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Found 459176 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:217184 (history)  Vaccinated:2003-11-14
Age:50.0  Onset:2004-11-14, Days after vaccination: 366
Gender:Female  Submitted:2004-01-13, Days after onset: 306
Location:Alaska  Entered:2004-03-04, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Allergy to codeine and Emycin
Diagnostic Lab Data: UNK
CDC 'Split Type': AK200422
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1141AA3IMRA
Administered by: Other     Purchased by: Other
Symptoms: Pharyngeal oedema
SMQs:, Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Vaccine administer IM to pt. per pt''s requests. No problems with previous dose or allergy to egg products. Within 20-30 minutes pt experienced swelling of throat no difficulty breathing pt''s signs and symptoms resolved within the hour. Administering nurse not informed of reaction until over and hour later. No treatment given.

VAERS ID:217534 (history)  Vaccinated:2003-07-23
Age:50.0  Onset:2003-07-23, Days after vaccination: 0
Gender:Male  Submitted:2004-03-05, Days after onset: 226
Location:Unknown  Entered:2004-03-09, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0312USA00171
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Injection site nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: INJECTION SITE NODULE. Information has been received from a registered nurse concerning an "otherwise healthy" 50 year old black male who on 18JUN2003 and 23JUL2003 was vaccinated with a first and second dose of hepatitis B virus vaccine rHBsAg (yeast)(1st dose lot #644099/0835M; 2nd dose lot #1018N), respectively. After receipt of the second vaccination in his right arm, the patient developed a nodule at the injection site. It was not red, inflammed or painful for the patient. It was reported that this was discovered upon the patient''s return for a third vaccination. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested.

VAERS ID:217818 (history)  Vaccinated:2004-03-06
Age:50.0  Onset:2004-03-06, Days after vaccination: 0
Gender:Male  Submitted:2004-03-11, Days after onset: 5
Location:Florida  Entered:2004-03-16, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0712SCLA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Injection site induration, Malaise, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Localized induration, with tingling sensation of vaccinated site the night after. Also stomach cramp and generalized malaise.

VAERS ID:218047 (history)  Vaccinated:2003-10-20
Age:50.0  Onset:2004-10-27, Days after vaccination: 373
Gender:Female  Submitted:2004-03-01, Days after onset: 239
Location:Michigan  Entered:2004-03-23, Days after submission: 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: Many environmental allergies. Mold ASA Sulfa.
Diagnostic Lab Data: IgA confirmed by multiple biopsies.
CDC 'Split Type': MI2004018
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG5379H40IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dermatitis, Immune system disorder, Laboratory test abnormal, Oedema, Skin nodule, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 1 week after shots had hives. Took Benadryl and Prednisone. Starts with small bumps, get larger than blister some 30 X 40 mm. In various stages on body. Diagnosed as: Linear IgG Bulbous Disease since January has been taking: Hydroxyzine 50 mg Dapson 50 mg daily Doxycycline 100 mg twice a day, Naspan 500 mg twice a day, Ranitidine 150 mg daily, Prednisone. 7/7/06 Received medical records from primary dermatologist which reveal patient experienced linear IgA dermatitis (confirmed by multiple biopsies) beginning 1 week after her 1st Hep B vax & continues to have frequent flares/recurrences w/occasional infections from scalp, face incl eyes & mouth, trunk, arms, buttocks, legs & occasionally eyes. Continues on Prednisone w/intermittent flare ups. 7/13/06 Received medical records from dermatology clinic which reveal patient see 3/05 & concurred with dx of linear IgA dermatitis. Meds adjusted & some changed.

VAERS ID:218360 (history)  Vaccinated:2004-03-23
Age:50.0  Onset:2004-03-24, Days after vaccination: 1
Gender:Female  Submitted:2004-03-25, Days after onset: 1
Location:Maryland  Entered:2004-03-31, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0926N0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Patient complains of soreness at injection site "welt" developed next day. Measured site 3-25-04. Two areas from injection site to midline. One (top) measures at 8 cm length, 1 1/2 cm wide. Second (bottom) measures at 10 cm length 2 1/2 cm wide.

VAERS ID:218760 (history)  Vaccinated:2004-03-25
Age:50.0  Onset:2004-03-27, Days after vaccination: 2
Gender:Female  Submitted:2004-04-01, Days after onset: 5
Location:Kentucky  Entered:2004-04-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Prevacid, Cenestine, Lexapro, Fosamax
Current Illness: NONE
Preexisting Conditions: Percocet, Sulfa
Diagnostic Lab Data: General Chemistry: Glucose-174MG/DL, Bun-15, Creat-0.9, Calcium-8.3, NA-139, K-4.5, CL-105, TC02-29.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE059AA0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Hypersensitivity, Hypoaesthesia, Laboratory test abnormal, Malaise, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Headache, malaise, numbness, itching at injection site started approximately 36 hours post vaccination.

VAERS ID:219094 (history)  Vaccinated:2003-11-18
Age:50.0  Onset:2004-02-28, Days after vaccination: 102
Gender:Female  Submitted:2004-03-08, Days after onset: 9
Location:Texas  Entered:2004-04-16, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Toprol; Estratest; Lamisel
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 RA
Administered by: Other     Purchased by: Other
Symptoms: Bronchitis, Injection site vesicles, Night sweats, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: As per patient, smallpox vaccination site had healed ok. On 2/28/04 she noticed small vesicles on vaccination site. Other symptoms that day and the day after included fever, body aches, and night sweats. Patient saw her physician who stated to her that symptoms were not related to vaccine but to bronchitis which she has had for the last three weeks. Patient is taking treatment.

VAERS ID:219453 (history)  Vaccinated:2004-02-05
Age:50.0  Onset:2004-02-08, Days after vaccination: 3
Gender:Female  Submitted:2004-04-23, Days after onset: 74
Location:Georga  Entered:2004-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: High cholesterol;
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURERW141920 LA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Hypoaesthesia, Injection site pain, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Aching throbbing around injection site for several weeks, arm also felt numb and very weak, hurt when moved. Hands continued to be swollen for a few weeks.

VAERS ID:219576 (history)  Vaccinated:2004-04-20
Age:50.0  Onset:2004-04-21, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Virginia  Entered:2004-04-28
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: PCN, Sulfur, Eggs, Codeine.
Diagnostic Lab Data: CBC
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS7946A6 IM 
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURW0460 SC 
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.1080M SC 
TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU1001AA IM 
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site reaction, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Reaction to Polio & Tetanus right shoulder swollen & red with heat. Swollen under arm. Given antibiotics & quarters for 72 hours on 22 Apr 04.

VAERS ID:221318 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-05-14
Location:Unknown  Entered:2004-05-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0311USA01512
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Malaise, Pain, Skin ulcer
SMQs:
Write-up: Information has been received from an approx. 50 year old female nurse who in 2002 was vaccinated with a first dose of varicella virus vaccine live. Subsequently, for the following six months, the pt experienced malaise, aches, and lesions around her mouth, inside her mouth, and around her eyes. It was unknown if treatment was given. The condition had resolved. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.

VAERS ID:221355 (history)  Vaccinated:2004-05-20
Age:50.0  Onset:2004-05-20, Days after vaccination: 0
Gender:Male  Submitted:2004-05-21, Days after onset: 1
Location:Ohio  Entered:2004-05-21
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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0833SCLA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Hyperhidrosis, Similar reaction on previous exposure to drug, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad)
Write-up: After recieving 4th Anthrax on 20 May 2004 member had episode of tachycardia and diaphoresis that lasted for 2 1/2-3 hrs then resolved. Pulse was 113 b/p 153/89. Denied CP or SOB. Symptoms began approx 4 hrs after shot. Member did come to clinic but was told he needed to go to PCP or ER for treatment as this is not a treatment facility. Member did not seek care despite advice to do so. Only problems with 3 previous Anthrax doses was headache which pt treated effectively with tylenol. Previous 3 doses were all in year 2000.

VAERS ID:222729 (history)  Vaccinated:1999-10-15
Age:50.0  Onset:1999-10-18, Days after vaccination: 3
Gender:Male  Submitted:2004-06-16, Days after onset: 1703
Location:Unknown  Entered:2004-06-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DENIES
Current Illness: DENIES
Preexisting Conditions: DENIES
Diagnostic Lab Data: Ear culture Nov 99: culture lost. CXR 29 Nov 99: except for scoliosis normal chest. MRI Brain 03 Nov 99: Is within normal limits for age. Solitary punctuate focus of T2 prolongation in right frontal subcortical white matter. prostAg, ANA, Westergren 23 Nov 99: normal Tosoplasma IGG and IGM, HIV, urinalysis 23 Nov 99: normal CBC, electrolytes, lipid panel, 11 Jan 00: normal Lyme Disease AB screen 03 Dec 99: is seronegative 03 Dec 99: B Henselae IGG:1:64 B Quintana IGG: 1:64 (ref ranges IGG < 1:64; " IGM: < 1:20 " IGM: <1:20 IGM< 1:20) Alpha 1& 2, Beta, andGamma Globulin 11 Jan 00: normal Albumin EP, Total Protein EP, and Protein, total 11 Jan 00: normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERU0135AA IMUN
Administered by: Military     Purchased by: Military
Symptoms: Blindness, Dermatitis exfoliative, Headache, Laboratory test abnormal, Oedema, Optic neuritis, Skin ulcer, Uveitis, Visual disturbance
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Optic nerve disorders (narrow), Cardiomyopathy (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad), Hypersensitivity (narrow)
Write-up: 23 SEPT 99 RECEIVED ANTHRAX #6 AND ON 15 OCT 99 RECEIVED INFLUENZA. ON 18 OCT THROUGH 30 OCT NOTICED HEADACHES THAT REQUIRED MEDICAL ATTENTION. ON 01 NOV DEVELOPED LESIONS ON EAR AND NOTICED SPOTS IN VISUAL FIELD OF LEFT EYE. EAR LESIONS CLEARED IN 3-4 DAYS AND PT WENT ON TO DEVELOP LEFT CENTRAL VISUAL LOSS BY 22 NOV 99. NO FURTHER CHANGES IN VISION SINCE THAT TIME. 26 Jan 00: Examined by Dr. His impression which includes no definitive diagnosis is provided in attached letter dated Jan 26, 2000. Letter reports: Pt has evidence for a left optic neuropathy. A definite possibility would be post-vaccination optic neuropathy from influenza. I cannot put that together with his red ear nor with the cells in the vitreous. I do not think anthrax is a possibility here. Another possibility would be a nonarteritic anterior ischemic optic neuropathy, however, I would not anticipate that would cause cells in the vitreous. I do not think that his MRI is consistent with a diagnosis of multiple sclerosis. Nurse follow up on 06/28/04 states: "ADD: swelling of ear, eschar of ear, iritis."

VAERS ID:223171 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-05-28
Location:Unknown  Entered:2004-06-22, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0311USA018242
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Information has been received from a registered nurse via a company representative concerning a female patient "in her 50s", with an unknown medical history, who was vaccinated with a dose of measles virus vaccine live + mumps virus vaccine live + rubella virus vaccine live. Subsequently the patient experienced severe joint pain and fever. No other information is available. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:223970 (history)  Vaccinated:2004-06-27
Age:50.0  Onset:2004-06-27, Days after vaccination: 0
Gender:Female  Submitted:2004-07-05, Days after onset: 8
Location:Massachusetts  Entered:2004-07-15, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: wheeze and nausea~Tetanus Toxoid (no brand name)~~27.00~In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: Omoxycillin
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD104   
Administered by: Military     Purchased by: Other
Symptoms: Anorexia, Asthenia, Dizziness, Dysgeusia, Headache, Injection site erythema, Injection site swelling, Nausea, Somnolence, Staring, Tenderness
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (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: Vaccine administered 6/27, approximately 10AM. 1. "spacey" and weak after lag of 30 minutes, headache began, weak, fell asleep. 2. next AM (24 hours later) severe nausea light headed, weak, anorexia: metallic taste (6 days +) extreme soreness, redness, swelling at site.

