rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Blister, Erythema, Injection site erythema, Injection site haemorrhage, Injection site pain, Injection site warmth, Local reaction, Nodule, Pyrexia, Rash erythematous, Skin discolouration, Tenderness, Vaccination complication, Viral infection
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: We saw patient with a reaction to her pneumococcal vaccine. As you know, she is a very pleasant 25-year-old with allergic rhinitis and asthma whose respiratory allergic diseases have been pretty well controlled except frequent rhinorrhea. She was seen her on October 31st and given DYMISTA samples since the nasal steroid alone was inadequate. Her asthma was better controlled with DULCRA 200 2 puffs b.i.d. along with SINGULAIR. She needed her rescue inhaler much less often. At that visit, the pneumococcal vaccine was administered in the left deltoid since it is recommended that asthmatics be kept up to date on the PVAX. On November 1st, she noted a small red bump that morning. Later that day, she had a temperature of 102 that eventually spiked to 104 the next day. On November 2nd, she went to the urgent care with a large red knot and was given prednisone. The area is still exquisitely tender and red with a central purple area. She states it was bubbled up a couple of days ago but that fluid must have popped on the way over her. Overall, the affected area is decreasing except last night she noted some increase in redness at the inferior aspect of the reaction. She has not had any respiratory problems. Her fever has been gone since she was placed on prednisone. At urgent care, they told her she had a viral infection as the cause of her fever but had also given her prednisone presumably because of the large local reaction to the vaccine. On exam today, her left upper arm has an area of erythema of about 12 x 8 cm. Around the central area where the injection was administered, there is a 3 x 2 cm darker ecchymotic lesion. There is some appearance as if it had been a fluid-filled area though now drained. There is currently no drainage, fluctuants or purulence. The area is mildly warm and exquisitely tender.

VAERS ID:475037 (history)  Vaccinated:2012-07-25
Age:25.0  Onset:2012-08-06, Days after vaccination: 12
Gender:Female  Submitted:2012-11-16, Days after onset: 102
Location:Virginia  Entered:2012-11-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The subject had no significant past medical history.
Diagnostic Lab Data: ECG: 06 August 2012: Abnormal; Echocardiogram: 06 August 2012: Normal
CDC Split Type: 201210646
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR  IDUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR  SYRUN
Administered by: Military     Purchased by: Military
Symptoms: Echocardiogram normal, Electrocardiogram abnormal, Pericarditis, Troponin I increased
SMQs:, Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This study case was received from the investigator on 12 November 2012. A 25-year-old female subject received the following vaccinations: On 25 July 2012 an injection of ACAM2000 (lot number not reported), an injection of TYPHIM VI, sanofi pasteur SA (lot number not reported) and ANTHRAX (manufacturer and lot number not reported). The subject previously received a dose of ANTHRAX (manufacturer and lot number not reported) on 26 June 2012. The subject had no significant medical history. On 06 August 2012, the subject had an abnormal troponin I of 00.99, a abnormal electrocardiogram (ECG) and a normal echocardiogram. On 06 August 2012, the subject was diagnosed with other and unspecified acute pericarditis. The outcome was not reported. Additional information will be requested from the investigator. Note: There is no reporter causality assessment as this is a safety surveillance (data mining, non-interventional) study. Documents held by sender: None.

VAERS ID:475090 (history)  Vaccinated:2012-11-19
Age:25.0  Onset:2012-11-20, Days after vaccination: 1
Gender:Female  Submitted:2012-11-21, Days after onset: 1
Location:Texas  Entered:2012-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H011907 SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness, and blistering at injection site approx 3cm in length.

VAERS ID:475114 (history)  Vaccinated:2011-08-20
Age:25.0  Onset:2011-08-20, Days after vaccination: 0
Gender:Female  Submitted:2012-11-22, Days after onset: 460
Location:Oklahoma  Entered:2012-11-22
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: My grown daughter''s husband came home from abroad in August 2011. He got the nasal H1N1 and flu shot. Within one to two days she developed signs of Guillain Barre syndrome and she fell. She has been immobile for over a year.
Preexisting Conditions: None
Diagnostic Lab Data: Patient is seeing special neurologist.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 1IN 
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: My daughter became weak in the legs severely where she fell and hurt her ankle severely. She has severe nerve damage in her feet, legs, and upper extremities.

VAERS ID:475375 (history)  Vaccinated:2012-11-13
Age:25.0  Onset:2012-11-13, Days after vaccination: 0
Gender:Female  Submitted:2012-11-13, Days after onset: 0
Location:Wisconsin  Entered:2012-11-25, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Slight sore throat
Preexisting Conditions:
Diagnostic Lab Data: None yet.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206301A IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site haematoma, Pain, Pain in extremity
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Small bruise at injection site. Entire upper arm very sore. Soreness began evening of 13th and got progressively worse on 11-15. Movement of arm is painful. Patient reports that her mother is a nurse and that her mother said injection given approximately 3 inches too high. Patient has had multiple influenza vaccinations in past without pain (but with occasional bruising).

VAERS ID:475255 (history)  Vaccinated:2012-11-10
Age:25.0  Onset:2012-11-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-26, Days after onset: 16
Location:Pennsylvania  Entered:2012-11-26
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: History of Fibromyalgia with chronic pain
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Asthenia, Injection site erythema, Injection site swelling, Pain
SMQs:, Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A few hours after receiving a Tdap vaccination patient had some swelling and redness of left deltoid/ after icing and using Benadryl the swelling decreased/through out the day she felt like she had been punched in he left arm, neck and whole left side of her body/next day pain was everywhere per patient/ patient states she had a decrease in strength and it was difficult for her to change her clothes.

VAERS ID:477543 (history)  Vaccinated:2012-11-13
Age:25.0  Onset:2012-11-14, Days after vaccination: 1
Gender:Female  Submitted:2012-11-16, Days after onset: 2
Location:Indiana  Entered:2012-11-26, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vit C; Iron Suppl.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None needed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4422AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site swelling, Local reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Dev. swelling at injection site next morning. By 24 hrs, golfball size, by 72 hrs softball size, red, sl. itching. Took BENADRYL 25mg PO x 3, TYL x 1. Diagnosis is: delayed local reaction.

VAERS ID:477557 (history)  Vaccinated:2012-02-07
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-28
Location:New Jersey  Entered:2012-11-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prometrium; ZOFRAN
Current Illness: Progesterone decreased; Nausea; Vomiting; Polycystic ovaries
Preexisting Conditions:
Diagnostic Lab Data: 03/01/2012, Diagnostic, Normal 8 weeks 3d Visualized
CDC Split Type: WAES1203USA00633
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0306AA2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Laboratory test normal, Maternal exposure during pregnancy, Progesterone decreased
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Information has been received from a healthcare professional via a pregnancy questionnaire for GARDASIL a pregnancy registry product, concerning a 25 year old female patient with a polycystic ovarian syndrome and no previous pregnancies reported who on 27-JUL-2011 was vaccinated with a first dose of GARDASIL (Lot # 668554/0306AA), on 28-SEP-2011 with a second dose of GARDASIL (Lot # 668554/0306AA) and on 07-FEB-2012 with a third dose of GARDASIL (Lot # 668554/0306AA). Concomitant therapy included PROMETRIUM, ondansetron hydrochloride and citranatal as a prenatal vitamin. It was reported that the patient had her LMP on 05-JAN-2012 and on 01-MAR-2012 an ultrasound was performed which showed normal results and a fetus of 8 weeks and 3 days was visualized. In February 2012 the patient experienced low progesterone. The estimated delivery date would be on 08-OCT-2012. At the time of the report the outcome of the patient was unknown. Additional information has been requested. Follow-up information received on 16-NOV-2012 from a health professional via a pregnancy questionnaire. On 15-OCT-2012 a normal male infant was born (birth weight 8 lbs and 13 oz) 42 weeks after the last menstrual period. It was reported that the patient did not have any complication during her pregnancy. The infant had no congenital anomalies and there were no other complications or abnormalities for the infant. The mother had hypertension post-partum on approximately 15-OCT-2012 which improved on an unknown date in 2012. The relatedness for the event post-partum hypertension was not provided. Additional information is not expected.

VAERS ID:475689 (history)  Vaccinated:2012-11-21
Age:25.0  Onset:2012-11-21, Days after vaccination: 0
Gender:Female  Submitted:2012-11-29, Days after onset: 8
Location:Illinois  Entered:2012-11-29
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: Hashimoto''s Thyroiditis, Allergy to Amoxicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB538AA1IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR154210IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Fatigue, Paraesthesia oral
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Within 5 min of immunizaiton, patient began complaining of strange feeling in throat, like it was hard to swallow, and then that her tongue felt enlarged/swollen. A doctor was summoned and at the same time, patient complained of feeling light-headed and faint. Patient was reclined and legs elevated. Doctor examined and noted airway was patent with no signs of respiratory distress. Pulse ox 100%, B/P 90/48, Pulse 55. (Patient stated she runs 4-5 miles/day and her pulse is usually in the 60''s. Doctor recommended transport to ER by ambulance. Patient refused. At 12:10 PM patient called her mother to come pick her up. Continued to c/o light-headedness. B/P 110/86. Stated her throat and tongue were feeling "better". At 12:30 PM she tried sitting up, took sips of water without difficulty and asked for something with sugar in it. Stated she had worked all night and came straight from work to appointment. Very tired and had last eaten at 8:00 AM (only applesauce). Apple juice given. Tolerated well. At 12:45, her mother arrived. Mother stated she would take patient to ER. At 12:55 PM patient''s B/P 110-84, patient still complaining of slight light-headedness, but stated her throat and tongue feel better. Patient released with her mother.

VAERS ID:475730 (history)  Vaccinated:2006-01-01
Age:25.0  Onset:2006-01-16, Days after vaccination: 15
Gender:Male  Submitted:2012-11-29, Days after onset: 2509
Location:Kentucky  Entered:2012-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations: Rash~Hep A + Hep B (no brand name)~3~26.00~Patient
Other Medications: Allegeries medications
Current Illness:
Preexisting Conditions: Food allergies, allergies
Diagnostic Lab Data: Lesions (rash) have been biopsied and currently awaiting results.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 3UNUN
Administered by: Unknown     Purchased by: Other
Symptoms: Biopsy skin, Rash generalised, Renal failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Chronic kidney disease (narrow), Hypersensitivity (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash on hands and then spread all over the body which he is currently seeking treatment through the dermatologist. Lesions have been biopsied and currently awaiting results. Treatment is ointment with steroid and now on antibotics. He also has some other issues down the road such renal/kidney failure and was hospitalized.

VAERS ID:476008 (history)  Vaccinated:2012-11-09
Age:25.0  Onset:2012-11-10, Days after vaccination: 1
Gender:Female  Submitted:2012-12-03, Days after onset: 23
Location:Connecticut  Entered:2012-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, GERD, Celiacs Dz Allergies- PCN, Xolair
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Unknown     Purchased by: Other
Symptoms: Incisional drainage, Injection site abscess, Injection site cellulitis, Injection site erythema, Injection site induration, Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth, Urticaria, Wound treatment
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initially red welt over injection site, advanced to 9cmx5cm reddened, swollen area. Hard to the touch in center. Severely painful. Warm to the touch. Dx as cellulitis. Swelling became worse over hard area in center, abscess, treated with an incision and drainage. Wound now has to be packed daily with gauze until healed.

VAERS ID:476305 (history)  Vaccinated:2012-11-26
Age:25.0  Onset:2012-11-27, Days after vaccination: 1
Gender:Female  Submitted:2012-11-30, Days after onset: 3
Location:Massachusetts  Entered:2012-12-04, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH746AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site rash, Rash, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt rcd flu vaccine on 11/26, went to ER on 11/27 with facial swelling and rash bilat upper arms and neck. All sx resolved with IV abx. Pt instructed to never get flu shot again.

VAERS ID:476374 (history)  Vaccinated:2012-10-18
Age:25.0  Onset:2012-10-19, Days after vaccination: 1
Gender:Female  Submitted:2012-11-28, Days after onset: 40
Location:Virginia  Entered:2012-12-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergy to Latex
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED06349211A0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Site (L) arm was swollen, red, warm & painful for a week. Tx w/ ice and ibuprofen.

VAERS ID:476469 (history)  Vaccinated:2012-10-25
Age:25.0  Onset:2012-11-01, Days after vaccination: 7
Gender:Female  Submitted:2012-11-30, Days after onset: 29
Location:Illinois  Entered:2012-12-04, 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: SPRINTEC; Omeprazole; Fluoxetine
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
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Dose
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB945BA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Movement disorder, Pain
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad)
Write-up: Sharp, shooting pain down front of right shoulder. Arm movement very limited. OTC pain meds & heating pad.

VAERS ID:476482 (history)  Vaccinated:2012-11-20
Age:25.0  Onset:2012-11-20, Days after vaccination: 0
Gender:Male  Submitted:2012-11-29, Days after onset: 9
Location:Minnesota  Entered:2012-12-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS039AA IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0288AE SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Gaze palsy, Pallor
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Ocular motility disorders (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: RN administered Hep B vaccine to patient in (L) arm without problems. RN administered MMR to (L) arm, less than 1 minute later, patient reported he was "going to faint". RN called for assist, patient did not loose consciousness, but did appear pale an eyes rolled back. Patient assisted to floor, then assisted to sitting in chair, walked out of clinic w/escort.

VAERS ID:476657 (history)  Vaccinated:2012-12-04
Age:25.0  Onset:2012-12-04, Days after vaccination: 0
Gender:Female  Submitted:2012-12-05, Days after onset: 1
Location:Texas  Entered:2012-12-05
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0385AE IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Decreased appetite, Fatigue, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Around 3pm yesterday, 12/4/12, she started experiencing body aches, fatigue, loss of appetite, and nausea when trying to eat. She took Tylenol and ibuprofen last night but continues to feel the same today. She took Tylenol again today but it has not helped with the body aches. She states she will go to the doctor if she doesn''t feel better by tomorrow 12/6/12.

VAERS ID:476666 (history)  Vaccinated:2012-12-04
Age:25.0  Onset:2012-12-05, Days after vaccination: 1
Gender:Female  Submitted:2012-12-05, Days after onset: 0
Location:California  Entered:2012-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Injection site erythema, Nausea, Sinus disorder, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: Dizziness leading to nausea all day. Redness around injection site. Doctor guessed the injection inflamed sinuses, leading to vertigo.

VAERS ID:479740 (history)  Vaccinated:2012-11-05
Age:25.0  Onset:2012-11-26, Days after vaccination: 21
Gender:Female  Submitted:2012-12-05, Days after onset: 9
Location:New Jersey  Entered:2012-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins (unspecified); vitamin D (unspecified); progesterone
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1212USA000087
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This spontaneous report as received from a physician refers to a 25 years old female patient with no drug allergy. The patient was vaccinated with VARIVAX (Merck) (lot # reported as G007690, exp date 05-AUG-2013, route unknown) on 05-NOV-2012. No other co-suspects were reported. Concomitant medications included multivitamin (unspecified), vitamin D (unspecified) and progesterone pill. On 26-NOV-2012 the patient experienced broken out in varicella rash about 3 weeks after received VARIVAX (Merck). The treatment information was reported as acyclovir. The patient had sought medical attention via office visit. The outcome of broken out in varicella rash was unknown. Additional information has been requested.

VAERS ID:477132 (history)  Vaccinated:2012-12-07
Age:25.0  Onset:2012-12-07, Days after vaccination: 0
Gender:Female  Submitted:2012-12-07, Days after onset: 0
Location:Idaho  Entered:2012-12-07
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.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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TDAP: TDAP (ADACEL)SANOFI PASTEURC4311AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pain in extremity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient returned to Immunization clinic after going to the lab complaining of fore arm redness, pain, and itching in the same arm a TDap was given. The arm was inspected, no swelling was noted but it appeared slightly more red than the unaffected arm. She stated it was slightly itchy, and somewhat painful. The site of the injection had no symptoms. I contacted my officer in charge, a physician, and he stated it did not sound like an adverse event but to continue with a VAERS report. I noitified the patient of these procedures and instructed her to return if she felt any difficulty breathing, if she noticed the pain/redness spreading, or felt itching anywhere else in her body. The patient verbalized her understanding of these instructions.

VAERS ID:477159 (history)  Vaccinated:2012-11-29
Age:25.0  Onset:2012-11-29, Days after vaccination: 0
Gender:Female  Submitted:2012-12-08, Days after onset: 9
Location:California  Entered:2012-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1SYRRA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: I started to get a really bad headache, then the next day it was worse the pain, then the next day the head pain with dizziness, then the next day the head pain dizziness and throwing up. It got to the point I went to the ER. Its been a week and 2 days and I still have symptoms.

VAERS ID:477377 (history)  Vaccinated:2012-12-07
Age:25.0  Onset:2012-12-08, Days after vaccination: 1
Gender:Male  Submitted:2012-12-10, Days after onset: 2
Location:Texas  Entered:2012-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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Dose
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TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30002202PO 
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Awoke with hives and itching 14 hours after taking third dose oral live virus typhoid. Treated self with oral Benadryl did not seek any other care.

VAERS ID:477491 (history)  Vaccinated:2012-12-10
Age:25.0  Onset:2012-12-10, Days after vaccination: 0
Gender:Female  Submitted:2012-12-10, Days after onset: 0
Location:Kansas  Entered:2012-12-11, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: BP 78/51 HR 51 when taken 5 minutes after onset
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206301 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Cold sweat, Dysstasia, Somnolence, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient received 0.5 mL FLUVIRIN, then fainted about 5 minutes later walking down a store aisle. Patient appeared groggy, clammy, and was unable to stand/sit without assistance. Paramedics arrived w/i 10 minutes.

VAERS ID:477646 (history)  Vaccinated:2012-12-07
Age:25.0  Onset:2012-12-07, Days after vaccination: 0
Gender:Female  Submitted:2012-12-11, Days after onset: 4
Location:Texas  Entered:2012-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Zetonna 1sp EN daily; Dulera 100/5 two puffs BID; Ventolin HFA two puffs Q4-6hrs PRN; Naproxen 1tab Q12hrs PRN
Current Illness: No. Pt denied fever, shortness of breath, chest pain, headache, nausea, vomiting, diarrhea, abd pain, or lethargy.
Preexisting Conditions: Specific antibody deficiency (streptococcus pneumoniae) Rule out immune deficiency. Under evaluation. Asthma. Mitral valve prolapse. Food hypersensitivity (food allergy). Under evaluation.
Diagnostic Lab Data: Per report by Surgeon and Hospitalist, elevated WBC ~20,000. Gram stain is negative with fluid and blood cultures pending.
CDC Split Type:
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0025AE1SCRA
Administered by: Private     Purchased by: Private
Symptoms: Blood culture, CSF culture, Cellulitis, Gram stain negative, Incisional drainage, Infection, Injection site erythema, Injection site pain, Injection site swelling, Muscle oedema, Nuclear magnetic resonance imaging abnormal, Purulent discharge, Pyrexia, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The patient (pt) had pain, redness and swelling over injection site. Pt developed fever over the following 24 hrs. She was admitted to the hospital for cellulitis. She was place on IV antibiotics. The pain and swelling increased with persistent fever. She had a surgical consult due to a MRI of her arm showing a fluid collection in the muscle with substantial edema. The patient had an incision and drainage in the operating room which showed purulent fluid (suspicious for infection)without abscess. There was no sign of necrotizing fasciitis or necrosis of the muscle. Pt is recovering in the hospital on IV antibiotics.