VAERS ID:224010 (history)  Vaccinated:2004-07-06
Age:50.0  Onset:2004-07-07, Days after vaccination: 1
Gender:Female  Submitted:2004-07-13, Days after onset: 6
Location:Montana  Entered:2004-07-15, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Mosquito, Neomycin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0679N0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Injection site swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Noticed itching Wednesday evening. Saw large welt. Takes Benadryl or Allegra every day. Came in to office 7/9/04. 60cm diameter with center 30cm diameter: raised, red, hot . Center is distinctly redder. Topical Benadryl (gel x strength applied 7/9/04._

VAERS ID:224133 (history)  Vaccinated:2004-06-17
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-07-13
Location:Missouri  Entered:2004-07-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Coral calcium, Naprosyn, Metformin HCL, Aspirin, Lipitor
Current Illness: NONE
Preexisting Conditions: Diabetes Mellitus, Perimenopausal, Overweight, IBS, Abnormal Mammogram
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1180N1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pyrexia, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt reports in yesterday to see doctor. Has pneumonia vaccine. Arm is swelling and sore, swelling is 7x6 inches in area, reddened, and feverish, reddened are is 6x4 inches.

VAERS ID:224394 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-05-30
Location:Illinois  Entered:2004-07-27, Days after submission: 58
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tetanus Toxoid (unknown mfr);muscle weakness;;0;In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: Past medical history includes mitral valve prolapse. The pt received a tetanus vaccination over ten years ago and shortly after being diagnosed with pneumonia. A couple of months after receiving the vaccination, the pt experienced signs and symptoms of muscle weakness, muscle wasting and weight loss. There was a gradual improvement of symptoms, but not 100% as per the reporter. The
Diagnostic Lab Data:
CDC 'Split Type': 2004020180
Vaccination
Manufacturer
Lot
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Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEUR    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypotonia, Similar reaction on previous exposure to drug, Weight decreased
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: From initial information received on 24May04 from a physician regarding an adverse event. It was reported that a 50 year old female pt received a TET TOX Booster USP vaccination at a travel clinic (manufacturer, lot number and route of administration not reported) sometime during the summer of 2003. Two to three months following vaccination, the pt experienced muscle weakness and weight loss. The pt had previously experienced the muscle weakness, muscle wasting and weight loss following a tetanus vaccination (lot number, manufacturer, and route of administration not reported) over ten years ago and she had been diagnosed with post pneumonia paralytic syndrome. The physician stated that she is not sure if the events are related to the vaccination. The pt was not hospitalized, but her symptoms were ongoing at the time of this report.

VAERS ID:224406 (history)  Vaccinated:2004-06-18
Age:50.0  Onset:2004-06-18, Days after vaccination: 0
Gender:Female  Submitted:2004-07-27, Days after onset: 39
Location:Massachusetts  Entered:2004-07-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Td Adsorbed, Adult (unknown mfr);see above;;480;In Patient
Other Medications: multivitamin, calcium
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: n/a
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: About five minutes after receiving tetanus booster injection, I experienced nausea and broke out in a cold sweat. I felt I might pass out for maybe five minutes, and then it all abated spontaneously. Exactly the same thing happened to me ten years ago when I got my last tetanus booster. I have no known allergies and have not experienced these symptoms in this way at any other time. (I also had mild arm soreness a day later.)

VAERS ID:224473 (history)  Vaccinated:2004-07-19
Age:50.0  Onset:2004-07-20, Days after vaccination: 1
Gender:Male  Submitted:2004-07-21, Days after onset: 1
Location:Iowa  Entered:2004-07-28, 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: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1184AA SCRA
Administered by: Other     Purchased by: Other
Symptoms: Drug administration error, Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt given tetanus instead of TB forearm area red and swollen.

VAERS ID:224933 (history)  Vaccinated:2003-11-03
Age:50.0  Onset:2003-11-03, Days after vaccination: 0
Gender:Female  Submitted:2004-07-30, Days after onset: 269
Location:Wisconsin  Entered:2004-08-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec; Synthroid; Nasonex;
Current Illness: NONE
Preexisting Conditions: Drug hypersensitivity;
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0311USA01956
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0988N IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a CMA concerning a 50 year old female with a drug allergy to sulfamethoxazole (+) trimethoprim (Bactrim) and sulfa medications who on 11/03/03 was vaccinated IM with a first 0.5mL dose of pneumococcal 23v polysaccharide vaccine (Lot # 647357/0988N). Concomitant therapy included levothyroxine Na (Synthroid), cetirizine hydrochloride (Zyrtec), and mometasone furoate (Nasonex). Subsequently, the pt developed a local reaction that was described as redness and swelling of her arm. The pt went to an urgent care center. A prescription drug was not required. No diagnostic lab studies were performed. It was noted that therapy was discontinued and that the adverse event abated. A product quality complaint was not involved. Follow up information was received from the CMA which indicated that the event was "taken care of with pt." No further information is expected. It was also reported that another female pt was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine and developed a local reaction with a raised, warm and painful injection site (WAES #0311USA01430).

VAERS ID:224957 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2004-07-30
Location:New Jersey  Entered:2004-08-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: unk
CDC 'Split Type': WAES0312USA00128
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information ahs been received from physician concerning a 50 year old male who was vaccinated with a first dose of pneumococcal 23v polysaccharide vaccine. The reporter indicated that the pt recently developed a site reaction after vaccination. The reaction was marked by redness, swelling and pain at the injection site. The pt did not have an extended recovery period. Unspecified medical attention was sought. A product quality complaint was not involved. Additional info has been requested. The physician also reported similar reactions in two other adult patient after therapy with penuemococcal 23v polysaccharide vaccine.

VAERS ID:224968 (history)  Vaccinated:2003-12-02
Age:50.0  Onset:2003-12-03, Days after vaccination: 1
Gender:Male  Submitted:2004-07-30, Days after onset: 239
Location:New York  Entered:2004-08-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified); interferon (unspecified);
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Body temp (12/03/03): <102;
CDC 'Split Type': WAES0312USA00551
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Headache, Myalgia, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Information has been received from a 50 year old male company representative with no pertinent medical history who on 12/02/03 was vaccinated IM with a 0.5mL dose of pneumococcal 23v polysaccharide vaccine. Concomitant therapy included interferon (unspecified) and "ribovioren". On 12/03/03 the pt experienced soreness in his tricep muscle, a fever below 102, a headache and muscle aches throughout his body. Medical attention has not been sought and no lab tests were performed. No product quality complaint was involved. Additional information has been requested.

VAERS ID:225025 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:2003-12-06
Gender:Male  Submitted:2004-07-30, Days after onset: 236
Location:Unknown  Entered:2004-08-05, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0401USA01939
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a pharmacist concerning himself, a 50 year old white male who was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine. The reporter indicated that he had a painful area around the injection site about the size of the palm of his hand for a few days. He also noticed some redness. No medical attention was sought and no treatment was required. The event abated and the pt recovered. A product quality complaint was not involved. Follow up information was received from the pharmacist who indicated that on 06Dec03 at 5:00PM he developed pain at the injection site lasting approximately 48 hours. He subsequently recovered. No further information is expected.

VAERS ID:225106 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-07-30
Location:Massachusetts  Entered:2004-08-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0404USA01479
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0864N  UN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis
SMQs:
Write-up: Information has been received from a physician concerning a 50 year old female who was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine (Lot # 647635/0864N). Subsequently, the pt experienced cellulitis. It was reported that she was not hospitalized, but she did seek medical attention and was treated with an antibiotic. The pt has recovered. No additional information was provided. No product quality complaint was involved. Additional information is not expected.

VAERS ID:225135 (history)  Vaccinated:2004-05-25
Age:50.0  Onset:2004-05-25, Days after vaccination: 0
Gender:Male  Submitted:2004-07-30, Days after onset: 66
Location:Arizona  Entered:2004-08-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0405USA01973
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a physician concerning a 50 year old male who on 05/25/04 was vaccinated IM in his deltoid with a first dose of pneumococcal 23v polysaccharide vaccine. On 05/25/04, "later that evening" he began feeling soreness and tenderness in the injection arm. He returned to the clinic "today" on 05/26/04 with erythema and warmness from the deltoid region to about 4cm below his elbow of the injection arm. The arm was also warm to touch and had "a little" edema in the elbow area. There were no systemic effects present. There was no treatment required. Unspecified medical attention was sought. There was no product quality complaint involved. No further information was provided. Additional information has been requested.

VAERS ID:225752 (history)  Vaccinated:2003-12-17
Age:50.0  Onset:2003-12-17, Days after vaccination: 0
Gender:Female  Submitted:2004-08-19, Days after onset: 245
Location:New Hampshire  Entered:2004-08-24, 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: Hormone Replacement Therapy; Antidepressants; Lexapro; Wellbutrin
Current Illness: NONE
Preexisting Conditions: The pt''s past medical history is significant for osteoporosis and osteopenia. On 02Mar1990, the pt was seen in the office with c/o right shoulder pain. Physical examination revealed right rotator cuff tendinitis, which was already resolving. Right lateral epicondylitis was also noted. Physical examination on 11May90 revealed mild residual rotator cuff tendinitis. On 12Jan93, the pt
Diagnostic Lab Data: 26Dec03-An ortho x-ray with AP, scapular Y and axillary view of the right shoulder showed no acute bony pathology. It also revealed an open AC joint type one to two to acromion. The impression was right shoulder bursitis with no evidence on
CDC 'Split Type': 200400663
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1148EA0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bursitis, Myasthenic syndrome, Tenderness
SMQs:, Malignancy related conditions (narrow)
Write-up: There was no seriousness criteria reported. However, based upon the follow up information received on 8/11/04, this case is now considered serious (OMIC). From initial information received on 2/20/04 from the patient regarding an adverse event occurring in the USA, it was reported that a 50 year old female patient received a FLUZONE vaccination, lot number U1148EA, administered in the right arm on 12/17/03. The patient stated that immediately following vaccination she had pain in her arm, and the pain worsened over six days. She was seen by an orthopedist and has been in physical therapy since 12/31/03. At the time of the report the patient has not recovered from this event. From additional information received on 7/21/04, it was reported that an x-ray of the right shoulder on 12/26/03 showed no bony pathology. The patient was diagnosed with right shoulder bursitis on an unspecified date. She was advised to see the orthopedic doctor again and was scheduled to have an ultrasound on 7/16/04. A follow up telephone call was placed to the physician on 7/22/04 and he reported that he had referred the patient to an orthopedic doctor in December 2003 and has not seen the patient that time. No additional information was provided. From additional information received on 8/11/04 from a health care professional, the patient''s date of birth was reported as 2/1/1954. It was initially reported as 2/10/54. The patient was seen in the office on 12/26/03 for complaints of right shoulder pain. The patient started to experience the pain on 12/17/03 immediately after receiving her flu shot. The patient stated that it felt as though the needle hit the bone. Initially, the pain was primarily with abduction type maneuvers of that arm, but did okay beyond the arc of 90. However, it became more persistent and constant. The patient had initially been on ibuprofen for a back problem, but had recently switched to Naprosyn and noted that she had not had quite as much pain relief with that. The patient denied any numbness, tingling, or paresth

VAERS ID:226473 (history)  Vaccinated:2004-08-24
Age:50.0  Onset:2004-08-25, Days after vaccination: 1
Gender:Male  Submitted:2004-08-31, Days after onset: 6
Location:North Carolina  Entered:2004-09-09, Days after submission: 9
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: Benadryl; PCN; sulfa-Depression
Diagnostic Lab Data: NONE
CDC 'Split Type': NC04102
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0949N0SCLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1201N0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEUR30003413PO 
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad)
Write-up: Vaccines given 8/24/04. On 8/25 pt reports he became weak, fatigued and developed a fever of 102.5 c/o pain left deltoid area. Fever resolved by 8/26 Tired weak tel 8/27.

VAERS ID:227022 (history)  Vaccinated:2003-10-30
Age:50.0  Onset:2003-10-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2004-09-27
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Unknown
Symptoms: Abnormal behaviour, Amnesia, Chills, Convulsion, Diplopia, Encephalitis, Headache, Herpes simplex, Influenza, Malaise, Neck pain, Paraesthesia, Urinary tract infection, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ocular motility disorders (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad)
Write-up: On Thursday, 10/30/03, I had received a flu vaccine while on the job. The injection was given IM by the nurse. Immediately after I had received the injection, I began to feel very ill. A cold chill went through my body and I had to sit down in the pharmacy. The next day, 10/31/03, I was not able to get off the sofa at my home. I was not required to go to work until 11/5/03. I had then began to feel somewhat better, however, I still had a persistent headache. Then, on 11/6/03, I had such a severe headache I could not hold my head up. My friend drove me to the emergency room. The diagnosis at the ER was that I had the flu and a urinary tract infection and I was sent home with Levaquin 400mg for 4 days. My friend had informed the hospital that I have had a history of genital herpes, and that I did not have an outbreak at that time. I was then sent home from the hospital in the care of my mother and brother. The severe headache gradually got better, however, I developed double vision for part of the next day, 11/7 and was severely vomiting. I gradually began to feel better from 11/8 to 11/14, and returned to work on 11/16. I continued to have a dull headache and some neck pain and tingling in my fingers. On 12/10 I went to see the doctor. I explained my symptoms to the doctor and he suggested that I see a neurologist. The doctor told me that he though I had viral encephalitis. While I was at work on 12/14/03, I was transposing numbers on the computer. Suddenly, the telephone rang in the pharmacy but I picked up the stapler and was talking to it. I was immediately taken to the hospital. After a spinal tap was done, I was diagnosed as having herpes simplex encephalitis. While in the hospital for 4 days, I was given Acyclovir 550mg IV every 8 hours and was then sent home on this same medication through 12/24. I have enclosed documentation from the hospital. I am currently seeing a doctor. I am also seeing a neurologist at the hospital. Currently, I am going to speech therapy 3 times weekly. Soon I will begin to do work

VAERS ID:227493 (history)  Vaccinated:2003-07-15
Age:50.0  Onset:2003-07-20, Days after vaccination: 5
Gender:Female  Submitted:2004-10-04, Days after onset: 442
Location:Unknown  Entered:2004-10-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: Motor vehicle accident;
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0409USA02679
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.   UN
Administered by: Other     Purchased by: Other
Symptoms: Bronchitis, Pneumonia
SMQs:, Eosinophilic pneumonia (broad)
Write-up: Information has been received from a 50 year old female with a history of a motor vehicle accident (07/15/03) who on 07/15/03, after the MVA, was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine. On 07/20/03, five days later, the pt developed pneumonia that lasted 2 weeks. She was treated with 3 rounds of antibiotics as an intervention before the pneumonia resolved. Since then, she has had frequent bouts of bronchitis. Unspecified medical attention was sought. The outcome was reported as recovered. Pneumonia and bronchitis were considered to be disabling. Pneumonia and bronchitis were considered to be other important medical events (OMIC). Additional information has been requested.

VAERS ID:227586 (history)  Vaccinated:2004-09-24
Age:50.0  Onset:2004-10-01, Days after vaccination: 7
Gender:Female  Submitted:2004-10-01, Days after onset: 0
Location:California  Entered:2004-10-11, 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: Metform
Current Illness: diabetes
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEUR41283AA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Cellulitis, Headache, Injection site reaction
SMQs:
Write-up: Cellulitus at site of Td. Discharge Summary received on 2/18/2005 states headache.

VAERS ID:227832 (history)  Vaccinated:2004-10-04
Age:50.0  Onset:2004-10-06, Days after vaccination: 2
Gender:Male  Submitted:2004-10-15, Days after onset: 9
Location:California  Entered:2004-10-15
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
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Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1504AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Haemoptysis, Hyperhidrosis, Myalgia, Neck pain, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Agranulocytosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Got Fluzone shot on 10/4. 1-2 days later got ache on left side of my neck. On Sat. 10/9, got a cold or flu. Bad part lasted two days. Started with raw throat coughing out blood streaks in sputum. Muscle ache, weakness, raw throat, coughing, headache, stuffy nose. Fever got up to 101. On third day, got better. Fever went down to 99 and started sweating. Took cough syrup (with codeine) a few times for cough. Drank ample water, soup, tea.. Info of of receipt: Rx#6619739 Tx#1038840 Auth:T90410043LWM11 Fluzone 2004 Inj Aven NDC:49281-0374-15

VAERS ID:228231 (history)  Vaccinated:2004-10-08
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-10-25
Location:Maryland  Entered:2004-10-25
Life Threatening? No
Died? Yes
   Date died: 2004-10-20
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Sciatica, HTN
Diagnostic Lab Data: unknown to me at this time
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1489AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiac failure, Cerebral infarction, Circulatory collapse, Gait disturbance, Hyperlipidaemia, Hypertension, Lung disorder, Myasthenic syndrome, Myelitis transverse, Pain, Paraesthesia, Pulmonary oedema, Renal impairment
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (narrow), Dyslipidaemia (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Ischaemic cerebrovascular conditions (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Demyelination (narrow), Lipodystrophy (broad), Hypersensitivity (narrow), Tumour lysis syndrome (broad)
Write-up: unknown to me at this time. Nurse follow up on 10/29/04 states: "multiple lacunar infarcts in the thalami, (L) caudate head & periventricular white matter; transverse myelitis; hypertension; hyperlipidemia; pain & numbness; weakness of lower extrem; difficulty walking." Autopsy Report received on 12/07/2004 states severe acute CHF, bilateral acute ischemic renal infarcts, severe pulmonary congestion and edema, severe congestion, liver and spleen, and circulatory collapse. 11/18/04 Lab reports received. No new evidence found.

VAERS ID:228291 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-10-26
Location:Massachusetts  Entered:2004-10-27, 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: Zyrtec
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURV044388   
Administered by: Other     Purchased by: Other
Symptoms: Feeling hot, Oedema, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: I broke out in hives, my arm was hot and swollen. I started itching uncontrollably. Saw a Dr in April 2001. I''m still itching and on Zyrtec. By appt finally April 2001.

VAERS ID:228535 (history)  Vaccinated:2003-11-07
Age:50.0  Onset:2003-11-08, Days after vaccination: 1
Gender:Male  Submitted:2004-09-01, Days after onset: 297
Location:Unknown  Entered:2004-11-01, Days after submission: 61
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: First course of OncoTICE and Intron 10 MIU without adverse events.
Diagnostic Lab Data:
CDC 'Split Type': 2004116162NL
Vaccination
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BCG: BCG (TICE)ORGANON-TEKNIKA    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Dysuria, Haematuria, Micturition urgency, Pollakiuria, Pyrexia, Vaccine positive rechallenge
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: A 49 year male patient received the first instillation of a second course of OncoTICE and Introl A 50 MIU. The next day he experienced fever, chills, urinary urgency, urinary frequency , hematuria and dysuria. After the second instillation the patient experienced the same events. The treatment is not discontinued.

VAERS ID:228583 (history)  Vaccinated:2004-05-27
Age:50.0  Onset:2004-05-28, Days after vaccination: 1
Gender:Female  Submitted:2004-11-01, Days after onset: 157
Location:Nevada  Entered:2004-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None know
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: None done at this time
CDC 'Split Type':
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TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1025AA IMRA
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: After receiving a Td booster in her right upper arm the client initally developed approx. 3 mm area of pinkness and slight swelling. This resolved after a couple of days. However, the client has been having continious localized pain around the injection site (approx. quarter size area) since the morning after receiving the IZ. On a scale of 1-10 she describes the pain at a 2 when not moving her arm and a 4-6 when she moves her arm.

VAERS ID:228628 (history)  Vaccinated:2004-10-25
Age:50.0  Onset:2004-10-27, Days after vaccination: 2
Gender:Male  Submitted:2004-10-28, Days after onset: 1
Location:Iowa  Entered:2004-11-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: AODM (Type II Diabetes)
Diagnostic Lab Data: had EKG; blood counts
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1443AA IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Hyperhidrosis, Muscle spasms, Pain
SMQs:, Neuroleptic malignant syndrome (broad), Dystonia (broad)
Write-up: Had sharp pain at arm; muscle spasm, sweats, involuntary muscle spasm,causing motor vehicle accident.

VAERS ID:228695 (history)  Vaccinated:2004-10-21
Age:50.0  Onset:2004-10-22, Days after vaccination: 1
Gender:Female  Submitted:2004-11-02, Days after onset: 11
Location:Oregon  Entered:2004-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Fibromyalgia, IM type II, Obesity
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1496AA  LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0190P  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Cellulitis, Feeling hot, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Patient states went to hospital ER 10/23 with temperature of 103 and severe upper left arm pain. Status post Fluzone and PCV7 vaccine 10/21. On 10/26/2004 evaluated at clinic with ongoing severe left upper arm pain, warmth and redness. Diagnosed with cellulitis.

VAERS ID:228793 (history)  Vaccinated:2004-09-07
Age:50.0  Onset:2004-09-11, Days after vaccination: 4
Gender:Female  Submitted:2004-11-01, Days after onset: 51
Location:New Mexico  Entered:2004-11-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Had been diagnosed with borderline DM in 1997 but did not follow up.
Diagnostic Lab Data: Skin punch biopsy: vascular and granular IgA staining; Complete work up HSP.
CDC 'Split Type':
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HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Bacterial infection, Cellulitis, Erythema, Hypersensitivity, Leukocytosis, Oedema peripheral, Purpura, Skin ulcer, Vasculitis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vasculitis (narrow), Hypersensitivity (narrow)
Write-up: Developed raised purpuric lesions on lower extremities 3-4 days after receiving Hep B #1 and PPD placement through another provider. Lesions spread to trunk and upper extremities. Biopsy confirmed HSP/hypersensitivity vasculitis. No other meds/exposure prior to onset. Medical Record received on 12/15/2004 states pt experienced cellulitis, open leg wounds, bacterial infection, leukocytosis, leg edema and erythema legs. Follow up 02/07/05: Extensive vasculitis lesions (Hypersensitvity vasculitis of the adult) in lower extremities. In differnt stages of recovery. One of the lesions in the posterior thigh got infected with an abcess, that required surgical drainage. As per annual follow up report Patient moved no longer her provider.

VAERS ID:228805 (history)  Vaccinated:2004-08-04
Age:50.0  Onset:2004-08-04, Days after vaccination: 0
Gender:Male  Submitted:2004-11-01, Days after onset: 89
Location:Unknown  Entered:2004-11-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium 500mg/vitamin D 200UNT, Clobetasol Propionate 0.05%, Oint. Clobetasol Propionate 0.05%, Top Soln Etanercept 25mg Vial inj., Kit hydrocortisone 1% cream, Ketoconazole 2% cream Multivitamin Cap/tab Naproxen 500mg, Promethazine HCL 12.
Current Illness:
Preexisting Conditions: Prior allergy to SUlfa, past medical history: Psoriasis, EtoH abuse, Reiter''s syndrome, Aseptic boney necrosis, GI bleed.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Oedema, Similar reaction on previous exposure to drug, Skin exfoliation
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Pt received Pneumovax 23 injection on 08/04/04 and reported to emergency dept on 08/08/04 reporting redness and peeling associated with the minimal swelling. Involves most of his cheeks and forehead. No difficulty swallowing, seeing, breathing, eating, He states that he has had a reaction to a vaccine in the past.

VAERS ID:228807 (history)  Vaccinated:2004-11-01
Age:50.0  Onset:2004-11-01, Days after vaccination: 0
Gender:Female  Submitted:2004-11-01, Days after onset: 0
Location:Maryland  Entered:2004-11-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Coreg, Aspirin, Altace, Lipitor, Synthroid, Plavix
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hot flush, Injection site erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: I felt a flush of heat and itching travel up my left forearm and when I looked at my arm it was red and hot.

VAERS ID:228832 (history)  Vaccinated:2004-10-07
Age:50.0  Onset:2004-10-07, Days after vaccination: 0
Gender:Female  Submitted:2004-10-08, Days after onset: 1
Location:Washington  Entered:2004-11-05, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, Advil
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1447AA  RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site haemorrhage, Injection site warmth, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: Pain at right deltoid, right shoulder, right neck. Ecchymosis at site, hot to touch, increased bleeding at site. No anticoagulant meds or bleeding disorders.

VAERS ID:228878 (history)  Vaccinated:2004-10-28
Age:50.0  Onset:2004-10-30, Days after vaccination: 2
Gender:Female  Submitted:2004-11-06, Days after onset: 7
Location:California  Entered:2004-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxycontin
Current Illness: Interstial Cystitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Nausea, Pain, Pyrexia, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Two days after vaccine developed body aches "like bugs gnawing at muscles", low grade fever, weak could not get out of bed. Nausea and weight loss. Not eating.