VAERS ID:477744 (history)  Vaccinated:2012-12-01
Age:25.0  Onset:2012-12-05, Days after vaccination: 4
Gender:Female  Submitted:2012-12-11, Days after onset: 6
Location:California  Entered:2012-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12261P0IMRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC113AB0IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB554AA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site reaction, Paraesthesia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient called 5 days after given Hep B & A vaccines. Patient reported red welt below Hep B injection site on left arm. Pt also reported some itching, pain at injection site and tingling sensation in left hand.

VAERS ID:480260 (history)  Vaccinated:2012-01-24
Age:25.0  Onset:0000-00-00
Gender:Unknown  Submitted:2011-12-14
Location:Unknown  Entered:2012-12-14, Days after submission: 366
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: WAES1212USA005279
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H014282 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a pharmacist who received the following information from a nurse, refers to 2 patients (demographics unspecified) who developed swelling, pain and suspected cellulitis after receiving PNEUMOVAX23 (route not reported) in the past. It was unspecified what lot of 23this 2 patients received. It was unspecified what date PNEUMOVAX23 was received in these 2 patients. All other information of this 2 patient was unspecified. This is one of two reports received from the same source. Additional information has been requested.

VAERS ID:478581 (history)  Vaccinated:2012-12-11
Age:25.0  Onset:2012-12-11, Days after vaccination: 0
Gender:Female  Submitted:2012-12-13, Days after onset: 2
Location:New York  Entered:2012-12-18, 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: NUVARING; MIRALAX
Current Illness: No
Preexisting Conditions: PCN; CECLOR; Acne
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA734AA SYRLA
Administered by: Private     Purchased by: Other
Symptoms: Burning sensation, Erythema, Feeling hot, Injection site warmth, Joint swelling, Pruritus generalised, Rash, Skin warm, Throat irritation, Tremor, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Rash on extremities, hive on face & arm, red burning hands, knees swelling & hot. Injection site hot, throat irritation, (itching generalized). Ears hot & red, tremors.

VAERS ID:478933 (history)  Vaccinated:2012-11-09
Age:25.0  Onset:2012-11-09, Days after vaccination: 0
Gender:Male  Submitted:2012-12-20, Days after onset: 41
Location:Unknown  Entered:2012-12-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204901 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Heart rate increased, Pruritus, Pulmonary congestion, Rash, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash/Hives, itching, chest congestion, increase in pulse. EMT called.

VAERS ID:479117 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2012-12-21
Location:Pennsylvania  Entered:2012-12-21
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: On physical examination, patient had full active and passive range of motion of her cervical spine, shoulder, elbow, forearm and wrist. Left thumb IP joint active range of motion was absent with passive range of motion from 0 degrees to 60 degrees. She did demonstrate active flexion against gravity with her index finger FDP; however, she was unable to flex it against minimal resistance, indicating grade 3/5 motor strength. Repeat EMG and nerve conduction velocity studies (performed 5 months after the inciting event): demonstrated increased insertional activity in the AIN innervated FPL and index finger FDP as well as the median nerve innervated palmaris longus and abductor pollicis brevis. This study was consistent with a high median nerve
CDC Split Type: WAES1212USA004296
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Electromyogram abnormal, Grip strength decreased, Laboratory test normal, Motor dysfunction, Muscle disorder, Nerve conduction studies normal, Pain, Rheumatoid factor negative, Serology normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: This literature marketed report as received from a physician refers to a 25 years old, right hand-dominant female patient with a presumptive diagnosis of left carpal tunnel syndrome of 5 months duration. The patient''s chief complaint was loss of hand dexterity due to the inability to flex her left thumb interphalangeal joint. The patient had received two of the series of three GARDASIL vaccination into the left deltoid of the affected upper extremity. Three days after the second injection, she noted intense burning pain in her entire left upper arm. After the pain subsided over the next 24 to 48 hours, the patient noted that she was unable to grip a glass due to lack of thumb flexion while washing dishes. Other than the initial pain, she denied febrile illness, night sweats, chills, or any dermatologic-type rash. At the time of second injection, patient denied having viral or flu-like symptoms. There was no neurological symptoms, numbness, tingling, or paresthesias at the time of injection to suggest an intraneural injury. Initial electromyographic(EMG) and nerve conduction velocity studies performed 3 months after the onset of symptoms were intrepreted as normal; however, electro-diagnostic motor testing of the flexor pollicis longus(FPL), pronator quadratus, and flexor digitorum profundus(FDP) to the index finger was not performed. Serologic testing for rheumatoid and other autoimmune or inflammatory disorders was normal. She denied hereditary familial neuritis or neuralgic amyotrophy. On physical examination, patient had full active and passive range of motion of her cervical spine, shoulder, elbow, forearm and wrist. Left thumb IP joint active range of motion was absent with passive range of motion from 0 degrees to 60 degrees. She did demonstrate active flexion against gravity with her index finger FDP; however, she was unable to flex it against minimal resistance, indicating grade 3/5 motor strength. Grip strength measured 55lb on the right and 45 lb on the left. Sensation was intact and symmetric with Semmes-Weinstein monofilament testing and 128Hz vibratory sensation. Tinel''s sighs were negative over the brachial plexus. Guyon''s canal, carpal tunnel, and dorsal radial sensory nerve. Repeat EMG and nerve conduction velocity studies performed 5 months after the inciting event. This study demonstrated increased insertional activity in the AIN innervated FPL and index finger FDP as well as the median nerve innervated palmaris longus and abductor pollicis brevis. This study was consistent with a high median nerve distribution palsy. Physician recommended treatment by observation. By 8 months, the patient began to experience increasing strength in her index finger FDP. At 1 year after the onset of symptoms, she had largely regained her index FDP strength but still had complete loss of function of her FPL muscle with a persistent loss of manual dexterity. Fortunately, at 16 months following the initial insult, patient experienced return of FRL function with improved dexterity, obviating the need for tendon transfer. Reports of brachial plexus neuritis can be found in the literature after other vaccinations. Brachial neuritis after vaccination administration is a well-described phenomenon although the exact etiology is unknown. Cases of neuritis after tetanus vaccination, an immune-mediated, local demyelinating response to the tetanus toxoid is believed to be the cause of the neuritis. The CDC considers brachial neuritis occurring 2 to 28 days after tetanus vaccination a reportable event with presumed vaccine causation; however, this relationship has not been defined for brachial neuritis after HPV vaccination. The HPV vaccine, however, does not contain a toxoid so the exact mechanism leading to neuritis of the brachial plexus remains unclear. To our knowledge, this is the second case of brachial neuritis after an HPV vaccine reported in the literature. In our search of the Vaccine Adverse Event Reporting System (VAERS) data o

VAERS ID:479985 (history)  Vaccinated:2012-12-15
Age:25.0  Onset:2012-12-15, Days after vaccination: 0
Gender:Female  Submitted:2012-12-31, Days after onset: 16
Location:New York  Entered:2012-12-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Junel Fe Birth Control
Current Illness: None
Preexisting Conditions: Allergic to Latex
Diagnostic Lab Data: Diagnosed with cellulitis and abscess at site of injection
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3091IMLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Injection site abscess, Injection site cellulitis, Injection site inflammation, Injection site pain, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Started feeling nauseous and having body aches and chills these symptoms stopped 12/17/2012; site of injection became very sore and inflamed. Went to urgent care 12/18/2012 12:00pm was diagnosed with cellulitis and an abscess at site of injection. I was prescribed Doxycycline 100mg 2xs a day for 10 days. Followed up with Primary care Dec 19th 2:00pm was told to continue antibiotics and to come back in 5 days to see if they helped. Followed up with Primary care Dec 24th 8:00am and the cellulitis was clearing and abscess went down a significant amount. No further action was required.

VAERS ID:480350 (history)  Vaccinated:2012-12-31
Age:25.0  Onset:2013-01-03, Days after vaccination: 3
Gender:Female  Submitted:2013-01-06, Days after onset: 3
Location:Oregon  Entered:2013-01-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU4065AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Malaise, Pain in extremity, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Tendinopathies and ligament disorders (broad)
Write-up: Donor began feeling general malaise on 01/03/13, with congestion and cough. Generalized soreness in left extremities. Tetanus was given on 12/31/12. Donor felt fine upon leaving the center.

VAERS ID:480769 (history)  Vaccinated:2013-01-08
Age:25.0  Onset:2013-01-08, Days after vaccination: 0
Gender:Female  Submitted:2013-01-09, Days after onset: 1
Location:Texas  Entered:2013-01-09
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
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Heart rate increased, Insomnia, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Fast heart beat, nausea, insomnia.

VAERS ID:480894 (history)  Vaccinated:2012-12-10
Age:25.0  Onset:2012-12-10, Days after vaccination: 0
Gender:Female  Submitted:2013-01-10, Days after onset: 31
Location:Pennsylvania  Entered:2013-01-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sronyx
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Activities of daily living impaired, Injection site pain
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain at the sight of injection which adversly affects day to day activities such as dressing and other regular uses of the arm.

VAERS ID:480937 (history)  Vaccinated:2011-09-16
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-30
Location:Wisconsin  Entered:2013-01-10, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZYRTEC; MAXALT; PRILOSEC
Current Illness:
Preexisting Conditions: Allergy to oxycodone; Allergy to bee stings; Pregnant: Yes
Diagnostic Lab Data:
CDC Split Type: 2011029887
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.0841AA0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Maternal exposure during pregnancy, Pregnancy test urine positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: This medically confirmed spontaneous report (initial receipt: 16-Sep-2011) concerns a 25 year old female pregnant patient, who was allergic to oxycodone and bee stings. Concomitant medications included cetirizine hydrochloride, rizatriptan and omeprazole. On an unknown date the patient received unspecified flu vaccine (manufacturer unknown). On 16-Sep-2011 the patient also requested to receive her first dose of 0.5 mL of GARDASIL (batch number: 0841AA) intramuscular injection. After receiving her first dose of GARDASIL, the patient requested to be on birth control pills. The standard policy of the office was to do a urine pregnancy test prior to receiving birth control pills. The patient was found to be positive for pregnancy. The event outcome was not reported. In the absence of a reported date of last menstrual period (LMP) or estimated date of delivery (EDD), CSL has approximated the EDD to be 11-May-2012, using the CSL receipt date of this initial report to be the date of six week gestation. Follow up (29-Sep-2011): concomitant medication (dose, frequency, indication for use).

VAERS ID:480960 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-01-06
Location:Arizona  Entered:2013-01-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0151350SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Injection site painful. No obvious infection. No edema nor erythema. Patient to use local warm heat and TYLENOL or ADVIL for pain.

VAERS ID:481205 (history)  Vaccinated:2013-01-07
Age:25.0  Onset:2013-01-09, Days after vaccination: 2
Gender:Male  Submitted:2013-01-14, Days after onset: 5
Location:Indiana  Entered:2013-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: von Willebrand Disease Type 1; Menorrhagia; Ulcerative Colitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC046AA2IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0184410IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Headache, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Phoned wilth c/o general malaise, h/a, joint aches fever, up to 102 F. States s&s initiated approx 2 hours after injections. Diarrhea, nausea; no vomiting.

VAERS ID:481220 (history)  Vaccinated:2013-01-08
Age:25.0  Onset:2013-01-08, Days after vaccination: 0
Gender:Female  Submitted:2013-01-09, Days after onset: 1
Location:Virginia  Entered:2013-01-14, 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: Attached; SOLUMEDROL injection IM into left glut max; Pt was given diphenhydramine hydrochloride 25mg, oral
Current Illness: Office note attached
Preexisting Conditions: PMH in attached office note; Appendectomy; Wisdom teeth; NKDA; H/O right side pain; Family medical history: F-HTN; Elevated chol; M-Borderline Elevated Chol
Diagnostic Lab Data: 12/20/12 lab result (attached)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC002BA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Flushing, Heart rate abnormal, Hyperhidrosis, Hypoaesthesia, Laboratory test, Neck pain, Paraesthesia
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Shortness of breath; fluttering heart rate; left neck pain; facial numbness in tingling on left side of face, dizzy, flushed, sweaty.

VAERS ID:481556 (history)  Vaccinated:2013-01-15
Age:25.0  Onset:2013-01-15, Days after vaccination: 0
Gender:Male  Submitted:2013-01-16, Days after onset: 1
Location:Texas  Entered:2013-01-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Feeling a little under the weather
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV039 UNUN
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Headache, Influenza like illness, Nausea, Neck pain, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Pt reports that his whole body feels sore, with headache described as an aching in temple areas, going to back of head, neck and back. Rates headache as a # 4-5 on scale of 1-10 and stated this is not the worse headache he has had. He reports nausea, but no emesis and is keeping fluids down. He denies fever, cough and sneezing, and stated he feels like he has the flu. He reported that he was feeling a little under the weather prior to the administration of AVA. He reported that he usually feels bad following immunizations including his flu shot he received in Sep. Stated he has not taken anything for his symptoms. He denied any significant medical history.

VAERS ID:481575 (history)  Vaccinated:2013-01-12
Age:25.0  Onset:2013-01-12, Days after vaccination: 0
Gender:Female  Submitted:2013-01-16, Days after onset: 4
Location:Georgia  Entered:2013-01-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PROVENTIL; LORYNA; EPIPEN
Current Illness: None
Preexisting Conditions: Allergy to cephalosporins
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1207021 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Breath sounds abnormal, Bruxism, Convulsion, Dizziness, Dyspnoea, Loss of consciousness, Moaning, Muscle contractions involuntary, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Dystonia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)
Write-up: Patient reported feeling faint after receiving vaccine, so she laid down on the ground & put her knees up. A couple minutes later, she said she was about to faint then went unconscious. Immediately after going unconscious, she began having involuntary muscle contractions, mainly in her arms, neck & face & she was moaning & gasping for breath. Within 30-60 seconds, she was breathing noisily and clenching her teeth. After 3-4 minutes, the seizure/convulsive syncope ended & she woke up. She was checked out by EMS, who were called at the beginning of the incident & she refused to go to the hospital b/c she said this has happened to her most of her life, including when receiving any vaccine b/c her blood pressure dropping so low. She has been seen for this issue in the past.

VAERS ID:481910 (history)  Vaccinated:2013-01-18
Age:25.0  Onset:2013-01-19, Days after vaccination: 1
Gender:Female  Submitted:2013-01-20, Days after onset: 1
Location:Florida  Entered:2013-01-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamin-1 tab daily, Vitamin B6-25mg TID, Pepcid 20mg bid, Tylenol q4hrs PRN, Colace 100mg bid
Current Illness: Pregnancy
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness and moderate soreness at injection site.

VAERS ID:481995 (history)  Vaccinated:2013-01-18
Age:25.0  Onset:2013-01-18, Days after vaccination: 0
Gender:Female  Submitted:2013-01-20, Days after onset: 2
Location:California  Entered:2013-01-20
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: Chromosome disorder
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0653AE0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Injection site erythema, Pyrexia, Vaccination site swelling
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling and redness at site of vaccination on 1/18/2013. Pt. took IBU / BENADRYL. 1/19/2013 Slight fever 100 degrees -$g then 99 degrees -$g per mom have IBU / TYLENOL. 1/20/2013 Fever and redness in afternoon went to urgent care.

VAERS ID:481949 (history)  Vaccinated:2013-01-20
Age:25.0  Onset:2013-01-20, Days after vaccination: 0
Gender:Female  Submitted:2013-01-21, Days after onset: 1
Location:Kentucky  Entered:2013-01-21
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
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMRA
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Asthenia, Chills, Muscle spasms, Vomiting
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Vomiting, chills, weakness, cramps.

VAERS ID:482151 (history)  Vaccinated:2012-11-15
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-01-21
Location:Florida  Entered:2013-01-21
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: WAES1301USA004821
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Maternal exposure during pregnancy, No adverse event
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 25 years old female consumer regarding herself. Patient had no pertinent medical history and drug reactions or allergies. On 15-NOV-2012, the patient was vaccinated with her first and only dose of GARDASIL (lot#, dose and route not reported). No concomitant medications were reported. Subsequently on 28-NOV-2012, the patient found out that she was pregnant with an LPM of 28-OCT-2012 and an EDD of 04-AUG-13. She was not going to have the second or third shot until the pregnancy was completed. No treatment was given. No laboratory test were performed. Patient sought medical attention (called the Healthcare professional). No adverse reactions were reported. Initial exposure to GARDASIL was at 2 weeks. Additional information has been requested.

VAERS ID:482243 (history)  Vaccinated:2013-01-15
Age:25.0  Onset:2013-01-15, Days after vaccination: 0
Gender:Male  Submitted:2013-01-15, Days after onset: 0
Location:Colorado  Entered:2013-01-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: BP of patient after fall: 92/50, 54 BPM, 2nd test; 90/43, 49 BPM, 1st test
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07949221A IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness, Fall, Head injury, Loss of consciousness, Thirst
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: After receiving Flu shot, customer passed out and struck head on shelves near front of store. Patient stated he was lightheaded, dizzy and thirsty. Also stated he had not eaten today. EMS arrived w/in 5 minutes and took over care.

VAERS ID:482390 (history)  Vaccinated:2013-01-12
Age:25.0  Onset:2013-01-12, Days after vaccination: 0
Gender:Female  Submitted:2013-01-24, Days after onset: 12
Location:Unknown  Entered:2013-01-24
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: WAES1301USA006591
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H016715 IDUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect route of drug administration, Injection site vesicles, Laceration
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad), Medication errors (narrow)
Write-up: This spontaneous report as received from a registered pharmacist refers to a 25 years old female nurse. The patient was vaccinated with a 0.5 ml dose of (Merck) VARIVAX (lot # reported as H016715; expiration date: 07-SEP-2014) intradermally on 12-JAN-2013. No other co-suspects were reported. No concomitant medications were reported. The nurse reported that the skin at her insertion site had fluid-filled blister, like the solution did not go in deep enough, The nurse clarified that the blister did not look like a varicella-like rash, but more like a single collection of fluid immediately beneath the surface of her skin. The nurse who received the dose of (Merck) VARIVAX told the pharmacist that it looked like the dose was injected intradermally. When the nurse took off the bandage that was covering her injection site, she reported to the pharmacist that her skin ripped off. At the time of the report, the patient had not recovered. This is one of several reports received from the same source. Additional information has been requested.