VAERS ID:228977 (history)  Vaccinated:2004-11-01
Age:50.0  Onset:2004-11-02, Days after vaccination: 1
Gender:Female  Submitted:2004-11-09, Days after onset: 7
Location:Illinois  Entered:2004-11-09
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':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0287P0IMLA
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: approx. 20 hrs. after receiving IM injection in left deltoid, her arm was red, swelled, and painful from injection site to elbow. 24 hrs. later these symptoms increased with painful swelling and redness from injection site to hand. Went to dr., received PCN IM and placed on Augmentin.

VAERS ID:229088 (history)  Vaccinated:2004-09-28
Age:50.0  Onset:2004-09-29, Days after vaccination: 1
Gender:Female  Submitted:2004-09-30, Days after onset: 1
Location:Georga  Entered:2004-11-10, Days after submission: 41
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':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1448AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0740N SCLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient received influenza (front left deltoid) and Pneumovax (back left) per her request. Patient reported swelling from back of arm to her elbow. Shots received Tuesday; symptoms began Wednesday. Was somewhat better Thursday although still some redness and heat down the back of the arm.

VAERS ID:229161 (history)  Vaccinated:2004-11-01
Age:50.0  Onset:2004-11-02, Days after vaccination: 1
Gender:Female  Submitted:2004-11-09, Days after onset: 7
Location:Missouri  Entered:2004-11-12, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Sudafed, Fonase Nasal Spray, Zoloft, Zantac
Current Illness: NONE
Preexisting Conditions: Environmental Allergies, sulfa allergy, GERD
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1488AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site reaction, Pruritus, Tenderness, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Developed a 2" circular, raised, red wheal at injection site with soreness and pruritus. Approximately 18 hours after vaccine given.

VAERS ID:229210 (history)  Vaccinated:2004-10-27
Age:50.0  Onset:2004-10-27, Days after vaccination: 0
Gender:Female  Submitted:2004-11-01, Days after onset: 5
Location:Kentucky  Entered:2004-11-15, Days after submission: 14
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: morphine and Aspirin Asthma and Emphysema
Diagnostic Lab Data: none
CDC 'Split Type': KY2004043
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1443AA5IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dyspnoea, Erythema, Oedema, Rash, Wheezing
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: 2 hours after injection, started to wheeze with some breathing difficulty, used albuterol inhaler (1 puff), next day- had red rash about size of golf ball was hot and puffy

VAERS ID:229353 (history)  Vaccinated:2004-11-16
Age:50.0  Onset:2004-11-16, Days after vaccination: 0
Gender:Female  Submitted:2004-11-17, Days after onset: 1
Location:Massachusetts  Entered:2004-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1555AA0 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site reaction, Injection site swelling, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Site was itchy immediately, around 24 hours later red, hot , swollen at injection site.

VAERS ID:229633 (history)  Vaccinated:2004-11-09
Age:50.0  Onset:2004-11-10, Days after vaccination: 1
Gender:Female  Submitted:2004-11-23, Days after onset: 13
Location:California  Entered:2004-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Remicade; Vicodin; Folate; HCTZ; Clonazepam; Fosamax
Current Illness: Rheumatoid Arthritis
Preexisting Conditions: Flagyl; Macrodantin Information from Discharge summary states chronic obstructive lung disease, drug dependence, tobacco. msv
Diagnostic Lab Data: Normal MRI brain; C-spine; Negative Lumbar Puncture. Medical Records received on 1/25/2005 states lab work abnormal. Information from discharge summary states H&H decreased, lab test abnormal. msv
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURV1449AA0IM 
Administered by: Private     Purchased by: Private
Symptoms: Anaemia, Asthenia, Dysuria, Laboratory test abnormal, Pain, Sensation of heaviness
SMQs:, Haematopoietic erythropenia (broad), Guillain-Barre syndrome (broad)
Write-up: Patient received flu vaccine plus Remicade injections at same time. She woke the next morning with loss of strength and feeling in legs and heaviness in arms. Information from discharge summary sttes pain, difficulty urinating. msv

VAERS ID:229679 (history)  Vaccinated:2004-10-29
Age:50.0  Onset:2004-10-29, Days after vaccination: 0
Gender:Female  Submitted:2004-11-15, Days after onset: 17
Location:Oregon  Entered:2004-11-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Augmentin, Zoloft, Sinemet, Lisinopril
Current Illness: Poisonous spider bite 10/21/04
Preexisting Conditions: Zoloft for Depression, HTN
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1489AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0945N IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site reaction, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: "achy the rest of the day". More severe pain started 10/30/2004. Pain extends from neck to elbow. "it feels like when I had bursitis", continues to be very painful, taking antiinflammatory. Reaction site occurred from influenza vaccine left deltoid.

VAERS ID:229766 (history)  Vaccinated:2004-10-20
Age:50.0  Onset:2004-10-21, Days after vaccination: 1
Gender:Female  Submitted:2004-10-28, Days after onset: 7
Location:Washington  Entered:2004-11-29, Days after submission: 32
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins/Minerals
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Very sick again on 11/6-10 = flu
CDC 'Split Type': WA042079
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1489AA IM 
Administered by: Military     Purchased by: Public
Symptoms: Chills, Eye inflammation, Infection, Influenza like illness, Joint stiffness, Musculoskeletal stiffness, Nasal congestion, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Corneal disorders (broad), Arthritis (broad)
Write-up: Ache/stiffness from neck down to elbow x 2 days. Nausea, head cold lasted 5 days, temperature, chills, severe flu-like symptoms secondary eye infection required antibiotics.

VAERS ID:229825 (history)  Vaccinated:2004-10-27
Age:50.0  Onset:2004-10-27, Days after vaccination: 0
Gender:Female  Submitted:2004-11-30, Days after onset: 34
Location:Illinois  Entered:2004-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0512P1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Feeling hot, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 2 hours after getting pneumovax 23 injection, started feeling warm all over, but did not have fever. Right upper arm began swelling from just below injection site down to elbow. Arm became red, hot to touch and extremely painful. Client stated that her right arm looked like the arm of the cartoon character "Popeye." Took 1 week for swelling and discomfort to completely subside.

VAERS ID:229851 (history)  Vaccinated:2004-11-22
Age:50.0  Onset:2004-11-22, Days after vaccination: 0
Gender:Male  Submitted:2004-11-23, Days after onset: 1
Location:California  Entered:2004-11-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1411AA0ID 
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Insomnia, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: pt describes mild aches, chills and cannot sleep at night. Temp 38.0C. Pt received flu vaccine 11/22/04 in afternoon. Symptoms began late that night. Sent home form work 11/23/04 to rest.

VAERS ID:229935 (history)  Vaccinated:2004-10-21
Age:50.0  Onset:2004-10-22, Days after vaccination: 1
Gender:Female  Submitted:2004-11-01, Days after onset: 10
Location:California  Entered:2004-12-02, Days after submission: 31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': MEDI0002364
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INCIN500335P IN 
Administered by: Other     Purchased by: Private
Symptoms: Cough, Eye irritation, Laryngitis, Pharyngolaryngeal pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Corneal disorders (broad)
Write-up: This is a non serious spontaneous case from a pharmacist of Burning Sensation in Eye. The reporter causality was not provided to FluMist. A pharmacist reported loss of voice, sore throat, runny nose, cough, the burning sensation in the left nostril, and eye area in a 50 year old female after receiving her first FluMist dose on 21Oct04. The reporter would not disclose the pt''s history or contact information. On 26Oct04 the pt stated to the reporter that one day after receiving FluMist she had a burning sensation in her left nostril. She also had a runny nose and congestion which subsided by 29Oct04. On 29Oct04 the pt complained of cough, sore throat and loss of voice. The burning sensation in her nostril remained and had spread to her eye area. No further information is available.

VAERS ID:229937 (history)  Vaccinated:2004-11-04
Age:50.0  Onset:2004-11-06, Days after vaccination: 2
Gender:Female  Submitted:2004-11-16, Days after onset: 10
Location:North Carolina  Entered:2004-12-02, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allergy Med
Current Illness:
Preexisting Conditions: Pollen Allergy, allergy shots within 4 weeks of receiving FluMist.
Diagnostic Lab Data:
CDC 'Split Type': MEDI0002435
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Private     Purchased by: Other
Symptoms: Influenza like illness
SMQs:
Write-up: This is a non serious spontaneous case from a physician who reports a pt experienced influenza like symptoms after receiving FluMist. The reporter did not provide causality between events and FluMist. A female pt experienced flu like symptoms within 48 hours of receiving FluMist IN (date unknown). The pt recovered one week after the start of the events. The reporter did not provide causality between event and FluMist vaccination. Follow up 03/07/05: Lot number for vaccine not recorded.

VAERS ID:230288 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2004-10-08
Location:Unknown  Entered:2004-12-09, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drug not reported.
Current Illness:
Preexisting Conditions: No risk factors reported. Developed neurological symptoms in the past after receiving antibiotics and unspecified pain medications.
Diagnostic Lab Data:
CDC 'Split Type': PJP200300811
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Mental impairment, Neuropathy, Tremor
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: A report was received from a consumer on 10/15/2003 concerning a 50 year old male vaccinee who experienced neurological symptoms with shaking at the back of the head and alteration of mental status approximately 5 hours after vaccination on an unspecified date. On an unspecified date the vaccinee experienced neurological symptoms with shaking at the back of the head and alteration of mental status described as a dream-like or fog-like state. The vaccinee recovered on an unspecified date without sequalae or treatment. The vaccinee developed similar neurological symptoms (though not as marked) in the past after receiving antibiotics and unspecified pain medications. Follow up pending.

VAERS ID:230415 (history)  Vaccinated:2003-10-31
Age:50.0  Onset:2003-10-31, Days after vaccination: 0
Gender:Male  Submitted:2004-10-08, Days after onset: 342
Location:Unknown  Entered:2004-12-09, Days after submission: 62
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': PJP200300960
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES7651811IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report was received from a health care professional on 31 October 2003 concerning a 50 year old male vaccine who inadvertently received a double dose of Fluvirin on 31 October 2003. On 31 October 2003 the vaccine received a double dose of Fluvirin. The vaccine had experienced no adverse reaction at the time of the report. No follow-up pending, all information received. There was insufficient information to determine the reporter''s causality assessment. Update 1, 17 February 2004. A follow-up report was received from a health care professional indicating that no adverse event had occurred at the time of reporting.

VAERS ID:230423 (history)  Vaccinated:2003-11-01
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2004-10-08
Location:Unknown  Entered:2004-12-09, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug Not Reported
Current Illness:
Preexisting Conditions: No risk factors reported.
Diagnostic Lab Data:
CDC 'Split Type': PJP200300969
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35792KA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Accidental overdose, Medication error
SMQs:, Drug abuse and dependence (broad)
Write-up: A report was received from a health care professional on 11/02/03 concerning a 50 year old female vaccinee who inadvertently received expired Fluvirin on 11/01/03. The vaccinee had experienced no adverse reaction at the time of the report. There was insufficient information to determine the reporter''s causality assessment. Update 1, 02/02/04: A follow up report was received from a health care professional indicating that the vaccinee inadvertently received 1ml of expired Fluvirin on 11/01/03. No adverse events were reported at the time of the follow up report. No follow up pending, all information received. See ref$g: PJP200300968 and PJP20030970$g

VAERS ID:230453 (history)  Vaccinated:2003-11-04
Age:50.0  Onset:2003-11-04, Days after vaccination: 0
Gender:Female  Submitted:2004-10-08, Days after onset: 338
Location:Unknown  Entered:2004-12-09, Days after submission: 62
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drug not reported.
Current Illness:
Preexisting Conditions: No risk factors reported.
Diagnostic Lab Data:
CDC 'Split Type': PJP200301005
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES766049 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: A report was received from a healthcare professional on 5 November 2003 concerning a 50 year old female vaccinee who experienced a 3-4 inch red area which was itchy, painful and hot on the same day as receiving Fluvirin on a 4 November 2003. On 4 November 2003 the vaccinee experienced a 3-4 inch red area which was itchy, painful and hot. The vaccinee had not recovered at the time of the report. There was insufficient information to determine the reporter''s causality assessment. Follow up pending.

VAERS ID:230555 (history)  Vaccinated:2003-11-18
Age:50.0  Onset:2003-11-19, Days after vaccination: 1
Gender:Female  Submitted:2004-10-08, Days after onset: 323
Location:Unknown  Entered:2004-12-09, Days after submission: 62
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: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200301131
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES765751 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: A report was received from a health care professional on 11/19/03 concerning a 50 year old female vaccinee who experienced a localized red wheal at the injection site which was raised and warm to touch 1 day after receiving Fluvirin on 11/18/03. On 11/19/03, the vaccinee experienced a localized red wheal at the injection site, which was a nickel to half a dollar in size, raised and warm to the touch. The vaccinee had not recovered at the time of the report. There was insufficient information to determine the reporters causality assessment. Follow up pending.

VAERS ID:230558 (history)  Vaccinated:2003-11-18
Age:50.0  Onset:2003-11-19, Days after vaccination: 1
Gender:Female  Submitted:2004-10-08, Days after onset: 323
Location:Unknown  Entered:2004-12-09, Days after submission: 62
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: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200301134
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES765751 IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site swelling, Injection site warmth, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: A report was received from a health care professional on 11/19/03 concerning a 50 year old female vaccinee who experienced a localized red wheal at the injection site which was raised, itchy and warm to touch 1 day after receiving Fluvirin on 11/18/03. On 11/19/03 the vaccinee experienced a localized red wheal at the injection site, 4x4 inches in size, raised and warm to the touch. The vaccinee had not recovered at the time of the report. There was insufficient information to determine the reporter''s causality assessment. Follow up pending.

VAERS ID:230971 (history)  Vaccinated:2003-10-23
Age:50.0  Onset:2003-10-23, Days after vaccination: 0
Gender:Female  Submitted:2004-10-08, Days after onset: 351
Location:Unknown  Entered:2004-12-14, Days after submission: 67
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: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200400028
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: A report was received from a health care professional on 24Oct03, concerning three female vaccinees of unk age who were inadvertently administered last years vaccine (2002-2003) on an unk date. On an unk date three female vaccinees were inadvertently administered last years vaccine (2002-2003). No adverse reactions had occurred at the time of reporting. There was insufficient information to determine the reporter''s causality assessment. Update 1:10Dec03, Follow up report was received from a health care professional on 10Dec03 which indicated that a 50 year old female vaccinee inadvertently received 1ml of expired Fluvirin on 23Oct03. No adverse events were reported to date. Follow up pending. Cross referenced to PJP200300917 and PJP2003200400033.

VAERS ID:231479 (history)  Vaccinated:2004-11-01
Age:50.0  Onset:2004-11-05, Days after vaccination: 4
Gender:Male  Submitted:2004-12-22, Days after onset: 47
Location:California  Entered:2004-12-27, 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''s past medical history is unknown as per the reporter. It is unknown whether the patient had any illnesses at the time of vaccination.
Diagnostic Lab Data:
CDC 'Split Type': 200403990
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEUR    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated
SMQs:
Write-up: From initial information received on 12/20/04 from a physician regarding an adverse event occurring in the USA, it was reported that an approximately 50 year old male patient received MENOMUNE A/C/Y/W-135, sometime in November 2004 (exact date was not reported). The route and site of administration were not reported and the physician reported that the lot number information was not documented. Four to five days after receiving the vaccine, the patient developed an exacerbation of multiple sclerosis. The reporting physician did not have the patient information at the time of this report, but reportedly will be able to access it at a later date. It was not reported whether the patient recovered from this event. (OMIC)

VAERS ID:231544 (history)  Vaccinated:2003-10-02
Age:50.0  Onset:2003-10-03, Days after vaccination: 1
Gender:Female  Submitted:2004-01-22, Days after onset: 111
Location:New York  Entered:2004-12-28, Days after submission: 341
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Compromised immune system.
Preexisting Conditions: Immunosuppressed.
Diagnostic Lab Data:
CDC 'Split Type': 200302387
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1097AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Immune system disorder, Influenza like illness, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: From initial information received on October 15,2003 from the patient regarding an adverse event occurring in the USA, it was reported that a female patient (age and birth not reported) received Fluzone SV ''2003-2004'' UPS, lot number U1097AA, administered intra-muscularly in the left deltoid on October 09,2003. One day later, the patient developed a fever, chills, general malaise, and "flu-like symptoms". The patient was prescribed Tylenol and advised to force fluids. The patient''s medical conditions include immunosuppression and at the time of vaccination the patient had a compromised immune system. Reportedly, the patient recovered from this event. From additional information received on 01/14/2004 from the responsible physician, it was reported that the patient received the Fluzone SV ''2003-2004'' vaccination on October 02,2003, not October 09,2003 as previously reported. Additionally, the adverse event onset date was updated to October 03,2003, not October 10,2003 as previously reported. The patient''s date of birth and contact information were also provided.

VAERS ID:231670 (history)  Vaccinated:2004-12-01
Age:50.0  Onset:2004-12-02, Days after vaccination: 1
Gender:Female  Submitted:2004-12-10, Days after onset: 8
Location:Unknown  Entered:2004-12-28, 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: Botox inj 100 U, in left deltoid previous at another facility
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1579AA  RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0863N SC 
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1354AA  RA
Administered by: Private     Purchased by: Private
Symptoms: Feeling hot, Injection site pain, Injection site reaction, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt had swollen arm from elbow to shoulder and warm to touch about 8 hrs after injections. 3 shots in right arm. Td, Flu, Pneumovax, lasted a few days and got better. Iced and used her pain meds. In from arm pit down to elbow from Pneumovax, site swollen

VAERS ID:231738 (history)  Vaccinated:2003-03-06
Age:50.0  Onset:2003-03-19, Days after vaccination: 13
Gender:Male  Submitted:2004-12-27, Days after onset: 649
Location:D.C.  Entered:2004-12-29, Days after submission: 2
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Active hypertension
Diagnostic Lab Data: Repeated MRIs of the brain show MRI Brain/Angiogram and 3D reconstruction 17APR "Multiple periventricular and deep white matter foci of signal abnormality. The imaging findings are most consistent with a demyelinating process, through other inflammatory or infectious etiologies such as Lyme disease, sarcoid are not excluded. Similarly, atypical ischemia, though a possibility is felt to be unlikely as well. MRI Brain w/wo contrast 20JUN03: findings most consistent with demyelinating disease. Differential diagnosis would also include a post infections/inflammatory process. Overall, there is improvement.." MRI Brain 13AUG03: multiple periventricular and subcortical white matter lesions as described with a new enhancing lesion involving the lef
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH    
Administered by: Military     Purchased by: Military
Symptoms: Demyelination, Laboratory test abnormal, Multiple sclerosis, Nervous system disorder
SMQs:, Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow)
Write-up: CNS Demyelinating disease, probable Multiple sclerosis symptoms 13 days following AVA and Smallpox vaccine.

VAERS ID:231798 (history)  Vaccinated:2004-12-28
Age:50.0  Onset:2004-12-29, Days after vaccination: 1
Gender:Female  Submitted:2004-12-30, Days after onset: 1
Location:Colorado  Entered:2004-12-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1354AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0513P0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Fatigue, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Myalgias, arthralgias, fatigue, sore arm, in arm given.

VAERS ID:231883 (history)  Vaccinated:2004-12-20
Age:50.0  Onset:2004-12-21, Days after vaccination: 1
Gender:Female  Submitted:2004-12-30, Days after onset: 9
Location:Missouri  Entered:2005-01-04, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Antimicrobial; Corticosteroids
Current Illness:
Preexisting Conditions: Community acquired pneumonia; Hospitalization
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0412USA02893
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0  
Administered by: Other     Purchased by: Other
Symptoms: Respiratory distress
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Hypersensitivity (broad)
Write-up: Information has been received from a physician concerning a 50 year old hospitalized female with community acquired pneumonia and no allergies who on approximately 12/20/04 was vaccinated with a first dose of pneumococcal 23v polysaccharide vaccine. Concomitant therapy included an unspecified influenza virus vaccine, antibiotics and steroids. On 12/21/04 twelve hours after vaccination, the patient developed acute respiratory distress. Twenty four hours after vaccination, the patient was placed on life support with a ventilator. It was reported that the patient has not recovered. No product quality complaint was involved. Acute respiratory distress was considered to be immediately life threatening. Additional information has been requested. Per Follow up report received on 06/14/2005: Patient still has not recovered.

VAERS ID:231898 (history)  Vaccinated:2004-12-21
Age:50.0  Onset:2004-12-21, Days after vaccination: 0
Gender:Female  Submitted:2004-12-23, Days after onset: 2
Location:Kentucky  Entered:2005-01-04, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1561AA IMRA
Administered by: Military     Purchased by: Private
Symptoms: Hypoaesthesia oral, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: Rash, itching, numbness in mouth and tongue.

VAERS ID:232112 (history)  Vaccinated:2004-10-25
Age:50.0  Onset:2004-10-25, Days after vaccination: 0
Gender:Male  Submitted:2004-10-28, Days after onset: 3
Location:Colorado  Entered:2005-01-11, Days after submission: 75
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair for COPD
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: none
CDC 'Split Type': CO04019
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR1378AA3IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blister, Herpes zoster
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: On 10/25 dx''d with shingles given oral medication. Pt. said sore started below elbow on left arm, like an infected hair about 4 hrs after flu shot. Got to the size of a penny by bedtime. Next am had bump like that on left shoulder. Over weekend turned to blisters that scabbed over. Denies pain. 10/29 getting better - no pain.

VAERS ID:232297 (history)  Vaccinated:2001-10-01
Age:50.0  Onset:2001-10-01, Days after vaccination: 0
Gender:Female  Submitted:2002-10-10, Days after onset: 374
Location:Unknown  Entered:2005-01-14, Days after submission: 827
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug Not Reported
Current Illness:
Preexisting Conditions: No risk factors reported
Diagnostic Lab Data:
CDC 'Split Type': PJP200100350
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Influenza like illness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: A report was received from a health professional on 10/17/01, concerning a 70 year old female patient who experienced mild flu like symptoms and a hot and red arm, 1 hour after receiving the Fluvirin vaccine on 10/10/01. The patient experienced a similar reaction last year but it is unknown if it was due to Fluvirin. The patient recovered on 10/16/01. There was insufficient information to determine the causality assessment of the reporter.

VAERS ID:232342 (history)  Vaccinated:2001-11-07
Age:50.0  Onset:2001-11-12, Days after vaccination: 5
Gender:Male  Submitted:2002-10-10, Days after onset: 331
Location:Unknown  Entered:2005-01-14, Days after submission: 827
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetylsalicylic acid, Vitamins
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': PJP200100435
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: A report was received from a health professional on 11/16/2001 concerning a 50 year old male patient who experienced persistent lightheadedness 5 days after receiving Fluvirin on 11/07/2001. On 11/12/2001 the patient developed lightheadedness that had persisted since onset. The patient did not have a fever or exhibit any flu-like symptoms. The patient''s blood pressure and pulse were normal and a neurological exam was normal. The patient was not receiving treatment for lightheadedness at the time of the report. The reporter''s causality assessment was recorded as possible.

VAERS ID:232385 (history)  Vaccinated:2005-01-12
Age:50.0  Onset:2005-01-12, Days after vaccination: 0
Gender:Female  Submitted:2005-01-17, Days after onset: 5
Location:Illinois  Entered:2005-01-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillin and many others
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1462AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Arm red and swollen to elbow area fingers swollen next A.M.

VAERS ID:232992 (history)  Vaccinated:2004-12-29
Age:50.0  Onset:2005-01-01, Days after vaccination: 3
Gender:Male  Submitted:2005-01-19, Days after onset: 18
Location:Pennsylvania  Entered:2005-01-27, 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: Trazadone
Current Illness:
Preexisting Conditions: Information from discharge summary states anxiety as preexisting S/S.
Diagnostic Lab Data: Cerebrospinal fluid protein - 69 (H).
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500338P0IN 
Administered by: Private     Purchased by: Private
Symptoms: Back pain, CSF protein increased, CSF test abnormal, Epidural blood patch, Fatigue, Guillain-Barre syndrome, Headache, Hyporeflexia, Inappropriate schedule of drug administration, Lethargy, Muscular weakness, Pain, Pain in extremity, Paraesthesia, Plasmapheresis, Sick relative
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow)
Write-up: Slight paresthesia of fingertips 12/30 Aching and weakness in legs 01/01 Increase weakness in legs and hospitalized 01/06 01/28/05 Pt states he had hx of a headache and lethargy early in December. Wife and son had ''stomach bug'' (gas, bloating, diarrhea) in mid December,''but I didn''t get it'', and back pain on 12/17 which went down his leg ''like sciatica''. Pt continues with out pt therapyand finds fatigue most difficult part of recovery. 02/16/05 Discharge summary received for 1/6-1/13/2005 FINAL DX: Guillain-Barre syndrome & spinal headache, improved. Time line is FluMist vax on 12/29/04, developed leg pain, weakness and numbness starting 01/01/05. He was evaluated in PMP on 01/06/05 and admitted w suspected onset of GBS. Exam revealed deceased reflexes and increased CSF protein. Was evaluated and treated by neurologist given 4 courses of plasmapheresis, symptoms improved and was discharged home 01/13/05 w/outpatient rehab & Neuro f/u.