VAERS ID:482734 (history)  Vaccinated:2013-01-23
Age:25.0  Onset:2013-01-23, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Wisconsin  Entered:2013-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: S/p splenectomy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0162830SYRRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, redness, tenderness prox (R) arm around inj site 10 x 18 cm.

VAERS ID:482819 (history)  Vaccinated:2013-01-17
Age:25.0  Onset:2013-01-21, Days after vaccination: 4
Gender:Female  Submitted:2013-01-28, Days after onset: 7
Location:Unknown  Entered:2013-01-28
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: WAES1301USA011798
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0097463IMUN
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: This spontaneous report as received from a register nurse refers to a patient of unknown age and gender, who in 17-JAN-2013, was vaccinated with the fourth dose of GARDASIL (dose, route and lot number were not reported). No other co-suspects were reported. No concomitant medications were reported. The nurse reported that on 21-JAN-2013, the patient developed chest pain and right arm numbness. No treatment information was reported. At the time of the report, the patient''s outcome for the adverse event was unknown. The relatedness for the adverse event was unknown for GARDASIL. Additional information has been requested.

VAERS ID:482984 (history)  Vaccinated:2013-01-16
Age:25.0  Onset:2013-01-17, Days after vaccination: 1
Gender:Male  Submitted:2013-01-25, Days after onset: 8
Location:New Mexico  Entered:2013-01-30, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccination and a past medical history of hepatitis C.
Diagnostic Lab Data: Not reported
CDC Split Type: 201300956
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEUR  SYRUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Depressed mood, Emotional disorder, Hallucination, auditory, Thinking abnormal
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (narrow)
Write-up: Initial report was received from a consumer, who was also the patient, on 18 January 2013. A 25-year-old male patient had received an injection of INFLUENZA VACCINE, Sanofi Pasteur, (lot number, route and site of administration not reported) on 16 January 2013 in the emergency room and "had a reaction to it". On 17 January 2013, when the patient woke up, he noticed his thinking was not normal, had no anger, felt like he could not stand up for himself, was depressed and could not cry. His emotions were not right and asked if there was a medication to take the vaccine out of him. He used to hear voices in his head and now he does not and he does not want to be angry. The patient had no illness at the time of vaccination and a medical history of Hepatitis C. Outcome was not recovered. Documents held by sender: None.

VAERS ID:483117 (history)  Vaccinated:2013-01-26
Age:25.0  Onset:2013-01-26, Days after vaccination: 0
Gender:Male  Submitted:2013-01-31, Days after onset: 5
Location:Arizona  Entered:2013-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium.....olanzapine
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12068010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient returned to pharmacy after feeling faint while shopping with mother.

VAERS ID:483528 (history)  Vaccinated:2013-01-28
Age:25.0  Onset:2013-01-29, Days after vaccination: 1
Gender:Female  Submitted:2013-02-05, Days after onset: 7
Location:Unknown  Entered:2013-02-05
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: Drug hypersensitivity
Preexisting Conditions: Aspirin, drug hypersensitivity; Ibuprofen, drug hypersensitivity; Penicillin, drug hypersensitivity; Sulfa, drug hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1302USA000655
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1524AA0UNAR
Administered by: Other     Purchased by: Other
Symptoms: Confusional state, Hypoaesthesia, Malaise
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: This spontaneous report as received from a doctor of medicine refers to a 25 years old female patient with no pertinent medical history and sulfa allergy, penicillin allergy, ibuprofen allergy and aspirin allergy. The patient was vaccinated with first dose GARDASIL (lot # 672193/1524AA) on 28-JAN-2013. There was no concomitant medications. On 29-JAN-2013 the patient developed confusion, malaise and numbness in the arm where she received the GARDASIL. The patient did not receive treatment. No lab diagnostics studies were performed. The patient sought unspecified medical attention. At the time of reporting, the patient''s outcome was not recovered. Action taken and the relatedness for all events and GARDASIL were both unknown. Additional information has been requested.

VAERS ID:484089 (history)  Vaccinated:2012-11-07
Age:25.0  Onset:2012-11-07, Days after vaccination: 0
Gender:Female  Submitted:2013-01-24, Days after onset: 78
Location:Massachusetts  Entered:2013-02-11, Days after submission: 18
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:
Diagnostic Lab Data: UNK
CDC Split Type: A1001274A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA736AA SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Wrong drug administered
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of wrong vaccine administered in a 25-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). On 7 November 2012 at 15:00 the subject received unspecified dose of FLULAVAL (.1 ml, unknown, right arm) and experienced wrong vaccine administered. On 7 November 2012, within a week of the vaccination with FLULAVAL, the subject experienced wrong vaccine administered, injection site redness, injection site swollen and hotness at injection site. The subject was supposed to receive a Tb test, but 0.1 ml of FLULAVAL was placed in the right arm instead of Tb test. The subject''s arm was red, swollen and hot, like it would occur with a concentrated reaction at the site of administration. The reporter could not provide any additional details. At the time of reporting the outcome of the injection site redness, injection site swollen and hotness at injection site were unspecified. Follow up was received from the healthcare professional (occupational health nurse) on 8 January 2013. The nurse reported that on 10 November 2012, the events of injection site redness, injection site swollen, and hotness at injection site had resolved. The nurse did not consider these events serious. The nurse stated that these events were the result of erroneous administration where they "administered flu vaccine instead of PPD."

VAERS ID:484132 (history)  Vaccinated:2013-01-31
Age:25.0  Onset:2013-02-01, Days after vaccination: 1
Gender:Female  Submitted:2013-02-07, Days after onset: 6
Location:North Carolina  Entered:2013-02-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: Nausea; Diarrhea
Preexisting Conditions: States had reaction to a vaccine given in infancy became limp, high fever was not given last dose of series.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS507011AA1IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient reports the day vaccine was administered prior to administration she had mild nausea and diarrhea. Rabies vaccines was administered 1/31/13 at 10:30AM. On 2/1/13 about 4pm developed itching of feet, hands, torso and jaw. Noted "large welts" "hives" on torso. Redness of feet and hands. Took BENADRY. Resolved in about 30 minutes.

VAERS ID:484417 (history)  Vaccinated:2012-10-26
Age:25.0  Onset:2012-10-26, Days after vaccination: 0
Gender:Female  Submitted:2013-02-13, Days after onset: 110
Location:Unknown  Entered:2013-02-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA740AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Participant felt numbness and tingling in left arm, both legs and right side by waist after receiving flu vaccination. Symptoms did not subside, 911 was called and participant was taken to the local hospital.

VAERS ID:484677 (history)  Vaccinated:2013-02-13
Age:25.0  Onset:2013-02-15, Days after vaccination: 2
Gender:Female  Submitted:2013-02-15, Days after onset: 0
Location:Washington  Entered:2013-02-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cetirizine 10mg po once daily.
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12058011IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Wrong drug administered
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)
Write-up: Pt presented 2/13 for ppd placement; had mild diffuse redness at site. Evaluated by a provider, thought to be a mild allergic reaction. Staff checked lot # and expiration date documented - it didn''t match with tubersol, but did with Fluzone. Pt informed of error, no adverse events expected, verbalized understanding.

VAERS ID:484752 (history)  Vaccinated:2013-02-06
Age:25.0  Onset:2013-02-06, Days after vaccination: 0
Gender:Female  Submitted:2013-02-08, Days after onset: 2
Location:Texas  Entered:2013-02-18, Days after submission: 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206601 IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.40136380SCLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Malaise, Musculoskeletal stiffness, Nausea, Skin irritation
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Feb 6. 2013 about 1 hr after leaving, I started feeling sick/nausea and noticed my arm was irritated, red & stiff.

VAERS ID:484792 (history)  Vaccinated:2013-02-18
Age:25.0  Onset:0000-00-00
Gender:Male  Submitted:2013-02-18
Location:Pennsylvania  Entered:2013-02-18
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) (AFLURIA)CSL LIMITED  IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Muscle spasms, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Headache, intermittent muscle spasms and tingling to my arm down to my fingers, muscle soreness.

VAERS ID:484817 (history)  Vaccinated:2013-02-12
Age:25.0  Onset:2013-02-12, Days after vaccination: 0
Gender:Male  Submitted:2013-02-13, Days after onset: 1
Location:North Carolina  Entered:2013-02-18, 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: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4547BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pharyngeal oedema, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Influenza vaccine given around 8 AM. Within 30 to 40 minutes started itching all over & felt like throat was swelling. Seen at clinic, SOLU-MEDROL & BENADRYL given which relieved symptoms.

VAERS ID:484928 (history)  Vaccinated:2012-12-05
Age:25.0  Onset:2012-12-19, Days after vaccination: 14
Gender:Male  Submitted:2013-02-14, Days after onset: 57
Location:Virginia  Entered:2013-02-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The subject had a medical history of myocarditis, pericarditis, chest pain, and chest pressure.
Diagnostic Lab Data:
CDC Split Type: 201302236
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR  IDUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Echocardiogram normal, Electrocardiogram normal, Pericardial disease, Troponin I, Troponin normal
SMQs:
Write-up: This study case was received from the investigator in a trial on 05 February 2013. A 25-year-old male subject received the following vaccinations on 05 December 2012: an injection of ACAM2000 (lot number, route, site and date not reported), TYPHIM VI, sanofi pasteur SA, (lot number, route, site and date not reported), and anthrax (Manufacturer, lot number, route, site and date not reported). The subject had a medical history of myocarditis, pericarditis, chest pain, and chest pressure. On 14 December 2012, the subject had a normal Troponin I, normal electrocardiogram, and normal echocardiogram. On 19 December 2012, the subject was diagnosed with unspecified disease of the pericardium. No further information was available at the time of the report. The subject''s outcome was not reported. Additional information will be requested from the investigator. Note: There is no reporter causality assessment as this is a safety surveillance (data mining, non-interventional) study. Documents held by sender: None.

VAERS ID:485005 (history)  Vaccinated:2013-02-11
Age:25.0  Onset:2013-02-12, Days after vaccination: 1
Gender:Female  Submitted:2013-02-20, Days after onset: 8
Location:Washington  Entered:2013-02-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 1IMLA
Administered by: Other     Purchased by: Military
Symptoms: Injection site cellulitis, Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema with warmth at injection site consistent with cellulitic reaction.

VAERS ID:485485 (history)  Vaccinated:2013-02-23
Age:25.0  Onset:2013-02-23, Days after vaccination: 0
Gender:Female  Submitted:2013-02-25, Days after onset: 2
Location:Tennessee  Entered:2013-02-25
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: Lactose; VSD when born
Diagnostic Lab Data: Going to doctor for medical evaluation
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED0694921A UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Cough, Fatigue, Gait disturbance, Hyperhidrosis, Influenza like illness
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Coughing starting Saturday Sun - flu-like sx, joints achy, exhausted, Mon- not aching, increased energy but wobbly & weak, sweats when walks. Pt. to follow up physician. No SOB, no wheezing, remained conscious.

VAERS ID:485517 (history)  Vaccinated:2013-02-19
Age:25.0  Onset:2013-02-19, Days after vaccination: 0
Gender:Female  Submitted:2013-02-25, Days after onset: 6
Location:California  Entered:2013-02-25
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: WAES1302USA009421
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H010915 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: This spontaneous report as received from a physician via field employee referred to a 25 year old female patient. On 19-FEB-2013 the patient was vaccinated with GARDASIL (lot # H010915, exp date as 13-FEB-2015, dose/frequency and route were unspecified). Patient felt "queasy" following the vaccination on 19-FEB-2013. It was not known which dose in the schedule the patient received today''s vaccine. Patient did not seek medical attention. No treatment was given for the event. The outcome of felt "queasy" following the vaccination was unknown. The relationship was not provided. Additional information is not expected.

VAERS ID:485570 (history)  Vaccinated:2013-02-20
Age:25.0  Onset:2013-02-21, Days after vaccination: 1
Gender:Female  Submitted:2013-02-26, Days after onset: 5
Location:Indiana  Entered:2013-02-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4586AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Axillary pain, Erythema, Oedema peripheral, Pyrexia, Skin reaction, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left arm red swollen warm to touch, pain in axillary, fever. No treatment.

VAERS ID:486124 (history)  Vaccinated:2012-08-25
Age:25.0  Onset:2012-08-25, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Unknown  Entered:2013-03-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: BERNA20120675
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30001320UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This is an initial case report reported by a healthcare professional on 30.Aug.2012 and forwarded by Crucell, no: CVAE-033-2012. A spontaneous report was received and concerns a 25-year-old male patient who, on 25.Aug.2012 received the first dose of VIVOTIF (batch no: 3000132). The patient''s medical history was not provided. Concomitant medication included prednisone. On 25.Aug.2012, following administration of the first dose of vaccination, the patient experienced hives. The patient did not take any more of the vaccine. The outcome of the event was not reported. The event was considered non-serious.

VAERS ID:486117 (history)  Vaccinated:2006-01-09
Age:25.0  Onset:0000-00-00
Gender:Male  Submitted:2013-02-10
Location:Indiana  Entered:2013-03-05, Days after submission: 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
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720 RA
Administered by: Military     Purchased by: Military
Symptoms: Injection site pain, Injection site reaction, Melanocytic naevus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Have a grown mole like area where shot was administered and from time to time it throbs.

VAERS ID:486223 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:2012-06-01
Gender:Female  Submitted:2013-03-05, Days after onset: 277
Location:Unknown  Entered:2013-03-05
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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1303USA000734
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Ectopic pregnancy, Ectopic pregnancy termination, Fallopian tube operation, Maternal exposure before pregnancy, Tubal rupture
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 prospective pregnancy report as received from a consumer refers to her 25 years old daughter. On an unknown date the patient was vaccinated with dose 3 of GARDASIL (Lot# and route not reported). The consumer stated that the patient had suffered (2) ectopic pregnancies after receiving the GARDASIL dosages (3). The first ectopic pregnancy occurred approximately eight months ago (approximately in June 2012) where she stayed at hospital for two days and had had one of her fallopian tubes removed due to a rupture. The LMP and EDD were not known. The pregnancy outcomes were ectopic termination. At the time of reporting, the patient''s outcome was unknown. Upon internal review, the second episode of ectopic pregnancy was considered to be an event of medically significant. Additional information has been requested. The patient was hospitalized.

VAERS ID:486298 (history)  Vaccinated:2012-06-05
Age:25.0  Onset:2012-06-05, Days after vaccination: 0
Gender:Male  Submitted:2013-03-07, Days after onset: 275
Location:Oregon  Entered:2013-03-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Carbatrol 300mlg 12hr cap 3 tabs 2x a day; Depakote sprinkles 125 mg 9 2x a day
Current Illness: No
Preexisting Conditions: Epilepsy, autism, Developmental disabilities
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B074CA SYR 
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Balance disorder, Convulsion, Decreased appetite, Erythema, Inflammation, Listless, Nausea, Pruritus
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (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), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Redness, itchy, inflamed not eating, drinking, listless, nausea, weak, equilibrium off on 3rd day seizure, She continues to have these symptoms including redness, itchy, and all above symptoms.

VAERS ID:486327 (history)  Vaccinated:2013-03-02
Age:25.0  Onset:2013-03-03, Days after vaccination: 1
Gender:Male  Submitted:2013-03-07, Days after onset: 4
Location:Unknown  Entered:2013-03-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Acute Dermatitis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3100IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURG154110IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dermatitis, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Full body rash to include genitals.

VAERS ID:486490 (history)  Vaccinated:2013-01-25
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-06
Location:California  Entered:2013-03-08, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had a past medical history of kidney stones before the vaccine. She had no treatment for infertility. Date of last menstrual period was reported as 09 May 2012 and estimated date of delivery was reported as 21 February 2013 (did not follow DD/MM/YYYY).
Diagnostic Lab Data: Not reported.
CDC Split Type: 201303582
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4464AA0IDUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abnormal labour, Exposure during pregnancy, Injection site pruritus, Peripartum haemorrhage, Vaccination site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Initial case was received from a consumer on 28 February 2013. An adult female patient (age not reported) received dose one an intradermal injection of FLUZONE intradermal, sanofi pasteur Inc., lot number UT4464AA (site and side not reported) on 25 January 2013. The patient was determined to be 37 weeks gestation at the time of vaccination. The patient''s current pregnancy history included kidney stones before the vaccine. She had no treatment for infertility. Date of last menstrual period was reported as 09 May 2012 and estimated date of delivery was reported as 21 February 2013 (did not follow DD/MM/YYYY). On an unspecified date, the patient experienced labor excessive bleeding (reported as current pregnancy history). The patient experienced vaccine insertion site slightly swollen and itchy on unspecified date. Laboratory or diagnostic tests and treatments were not reported. The patient''s outcome and pregnancy outcome were not reported. Documents held by sender: None.

VAERS ID:486608 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Michigan  Entered:2013-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Other
Symptoms: Impaired work ability, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Aches & pains, especially in my left arm. Numerous Dr. visits / tested for Guillain Barre / lost numerous days off work. Had to go to the E.R.

VAERS ID:486689 (history)  Vaccinated:2013-01-23
Age:25.0  Onset:2013-01-24, Days after vaccination: 1
Gender:Female  Submitted:2013-02-04, Days after onset: 11
Location:Illinois  Entered:2013-03-12, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Mefloquine; ZITHROMAX
Current Illness: Not stated
Preexisting Conditions: Uses NUVARING; MUCINEX prn
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH1452 SCRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA12011 UNLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000220 PO 
Administered by: Private     Purchased by: Private
Symptoms: Headache
SMQs:
Write-up: Headache, no other symptoms woke with headache done by noon drank fluids, recovered.

VAERS ID:486847 (history)  Vaccinated:2013-02-22
Age:25.0  Onset:2013-02-23, Days after vaccination: 1
Gender:Female  Submitted:2013-03-13, Days after onset: 17
Location:Utah  Entered:2013-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hyperlipidemia; Diabetes: Hypertension
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4251AA UNRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt stated her arm was red, swollen, and got fever. Went to ER for tx. was given antibiotic.