VAERS ID:233075 (history)  Vaccinated:2005-01-25
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2005-01-31
Location:Florida  Entered:2005-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500356P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Cough, Diarrhoea, Headache, Hyperhidrosis, Malaise, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Fever (101), cold sweats, malaise, diarrhea, coryza, cough, headache.

VAERS ID:233175 (history)  Vaccinated:2002-10-15
Age:50.0  Onset:2002-10-16, Days after vaccination: 1
Gender:Female  Submitted:2003-08-22, Days after onset: 310
Location:Unknown  Entered:2005-02-01, Days after submission: 529
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug Not Reported
Current Illness:
Preexisting Conditions: No risk factors reported
Diagnostic Lab Data:
CDC 'Split Type': PJP200200601
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE33922HA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: A report was received from a health care professional on 10/21/2002 concerning a 50 year old female vaccinee who developed diarrhea and experienced a large welt over the deltoid region of her arm which was described as red, swollen, painful, warm and itching on 10/16/02, after receiving 0.5 ml of Fluvirin on 10/15/02. The vaccine was administered intramuscularly. The welt was treated with ice and paracetamol. The vaccinee was reported as recovered since 10/18/02. There was insufficient information to determine the reporter''s causality assessment. Ref: PJP200200602, PJP200200598, PJP200200597 and PJP200200596.

VAERS ID:233208 (history)  Vaccinated:2002-10-28
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2003-08-22
Location:Unknown  Entered:2005-02-01, Days after submission: 529
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant drug not reported.
Current Illness:
Preexisting Conditions: No risk factors reported.
Diagnostic Lab Data:
CDC 'Split Type': PJP200200635
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report was received from a health professional on 10/30/2002, concerning approximately 10 vaccinees who inadvertently received last year''s Fluvirin. From 10/28/2002 to 10/30/2002, approximately 10 vaccinees were inadvertently vaccinated with expired Fluvirin. There was insufficient information to determine the reporter''s causality assessment. Update 1, 01/27/2003. A report was received from a healthcare professional concerning a 50 year old female vaccinee who received expired influenza vaccine (brand unspecified) on an unspecified date. The vaccinee was subsequently re-vaccinated with this years influenza vaccination and experienced no adverse reaction.

VAERS ID:233227 (history)  Vaccinated:2005-01-05
Age:50.0  Onset:2005-01-05, Days after vaccination: 0
Gender:Female  Submitted:2005-02-01, Days after onset: 27
Location:Michigan  Entered:2005-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Sore arm, delerious;Td Adsorbed, Adult (no brand name);1;0;In Patient
Other Medications: Synthroid, glucophage, premerin
Current Illness: No
Preexisting Conditions: Denies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1569AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain
SMQs:
Write-up: Within an hour of having shot arm became painful. Took Advil, effective until Advil wore off. Arm bad again, exercised last night.

VAERS ID:233260 (history)  Vaccinated:2005-01-04
Age:50.0  Onset:2005-01-05, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Pennsylvania  Entered:2005-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol, Allegra and Echinacea
Current Illness:
Preexisting Conditions: NI
Diagnostic Lab Data: NI
CDC 'Split Type': MEDI0002686
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC500357P IN 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Medication error, Myalgia, Postnasal drip
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: This is a non serious spontaneous case from a consumer in the USA who experienced postnasal drip after receiving FluMist. The reporter causality is not provided. A 49 year old female experienced post-nasal drip, nasal congestion, muscle pain and abdominal pain on day after receiving FluMist on 01/04/05. The patient received the FluMist at a doctor''s office where she works. The patient reported that the nurse administering the vaccines accidentally left them in the office at room temperature from the afternoon of 01/05/03, but initially thought that they can still use them. It was after 01/05/05, the patient experienced abdominal pain, which was relieved spontaneously without any intervention. She also reported post-nasal drip, nasal congestion and muscle pains for which she took Tylenol and Allegra together with herbal echinacea. The patient stated that the symptoms have since lessened. The patient has not yet recovered.

VAERS ID:233478 (history)  Vaccinated:2005-01-14
Age:50.0  Onset:2005-01-14, Days after vaccination: 0
Gender:Female  Submitted:2005-01-21, Days after onset: 7
Location:Texas  Entered:2005-02-07, Days after submission: 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: NONE
Preexisting Conditions: Allergy to PCN, sulfa drugs and Co, Blue cheese and honey
Diagnostic Lab Data:
CDC 'Split Type': TX05007
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.M0864P1IMRA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Injection site pain, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: 1/2 hour after injection, area of insertion started to hurt and burn, then right side and then the butt area started hurting and then settled in the small of the back. No strength in right leg. Sent to Doctor. Pain until Sunday 1/16/05. Pt at work 1/18/05.

VAERS ID:233712 (history)  Vaccinated:2001-04-19
Age:50.0  Onset:2001-04-19, Days after vaccination: 0
Gender:Male  Submitted:2002-03-14, Days after onset: 329
Location:Michigan  Entered:2005-02-11, Days after submission: 1065
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': BIT010005
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV048B7SCLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Lymphadenopathy, Malaise, Pharyngolaryngeal pain, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: A 50 year old male received the 8th dose of Anthrax vaccine on 04/19/2001. No other vaccines were given on this date. The 7th dose of Anthrax vaccine was given on 04/13/2000. The patient had no previous reaction for the Anthrax vaccine. Concomitant medication reported was Lipitor, once a day, by mouth, for high cholesterol. On 04/19/2001, the patient experienced a hive like rash on the left upper arm and experienced malaise, sore throat, and swollen neck glands 24 hours post vaccination. Six hours post vaccination on 04/19/2001, the patient noted six hive like areas on the left upper arm which were red, itchy, and raised. 24 hours post-vaccination, the patient experienced malaise, sore throat, and swollen neck glands. Four days after the vaccination, the two remaining spots were barely visible and the itching had completely subsided. The sore throat and swollen neck glands resolved after 7 days. By 05/10/2001, the patient had completely recovered.

VAERS ID:233789 (history)  Vaccinated:2005-02-02
Age:50.0  Onset:2005-02-03, Days after vaccination: 1
Gender:Female  Submitted:2005-02-10, Days after onset: 7
Location:Wisconsin  Entered:2005-02-14, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)AVENTIS PASTEURU1278AA4IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Joint stiffness, Joint 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), Arthritis (broad)
Write-up: Started with just sore arm Thursday 02/03/05 AM, then right deltoid became red/swollen at injection site on Friday- 02/04/05. Temperature also Thursday- high of 100.7. Saturday 02/05/05 patient noticed fingers slightly swollen/stiff that increased redness of injection site. Began to resolve that night then by 02/07/05 - "back to normal".

VAERS ID:233924 (history)  Vaccinated:2002-10-24
Age:50.0  Onset:2002-10-25, Days after vaccination: 1
Gender:Female  Submitted:2003-08-22, Days after onset: 301
Location:Unknown  Entered:2005-02-17, Days after submission: 545
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200200679
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35792KA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema, Medication error
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: A report was received from a health care professional on 01Nov02 concerning a 50 year old female vaccinee who was inadvertently administered Fluvirin SC and experienced local redness and warmth at the injection site one day after receiving Fluvirin on 24Oct02. On 24Oct02 the vaccinee was inadvertently admin 0.5ml Fluvirin SC. On 25Oct02 the vaccinee experienced local redness and warmth at the injection site. The vaccinee had recovered at the time of the report. The reporter has assessed the relationship of the vaccinee to the event as probable.

VAERS ID:233978 (history)  Vaccinated:2005-01-28
Age:50.0  Onset:2005-01-28, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Alabama  Entered:2005-02-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': AL0501
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1579AA1IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dizziness, Flushing, Heart rate increased, Hyperhidrosis, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: 10:10 flushed face, lighted headedness, nausea, perfuse perspiration, rapid pulse. Administered 0.3mg Epinephrine sq elevated feet.

VAERS ID:234083 (history)  Vaccinated:2002-10-22
Age:50.0  Onset:2002-10-22, Days after vaccination: 0
Gender:Female  Submitted:2003-08-22, Days after onset: 304
Location:Unknown  Entered:2005-02-22, Days after submission: 550
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug Not Reported
Current Illness:
Preexisting Conditions: No risk factors reported
Diagnostic Lab Data:
CDC 'Split Type': PJP20020792
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES    
Administered by: Unknown     Purchased by: Unknown
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: A report received from a health care professional on 11/18/02, concerning a 50 year old female vaccinee who experienced an injection site reaction after receiving Fluvirin on 10/22/02. On 10/22/02, the vaccinee experienced an injection site reaction after receiving Fluvirin on the same day. Symptoms included a 2-3 inch area of redness, swelling and warmth at the site of injection. The vaccinee was treated with diphenhydramine cream for 1 day, and the event resolved after one week. There was insufficient information to determine the reporter''s causality assessment.

VAERS ID:234143 (history)  Vaccinated:2002-10-08
Age:50.0  Onset:2002-10-08, Days after vaccination: 0
Gender:Female  Submitted:2003-08-22, Days after onset: 318
Location:Unknown  Entered:2005-02-22, Days after submission: 550
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: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200200883
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35502KA SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report received on 25Oct02 concerning a 33 year old vaccinee and approx 15 clinic staff members (demography unk) who were administered a Fluvirin injection by inappropriate route in error in Oct02. On an unk date in Oct02, the vaccinee and approx 15 staff members were administered Fluvirin with 1/2 inch needles. The reporter suspected that the staff members may have received the vaccine via a SC and not an IM route. No adverse events were reported. The reporter has assessed the relationship of the vaccines to the event unclassifiable. Update 1 13Dec02: An update report was received received from a health care professional on 13Dec02 concerning a 50 year old female vaccine who was administered Fluvirin SC on 08Oct02. On 08Oct02, the vaccinee was inadvertently administered Fluvirin SC. The outcome of the event was unk. No further information was provided. Ref: PJP200200657, PJP200200882, PJP200200890, PJP200200884, PJP200200885, PJP200200889.

VAERS ID:234145 (history)  Vaccinated:2002-10-08
Age:50.0  Onset:2002-10-08, Days after vaccination: 0
Gender:Female  Submitted:2003-08-22, Days after onset: 318
Location:Unknown  Entered:2005-02-22, Days after submission: 550
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: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200200885
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESE35502KA SC 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report received on 25Oct02 concerning a 33 year old vaccinee and approx 15 clinic staff members (demography unk) who were administered a Fluvirin injection by inappropriate route in error in Oct02. On an unk date in Oct02, the vaccinee and approx 15 staff members were administered Fluvirin with 1/2 inch needles. The reporter suspected that the staff members may have received the vaccine via a SC and not an IM route. No adverse events were reported. The reporter did not have further details (name, age, pregnancy, medical/drug history) of other staff members. The reporter has assessed the relationship of the vaccines to the event unclassifiable. Update 1 13Dec02: An update report was received received from a health care professional on 13Dec02 concerning a 49 year old female vaccine who was administered Fluvirin SC on 08Oct02. On 08Oct02, the vaccinee was inadvertently administered Fluvirin SC. The outcome of the event was unk. No further information was provided. Ref: PJP200200657, PJP200200883, PJP200200882, PJP200200885, PJP200200889, PJP200200890.