VAERS ID:486980 (history)  Vaccinated:2013-03-08
Age:25.0  Onset:2013-03-14, Days after vaccination: 6
Gender:Male  Submitted:2013-03-15, Days after onset: 1
Location:Maryland  Entered:2013-03-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Podofilox .5% soln--topical
Current Illness: None
Preexisting Conditions: 4 MAR 2013 11mm PPD Recent vaccinations: 1 MAR 2013 anthrax and Typhoid ViCPs
Diagnostic Lab Data: UA, CMP, CK, CK-MB, cTnt, CRP, ESR, CBC w/diff.= all normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A15IDLA
Administered by: Military     Purchased by: Military
Symptoms: Anxiety, Blood creatine phosphokinase MB normal, Blood creatine phosphokinase normal, C-reactive protein normal, Differential white blood cell count normal, Full blood count normal, Insomnia, Metabolic function test normal, Muscle twitching, Pallor, Red blood cell sedimentation rate normal, Tremor, Trismus, Troponin T normal, Urine analysis normal
SMQs:, Neuroleptic malignant syndrome (broad), Dyskinesia (broad), Dystonia (narrow), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Pt awoke with trismus, bilat. UE & LE trembling and twitching, anxiety, insomnia. His HR was 98 with RRR. He was very pale in appearence. PE completed (no cardiac Sxs--no R,M,G heard). Pt to ER for evaluation and HC Dr. notified (Immunologist at MC). Dr. was initially concerned about a cytokine storm. ER W/U and labs all normal. D/C Dx: anxiety and possible vaccine adverse event. Rx with diazepam. F/U with the fellow from Immunology svc.

VAERS ID:487255 (history)  Vaccinated:2013-02-20
Age:25.0  Onset:2013-02-20, Days after vaccination: 0
Gender:Female  Submitted:2013-03-19, Days after onset: 26
Location:Tennessee  Entered:2013-03-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Vesicare, Dulera, Xopenex, Claritin, Mucinex, Pseudephedrine, Spironolactone, Doxycycline
Current Illness:
Preexisting Conditions: Asthma, Allergies (environmental, penicillin, cephalosporin), endometriosis, polycystic ovarian syndrome, chronic daily headache
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURG15421 IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Abdominal pain upper, Asthenia, Dyskinesia, Loss of consciousness, Muscular weakness, Paraesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: Syncopal episode with sudden onset upper abdominal pain ten minutes prior, loss of consciousness for approximately 60 seconds accompanied by tonic movements. Alert and oriented upon waking, weakness and tingling in hands lasted ten minutes after syncopal episode.

VAERS ID:487264 (history)  Vaccinated:2013-03-15
Age:25.0  Onset:2013-03-18, Days after vaccination: 3
Gender:Male  Submitted:2013-03-19, Days after onset: 1
Location:Texas  Entered:2013-03-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0180141SCLA
Administered by: Other     Purchased by: Other
Symptoms: Blister, Pain, Rash erythematous, Rash maculo-papular, Tenderness
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: About 8-10 small red maculopapular rash with one vesicle. Vesicle painful and very tender if touched.

VAERS ID:487270 (history)  Vaccinated:2013-03-04
Age:25.0  Onset:2013-03-19, Days after vaccination: 15
Gender:Female  Submitted:2013-03-19, Days after onset: 0
Location:Nevada  Entered:2013-03-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Redness~Influenza (Seasonal) (no brand name)~UN~25.00~Patient
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H012140 SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt says the area has itched for about 3 days and today she noticed a red area on her left deltoid that is 2.75 inches wide by 3.5 inches long. She says she had the same type reaction to a flu shot in Jan 2013.

VAERS ID:487272 (history)  Vaccinated:2013-03-15
Age:25.0  Onset:2013-03-17, Days after vaccination: 2
Gender:Female  Submitted:2013-03-19, Days after onset: 2
Location:Washington  Entered:2013-03-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURERUNK0OTLA
Administered by: Military     Purchased by: Military
Symptoms: Secretion discharge, Skin discolouration, Skin lesion
SMQs:, Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pink bump on right shoulder. Noted a weeping lesion on base of neck on 3/19/2013 at 11:00 AM and third non-weeping lesion noted at 7:00 PM.

VAERS ID:487354 (history)  Vaccinated:2013-03-06
Age:25.0  Onset:2013-03-10, Days after vaccination: 4
Gender:Female  Submitted:2013-03-20, Days after onset: 9
Location:Unknown  Entered:2013-03-20
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: 02/2013, Post-traumatic neck syndrome; 02/2013, Road traffic accident
Diagnostic Lab Data:
CDC Split Type: WAES1303USA009316
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H017698 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Immediate post-injection reaction, Neck pain, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: This spontaneous report as received from a health professional refers to a 25 year old female patient. The patients medical history included car accident with neck whiplash approximately on an unknown date in February 2013 (reported as few weeks before vaccination). On 06-MAR-2013, the patient was vaccinated with a dose of GARDASIL (lot # H017698, expiry date was 02-JUL-2015, route and dose were not reported). On 06-MAR-2013, the patient became light headed immediately after vaccination. Approximately on 10-MAR-2013 (reported as 4-5 days after vaccination), the patient developed a sore arm and pain radiated into her neck. Laboratory tests performed was none. The patient sought medical attention and fluids were given for the event light headedness. In response to the events GARDASIL was discontinued on 06-MAR-2013. Approximately on an unknown date in MARCH 2013, the patient recovered from all the reported events. Additional information has been requested.

VAERS ID:487385 (history)  Vaccinated:2012-11-12
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-20
Location:Unknown  Entered:2013-03-20
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: COUMADIN; Doxycycline; PRILOSEC
Current Illness: Drug hypersensitivity
Preexisting Conditions: General symptom; SULFA, drug hypersensitivity; Penicillin, drug hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1303USA009134
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cardiac operation, Cerebrovascular accident, Endocarditis, General symptom, Heart valve replacement
SMQs:, Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This spontaneous report as received from a nurse refers to a 25 year old female patient with allergy to penicillin, allergy to sulfa and unspecified symptoms prior to her first dose of GARDASIL. The patient had no pertinent medical history. On 10-SEP-2012 the patient was vaccinated with the first dose of GARDASIL (dose, route, lot number were not provided). On 12-NOV-2012, the patient received of second dose of GARDASIL (dose, route, lot number were not provided). Concomitant therapies included COUMADIN, doxycycline and PRILOSEC. The nurse reported that the patient developed endocarditis after her second dose GARDASIL (Approximately in November 2012) which required open heart surgery and a valve replacement. Also reported the patient developed unspecified symptoms on an unspecified date in November 2012. The nurse also mentioned the patient had 2 strokes (date unspecified) when she was hospitalized. The patient was hospitalized (date unspecified). The patient''s outcome was reported as recovering. Endocarditis, open heart surgery, valve replacement, unspecified symptoms and 2 strokes were considered disabling, medically significant and life threatening by the reporter. Additional information has been requested.

VAERS ID:487452 (history)  Vaccinated:2013-03-04
Age:25.0  Onset:2013-03-04, Days after vaccination: 0
Gender:Female  Submitted:2013-03-04, Days after onset: 0
Location:California  Entered:2013-03-21, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No, but pregnant
Preexisting Conditions: Pregnant; no know allergies per patient
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4477BA IDAR
Administered by: Public     Purchased by: Private
Symptoms: Exposure during pregnancy, Rash, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient received Flu vaccine at approximately 200 pm on 3/4/13. Later that night, patient developed a red, itchy rash on torso/arms. 5 days later, rash spread to back. Reported to OB/GYN approximately on 3/15/13, who reported to us. (Pregnant). OB/GYN referred to dermatologist.

VAERS ID:487697 (history)  Vaccinated:2013-03-16
Age:25.0  Onset:2013-03-16, Days after vaccination: 0
Gender:Female  Submitted:2013-03-25, Days after onset: 9
Location:D.C.  Entered:2013-03-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Drug hypersensitivity
Preexisting Conditions: Clarithromycin, Drug hypersensitivity; CIPLACTIN, Drug hypersenstivity
Diagnostic Lab Data:
CDC Split Type: WAES1303USA010262
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0420AE IMUN
Administered by: Other     Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: This spontaneous report as received from a physician refers to a 25 year old female patient who was allergic to CIPLACTIN and clarithromycin. The patient was not pregnant. On 16-MAR-2013 the patient was vaccinated intramuscularly with 0.5 ml GARDASIL (lot # 0420AE, expiry date 01-DEC-2014). There was no other concomitant medication. The patient fainted after being administered GARDASIL on 16-MAR-2013 in the physician''s office. Ammonia capsule and cold pack were given for treatment. The outcome of fainted was reported as recovered/resolved on 16-MAR-2013. Additional information is not expected.

VAERS ID:487765 (history)  Vaccinated:2013-03-13
Age:25.0  Onset:2013-03-22, Days after vaccination: 9
Gender:Male  Submitted:2013-03-26, Days after onset: 4
Location:North Carolina  Entered:2013-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Krill oil
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV310 UNUN
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A IDUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Onset of rash around SPV site and chest, face and upper legs.

VAERS ID:487827 (history)  Vaccinated:2013-02-08
Age:25.0  Onset:2013-02-18, Days after vaccination: 10
Gender:Male  Submitted:2013-03-26, Days after onset: 35
Location:California  Entered:2013-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Negative ANA, CBC, Chem 18 normal, elevated ESR
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV310 IM 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0008AE IM 
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A ID 
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURH1481 IM 
Administered by: Military     Purchased by: Military
Symptoms: Antinuclear antibody negative, Full blood count, Laboratory test normal, Rash papular, Rash pruritic, Red blood cell sedimentation rate increased, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Erythematous pruritic papules, nonblanchable on dorsal hands, elbows, knees. Slightly tender to the touch.

VAERS ID:487939 (history)  Vaccinated:2013-03-25
Age:25.0  Onset:2013-03-25, Days after vaccination: 0
Gender:Female  Submitted:2013-03-27, Days after onset: 2
Location:Indiana  Entered:2013-03-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo Provera
Current Illness: None
Preexisting Conditions: Allergic to fish, iodine, Tremadol, Loratab
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMRA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Private     Purchased by: Other
Symptoms: Pruritus generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Stated itching on right side of neck, shoulder and back at 5:00 PM. It then moved quickly to full body. Took 50mgs of Benadryl. On 3/26/2013, took another 50mgs of Benadryl, this time it didn''t work. Hives started on both sides of neck under ears. Called doctor at 10 AM and got 6mgs of Decadron. Helped itching a little bit and hives went away. Went to the Emergency Room at 4 AM 3/27/2013 because of itching on the tongue in addition to itching head to toe. Was administered DexaMETHAsone Phos inj at 20mgs. Was prescribed Pepcid and Prelone and am to take both twice a day for 5 days. Was told to go to doctor if not better by 3/28/2013 or 3/29/2013.

VAERS ID:487942 (history)  Vaccinated:2013-03-13
Age:25.0  Onset:2013-03-25, Days after vaccination: 12
Gender:Male  Submitted:2013-03-27, Days after onset: 2
Location:California  Entered:2013-03-27
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 known illnesses
Preexisting Conditions: Sleep conditions, No known allergies
Diagnostic Lab Data: Patient returned to doctor on 26Mar2013 to state that he felt his vison had changed since swelling on his eye due to vaccine. Artificial tears and Lacrilube ointment was recommended. Patient will F/U with provider if condition worsens.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0 LA
Administered by: Military     Purchased by: Military
Symptoms: Eye swelling, Rash, Visual impairment
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Approx. 7-10 days after vaccine patient noticed a rash around corner of mouth and R eye swelling.

VAERS ID:487968 (history)  Vaccinated:2012-11-26
Age:25.0  Onset:2012-11-26, Days after vaccination: 0
Gender:Female  Submitted:2013-03-26, Days after onset: 119
Location:Ohio  Entered:2013-03-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Runny nose
Preexisting Conditions: NKA; Otherwise healthy except for "sensitive skin"
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC064AB0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt. reported this today for 1st time - came in for Hep B #3 today and stated after both doses #1 and #2 of Hep B, developed itching and hives within 3-4 hours - on both arms only. Did not seek treatment or do anything and both times the itching and hives resolved within a few more hours. Before getting final dose, pt advised to have titer done or see allergist.

VAERS ID:488088 (history)  Vaccinated:2013-03-15
Age:25.0  Onset:2013-03-16, Days after vaccination: 1
Gender:Female  Submitted:2013-03-28, Days after onset: 12
Location:New Jersey  Entered:2013-03-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL TABLETS; XANAX
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1303USA013139
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H015863 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This spontaneous report as received from a physician refers to a 25 year old female patient without pertinent medical history. The patient had no drug reactions or allergies. The patient was not pregnant. On 15-MAR-2013 the patient was vaccinated with the first dose of GARDASIL (lot # H015863, expiration date 24-MAR-2015) (the physician stated the lot number for the GARDASIL in question was either "H-zero-15863" or "H-letter O-15863") (dose, route and injection site were not reported). Concomitant therapies included amphetamine aspartate, amphetamine sulfate, dextroamphetamine saccharate, ADDERALL and XANAX. On 16-MAR-2013 the patient developed itchy rash on her face, arms and legs after receiving her first dose of GARDASIL. There was no laboratory diagnostics study performed. Treatment BENADRYL was given for adverse event. The action taken, causality and outcome were not provided at the time of the report. The patient sought unspecified medical attention. Additional information has been requested.

VAERS ID:488161 (history)  Vaccinated:2013-03-23
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-03-30
Location:Ohio  Entered:2013-03-30
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: No other medications
Current Illness: Allergy to vaccine, to unknown vaccines; Coeliac disease; Lactose intolerance; Rosacea; Asthma; Type 1 diabetes mellitus
Preexisting Conditions: Eczema
Diagnostic Lab Data:
CDC Split Type: WAES1303USA013193
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0186081UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site cellulitis
SMQs:
Write-up: This spontaneous report was received from a physician concerning an approximately 25 year old female patient with type 1 diabetes, asthma, rosacea, lactose and gluten intolerance and unspecified reaction to unknown vaccines. The medical history of the patient included eczema. On 08-DEC-2011, the patient was vaccinated with dose 1 of PNEUMOVAX23 (lot number, expiry date, dose and route unspecified) with no adverse events. On 23-MAR-2013, the patient was vaccinated with dose 2 of PNEUMOVAX 23 (lot number and expiry date reported as H018608 and 02-JUL-2014 respectively, dose and route unspecified). No concomitant medications were reported. On an unknown date, approximately in March 2013 (reported as recently), the patient was diagnosed with cellulitis at the injection site and was admitted to the hospital. The patient sought medical attention (hospitalized). Name of the hospital was unknown. Before hospitalization, the patient was advised to use heat on the injection site reaction and to take over the counter pain medication as a treatment. The patient had not recovered from cellulitis at the injection site at the time of reporting. The relatedness for the event was unknown for PNEUMOVAX23. Additional information has been requested.

VAERS ID:488299 (history)  Vaccinated:2013-03-23
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-02
Location:New Hampshire  Entered:2013-04-02
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: Interstitial cystitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000262 PO 
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Fatigue, Muscular weakness, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Fatigue, muscle weakness, nausea, diarrhea.

VAERS ID:488432 (history)  Vaccinated:2012-06-28
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-04
Location:Utah  Entered:2013-04-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin Xl, multivitamins
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0  
Administered by: Private     Purchased by: Private
Symptoms: Amenorrhoea
SMQs:, Fertility disorders (broad)
Write-up: Didn''t menstruate for 3 months after Gardasil vaccine. Had to get medicine to restart menstrual cycle.

VAERS ID:488566 (history)  Vaccinated:2013-04-02
Age:25.0  Onset:2013-04-03, Days after vaccination: 1
Gender:Female  Submitted:2013-04-04, Days after onset: 1
Location:New Hampshire  Entered:2013-04-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PROVENTIL
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0206840IMRA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Injection site erythema, Injection site pain
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Within 24 hours of vaccine, got severe (R) deltoid pain, temp to 103.5, redness overlying injection site.

VAERS ID:488786 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Unknown  Submitted:2013-04-09
Location:New Mexico  Entered:2013-04-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1304USA000790
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a physician via a company representative refers to a 25 year old patient of unknown gender. No medical history provided. On an unknown date the patient was inadvertently vaccinated with ZOSTAVAX, (dose unknown, subcutaneous, Lot# unknown, indication: prophylaxis ("immunization")) instead of VARIVAX. There was no concomitant medication. No adverse effects noted. No treatment was given. The patient sought medical attention. No further information reported. Additional information has been requested.

VAERS ID:489249 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-04-05
Location:Minnesota  Entered:2013-04-15, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC064CA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B103AA0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Infection, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Symp: Left arm pain. Diag: Left arm infection caused by vaccine.

VAERS ID:489627 (history)  Vaccinated:2013-02-10
Age:25.0  Onset:0000-00-00
Gender:Male  Submitted:2013-03-02
Location:Ohio  Entered:2013-04-19, Days after submission: 47
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; CLARITIN
Current Illness: None
Preexisting Conditions: HTN; seasonal allergies
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3101IMLA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Dizziness, Flatulence, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Dizziness after 12 hours, nausea day 2, diarrhea day 3 and excessive gas day 4.

VAERS ID:489704 (history)  Vaccinated:2013-04-12
Age:25.0  Onset:2013-04-13, Days after vaccination: 1
Gender:Female  Submitted:2013-04-19, Days after onset: 6
Location:Unknown  Entered:2013-04-19
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: WAES1304USA007741
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injury associated with device, Oedema peripheral, Skin tightness
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (broad)
Write-up: This spontaneous report was received from a 26 years old, female licensed practical nurse reporting on herself with no pertinent medica; history or drug reactions or allergies. The nurse noted that on 12-APR-2013 while preparing a dose of (Merck) PROQUAD (lot number and expiration date not reported) for a patient, she inadvertently "stuck" herself on her finger with a needle that contained the (merck) PROQUAD. Starting on 13-APR-2013 she noted "her finger was swollen and that the skin on her finger was tight". The nurse''s present status was not recovered. The nurse stated that no treatment was given for the events. The nurse reported that none lab diagnostic studies were performed. The reported did not seek medical attention. Additional information has been requested.

VAERS ID:489834 (history)  Vaccinated:2013-03-11
Age:25.0  Onset:2013-03-14, Days after vaccination: 3
Gender:Female  Submitted:2013-04-15, Days after onset: 32
Location:California  Entered:2013-04-23, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The subject did not have any medical history relevant to the event.
Diagnostic Lab Data:
CDC Split Type: 201304892
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR   LA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Electrocardiogram normal, Myopericarditis, Troponin normal
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This study case was received from the investigator in a trial on 08 April 2013. A 25-year-old female subject had received the following vaccination on 11 March 2013 in the left arm: ACAM2000 (lot number, and route not reported). Three days later, the subject experienced sharp/mild chest pain during a light jog following intense exercise (running stairs). This reoccurred on 2 subsequent days and stopped. The subject recovered on 16 March 2013. The subject did not seek care. Rapid/lab troponin levels from 18 March 2013 were normal (Result < 0.10 ng/mL). The electrocardiogram from 18 March 2013 was normal. The subject did not have any medical history relevant to the event and took no medications to treat the event. According to the reporter, there was a lower suspicion for myopericarditis, but could not rule out cardiac etiology. The subject was referred for care but did not go. The subject''s outcome was reported as recovered on 16 March 2013. According to the Investigator, the event of chest pain was considered an important event and possibly related. Documents held by sender: None.

VAERS ID:489997 (history)  Vaccinated:2013-04-17
Age:25.0  Onset:2013-04-18, Days after vaccination: 1
Gender:Female  Submitted:2013-04-24, Days after onset: 6
Location:Puerto Rico  Entered:2013-04-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08149211A IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H017759 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site cellulitis
SMQs:
Write-up: Patient present cellulitis in left arm was PNEUMOVAX vaccine was administered.

VAERS ID:490107 (history)  Vaccinated:2013-04-11
Age:25.0  Onset:2013-04-11, Days after vaccination: 0
Gender:Female  Submitted:2013-04-25, Days after onset: 14
Location:Unknown  Entered:2013-04-25
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: WAES1304USA014741
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0200020IMLA
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: This spontaneous report was received from a registered nurse referring to a 25 year old female patient who on 11-APR-2013, was vaccinated with a dose of GARDASIL, 0.5 ml, intramuscular in the left arm (supplied lot # H020002 expiration date, 08-AUG-2015). The registered nurse reported that the patient had a persistent arm pain after administration of GARDASIL the patient developed immediate pain in the left deltoid muscle after vaccination. The pain had continued since then. The patient called the office on 23-APR-2013 to report that the pain in the area of the left deltoid was the same as the day she got the shot. Additional information has been requested.

VAERS ID:490754 (history)  Vaccinated:2013-04-25
Age:25.0  Onset:2013-04-25, Days after vaccination: 0
Gender:Female  Submitted:2013-04-26, Days after onset: 1
Location:Georgia  Entered:2013-05-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hx of heart arrhythmia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEVX: JAPANESE ENCEPHALITIS (NO BRAND NAME)UNKNOWN MANUFACTURER11H91ECP0IMUN
Administered by: Public     Purchased by: Private
Symptoms: Feeling abnormal, Headache, Heart rate increased
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad)
Write-up: Pt received Japanese Encephalitis on 4/25/13 approx 3 minutes after receiving vaccine pt told nurse she felt funny - head hurting - and c/o rapid heart rate - pulse rate 90/ B/P 100/60 - pt denies itching or breathing issue - monitor pt for 30 minutes pulse rate down - left with father stable and alert. Spoke with pt on 4/26/13 no additional problems.

VAERS ID:490894 (history)  Vaccinated:2013-05-02
Age:25.0  Onset:2013-05-02, Days after vaccination: 0
Gender:Female  Submitted:2013-05-06, Days after onset: 4
Location:Maryland  Entered:2013-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Latex allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0024531IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Blister, Cellulitis, Induration, Pain, Skin lesion, Skin warm, Tenderness, Varicella post vaccine
SMQs:, Severe cutaneous adverse reactions (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Upraised lesions/chickenpox lesions/blisters in a cluster at the vaccination site (approx 4 cm in diameter) with surrounding cellulitis which extends from upper deltoid to above the elbow - warm, tender, painful with localized induration.

VAERS ID:491382 (history)  Vaccinated:2013-05-08
Age:25.0  Onset:2013-05-09, Days after vaccination: 1
Gender:Female  Submitted:2013-05-10, Days after onset: 1
Location:Florida  Entered:2013-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None identified
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0167150SCRA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Induration, Pain, Skin warm, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Client states that it started off just a little red, but now is an area about the size of the palm of her hand, it is hot to the touch and has a hard welted area in center. Client states it is very painful to touch. Advised client to apply cold compress to the area and if symptoms worsen to follow up with physician for evaluation.

VAERS ID:491622 (history)  Vaccinated:1990-04-10
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-05-15
Location:Unknown  Entered:2013-05-15
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: On unknown dates, the patient failed to seroconvert with one dose of each MMR II and RECOMBIVAX HB.; Antibody test, Negative; Hepatitis B surface antibody, Negative
CDC Split Type: WAES1305USA008105
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Exposure during pregnancy, Hepatitis B surface antibody negative, Live birth, Seroconversion test negative
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: This spontaneous retrospective pregnancy report as received from a pharmacist refers to a 25 year old female patient. On 14-JUL1989 the patient was vaccinated with one dose of MMR II (lot # and dose not reported). On 10-APR-1990, the patient was vaccinated with one dose of RECOMBIVAX HB (lot # and dose not reported). The patient became pregnant. The LMP and EDD is not known. The patient delivered a infant. The pregnancy outcome was unknown. The pharmacist reported that the patient failed to seroconvert with one dose of each MMR II and RECOMBIVAX HB that she received a child on an unknown date (the LMP and EDD were not known). The pregnancy outcome was unknown. At the time of reporting, the patient was not a pregnant. It was reported that the patient had not recovered from these events. Additional information has been requested.

VAERS ID:491848 (history)  Vaccinated:2013-05-10
Age:25.0  Onset:2013-05-10, Days after vaccination: 0
Gender:Female  Submitted:2013-05-17, Days after onset: 7
Location:Unknown  Entered:2013-05-17
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: WAES1305USA007133
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0226Z0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event, Product packaging issue
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report as received from a medical assitant refers to a patient of unknown age and unknown gender. On 10-MAY-2013 the patient was vaccinated with a dose of VARIVAX (Merck) lot # 666369/0226Z, expired date 28-JAN-2013 (dose, route not reported). No adverse effects reported. It was reported that potential mix expired VARIVAX vial with other VARIVAX vials in the same carton that were not expired. At the time of reporting, the patient''s outcome was unknown. PQC was filed. Additional information has been requested.

VAERS ID:491970 (history)  Vaccinated:2013-05-15
Age:25.0  Onset:2013-05-16, Days after vaccination: 1
Gender:Female  Submitted:2013-05-17, Days after onset: 1
Location:Minnesota  Entered:2013-05-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DULERA; EPIPEN; Albuterol; TYLENOL; Prednisone; YAZ; Multivitamin
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0157490IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site swelling, Nausea, Oedema peripheral, Pyrexia, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), 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), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever 103.0, hives, nausea, swelling Rt-upper arm to fingers.

VAERS ID:491923 (history)  Vaccinated:2013-04-20
Age:25.0  Onset:2013-04-20, Days after vaccination: 0
Gender:Male  Submitted:2013-05-18, Days after onset: 28
Location:Virginia  Entered:2013-05-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Rash~Anthrax (Biothrax)~1~24.00~Patient|Rash~Anthrax (Biothrax)~2~24.00~Patient|Rash~Anthrax (Biothrax)~3~25.00~Patient|Rash~Ant
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Photographs.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV317A4IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site reaction, Rash, Rash pruritic, Vaccine positive rechallenge
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash soon after injection locally, resolved after 1-2 hours. Over next several weeks, a pruitic rash occured for approx 1/2 hour daily at various times at injection site. Per pt he has had same reaction with each injection of anthrax vaccine he has received but never reported.

VAERS ID:491982 (history)  Vaccinated:2013-05-17
Age:25.0  Onset:2013-05-17, Days after vaccination: 0
Gender:Male  Submitted:2013-05-20, Days after onset: 3
Location:New Jersey  Entered:2013-05-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known or reported
Current Illness: Denied
Preexisting Conditions: Denied
Diagnostic Lab Data: Physical exam reveals small, moveable, tender nodule 1cm from medial end of left clavicle, slight enlargement of left shoulder on palpation and comparison to right shoulder.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4418AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Musculoskeletal pain, Nodule, Pyrexia, Swelling, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness, sore and tender at injection site, initially, then at 3:30 PM fever started and lasted until morning of 5/19/2013 (reported by patient). Highest temperature was 101 by mouth, was relieved by ibuprofen. Afternoon of 5/19/2013 patient noticed soreness in left shoulder and "bump" towards medial end of left clavicle. This is slowly resolving, though tenderness remains.

VAERS ID:492211 (history)  Vaccinated:2013-05-08
Age:25.0  Onset:2013-05-09, Days after vaccination: 1
Gender:Female  Submitted:2013-05-09, Days after onset: 0
Location:Georgia  Entered:2013-05-21, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4152AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Diarrhoea, Oedema peripheral, Skin warm, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: Started vomited and stomach ache at 1200 AM vomited x3. Right arm swollen and warm. Diarrhea x2 this AM.

VAERS ID:492286 (history)  Vaccinated:2000-05-03
Age:25.0  Onset:2008-11-29, Days after vaccination: 3132
Gender:Female  Submitted:2013-05-22, Days after onset: 1634
Location:Virginia  Entered:2013-05-22
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations: chronic reactive arthritis~Lyme (LYMErix)~3~26.00~Patient
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Anti La SSB
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG5001A42UNLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSVHA584A41UNRA
Administered by: Private     Purchased by: Other
Symptoms: Anti-SS-B antibody, Antinuclear antibody, Fatigue, Pain
SMQs:
Write-up: Pain, fatigue.

VAERS ID:492493 (history)  Vaccinated:2013-05-17
Age:25.0  Onset:2013-05-17, Days after vaccination: 0
Gender:Female  Submitted:2013-05-20, Days after onset: 3
Location:South Dakota  Entered:2013-05-24, 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: MIRENA
Current Illness: None
Preexisting Conditions: Allergies: PCN, sulfa and environmental; no other; (currently 4.5 months postpartum)
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.H0186891IMLA
Administered by: Private     Purchased by: Private
Symptoms: Eye pain, Gastric hypermotility, Headache, Hyporesponsive to stimuli, Migraine, Nausea, Photosensitivity reaction, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: Laid down and woke with acute headache/migraine pain focal point behind left eye - extreme photosensitivity - pain led to increased gastric emptying and severe nausea and vomiting - unable to respond/vocalize at times during the pain. Subsided around 2AM 5/18/13 - most intense headache of my life 9/10 pain.

VAERS ID:493375 (history)  Vaccinated:2013-03-13
Age:25.0  Onset:2013-03-26, Days after vaccination: 13
Gender:Male  Submitted:2013-06-03, Days after onset: 69
Location:Virginia  Entered:2013-06-05, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The subject had no past medical history.
Diagnostic Lab Data: 26 March 2013: Abnormal ECG; 27 March 2013: Normal echocardiogram; 28 March 2013: Abnormal MRI (heart)
CDC Split Type: 201306357
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR  IDUN
Administered by: Military     Purchased by: Military
Symptoms: Echocardiogram normal, Electrocardiogram abnormal, Myocarditis, Nuclear magnetic resonance imaging abnormal, Pericardial disease, Troponin I increased
SMQs:, Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This study case was received from the investigator on 24 May 2013. A 25-year-old male subject received the an injection of ACAM2000 (lot number, route and site of administration not reported) on 13 March 2013 and the following vaccinations on 12 March 2013: TYPHIM (lot number, route and site of administration not reported) and Anthrax (manufacturer, lot number, route and site of administration not reported). The subject was diagnosed with unspecified disease of pericardium on 26 March 2013 and other and unspecified acute myocarditis on 28 March 2013. Relevant laboratory data included abnormal Troponin I at 00.89 and an abnormal ECG on 26 March 2013, a normal echocardiogram on 27 March 2013 and an abnormal MRI (heart) on 28 March 2013. Treatments were not reported. The subject had no past medical history. Additional information will be requested from the investigator. The subject''s outcome was not reported. Note: There is no reporter causality assessment as this is a safety surveillance (data mining, non-interventional) study. Documents held by sender: None.

VAERS ID:493577 (history)  Vaccinated:2013-05-21
Age:25.0  Onset:2013-05-21, Days after vaccination: 0
Gender:Female  Submitted:2013-06-06, Days after onset: 16
Location:Unknown  Entered:2013-06-06
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: WAES1305USA016544
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:, Medication errors (narrow)
Write-up: This spontaneous report was received from a healthcare worker concerning an approximately 25 year old female patient. It was reported that the patient was given the third dose of GARDASIL early. On 25-FEB-2013, the patient was vaccinated with the first dose of GARDASIL (lot number, expiry date, dose and route unspecified). On 23-APR-2013, the patient was vaccinated with the second dose of GARDASIL (lot number, expiry date, dose and route unspecified). On 21-MAY-2013, the patient was vaccinated with the third dose of GARDASIL (lot number, expiry date, dose and route unspecified). No concomitant medications were reported. No adverse effects were reported. Additional information has been requested.

VAERS ID:493873 (history)  Vaccinated:2013-06-10
Age:25.0  Onset:2013-06-10, Days after vaccination: 0
Gender:Male  Submitted:2013-06-11, Days after onset: 1
Location:Texas  Entered:2013-06-11
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: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB532AA IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURH16041 SCRA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM12097 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4365AA IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURH148210IMRA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH668AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Oedema mouth, Pruritus generalised, Rash generalised, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt called health department experiencing rash and itching all over body, no breathing problems at that time. I instructed him to take Benadryl now and if symptoms worsened or signs of anaphylaxis appears, then to go to Emergency Room. Later in evening he had mouth and facial swelling so he went to ER where he was given Epinepherine and steroids. He states he is feeling better today (6/11/2013).

VAERS ID:494012 (history)  Vaccinated:2013-06-04
Age:25.0  Onset:2013-06-05, Days after vaccination: 1
Gender:Female  Submitted:2013-06-12, Days after onset: 7
Location:Oregon  Entered:2013-06-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known.
Current Illness: None known
Preexisting Conditions: Unknown
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0177060SCRA
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Moderate - significant swelling and redness at injection site. Fatigue reported.

VAERS ID:494360 (history)  Vaccinated:2013-06-14
Age:25.0  Onset:2013-06-16, Days after vaccination: 2
Gender:Female  Submitted:2013-06-17, Days after onset: 1
Location:Michigan  Entered:2013-06-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin; ibuprofen
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
MUR: MUMPS + RUBELLA (FOREIGN)MERCK & CO. INC.    
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Chills, Dizziness, Injection site erythema, Injection site pain, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (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)
Write-up: Intermittent dizziness, nausea, chills. Persistent 4-cm round area of redness/pain/swelling around injection site of yellow fever vaccine.

VAERS ID:494460 (history)  Vaccinated:2013-06-18
Age:25.0  Onset:2013-06-18, Days after vaccination: 0
Gender:Male  Submitted:2013-06-18, Days after onset: 0
Location:Illinois  Entered:2013-06-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~Pertussis (no brand name)~~0.00~Patient
Other Medications: Bicillin received immediately following vaccinations
Current Illness: No
Preexisting Conditions: Allergy to pertussis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ADEN_4_7: ADENOVIRUS TYPES 4 & 7, LIVE, ORAL (NO BRAND NAME)TEVA PHARMACEUTICALS34600086 PO 
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP510080IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4428AA0IMLA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURC4114AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Dysphagia, Swollen tongue
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tongue swelling, difficulty swallowing. 25mg Benadryl given IM at 10:35 AM.

VAERS ID:494753 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-06-21
Location:California  Entered:2013-06-21
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: Unspecified test (date unspecified): Titer of not immune
CDC Split Type: WAES1306USA006081
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0UNUN
Administered by: Military     Purchased by: Military
Symptoms: Antibody test negative
SMQs:
Write-up: This spontaneous report was received from a medical assistant concerning a 25 year old female patient with no pertinent medical history and no drug reactions or allergies. Approximately on an unknown date in 1998 (reported as at the age of 10 years old), the patient was vaccinated with dose 1 (Merck) VARIVAX (lot number, expiry date dose and route unspecified) at a clinic or hospital with funds since her was an employee and it was offered for children. There was no concomitant therapy. On an unknown date, the patient had a titer of not immune. The patient sought an unspecified medical attention. The outcome of titer of not immune was unknown. The relatedness for the event was unknown for (Merck) VARIVAX. Additional information has been requested.

VAERS ID:494891 (history)  Vaccinated:2013-06-20
Age:25.0  Onset:2013-06-20, Days after vaccination: 0
Gender:Female  Submitted:2013-06-20, Days after onset: 0
Location:Indiana  Entered:2013-06-24, 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: ZYRTEC; fish oil; vite
Current Illness: None
Preexisting Conditions: None known
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB672AA0IMRA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30004200PO 
Administered by: Other     Purchased by: Private
Symptoms: Musculoskeletal stiffness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Sl myalgia and sl stiffness. (R) ring and little fingers.

VAERS ID:495793 (history)  Vaccinated:2013-04-09
Age:25.0  Onset:2013-04-09, Days after vaccination: 0
Gender:Female  Submitted:2013-07-02, Days after onset: 84
Location:California  Entered:2013-07-02
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: Hypersensitivity; Asthma
Preexisting Conditions:
Diagnostic Lab Data: Pregnancy Test (22May2013): Positive
CDC Split Type: WAES1306USA007999
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0190880IMUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, No adverse event, Pregnancy test positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: This spontaneous prospective pregnancy report as received from a registered nurse refers to a 25 year old female patient with asthma and unspecified reaction to latex. On 09-APR-2013 the patient was vaccinated with the first dose of GARDASIL (INJ 0.5 ML) (lot # H019088, expiration date 26-JUN-2015), intramuscular for prevention of HPV. There was no concomitant medication reported. On 22-MAY-2013 the patient had a positive pregnancy test. It was reported that patient''s last menstrual period of 21-MAR-2013 and Estimated delivery date of 26-DEC-2013. Initial exposure to GARDASIL was at 2 weeks. The pregnancy outcome was unknown. On an unspecified date the patient was contacted in the office. The nurse stated that the patient had not had any adverse reactions. Additional information has been requested.

VAERS ID:495982 (history)  Vaccinated:2013-07-01
Age:25.0  Onset:2013-07-01, Days after vaccination: 0
Gender:Female  Submitted:2013-07-06, Days after onset: 5
Location:Louisiana  Entered:2013-07-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Be-Yaz
Current Illness: None
Preexisting Conditions: Allergies: Sulfa medication, Augmentin, Neomycin, adhesive
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNLA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Injection site erythema, Injection site mass, Injection site pain, Injection site swelling, Muscle spasms, Nausea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Nausea (18 hrs), vomiting (7 hours), diarrhea (24 hours), muscle cramps (24 hrs.), fever (24 hrs). Red, swollen injection site (4 days). Large, painful lump at injection site (5 days and counting...