VAERS ID:234162 (history)  Vaccinated:2005-02-10
Age:50.0  Onset:2005-02-14, Days after vaccination: 4
Gender:Female  Submitted:2005-02-14, Days after onset: 0
Location:Tennessee  Entered:2005-02-22, 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: NONE
Current Illness: NONE
Preexisting Conditions: Sulfa drugs caused upset stomach
Diagnostic Lab Data: NONE
CDC 'Split Type': TN05009
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1560AB0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt reports she noticed sporadic itching on left arm 4 days post vaccine admin. Today she has 5 small papules (2 2mm wide) confluent on left deltoid. No swelling, redness or pustules noted. Given Benadryl and hydrocortisone cream. Will call if needed.

VAERS ID:234229 (history)  Vaccinated:2002-10-28
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2003-08-22
Location:Unknown  Entered:2005-02-23, Days after submission: 551
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: NONE
Diagnostic Lab Data:
CDC 'Split Type': PJP200300054
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: A report received from a health professional on 30Oct02, concerning approx 10 vaccinees who inadvertently received last years formulation of Fluvirin. From 28Oct02 to 30Oct02, 20-30 staff members were vaccinated with Fluvirin. After finishing the vaccination, a staff member noticed that one of the used vials was last years vaccine (2001-2002). The vial was discarded, thus the batch number is not available. There was insufficient information to determine the reporters causality assessment. Update 1 27Jan03: A report was received from a health care professional concerning a 50 year old female vaccinee who received expired influenza vaccine (brand unspecified) on an unspecified date. The vaccinee was subsequently revaccinated with this years influenza vaccination and experienced no adverse reaction. See ref: PJP200200635, PJP200300049, PJP200300050, PJP200300051, PJP200200052, PJP200300053.

VAERS ID:234361 (history)  Vaccinated:2004-10-01
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2005-02-25
Location:New York  Entered:2005-02-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Allergies to food- soy, melon, wine
Diagnostic Lab Data: Muscle weakness test, Blood tests- CBC, ANA, C-Reactive protein, RA factory
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Public
Symptoms: Pain
SMQs:
Write-up: Pain in both arms from elbow to just below shoulder, thinks it began in November. Mentioned it to PCP. No treatment at this point. Then went to ER for arm pain where they ran tests for muscle weakness & blood tests. Referred to Cardiologist who tested his heart and found no problems. Referred to rheumatologist, has not had appointment yet. Arm still sore, burning ache and pain varies in intensity.

VAERS ID:234430 (history)  Vaccinated:2005-01-25
Age:50.0  Onset:2005-02-02, Days after vaccination: 8
Gender:Female  Submitted:2005-02-13, Days after onset: 11
Location:Massachusetts  Entered:2005-02-28, Days after submission: 15
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
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.1300N  RA
Administered by: Other     Purchased by: Unknown
Symptoms: Arthralgia, Demyelination, Fatigue, Lymphadenopathy, Pharyngolaryngeal pain, Rash
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (broad), Demyelination (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 8 days with vaccine lymph nodes developed on both sides neck, 13 days rash demyelination then overwhelming fatigue, intermittent sore throat, joints ache.

VAERS ID:234976 (history)  Vaccinated:2004-04-07
Age:50.0  Onset:2004-04-07, Days after vaccination: 0
Gender:Male  Submitted:2005-03-07, Days after onset: 334
Location:Unknown  Entered:2005-03-15, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0406USA01115
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1352N0  
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a health professional concerning a 50 year old male who on 07Apr04 was vaccinated in the right deltoid with a first dose of hep b virus vaccine rHBsAg (yeast) (lot 646601/1352N). It was noted that the pt had a pertinent medical history. Subsequently, the pt experienced a local reaction at the right deltoid including swelling at the site and redness at the site. It was reported that the pt did not return for his second dose until 09Jun04. Unspecified medical attention was sought. Additional information has been requested.

VAERS ID:235070 (history)  Vaccinated:2005-02-17
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-03-09
Location:Virginia  Entered:2005-03-16, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.0963N0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt rec''d measles immunization in left arm on 2/17/05. Arm became red, edematous, painful. Progressed to neuralgia. Pt returned to clinic on 3/7/05. Pt was sent to ER. Pt stated she had reaction x1 week prior to office visit which was reported-therefore onset approx 3/1/05, but states is unclear of actual onset of symptoms. Pt stated that she noticed something wrong right after the shot which was received on 2/17/05.

VAERS ID:235345 (history)  Vaccinated:2005-03-10
Age:50.0  Onset:2005-03-12, Days after vaccination: 2
Gender:Female  Submitted:2005-03-23, Days after onset: 11
Location:Colorado  Entered:2005-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metoprolol Naproxen Lansoprazole Sertraline Nasal fluticasone Amoldipine+atorvastatin Metformin Spironolactone Aspirin Eprosartan + hydrochlorothiazide Lorazepam
Current Illness: None acute
Preexisting Conditions: Diabetes mellitus Hypertension Hypercholesterolemia Sleep apnea Depression Allergic rhinitis Allergy=Penicillins, Sulfonamides
Diagnostic Lab Data: Affected left upper arm area incised, prurulent materal drained, packed and dressed.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1354AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site abscess
SMQs:
Write-up: Cutaneous abscess at injection site.

VAERS ID:235364 (history)  Vaccinated:2005-03-21
Age:50.0  Onset:2005-03-21, Days after vaccination: 0
Gender:Female  Submitted:2005-03-23, Days after onset: 2
Location:California  Entered:2005-03-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Myalgia
Preexisting Conditions: Hypertension, Hyperlipidemia, duct controlled type II diabetes.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1218BA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site oedema, Injection site warmth, Malaise, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Pt c/o swelling and warmth at injection site which began on day of injections then progressed to all over myalgia, subjective fevers, and malaise.

VAERS ID:235416 (history)  Vaccinated:2005-03-10
Age:50.0  Onset:2005-03-10, Days after vaccination: 0
Gender:Male  Submitted:2005-03-18, Days after onset: 8
Location:New Jersey  Entered:2005-03-25, Days after submission: 7
Life Threatening? No
Died? Yes
   Date died: 2005-03-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Betadine
Current Illness:
Preexisting Conditions: The patient had no known allergies. He has a history of numbness after receiving TD in 1993.
Diagnostic Lab Data: Autopsy being done
CDC 'Split Type': 200500544
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1211DA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiomyopathy, Coronary artery disease, Myocardial infarction, Similar reaction on previous exposure to drug
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Cardiomyopathy (narrow), Other ischaemic heart disease (narrow)
Write-up: From initial information received on 11Mar05 from a health care professional regarding an adverse event occurring, it was reported that a forty-nine-year old male pt was injured on the job and presented with a laceration to the tip of his fourth finger. He received a dose of Decavac vaccine with lot number U1211DA on 10Mar05 between 11 and 12AM. The route and site of administration were not reported. He also received four sutures on his fourth finger with Lidocaine and local care with Betadine on his fifth finger. The pt returned to work. Later the same day, at approx 6 PM, the pt was found dead at the plant where he worked. It was sometime between 4 and 6 PM that they think he passed away. An autopsy was being performed. Received Autopsy Report which stated COD as acute MI, coronary artery disease secondary to dilated cardiomyopathy.

VAERS ID:235582 (history)  Vaccinated:2005-01-26
Age:50.0  Onset:2005-01-29, Days after vaccination: 3
Gender:Female  Submitted:2005-03-30, Days after onset: 60
Location:California  Entered:2005-03-30
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: bad reaction as a young child but no problems when repeated at age 20~Smallpox (Dryvax)~~0.00~In Patient
Other Medications: Lexapro 20 mg, Levothyroxine 150mcg, Spironolactone 25mg
Current Illness: None
Preexisting Conditions: Hypothyroid-Hashimoto''s since 1990
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVA039AA0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURX11890SCRA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)SANOFI PASTEURU1341AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0439P0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Injection site pain, Joint range of motion decreased, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: A few hours after receiving the vaccines I had burning in the back of my left arm just above the elbow. A few days later I developed deep aching pain and weakness in my left elbow and left forearm. This pain and weakness is still present to the extent it hurts to hold a cup of coffee. I am unable to do normal lifting activities with my left arm. Weakness & pain in left arm lasted over 4 months, but is now gone.

VAERS ID:235981 (history)  Vaccinated:2005-03-31
Age:50.0  Onset:2005-03-31, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2005-04-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Fibromyalgia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0751P IMLA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1215DA IMRA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Nonspecific reaction, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt came in for blood work on 04/01 stating that left arm (upper) swollen and red. Iced area day before. Adverse reaction to pneumovax. To use cold compress x 48 hours, then warm.

VAERS ID:236012 (history)  Vaccinated:2002-11-14
Age:50.0  Onset:2002-11-15, Days after vaccination: 1
Gender:Female  Submitted:2005-04-07, Days after onset: 873
Location:Washington  Entered:2005-04-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Neurologic symptoms (NOS)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
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Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU0971AA3IMLA
Administered by: Other     Purchased by: Other
Symptoms: Balance disorder, Fatigue, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: The morning after receiving a flu shot, Pt reports she awoke with no sensation from hips thru toes and elbows through finger tips. Has fatigue and episodes of loss of balance since then. Resolving, partially according to Pt.

VAERS ID:236183 (history)  Vaccinated:2005-04-16
Age:50.0  Onset:2005-04-17, Days after vaccination: 1
Gender:Male  Submitted:2005-04-17, Days after onset: 0
Location:New Jersey  Entered:2005-04-17
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 noted
Preexisting Conditions: Patient is taking Tiazac, Diovan, Hydrochlorothyizide all for Blood Pressure.
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1557AA9IMUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX08503IMUN
Administered by: Military     Purchased by: Military
Symptoms: Face oedema, Hypoaesthesia, Pain, Speech disorder
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow)
Write-up: Chief complaint of right arm numbness, pain, difficulty speaking, asymmetry of lips at 2:30 in the afternoon following a vaccination of Influenza and Typhoid at 11:30am. Patient was taken to hospital by EMS.

VAERS ID:236217 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-01-25
Location:New Jersey  Entered:2005-04-18, Days after submission: 82
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Thyroxine sodium
Current Illness: UNK
Preexisting Conditions: 19Jan04: Physician reported that pt had swelling, likely secondary to MRI dye. Concurrent conditions were not reported. The indication for Levoxyl was not specified.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0522100A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2 LA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: This case was initially reported by a consumer and described the occurrence of knee joint pain in a 50 year old female pt who received Lyme disease vaccine recombinant (Lymerix). The initial reporter is the pt. Follow up information was received by a physician. Concurrent medication at the time of immunization included Thyroxine sodium (Levoxyl). The indication for Levoxyl was not specified. The consumer reported that on an unspecified date in 2000, the pt received the third dose of Lymerix in the right arm. Approx four years after the admin of Lymerix, on an unspecified date in April 2004, the pt experienced joint pain in both knees. The pt was seen at a physician''s office. The event was ongoing at the time of initial reporting. The physician subsequently reported that he examined the patient on 1/19/04. The physician stated that the patient experienced swelling likely secondary to MRI dye. He also stated "No report of reaction to Lyme disease."

VAERS ID:236360 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2005-04-14
Location:Alaska  Entered:2005-04-20, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: muscle, join aches, sleeplessness, appetite lost, fever and chills;Influenza (Fluzone);;0;In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1377AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Anorexia, Chills, Insomnia, Myalgia, Pyrexia, Tinnitus, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (narrow)
Write-up: Severe muscle and bone aches beginning about 6 hours after shot. Little or no sleep x 2 nights. Vertigo/ dizziness and ears ringing. Loss of appetite. Feel fever and chills, cannot work for 2-3 days.

VAERS ID:236382 (history)  Vaccinated:2005-04-18
Age:50.0  Onset:2005-04-19, Days after vaccination: 1
Gender:Female  Submitted:2005-04-20, Days after onset: 1
Location:Maryland  Entered:2005-04-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cenestin
Current Illness: no illness at time vaccination
Preexisting Conditions: none
Diagnostic Lab Data: none--temperature and vitals taken.
CDC 'Split Type':
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RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS3400112IMRA
Administered by: Military     Purchased by: Other
Symptoms: Arthralgia, Chills, Headache, Myalgia, Nausea, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), 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), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Fever of 103F with shaking chills, severe generalized arthralgias and myalgias, persistent headache and mild nausea, beginning at about 20hrs post-rabies vaccine booster and lasting for about 8hrs for fever, and about 24hrs for other symptoms.