VAERS ID:496277 (history)  Vaccinated:2003-06-01
Age:25.0  Onset:2003-06-01, Days after vaccination: 0
Gender:Male  Submitted:2013-07-09, Days after onset: 3691
Location:Washington  Entered:2013-07-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol as needed for headaches or muscle aches.
Current Illness: NA
Preexisting Conditions: Asthma, Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0 AR
Administered by: Military     Purchased by: Military
Symptoms: Induration, Injection site bruising, Injection site erythema, Injection site swelling, Injection site warmth, Myalgia, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), 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), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness at vaccine site, swelling as day went on, bruising, severe swelling and warmth at site. Eventually about 4-5" in diameter, hard to the touch, painful and warm. Muscle aches, nausea, slight fever.

VAERS ID:496445 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:0000-00-00
Gender:Male  Submitted:2013-07-10
Location:Unknown  Entered:2013-07-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1307USA002044
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Blister, Herpes zoster
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: This spontaneous report was received from the patient''s mom concerning her currently 25 years old son. On an unknown date, the patient was vaccinated with GARDASIL dose 1 (doses, route of administration and lot # not reported). There were no concomitant, pertinent medical history or drug reactions/allergies. On an unknown date, after the first dose, the patient got a case of shingles. It was on his left hand side of his torso, had the blisters. The patient was given antibiotics but did not remember the name (also reported as the patient did not receive treatment for the event). The patient sought medical attention. It was reported that no lab diagnostic studies were taken. The outcome of got a case of shingles. It was on his left hand side of his torso, has the blisters is unknown. The patient discontinued the course of treatment and went in to get the remaining 2 shots. Additional information has been requested.

VAERS ID:496506 (history)  Vaccinated:2013-07-08
Age:25.0  Onset:2013-07-08, Days after vaccination: 0
Gender:Female  Submitted:2013-07-11, Days after onset: 3
Location:California  Entered:2013-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins and Iron
Current Illness: Patient 33 weeks pregnant at time of vaccination
Preexisting Conditions: Allergic to PCN and Gabapentin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4421AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Injection site erythema, Injection site oedema, Injection site pain, Injection site swelling, Injection site warmth, Mobility decreased, Pain, Pyrexia, Tinnitus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hearing impairment (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 7/9/13 she was unable to move arm and noticed increase pain with swelling and redness around site. Developed fever, headaches, buzzing to Lt ear, body aches on 7/9/13 in the afternoon. Taking Tylenol 2 tablets last dose was last night. Patient was seen in our office on7/11/13 with the above complaints. On physical examination left deltoid was (approximately 5 in x 4 in area) red, slightly edematous and warm to the touch. Patient instructed to continue Tylenol 325 mg tabs 2 tabs every 6 hours. May take Benadryl 25 mg every 6 hours as needed and use aloe vera ointment on the affected for comfort.

VAERS ID:496909 (history)  Vaccinated:2012-10-23
Age:25.0  Onset:2012-12-01, Days after vaccination: 39
Gender:Female  Submitted:2013-07-16, Days after onset: 226
Location:Connecticut  Entered:2013-07-16
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: Immunisation
Preexisting Conditions:
Diagnostic Lab Data: Ultrasound, date unknown, result not provided, also reported that the patient was 5 and a half weeks pregnant as of 31-OCT-2012. Genetics test, result not provided; Home pregnancy test, date unknown, result not provided.
CDC Split Type: WAES1211USA012587
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H006950 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abortion spontaneous, Cytogenetic analysis, Exposure during pregnancy, Pregnancy test, Ultrasound scan, Uterine dilation and curettage
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 prospective pregnancy report as received from a nurse refers to a 25 years old female patient for VARIVAX (Merck), a Pregnancy Registry product, concerning vaccine exposure during pregnancy. The patient was "5 and 1/2 weeks pregnant as of 31-OCT-2012". The patient''s history of previous pregnancies and live births is not known. It has been reported that the patient has no pertinent medical history and no drug reactions or allergies. The patient was vaccinated with VARIVAX (Merck) (dose and route not reported, lot number H006950, exp. date 16-MAR-2014) on 23-OCT-2012. No other co-suspects were reported. No concomitant medications were reported. Subsequently, the patient became pregnant with an estimated Last menstrual period (LMP) of 22-SEP-2012 and an Estimated Date of Delivery (EDD) of 30-JUN-13. Initial exposure to VARIVAX (Merck) was estimated at 5 week(s). The patient was exposed to VARIVAX (Merck) during trimester 1. On 23-OCT-2012 the patient received VARIVAX (Merck) while pregnant. The patient experienced no adverse event. No treatment information was reported. The outcome of received VARIVAX (Merck) while pregnant was unknown. The relatedness for VARIVAX (Merck) while pregnant and no adverse event was unknown. It has been reported that the patient saw a nurse in regards to the events. This follow-up was received from a Register Nurse who reported the patient had a miscarriage in an approximately December 2012 followed by a D&C (Dilation and Curettage) procedure on 28-DEC-2012. The reporter stated that there were ultrasound, genetic tests and home pregnancy test performed (no results and dates provided). The outcome and relatedness for VARIVAX (Merck) regarding to the patient''s events were not reported. Upon internal review, the patient''s event of miscarriage was considered to be an other important medical event. Additional information is not expected. 15-JUL-2013. This is a correction. The ''as reported causality'' for the event of drug exposure during pregnancy was updated to ''not related''.

VAERS ID:496975 (history)  Vaccinated:2013-07-16
Age:25.0  Onset:2013-07-16, Days after vaccination: 0
Gender:Female  Submitted:2013-07-17, Days after onset: 1
Location:Wisconsin  Entered:2013-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tramadol 50 mg PO at 0800 same day.
Current Illness: None.
Preexisting Conditions: None known.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Diarrhoea, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Headache, nausea, diarrhea, body aches, joint pain.

VAERS ID:497351 (history)  Vaccinated:2013-06-27
Age:25.0  Onset:2013-06-27, Days after vaccination: 0
Gender:Male  Submitted:2013-07-18, Days after onset: 21
Location:California  Entered:2013-07-22, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccination. Any allergies or pre-existing conditions were unknown.
Diagnostic Lab Data: None
CDC Split Type: 201307781
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4366AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia, Hyporeflexia, Weight bearing difficulty
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Initial report was received from a healthcare professional on 12 July 2013. A 25-year-old male patient received an intramuscular injection in the left deltoid of ADACEL (lot number C4366AA) on 27 June 2013. By the afternoon of the same day, the patient''s left hand and foot became numb. The symptoms were progressing, as the patient could not bear weight and had decreased reflexes of the left foot. No other symptoms were reported. The patient had no illness at the time of vaccination. There were no relevant diagnostic tests or labs. Any allergies or pre-existing conditions were unknown. The patient''s outcome was reported as not recovered. Documents held by sender: None.

VAERS ID:497583 (history)  Vaccinated:2013-07-06
Age:25.0  Onset:2013-07-07, Days after vaccination: 1
Gender:Male  Submitted:2013-07-24, Days after onset: 17
Location:Maryland  Entered:2013-07-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 7/06/2013~Rabies (Rabivac)~2~25.00~Patient
Other Medications:
Current Illness: Cat bite-on antibiotic-Amoxicillin
Preexisting Conditions: None per client
Diagnostic Lab Data: Client takes Amoxicillin at same time - pt stated GI diarrhea from that - stopped 7/9 - diarrhea did improve
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABIVAC)NOVARTIS VACCINES AND DIAGNOSTICS519011C3IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Diarrhoea, Dizziness, Influenza like illness, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Client called 7/24 as he had received 4 dose treatment and client c/o of nausea, "feeling achy like the flu", lightheadedness about 24 hr after 7/6 vaccination - 24 hr later client stated and symptoms a24 hr after 7/10 and 7/17 (nausea and flu like achy ness")

VAERS ID:498007 (history)  Vaccinated:2013-07-16
Age:25.0  Onset:2013-07-16, Days after vaccination: 0
Gender:Female  Submitted:2013-07-30, Days after onset: 14
Location:Unknown  Entered:2013-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1307USA012407
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H019992 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a medical assistant refers to a 25 year old female patient. On 16-JUL-2013 the patient was vaccinated with PNEUMOVAX23, 0.5 ml, intramuscular in the right arm. Lot number H019992, expiry date 09-DEC-2013. On 16-JUL-2013, the patient experienced redness, swelling and pain at the injection site of her right arm. The patient called the clinic on 17-JUL-2013 to report the reactions. The patient was instructed to apply some ice to her injection site and use Ibuprofen to reduce the swelling and pain. The patient was seen by the medical staff at the clinic on 18-JUL-2013. After she was seen in the clinic the patient was prescribed Cephalexin. The outcome of the events was reported as recovering/resolving. Causality assessment was not provided. Additional information is not expected.

VAERS ID:498509 (history)  Vaccinated:2013-08-02
Age:25.0  Onset:2013-08-04, Days after vaccination: 2
Gender:Female  Submitted:2013-08-05, Days after onset: 1
Location:North Carolina  Entered:2013-08-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Large Rash~Varicella (no brand name)~1~25.00~Patient
Other Medications: Wellbutrin 150mg; Klonopin 1mg/ 2x per day
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Weakness, chills, fatigue 8/4-8/5. Intense itching all over body 8/5.

VAERS ID:498520 (history)  Vaccinated:2013-08-05
Age:25.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Female  Submitted:2013-08-05, Days after onset: 0
Location:Michigan  Entered:2013-08-05
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 (ADACEL)SANOFI PASTEURU4646AA UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Dizziness, Feeling hot, Head discomfort, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Pt. fell dizzy, felt hot, queasy, almost felt if would have diarrhea, head felt heavy. Gave pt. cold water to drink and cool compress to apply to face and neck. Reaction happened almost immediately. Within less than 5 minutes she felt better. No dizziness, queasiness, cooled off etc, but started headache. Had butalbital already prescribed and she will take it when she gets home.

VAERS ID:498545 (history)  Vaccinated:2013-07-23
Age:25.0  Onset:2013-07-24, Days after vaccination: 1
Gender:Male  Submitted:2013-07-26, Days after onset: 2
Location:Texas  Entered:2013-08-05, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Yes, TYLENOL 500mg
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA120261IMRA
Administered by: Other     Purchased by: Public
Symptoms: Activities of daily living impaired, Fatigue, Lethargy, Musculoskeletal stiffness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: "Fever couldn''t open eyes", fatigue, lethargy, can''t go to work. Stiff neck.

VAERS ID:498813 (history)  Vaccinated:2009-03-31
Age:25.0  Onset:2009-03-31, Days after vaccination: 0
Gender:Male  Submitted:2013-08-08, Days after onset: 1591
Location:Texas  Entered:2013-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None, no medications were taken
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1590SC 
Administered by: Military     Purchased by: Military
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient reports developing hives across forehead and bilateral upper lateral arms.

VAERS ID:498880 (history)  Vaccinated:2013-07-18
Age:25.0  Onset:2013-07-18, Days after vaccination: 0
Gender:Male  Submitted:2013-08-08, Days after onset: 21
Location:California  Entered:2013-08-08
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV322A0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ120110IMRA
Administered by: Military     Purchased by: Military
Symptoms: Balance disorder, Nausea, Visual impairment
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Nausea, coning down of vision, loss of balance.

VAERS ID:499131 (history)  Vaccinated:2012-08-01
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-08-10
Location:Unknown  Entered:2013-08-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins (unspecified)
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1302USA001376
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Maternal exposure before pregnancy
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 25 years old female patient with no pertinent medical history and no drug allergies. On an unknown date in August 2012 (reported as sometime at the end of August 2012, which was four to five weeks before the patient became pregnant), the patient was vaccinated with a dose of M-M-R II (Lot number, expiry date and dose were not reported). Concomitant medications included: vitamins (unspecified) (Prenatal vitamins). Subsequently, the patient became pregnant (first pregnancy) with a last menstrual period (LMP) of 21-SEP-2012 and an estimated date of delivery (EDD) of 28-JUN-2013. The patient was exposed to M-M-R II during trimester 1 and 2. None of the laboratory test was performed. At the time of the report the patient was about 19 weeks pregnant. The patient sought medical attention (had called the reporting pharmacist). The outcome of pregnancy was unknown (outcome pending). Additional information is not expected.

VAERS ID:499307 (history)  Vaccinated:2010-08-05
Age:25.0  Onset:2010-08-06, Days after vaccination: 1
Gender:Female  Submitted:2013-08-13, Days after onset: 1103
Location:Washington  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Celexa, doxy, Zyrtec, Benadryl, hydroxyzine
Current Illness: No
Preexisting Conditions: Anxiety, depression, panic disorder, vitiligo, eczema
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Feeling cold, Hyperaesthesia, Influenza like illness, Injection site reaction, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Flu-like weakness, pins and needles, tingling feelings, difficulty staying warm, sensitivity to touch (like when you''re sick and just sitting on a hard chair is painful). Symptoms subsided somewhat, and then after each shot (cause it takes 3 for Gardasil) was administered they would come back. 1 year after having the last shot I found I no longer had symptoms. Pain and weakness/tingling/pins and needles especially at the injection site, not necessarily when the rest of the body had the same symptoms. I also found that these vaccinations became progressively more painful - the first one hurt more than vaccines or shots usually do, the second one was worse and the third was like "holy fucking shit, are you injecting me with acid?" - I have a high pain tolerance too so I''m not just bitching.

VAERS ID:499416 (history)  Vaccinated:2009-01-02
Age:25.0  Onset:2009-01-02, Days after vaccination: 0
Gender:Female  Submitted:2013-08-15, Days after onset: 1685
Location:New York  Entered:2013-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: Allergic to Naproxen
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0SYRRA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Epistaxis, Fatigue, Gait disturbance, Immediate post-injection reaction, Immune system disorder, Vision blurred, Visual impairment
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Immediately after receiving the vaccine GARDASIL, my vision blurred and went dark. I had to receive help walking to the car as I felt I was about to faint. Over the next 3 weeks, I experienced extreme fatigue and a weakened immune system. Frequent nose bleeds occurred which has never happened before.

VAERS ID:499684 (history)  Vaccinated:2013-08-13
Age:25.0  Onset:2013-08-15, Days after vaccination: 2
Gender:Female  Submitted:2013-08-16, Days after onset: 1
Location:Washington  Entered:2013-08-16
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: Allergy to fluoxetine(sp?)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Local swelling, Lymph node pain, Tenderness
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tenderness above left collar bone. Feels like sore lymph node. Next morning that area was even more tender and was swollen.

VAERS ID:499954 (history)  Vaccinated:2013-08-12
Age:25.0  Onset:2013-08-12, Days after vaccination: 0
Gender:Female  Submitted:2013-08-20, Days after onset: 8
Location:Texas  Entered:2013-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin; Ultracet
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None yet
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABA06413 UNLA
Administered by: Private     Purchased by: Other
Symptoms: Muscular weakness, Pain, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Patient c/o burning pain/weakness/tingling of left arm since vaccination was given. Denies ny local reaction (redness, swelling, etc) at site of vaccination. Further workup and treatment in progress.

VAERS ID:500082 (history)  Vaccinated:2013-08-21
Age:25.0  Onset:2013-08-21, Days after vaccination: 0
Gender:Female  Submitted:2013-08-22, Days after onset: 1
Location:California  Entered:2013-08-22
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: Vital signs stable and afebrile with no significant injection site reaction.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH891AA0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cough, Dysphonia, Lip swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Parkinson-like events (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hoarseness at 02:00 PM and continuing; cough beginning at 3:00 PM; lip swelling beginning at 08:00 PM; treated by urgent care physician (reporting) at 08:45 PM.

VAERS ID:500184 (history)  Vaccinated:2013-07-19
Age:25.0  Onset:2013-08-19, Days after vaccination: 31
Gender:Female  Submitted:2013-08-22, Days after onset: 3
Location:Mississippi  Entered:2013-08-22
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: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0172440SCRA
Administered by: Other     Purchased by: Private
Symptoms: Blister, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash to ankles, legs, cheek fluid filled vesicles.

VAERS ID:500427 (history)  Vaccinated:2013-08-22
Age:25.0  Onset:2013-08-22, Days after vaccination: 0
Gender:Female  Submitted:2013-08-22, Days after onset: 0
Location:Florida  Entered:2013-08-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1307601 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Nausea, Pruritus, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Nausea, vomiting, headache, itching. Shot given at 1pm now 5pm.

VAERS ID:500634 (history)  Vaccinated:2013-08-16
Age:25.0  Onset:0000-00-00
Gender:Male  Submitted:2013-08-27
Location:Illinois  Entered:2013-08-27
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: Titers drawn for antibodies to M-M-R II: equivocal
CDC Split Type: WAES1308USA008676
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test abnormal
SMQs:, Vasculitis (broad), Hypersensitivity (broad)
Write-up: This spontaneous report as received from a physician refers to his now 25 year old son with no medical history or drug reactions/allergies. The patient was administered "two doses of M-M-R II on unspecified dates as per recommended timing when he was a child. He had titers drawn for antibodies to M-M-R when was an undergraduate student on an unspecified date and the results were equivocal. He was now applying to medical school and the medical school would not accept the equivocal titer results." Subsequently, the patient had a third dose of M-M-R II (lot #, expiration, route unspecified) administered on 16-AUG-2013. No concomitant medication. No treatment was given. At the time of report, the outcome of the event was unknown. Additional information has been requested.

VAERS ID:501137 (history)  Vaccinated:2003-07-28
Age:25.0  Onset:2003-08-22, Days after vaccination: 25
Gender:Female  Submitted:2013-08-29, Days after onset: 3660
Location:Unknown  Entered:2013-08-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Extensive and normal. Diagnostic tests negative, except for pulmonary CT showing nodules. May have Constrictive Bronchiolitis also.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV071 UNUN
Administered by: Military     Purchased by: Military
Symptoms: Activities of daily living impaired, Autonomic nervous system imbalance, Chronic fatigue syndrome, Computerised tomogram thorax abnormal, Laboratory test normal, Pulmonary mass, Upper respiratory tract infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: Developed chronic fatigue syndrome and dysautonomia symptoms temporally associated with receipt of Anthrax #4 and also had prolonged URI. Symptoms waxed and waned over the next years and now reports continuous symptoms with a great impact on daily functioning.

VAERS ID:501077 (history)  Vaccinated:2013-08-01
Age:25.0  Onset:2013-08-02, Days after vaccination: 1
Gender:Female  Submitted:2013-09-02, Days after onset: 31
Location:Massachusetts  Entered:2013-09-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No, but I got the TDAP vaccination shot 1 day previously.
Preexisting Conditions: No
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTDUNKNOWN0PO 
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Dizziness, Fatigue, Menstruation delayed
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad), Fertility disorders (broad)
Write-up: Extreme fatigue, some dizziness, lasted for multiple days. Not bad enough to skip work but was not very productive during, avoided extra activities and slept instead. Also delayed my period by 7 days.

VAERS ID:501420 (history)  Vaccinated:2013-08-30
Age:25.0  Onset:2013-08-31, Days after vaccination: 1
Gender:Female  Submitted:2013-09-04, Days after onset: 4
Location:North Carolina  Entered:2013-09-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Topamaz; BCP; Celexa
Current Illness: None
Preexisting Conditions: Allergic to E-mipin
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4646AA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site joint pain, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Redness, swelling, and pain at injection site. Pain into shoulder joint.

VAERS ID:501707 (history)  Vaccinated:2013-08-26
Age:25.0  Onset:2013-08-29, Days after vaccination: 3
Gender:Female  Submitted:2013-09-06, Days after onset: 8
Location:Minnesota  Entered:2013-09-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4655AA IMAR
Administered by: Public     Purchased by: Other
Symptoms: Diarrhoea, Local swelling, Nausea, Pain in extremity, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (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), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Arm pain and swelling, nausea and vomiting, diarrhea, fever.

VAERS ID:502293 (history)  Vaccinated:2013-09-09
Age:25.0  Onset:2013-09-11, Days after vaccination: 2
Gender:Male  Submitted:2013-09-12, Days after onset: 1
Location:Massachusetts  Entered:2013-09-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Provigil (Modafinil)100mg/daily Vitamin D 4000 IU/daily
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMLA
Administered by: Private     Purchased by: Public
Symptoms: Herpes virus infection, Oral herpes, Simplex virus test positive
SMQs:, Oropharyngeal infections (narrow)
Write-up: Facial Herpes Breakout in multiple spots. Patient has tested positive for herpes simplex type 1 and has experienced mild outbreaks (cold sores) around 1-2 times/year. Reports possible facial herpes outbreaks when young (4-7) however is unsure.

VAERS ID:502706 (history)  Vaccinated:2013-09-04
Age:25.0  Onset:2013-09-07, Days after vaccination: 3
Gender:Male  Submitted:2013-09-16, Days after onset: 9
Location:Washington  Entered:2013-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0OTLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH670AA0SCRA
Administered by: Military     Purchased by: Military
Symptoms: Activities of daily living impaired, Fatigue, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt experienced fever, body aches, extreme fatigue, headaches. Missed 1 day off of work and caused to him to go home early on 2nd day. Had sx''s for 3 days.

VAERS ID:502728 (history)  Vaccinated:2013-09-13
Age:25.0  Onset:2013-09-14, Days after vaccination: 1
Gender:Female  Submitted:2013-09-16, Days after onset: 2
Location:Virginia  Entered:2013-09-16
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: Allergies: Keflex, Bactrim, Neosporin, Adhesive Tapes Conditions: Postural Orthostatic Tachycardia Syndrome, Depression/Anxiety, allergies.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR 0IDRA
Administered by: Other     Purchased by: Other
Symptoms: Glossodynia, Lip blister, Lip exfoliation, Lip pain, Lip swelling, Oedema mouth, Oral discomfort, Oral pain, Pruritus, Swollen tongue, Tonsillar disorder
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: My lips started burning and itching. They then became swollen and painful. The tonsils on the back of my tongue hurts. On Sunday (9/14), my outer and inner lips had purple and red blisters. Today, 9/15, the skin is peeling off my lips. My inner checks and tongue hurt and feel a little swollen. My lips hurt very bad.

VAERS ID:502847 (history)  Vaccinated:2008-02-01
Age:25.0  Onset:2008-09-13, Days after vaccination: 225
Gender:Female  Submitted:2013-09-17, Days after onset: 1830
Location:Texas  Entered:2013-09-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypo thyroid
Diagnostic Lab Data: Did multiple biopsies and a lot of blood work. Removed lymph nodes, was tested for cancer, was told I had cancer, etc.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.   RA
Administered by: Public     Purchased by: Private
Symptoms: Biopsy, Blood test, Joint swelling, Local swelling, Lymphadenectomy, Neoplasm malignant, Pruritus, Rash, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Malignant tumours (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: First noticed itching on right calf, then swelling of leg and ankle, then dark spots that wouldn''t go away. The first symptoms were shortly after the 3rd shot of the Gardasil series.

VAERS ID:502860 (history)  Vaccinated:2013-09-06
Age:25.0  Onset:2013-09-09, Days after vaccination: 3
Gender:Female  Submitted:2013-09-17, Days after onset: 8
Location:Massachusetts  Entered:2013-09-17
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4328AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Body temperature, Headache, Injection site erythema, Injection site swelling, Injection site warmth, Lethargy
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)
Write-up: Temperature, headache, lethargic with raised red area around injection site that was warm to touch.

VAERS ID:503068 (history)  Vaccinated:2013-08-19
Age:25.0  Onset:2013-08-19, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Hampshire  Entered:2013-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0555AE0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4612AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0023161SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Tdap and VARIVAX injection site became sore and warm on evening she received injection. Today Tdap site (L) deltoid red (55mm) VARIVAX site back of (L) arm red (44mm). Both areas warm and painful to touch. Arm sore with lifting. 8/28/13 sites have cleared - no redness /pain. Small bump at Tdap site per client.

VAERS ID:503555 (history)  Vaccinated:2013-08-15
Age:25.0  Onset:2013-08-17, Days after vaccination: 2
Gender:Male  Submitted:2013-09-21, Days after onset: 35
Location:Unknown  Entered:2013-09-21
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:
Diagnostic Lab Data:
CDC Split Type: WAES1309USA009238
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: This spontaneous report was received from a 26-year-old male pharmacy technician (also reported as healthcare worker and is also the patient) via a company representative. The patient had no pertinent medical history and drug reactions/allergies. On 15-AUG-2013 the patient was vaccinated with a dose 1, 0.5 milliliters (ml) GARDASIL (lot#, expiration date not reported) intramuscularly (reported ''route as directed''). Approximately on 17-AUG-2013 (reported as 2 days after receiving the vaccine) the patient became very sleepy and tired. The events resolved on an unspecified date in 2013. Treatment was not rendered for the events. No laboratory diagnostic studies were performed for the events. Medical attention was not sought by the patient. Causality was not reported. Additional information has been requested.

VAERS ID:503402 (history)  Vaccinated:2012-09-20
Age:25.0  Onset:2013-09-20, Days after vaccination: 365
Gender:Male  Submitted:2013-09-22, Days after onset: 2
Location:California  Entered:2013-09-22
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: Possibly allergic to penicillin.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Public     Purchased by: Public
Symptoms: Back pain, Chest pain, Cold sweat, Headache, Mobility decreased, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Loss of mobility in arm followed by aches in chest, back, arms, hands, and head. Also, sharp pains in back of head area and cold sweats. Arm still has minimal mobility and headache persists but other symptoms have subsided.

VAERS ID:503677 (history)  Vaccinated:2013-09-13
Age:25.0  Onset:2013-09-13, Days after vaccination: 0
Gender:Male  Submitted:2013-09-14, Days after onset: 1
Location:Virginia  Entered:2013-09-23, 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: Unknown
Current Illness: None
Preexisting Conditions: Diabetes
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1307701 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Trismus
SMQs:, Dystonia (narrow)
Write-up: Lock jaw reported.

VAERS ID:503800 (history)  Vaccinated:2013-09-01
Age:25.0  Onset:2013-09-01, Days after vaccination: 0
Gender:Female  Submitted:2013-09-24, Days after onset: 23
Location:New Jersey  Entered:2013-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: waes1309usa005589
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMLG
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Injection site swelling, Pain, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This spontaneous report as received from a physician refers to an approximately 25 year old female nurse with no pertinent medical history. On 01-SEP-2013 the patient was vaccinated with a dose of GARDASIL, injection (lot #, expiration, dose unspecified), intramuscularly in the lower aspect of the lateral side of an unspecified leg. In September 2013 the patient complained of pain and swelling when walking. Physician stated after the injectio non 01-SEP-2013, the nurse stated the injection site hurt and the pain had progressively been getting worse along with swelling. The reporter also stated that the patient had experienced a rash from amoxicillin (manufacturer unknown) and LEVAQUIN. No lab diagnostics studies performed. The patient sought medical attention via office visit. No treatment was given. The event outcome was reported as not recovered. Additional information has been requested.

VAERS ID:504013 (history)  Vaccinated:2012-02-24
Age:25.0  Onset:2012-02-24, Days after vaccination: 0
Gender:Female  Submitted:2013-09-24, Days after onset: 577
Location:North Carolina  Entered:2013-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALLEGRA-D 12 hour
Current Illness: Hypersensitivity, Continuing
Preexisting Conditions:
Diagnostic Lab Data: Pregnancy test, Positive, Home pregnancy test positive; 03/09/2012, Diagnostic, Not yet completed. Reassurance patient GARDASIL exposure
CDC Split Type: WAES1203USA00342
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1668AA0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Exposure during pregnancy, Pregnancy test positive
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a licensed practical nurse, for GARDASIL, a Pregnancy Registry product, concerning a 25 year old female patient with no drug reactions or allergies and no pertinent medical history who on 24-FEB-2012, was vaccinated with a first dose of GARDASIL 0.5 ml, intramuscular (lot number reported as 1668AA, expiration date 15-AUG-2014). Concomitant therapy included ALLEGRA-D 12 hour. There was no treatment given for receiving the first dose of GARDASIL and being pregnant by the patient. It was reported that the patient was pregnant. On an unknown date, home pregnancy test was performed with positive result. The patient''s last menstrual period was on 31-JAN-2012. Estimated delivery date would be 06-NOV-2012. Follow-up information has been received from a licensed practical nurse for GARDASIL, a Pregnancy Registry product, concerning a 25 year old female patient with a history of one previous pregnancies and one full term deliveries and unknown obstetric history of birth defects or infant complications in previous pregnancies, who on 24-FEB-2012, was vaccinated with a first dose of GARDASIL. Concomitant therapy included ALLEGRA-D 12 hour for the treatment of allergies, and reporter was unsure it was taken afternoon (PM) by the patient. Ultrasound test was scheduled on 09-MAR-2012 to reassurance patient''s GARDASIL exposure. It was not completed at the time of the report. A follow-up information has been received from a nurse, who reported that the patient was no longer with the practice. Additional information is not expected.

VAERS ID:504027 (history)  Vaccinated:2013-09-24
Age:25.0  Onset:2013-09-25, Days after vaccination: 1
Gender:Female  Submitted:2013-09-25, Days after onset: 0
Location:South Carolina  Entered:2013-09-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: AVIANE - BCP
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0035300SCUN
Administered by: Private     Purchased by: Other
Symptoms: Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5 red bumps on left/back.

VAERS ID:504307 (history)  Vaccinated:2013-09-25
Age:25.0  Onset:2013-09-26, Days after vaccination: 1
Gender:Female  Submitted:2013-09-26, Days after onset: 0
Location:Pennsylvania  Entered:2013-09-26
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: Allergic to Ceclor
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Body temperature increased, Gait disturbance, Musculoskeletal discomfort, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: About 12 hours after receiving the vaccine I developed a temperature of ~101 that is not responding to NSAIDS. Muscles are achy. Joints are achy. Hips feel out of place. Difficult to walk. Comparable to actually having the flu, if not worse.

VAERS ID:504658 (history)  Vaccinated:2013-09-03
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-09-29
Location:California  Entered:2013-09-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: FLEXERIL
Current Illness: Hypersensitivity, unspecified reaction
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1309USA009258
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0056790IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Injection site pruritus, Injection site swelling, Lymph node pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This spontaneous report was received from a physician refers to a 25 year old female patient with vitamin C allergy (unspecified reaction) and no pertinent medical history. On 03-SEP-2013 the patient was vaccinated with 0.5 milliliters (ml), dose 1 GARDASIL (lot # J005679, expiration date 27-NOV-2015)intramuscularly in the left deltoid. Concomitant therapies included FLEXERIL. On an unknown date in September 2013 she developed a large area of tenderness and swelling at the injection site that was also itchy. The patient also reported having tender axillary and mandibular lymph nodes. The physician called into the physicians office on 06-SEP-2013 to report this event. The patient was seen by the physician on 10-SEP-2013 at which time she declined medication for treatment. The physician stated when he saw the patient, on 10-SEP-2013 she "seemed fine and was recovered". Laboratory diagnostic studies were not performed for this event. Additional information has been requested.

VAERS ID:504829 (history)  Vaccinated:2013-09-27
Age:25.0  Onset:2013-09-27, Days after vaccination: 0
Gender:Female  Submitted:2013-09-30, Days after onset: 3
Location:Louisiana  Entered:2013-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: n/a
Current Illness: None.
Preexisting Conditions: None
Diagnostic Lab Data: n/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH907AD IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Patient''s whole arm began to tingle and then became weak. Soon after the patient began to experience extreme pain.

VAERS ID:505023 (history)  Vaccinated:2013-09-26
Age:25.0  Onset:2013-09-26, Days after vaccination: 0
Gender:Male  Submitted:2013-10-01, Days after onset: 5
Location:New York  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13394P IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypersensitivity, Pruritus, Rash, Rash papular
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient came in to get the annual influenza vaccine at 10:30 am. At 11:20 am he complains of itching arms, neck, and chest-similar reaction to morphine in the past. Blood pressure and Pulse regular. Patient declined Benadryl due to excessive drowsiness. One hour later patient seen at E.D. due to allergic reaction involving itching and minimal raised papular rash on arms. No wheezing, SOB, or voice changes. Patient discharged with Pepcid 20 mg every 12 hours, and Benadryl 25 mg 2 capsules every 6 hours as needed for itching.

VAERS ID:505041 (history)  Vaccinated:2013-09-16
Age:25.0  Onset:2013-09-16, Days after vaccination: 0
Gender:Male  Submitted:2013-09-20, Days after onset: 4
Location:Ohio  Entered:2013-10-01, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR528074IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Oropharyngeal pain, Pain, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: I got a flu shot on Monday 9/16/13 at 11am. As the day progress, I started to have a runny nose. As I got off from work at 11pm, my throat became sore. Tuesday my body began to ache. Wednesday I went to my family doctor. Had warmth, tenderness, swelling and erythema at injection site, resolving.

VAERS ID:505071 (history)  Vaccinated:2013-10-01
Age:25.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Female  Submitted:2013-10-01, Days after onset: 0
Location:Rhode Island  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 200mg PO Q day HS; Ranitadine 300mg PO Q day HS
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Headache, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Severe headache and dizziness, low-grade fever, general malaise occurring within a half-hour of receiving 2nd dose of Gardasil vaccination.

VAERS ID:505095 (history)  Vaccinated:2013-09-28
Age:25.0  Onset:2013-09-28, Days after vaccination: 0
Gender:Female  Submitted:2013-10-01, Days after onset: 3
Location:Illinois  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Microgestin FE 1/20
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4723AA0IDLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 5 cm red, raised, bump at injection sign associated with pain at site starting 9/28/2013. Symptoms started to subside on 10/01/2013.

VAERS ID:505104 (history)  Vaccinated:2013-10-01
Age:25.0  Onset:2013-10-02, Days after vaccination: 1
Gender:Female  Submitted:2013-10-02, Days after onset: 0
Location:Indiana  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR557080IMRA
Administered by: Public     Purchased by: Other
Symptoms: Bronchospasm, Cough, Dysphagia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Coughing, airway felt tight, hard to swallow.

VAERS ID:505279 (history)  Vaccinated:2013-10-01
Age:25.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Female  Submitted:2013-10-02, Days after onset: 1
Location:Connecticut  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR546074IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling at site no warmth at site several hrs after inject. No itch. No systemic s/s.

VAERS ID:505281 (history)  Vaccinated:2013-09-25
Age:25.0  Onset:2013-09-26, Days after vaccination: 1
Gender:Female  Submitted:2013-09-27, Days after onset: 1
Location:Michigan  Entered:2013-10-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: LEVAQUIN allergy
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH898AD UNRA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Injection site erythema, Injection site warmth, Nausea, Pruritus, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 9 x 5 cm red warm area on (R) upper arm. Nausea, vomiting, low grade fever, pulse 96. Itching to (R) arm, diarrhea.

VAERS ID:505290 (history)  Vaccinated:2013-10-01
Age:25.0  Onset:2013-10-02, Days after vaccination: 1
Gender:Male  Submitted:2013-10-02, Days after onset: 0
Location:Michigan  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Finished last dose of a 10 course of Keflex on 9/30/13
Current Illness: None
Preexisting Conditions: Finished 10 day prescription of Keflex for cyst
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS45BL3 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed small red spots somewhat itchy rash on wrists, ankles, and back.

VAERS ID:505564 (history)  Vaccinated:2013-09-30
Age:25.0  Onset:2013-09-30, Days after vaccination: 0
Gender:Female  Submitted:2013-10-03, Days after onset: 3
Location:Virginia  Entered:2013-10-03
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: PCN, Moxifloxacin Hcl, Azithromycin, Oseltamivir, latex, seafood, peanuts, broccoli, cauliflower, celery
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Headache, Migraine, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Monday: Dizziness and headache. Tuesday: Fever and migraine. Wednesday: Migraine. Thursday: Dizziness and migraine. Took either Tylenol, Ibuprofen, or Excedrin without much luck from any of them.

VAERS ID:505705 (history)  Vaccinated:2013-10-01
Age:25.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Female  Submitted:2013-10-03, Days after onset: 2
Location:New York  Entered:2013-10-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU4472AA6UNRA
Administered by: Public     Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site urticaria, Injection site vesicles, Malaise, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 10-1-13 Pt. rec''d Quadrivalent FLUZONE Vaccine. Immediately c/o itching. 5 min. later - sm. blisters (hives) formed next to injection site. BENADRYL 50 adm. into other deltoid. Itching subsided. Pt. returned home and medicated self with BENADRYL again. No further itching. 10-2-13, general malaise and body aches - relieved with ADVIL.

VAERS ID:505755 (history)  Vaccinated:2013-09-28
Age:25.0  Onset:2013-09-28, Days after vaccination: 0
Gender:Female  Submitted:2013-10-02, Days after onset: 4
Location:Colorado  Entered:2013-10-04, Days after submission: 2
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NORTREL
Current Illness: None
Preexisting Conditions: Sulfa allergy
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH899AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Hypersensitivity, Hypoaesthesia, Respiratory tract inflammation, Tachycardia, Throat tightness, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt. went home and took nap after vaccination. Woke up several hours later with throat closing. Went to ER with severe allergic reaction including numbness from waist-up, blurry vision, tachycardia, inflamed airway and extreme shortness of breath. Was treated with BENADRYL and IV steroids. Was released when symptoms resolved.

VAERS ID:505921 (history)  Vaccinated:2013-10-05
Age:25.0  Onset:2013-10-05, Days after vaccination: 0
Gender:Female  Submitted:2013-10-06, Days after onset: 1
Location:Maryland  Entered:2013-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR55608 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness, Feeling hot
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Pt had syncope signs. She started feeling warm, dizzy, lightheaded. Helped her lay flat on the floor - felt better after 5 min''s. called 911 for medical help. Called pt 2 hrs after she was doing ok.

VAERS ID:506323 (history)  Vaccinated:2013-10-01
Age:25.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Female  Submitted:2013-10-08, Days after onset: 7
Location:Virginia  Entered:2013-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: No illness.
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4771AA3IMRA
Administered by: Military     Purchased by: Public
Symptoms: Headache, Nausea, Pain, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Aches, fever, shakes, nausea, headache Tylenol extra strength.

VAERS ID:506326 (history)  Vaccinated:2013-10-05
Age:25.0  Onset:2013-10-05, Days after vaccination: 0
Gender:Male  Submitted:2013-10-08, Days after onset: 3
Location:Michigan  Entered:2013-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tri-previfem, Effexor 37.5mg, Buspar 5mg
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Local swelling, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Arm became red, swollen, and very hot to touch.

VAERS ID:506484 (history)  Vaccinated:2013-09-05
Age:25.0  Onset:2013-09-06, Days after vaccination: 1
Gender:Male  Submitted:2013-09-30, Days after onset: 24
Location:Pennsylvania  Entered:2013-10-08, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillin allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13076010IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Brain oedema, Confusional state, Injection site erythema, Injection site swelling, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypoglycaemia (broad)
Write-up: Patient had redness and swelling at injection site, followed by increased pain and confusion. Patient reported to ER and was told that he had edema of the brain. He was given ibuprofen, the swelling came down and everything was normal after 2 days.

VAERS ID:506752 (history)  Vaccinated:2013-10-08
Age:25.0  Onset:2013-10-08, Days after vaccination: 0
Gender:Female  Submitted:2013-10-09, Days after onset: 1
Location:Georgia  Entered:2013-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1307801 IMRA
Administered by: Other     Purchased by: Military
Symptoms: Local swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling of arm, took 25 mg of Benadryl and subsided.

VAERS ID:506999 (history)  Vaccinated:2013-10-08
Age:25.0  Onset:2013-10-09, Days after vaccination: 1
Gender:Female  Submitted:2013-10-11, Days after onset: 2
Location:Maine  Entered:2013-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known or reported
Preexisting Conditions: None known or reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH910AC0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site inflammation, Injection site pain, Injection site swelling, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was treated at Medical Center for inflammation and pain at the injection site, swelling of the left arm distal to injection site, fever and vomiting.

VAERS ID:507086 (history)  Vaccinated:2013-10-08
Age:25.0  Onset:2013-10-11, Days after vaccination: 3
Gender:Female  Submitted:2013-10-11, Days after onset: 0
Location:New York  Entered:2013-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patches for pain
Current Illness: Yes, I am a cancer patient and was getting chemo at the time.
Preexisting Conditions: Adrenal cancer
Diagnostic Lab Data: Had to call doctor''s office, said it was from flu shot.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED 1  
Administered by: Private     Purchased by: Other
Symptoms: Abasia, Arthralgia, Back pain
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Pain in joints and lower back, can''t walk, in lots of pain.

VAERS ID:507478 (history)  Vaccinated:2013-09-30
Age:25.0  Onset:2013-09-30, Days after vaccination: 0
Gender:Female  Submitted:2013-10-10, Days after onset: 10
Location:Unknown  Entered:2013-10-11, 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: Vitamins
Current Illness: Prophylaxis; Asthma
Preexisting Conditions: Sexually transmitted disease
Diagnostic Lab Data:
CDC Split Type: WAES1310USA001760
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
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: Information has been received from Licensed Practical Nurse concerning a 25 year old female patient with asthma and a medical history of sexual transmitted disease who on 26-JUN-2013 was vaccinated with a first dose of GARDASIL (dose, route and lot # not provided) an on 30-SEP-2013 at 14 weeks of pregnancy was vaccinated with a second dose of GARDASIL (dose, route and lot # not provided). Concomitant therapies included influenza virus vaccine (unspecified) (manufacturer by Sanofi) and prenatal vitamins (unspecified)). The patient became pregnant with LMP of 24-JUN-2013 and EDD of 31-MAR-2014. There was no treatment given for the event. No adverse effect was reported. Additional information has been requested.

VAERS ID:507114 (history)  Vaccinated:2013-10-10
Age:25.0  Onset:2013-10-11, Days after vaccination: 1
Gender:Female  Submitted:2013-10-12, Days after onset: 1
Location:Unknown  Entered:2013-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Induration, Local swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Erythema, induration, itching, and local swelling. Majority of symptoms improved after second day.

VAERS ID:507192 (history)  Vaccinated:2013-04-01
Age:25.0  Onset:2013-04-01, Days after vaccination: 0
Gender:Female  Submitted:2013-10-14, Days after onset: 196
Location:Colorado  Entered:2013-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Latex
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0109150IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Rash
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pain and swelling, redness at site and also rash on same arm.

VAERS ID:507591 (history)  Vaccinated:2013-09-30
Age:25.0  Onset:2013-09-30, Days after vaccination: 0
Gender:Female  Submitted:2013-10-02, Days after onset: 2
Location:New York  Entered:2013-10-15, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH908AB IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Erythema, Local swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red, swollen hives on arms and legs 2 hours after vaccine reaction. Photos taken.

VAERS ID:507329 (history)  Vaccinated:2013-10-11
Age:25.0  Onset:2013-10-11, Days after vaccination: 0
Gender:Female  Submitted:2013-10-16, Days after onset: 5
Location:Wisconsin  Entered:2013-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS   LA
Administered by: Private     Purchased by: Other
Symptoms: Headache, Injection site erythema, Injection site rash, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Headache, red welt/rash around injection site.

VAERS ID:507339 (history)  Vaccinated:2013-10-03
Age:25.0  Onset:2013-10-03, Days after vaccination: 0
Gender:Female  Submitted:2013-10-16, Days after onset: 13
Location:California  Entered:2013-10-16
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: Egg protein
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08649211A4IMRA
Administered by: Military     Purchased by: Military
Symptoms: Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Nausea and vomiting.

VAERS ID:507573 (history)  Vaccinated:2013-10-16
Age:25.0  Onset:2013-10-16, Days after vaccination: 0
Gender:Female  Submitted:2013-10-17, Days after onset: 1
Location:Michigan  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Citalopram, fluticasone, and falmina
Current Illness: No
Preexisting Conditions: Depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Fatigue, Headache, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Difficulty breathing, soreness, nausea, headache, fever, and fatigue.

VAERS ID:507743 (history)  Vaccinated:2013-08-20
Age:25.0  Onset:2013-08-20, Days after vaccination: 0
Gender:Female  Submitted:2013-10-17, Days after onset: 58
Location:Kentucky  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 50 micrograms; TriNessa multivitamins
Current Illness: No
Preexisting Conditions: Hypothyroidism, premature ovarian failure
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Other
Symptoms: Anxiety, Arthralgia, Chest pain, Chills, Diarrhoea, Dizziness, Fatigue, Headache, Immediate post-injection reaction, Insomnia, Loss of consciousness, Muscle contractions involuntary, Muscular weakness, Myalgia, Nausea, Night sweats, Pain, Palpitations, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: 4-5 weeks of worsening symptoms of adverse reaction, including: blackout at time of injection, fatigue, light-headedness, headaches, cold chills, night sweats, diahrrea, achey muscles, insomnia, nausea, muscle fasciculations, weakness in arms, legs, and hands, vomiting, chest pains, anxiety, racing heartbeat, pain in joints, back, neck, legs, and head (temples, eyes, forehead), pain at injections site.

VAERS ID:508610 (history)  Vaccinated:2013-08-01
Age:25.0  Onset:0000-00-00
Gender:Female  Submitted:2013-10-18
Location:Unknown  Entered:2013-10-18
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: WAES1310USA002573
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
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 spontaneous prospective pregnancy report was received from a 25 year old female patient regarding herself. On an unknown date in August 2013 the patient was vaccinated with a dose of VARIVAX (Merck) (lot #, expiration date and route not reported). The patient reported that she was pregnant when she received VARIVAX (Merck). The patient discovered that she was pregnant on 01-OCT-2013. The Last Menstrual Period (LMP) and Estimated Delivery Date (EDD) is not known. Additional information is not expected.

VAERS ID:508655 (history)  Vaccinated:0000-00-00
Age:25.0  Onset:2013-09-01
Gender:Female  Submitted:2013-10-20, Days after onset: 49
Location:California  Entered:2013-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 09/01/2013, Human papilloma virus test, Positive; 2013, Smear cervix, Normal
CDC Split Type: WAES1310USA004528
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Colposcopy, Human papilloma virus test positive, Smear cervix normal
SMQs:
Write-up: This spontaneous report was received from a physician via a company representative refers to a 25-year-old female patient of unknown age with no pertinent medical history and drug reactions/allergies. On an unknown date in 2008 the patient who completed GARDASIL (20 micrograms(mcg) - 40 mcg-20mcg/0.5 ml 1 standard package vial of 0.5) (lot#, expiration date not reported) series, 0.5 milliliter (ml), intramuscularly. Concomitant medications included unspecified birth control pills. On an unknown date in 2013 (reported as recently) patient had Pap smear and HPV DNA test done. The Pap smear result came back normal but she tested positive for HPV 16 on an unknown date in September 2013. No additional information provided. Treatment was not rendered for the event. Additional laboratory investigations included Colposcopy (results pending). Patient sought medical attention by office visit. The event was not resolved at the time of this report. Causality was not reported. Additional information has been requested.

VAERS ID:508618 (history)  Vaccinated:2013-10-08
Age:25.0  Onset:2013-10-08, Days after vaccination: 0
Gender:Female  Submitted:2013-10-21, Days after onset: 13
Location:Colorado  Entered:2013-10-21
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) (FLUZONE)SANOFI PASTEURUH910AC IMRA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Right 5th finger has lateral numbness/tingling. No pain or change in appearance, no temperature change from rest of hand.

VAERS ID:508870 (history)  Vaccinated:2013-09-23
Age:25.0  Onset:2013-09-23, Days after vaccination: 0
Gender:Female  Submitted:2013-10-22, Days after onset: 29
Location:California  Entered:2013-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Did not state any complaints of illness
Preexisting Conditions: Did not state any pre-exisiting conditions
Diagnostic Lab Data: Unknow to this person
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC064AB4IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Defaecation urgency, Dysgeusia, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)
Write-up: She stated she had a funny taste in her mouth and needed to have a bowel movement and then she passed out.

VAERS ID:509176 (history)  Vaccinated:2013-09-13
Age:25.0  Onset:2013-09-14, Days after vaccination: 1
Gender:Female  Submitted:2013-10-23, Days after onset: 39
Location:New York  Entered:2013-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Fludrocortisone, atenolol, Singulair, Celexa, Ortho Cyclen.
Current Illness: NO
Preexisting Conditions: Postural Orthostatic Tachycardia Syndrome; Asthma
Diagnostic Lab Data: CT scan, x-ray, and ultrasound of arm showed nothing of significance. High white blood cell count.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH906AC10IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0129720IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Chills, Computerised tomogram normal, Injection site reaction, Myalgia, Pain, Pyrexia, Ultrasound scan normal, White blood cell count increased, X-ray limb normal
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Severe pain in muscle where injection was give. Fever, chills, and body aches.

VAERS ID:509188 (history)  Vaccinated:2011-05-15
Age:25.0  Onset:2011-05-24, Days after vaccination: 9
Gender:Male  Submitted:2013-10-23, Days after onset: 883
Location:Virginia  Entered:2013-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Preworkout supplements "C4"
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: PT diagnosed with "community acquired pneumonia"
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A  RA
Administered by: Other     Purchased by: Military
Symptoms: Chest pain, Dyspnoea, Middle insomnia, Pneumonia
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Chest pain, sob, pain woke him up from sleeping.

VAERS ID:509193 (history)  Vaccinated:2013-10-14
Age:25.0  Onset:2013-10-14, Days after vaccination: 0
Gender:Female  Submitted:2013-10-23, Days after onset: 9
Location:South Dakota  Entered:2013-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec 10mg po daily; Tri Previum oral contraceptive; Prenatal Vitamin
Current Illness: None
Preexisting Conditions: Nickel, grass
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4720AA0IDLA
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Injection site cellulitis, Injection site erythema, Lacrimation increased, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness around injection site, raised area measuring 5x6cm at the widest mark, then at 7:00pm, developed shortness of breath, itching ears, watery eyes. Nebulizer given to self and took Benadryl 50mg by mouth. On October 16th, 2013, redness developed into cellulitis on left forearm where injection was given. Treated with Keflex 500mg by mouth twice a day for 7 days. As of today''s date, 10/23/2013, left forearm is clear of any infection.

VAERS ID:509241 (history)  Vaccinated:2013-10-11
Age:25.0  Onset:2013-10-11, Days after vaccination: 0
Gender:Female  Submitted:2013-10-23, Days after onset: 12
Location:California  Entered:2013-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BH2029 IN 
Administered by: Public     Purchased by: Private
Symptoms: Disorientation, Dyspnoea, Hyperhidrosis, Nausea, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: While at lunch nausea, disorientation, diaphoresis, emesis, hives on face and difficulty breathing over course of 1 hour. Was taken to Urgent Care, where received Benadryl and medication for nausea. Went home and slept for 5 hours then felt fine.

VAERS ID:509352 (history)  Vaccinated:2013-10-23
Age:25.0  Onset:2013-10-24, Days after vaccination: 1
Gender:Female  Submitted:2013-10-24, Days after onset: 0
Location:New York  Entered:2013-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Crohn''s disease; allergy ANCEF
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR55608 UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0177590UNLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt. rec''d AFLURIA and PNEUMOVAX on 10/23/13 both in left arm. Late that evening, area became tender and swollen, spreading to underarm the next day.

VAERS ID:509463 (history)  Vaccinated:2013-10-23
Age:25.0  Onset:2013-10-24, Days after vaccination: 1
Gender:Male  Submitted:2013-10-24, Days after onset: 0
Location:Georgia  Entered:2013-10-24
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
DPP: DIPHTHERIA TOXOID + PERTUSSIS + IPV (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Private
Symptoms: Chills, Headache, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever of 102.7. Body aches, headache, and chills.

VAERS ID:509622 (history)  Vaccinated:2013-10-01
Age:25.0  Onset:2013-10-11, Days after vaccination: 10
Gender:Female  Submitted:2013-10-06, Days after onset: 5
Location:New Mexico  Entered:2013-10-25, Days after submission: 19
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: Hyperinsulinism
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1302901 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Injection site pain, Injection site swelling
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Painful injection site swelling - difficulty breathing.

VAERS ID:509951 (history)  Vaccinated:2013-10-20
Age:25.0  Onset:2013-10-20, Days after vaccination: 0
Gender:Female  Submitted:2013-10-22, Days after onset: 2
Location:Minnesota  Entered:2013-10-28, 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: Allergic to CECLOR; Migraines
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Migraine, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad)
Write-up: Shortness of breath, migraine, nausea, dizziness, severe pain in arm that got flu shot.

VAERS ID:510002 (history)  Vaccinated:2013-10-24
Age:25.0  Onset:2013-10-26, Days after vaccination: 2
Gender:Male  Submitted:2013-10-28, Days after onset: 2
Location:California  Entered:2013-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient states he is not currently taking any medications.
Current Illness: Lingering cold but he is ok now
Preexisting Conditions: No drug allergy
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR53807 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pruritus, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient experiences rash all over the body and itching, no other symptoms.

VAERS ID:510393 (history)  Vaccinated:2013-10-28
Age:25.0  Onset:2013-10-30, Days after vaccination: 2
Gender:Female  Submitted:2013-10-30, Days after onset: 0
Location:Michigan  Entered:2013-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS4E529 IMRA
Administered by: Public     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: Redness and slight swelling at site, warmth to touch.

VAERS ID:510411 (history)  Vaccinated:2013-10-25
Age:25.0  Onset:2013-10-25, Days after vaccination: 0
Gender:Female  Submitted:2013-10-30, Days after onset: 5
Location:Maryland  Entered:2013-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt received FluMist Quadrivalent by Medimmune -drop down did not have this listed.
Current Illness: NA
Preexisting Conditions: Allergic to Dilantin. PMH: seizure in July, 2013 and July, 2010. Current Medications: Klonopin, and med for HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BJ21090IN 
Administered by: Public     Purchased by: Public
Symptoms: Feeling of body temperature change, Headache, Rash, Rash pruritic, Sneezing
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: "Bad headache, sneezing, itchy rash over face, arms, back, and stomach. Also c/o feeling Hot and cold on and off. Benadryl 25 mg given to employee to take. She was concerned that it would make her too tired, so she only took one 12.5 mg tab while at work- said helped some. Stated she will take other 12.5 mg tab when she gets home. Pt plans to buy Benadryl and Caladryl clear.

VAERS ID:510436 (history)  Vaccinated:2013-10-28
Age:25.0  Onset:2013-10-29, Days after vaccination: 1
Gender:Female  Submitted:2013-10-30, Days after onset: 1
Location:California  Entered:2013-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
Administered by: Unknown     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site hypersensitivity, Injection site pain, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: High temperature, bad pain in injection site, redness, swelling, allergic reaction at injection site, Body chills, body aches. Went and seen a nurse who advised to ice injection site and take some Tylenol and to return to the Dr. who gave the shot if it doesn''t subside.

VAERS ID:510440 (history)  Vaccinated:2013-10-22
Age:25.0  Onset:2013-10-25, Days after vaccination: 3
Gender:Female  Submitted:2013-10-30, Days after onset: 5
Location:New York  Entered:2013-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4618AA1IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Rash at injection site.

VAERS ID:510461 (history)  Vaccinated:2013-05-08
Age:25.0  Onset:2013-05-08, Days after vaccination: 0
Gender:Female  Submitted:2013-10-30, Days after onset: 175
Location:California  Entered:2013-10-30
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: Blood tests, urine tests
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1IMAR
Administered by: Unknown     Purchased by: Private
Symptoms: Abdominal pain upper, Blood test, Chills, Erythema, Flushing, Headache, Malaise, Myalgia, Nausea, Pain in extremity, Pollakiuria, Pyrexia, Rash, Syncope, Tremor, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Rash/redness on arms, flushed in face and tremors in hand where vaccine administered. Severe stomach cramps, fainting, headache leg pain, chills, shakes, fever, aching muscles, frequent urination, feeling of throwing up and general feeling unwell. These symptoms occur 4-5 times per week.

VAERS ID:511051 (history)  Vaccinated:2013-11-02
Age:25.0  Onset:2013-11-02, Days after vaccination: 0
Gender:Male  Submitted:2013-11-02, Days after onset: 0
Location:North Carolina  Entered:2013-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Vomiting
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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