VAERS ID:236554 (history)  Vaccinated:2005-04-11
Age:50.0  Onset:2005-04-14, Days after vaccination: 3
Gender:Female  Submitted:2005-04-25, Days after onset: 11
Location:Massachusetts  Entered:2005-04-25
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
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB021AA IMLA
JEV: JAPANESE ENCEPHALITIS (JE-VAX)AVENTIS PASTEUREJN213A SCLA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURTD106 IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, Chills, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Left arm Deltoid area, presented with cellulitis- 4cm presented with fever, chills achy body within of vaccine. 04/18/2005 Office visit, no erythema, or swelling. Pt well.

VAERS ID:236614 (history)  Vaccinated:2005-04-19
Age:50.0  Onset:2005-04-19, Days after vaccination: 0
Gender:Male  Submitted:2005-04-20, Days after onset: 1
Location:Iowa  Entered:2005-04-26, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone 20mg BID x 12 D, Triamsinalone 1ml given in R deltoid
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0751P  LA
Administered by: Private     Purchased by: Unknown
Symptoms: Face oedema, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Rash on arms bilaterally with facial swelling and rash.

VAERS ID:236675 (history)  Vaccinated:2005-04-20
Age:50.0  Onset:2005-04-24, Days after vaccination: 4
Gender:Male  Submitted:2005-04-26, Days after onset: 2
Location:Texas  Entered:2005-04-26
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
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Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000672 PO 
Administered by: Other     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 04/26/2005 Employee presents with a round circular at site of injection. Appears to be same size as round adhesive band aid placed over site of injection. Administered diphenhydramine 25mg to relieve itching. Event: On 04/20/05 employee received a business travel related injectable vaccine and a circular band aid was placed at the site of vaccination. On 04/24/2005, employee removed the band aid and found a circular shape rash had developed. 04/26/2005: Reported to medical. Skin rash on left upper arm possibly due to sensitivity to adhesive bandaid. Administered OTC medication for relief of itching, no restriction, no lost time.

VAERS ID:237055 (history)  Vaccinated:2003-11-10
Age:50.0  Onset:2003-12-30, Days after vaccination: 50
Gender:Male  Submitted:2005-05-05, Days after onset: 491
Location:Illinois  Entered:2005-05-05
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: Numberous blood tests have been performed as well as skin biopsy of lesions.
CDC 'Split Type':
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0800IM 
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1129AA0IM 
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5373A60IM 
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUB493AA0SC 
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1081M0IM 
Administered by: Military     Purchased by: Military
Symptoms: Rash, Rash erythematous, Skin disorder, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Soldier received vaccinations in November of 03 and reported onset of rash starting at neck in late December of 04. Rash continued to worsen over the following 16 months with the rash presenting at it''s worse in Dec. 04 according to the patient. Non-pruritic and non painful. Rash is located over the entire torso accept for the palms and soles. Very minimal rash occurance to the face, with facial involvement not occuring until December of 2004. White pigmentation is present over a large majority of the skin possibly suggesting permanent scarring. Rash is raised with crusty appearance noted on some of the lesions. No other health issues have been noted by the patient. Patient reports that lesions have opened on occasion but were non draining. Was treated with topicals periodically and completed a course of Prednisone in early March 2005 with no effect noted. Has been seen by numerous specialists with no definitive diagnoses being made.

VAERS ID:237096 (history)  Vaccinated:2005-03-23
Age:50.0  Onset:2005-03-23, Days after vaccination: 0
Gender:Female  Submitted:2005-03-28, Days after onset: 5
Location:Idaho  Entered:2005-05-06, Days after submission: 38
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: Allergy to Penicillin
Diagnostic Lab Data:
CDC 'Split Type': ID05014
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUE317AA0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Client called 3/28/05 states had reaction to meningitis vaccine given 3/23/05 states 2 hrs after receiving vaccine had fever, nausea, and headache. Did not seek medical treatment. States did not feel good for 3 days.

VAERS ID:237232 (history)  Vaccinated:2005-03-03
Age:50.0  Onset:2005-03-03, Days after vaccination: 0
Gender:Female  Submitted:2005-05-10, Days after onset: 67
Location:Unknown  Entered:2005-05-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: rash, hives~Influenza (Seasonal) (Flu-Imune)~1~0.00~Patient
Other Medications: Prescribed: Zolpidem Tartrate 10 mg po hs sleep Gatifloxacin 400mg po (began 3/2/05) x 21 days for URI Lisinopril 20 mg po daily for hypertension Flonase nasal spray 2 puff each nostril for URI Nasal Saline spray 3 sprays prn each nost
Current Illness: chronic sinusitis
Preexisting Conditions: 1. Lumbago 2. Hypertension 3. Herpes Zoster (shingles) 4. chest pain 5. Adverse effects of drug therapy vaccines 6. sensorineural hearing loss: right 7. Bulging Disc (L3-4) 8. dysphagia 9. costochondritis (Tietze's syndrome) 10. chronic sinusitis 11. tension headaches 12. atopic eczematous dermatitis 14. allergic rhinitis history rash/hives with Imitrex 2003 and influenza 12/2004
Diagnostic Lab Data: 14 April 2005 Protein Electrophoresis-Serum Protein SERUM 7.9 Albumin SERUM 4.59 Albumin SERUM 58.14 A-1-Glob SERUM 0.36 A-1-Glob SERUM 4.55 A-2-Glob SERUM 8.66 B-Glob SERUM 1.30 (H) B-Glob SERUM 16.51 (H) A-2-Glob SERUM 0.68 G-Glob SERUM 0.96 G-Glob SERUM 12.14 SPEP Interpretation SERUM NO ABNORMAL PROTEIN BANDS DETECTED
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Condition aggravated, Dyspnoea, Erythema, Headache, Hearing impaired, Hypersensitivity, Laboratory test abnormal, Pain, Palpitations, Pruritus, Similar reaction on previous exposure to drug, Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hearing impairment (narrow), Hypersensitivity (narrow)
Write-up: This healthy 50 year-old received her Pneumovax vaccination on 03 March 2005 at a Clinic where she was undergoing evaluation for chronic sinusitis. While in the lab 20-30 minutes post vaccination, she began to feel a prickly sensation with itching to her shoulders, chest, face and wrists. She noticed blotching with hives and redness to these areas. She complained of shortness of breath secondary to feeling a lump in her throat with tightness in her throat and chest. She denied any inability to breath, chest pain, nervousness or syncope. She states these symptoms were similar to reactions she had had in December 2004 with the influenza vaccine and reactions following use of Motrin, NSAIDs, Ultram and Imitrex in 2003. She returned to Allergy and Immunology and was evaluated. MD documented generalized erythema of small areas 4mm on the upper shoulders and arms. She began to complain of increasing tightness in her throat and Zyrtec, 0.3cc Epinephrine IM, 60 mg Prednisone PO and 25 mg Benadryl PO were administered. She complained of palpitations following the epinephrine, but again denied any chest pain or palpitations prior to. She was observed for one hour with resolution of symptoms except for persistent mild pruritic redness to the right cheek and shoulder with complaints of a headache. She was given 325 mg Tylenol PO for the headache. The HC was called to assist in a case review and VAERS write up. MD has been evaluating this patient with referral to another MD for chronic sinusitis, constant maxillofacial pain right side with diminished hearing and teeth sensitivity. She is currently undergoing full laboratory and diagnostic evaluation.

VAERS ID:237258 (history)  Vaccinated:2005-04-13
Age:50.0  Onset:2005-04-15, Days after vaccination: 2
Gender:Female  Submitted:2005-05-02, Days after onset: 17
Location:California  Entered:2005-05-12, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUE499AA0SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Headache, Myocardial infarction, Neck pain, Pain, Pallor, Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Embolic and thrombotic events, arterial (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: 5/02/2005 Pt called to report vaccine adverse event. Pt took yellow fever injection 4/13/2005 at about 3 PM. Two days later 4/15/2005, while driving, pt stated her heart started to race, she kept driving another 10 minutes or so arriving at her destination. She got a severe headache and a crushing neck pain, took a Tylenol and her daughter said she looked gray. She called her sister and asked her to read the yellow fever VIS which mentioned a fast heartbeat. But now its about 5:30 and left arm is starting to hurt. She called the health center toll free number which directed her to call her MD/911. Went to hospital. MD in ER gave her a test which resulted in a diagnosis of heart attack. MD seemed to think it was a result of taking Claritin D tablet that morning. Pt states that she had taken Claritin D before with no adverse reaction and thinks it was the yellow fever injection.

VAERS ID:237485 (history)  Vaccinated:2005-05-12
Age:50.0  Onset:2005-05-15, Days after vaccination: 3
Gender:Male  Submitted:2005-05-17, Days after onset: 2
Location:Georga  Entered:2005-05-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0267P SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eyelid oedema, Rash, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: rash on both arms and both sides of neck. eyes swollen

VAERS ID:237518 (history)  Vaccinated:2005-01-15
Age:50.0  Onset:2005-01-22, Days after vaccination: 7
Gender:Female  Submitted:2005-05-18, Days after onset: 115
Location:Massachusetts  Entered:2005-05-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Voltrex
Current Illness: Herpes-- on Voltrex (suppressive therapy for herpes)
Preexisting Conditions: Herpes
Diagnostic Lab Data: States CDC, Mono test and lyme test WNL. ANA was borderline (150). Will get more lab tests done today. States lyme is endemic in her area and lyme test not reliable so may get treated for lyme. Had negative HIV test last year, but will get
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR 5  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bacterial infection, Bronchitis, Fatigue, Sinusitis
SMQs:
Write-up: One week after flu vaccine, had fatigue and sinusitis, and bronchitis. Treated with antibiotics, recovered and had recurrence of sinusitis in Feb.and bronchitis in late April. Has been in bed, off work with severe fatigue since February, 2005.

VAERS ID:237535 (history)  Vaccinated:2004-03-15
Age:50.0  Onset:2004-03-16, Days after vaccination: 1
Gender:Male  Submitted:2004-05-06, Days after onset: 50
Location:Utah  Entered:2005-05-19, Days after submission: 378
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dog bite
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type': 200401508
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEUR 3  
Administered by: Public     Purchased by: Public
Symptoms: Injection site rash, Injury, Pruritus
SMQs:, Anaphylactic reaction (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Hypersensitivity (narrow)
Write-up: From initial information received on 4/14/04 from the patient regarding an adverse event occurring in the USA, it was reported that a male patient (age not reported) received his fourth dose of IMOVAX RABIES on 3/15/04 due to a dog bite to his ankle. The lot number of the vaccine as well as route and site of administration were not reported. The following day, the patient experienced rash at the site of injection as well as intermittent itching like ant bites all over his body. Reportedly, the patient did not recover from these events. He received his first dose of IMOVAX RABIES as well as a dose of IMMUNOGLOBULIN HUMAN ANTIRABIES vaccine on 2/27/04 with no reaction reported. From additional information received on 4/26/04 from the patient, the patient''s date of birth was provided. It was also reported that the dose administered was from a post-exposure series. The patient was vaccinated at a pubic health clinic/hospital and purchased the vaccine with public funds. The telephone number for the responsible facility was provided. Reportedly, the patient experienced a very swollen arm with the fourth dose of vaccination and two days later complained of pruritus throughout the entire body. The patient had also previously received a dose of TD ADS ADULT with no reaction reported. It was also reported that the patient has gone for a doctor''s visit and still complains of pruritus.

VAERS ID:237536 (history)  Vaccinated:2004-03-31
Age:50.0  Onset:2004-04-07, Days after vaccination: 7
Gender:Male  Submitted:2004-04-26, Days after onset: 19
Location:Texas  Entered:2005-05-19, Days after submission: 388
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': 200401513
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEUR   LA
Administered by: Public     Purchased by: Unknown
Symptoms: Headache, Injection site pain, Insomnia, Mood altered, Nervousness
SMQs:, Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad)
Write-up: From initial information received on 4/15/04 from a workman''s compensation representative regarding an adverse event occurring in the USA, it was reported that a 50 year old male patient received a dose of IMOVAX RABIES in the left arm on 3/31/04. The lot number, route and dose number were not reported. It was not reported whether the patient received the product as part of a pre- or post-exposure series. On 4/7/04, the patient complained of headache and sleeplessness. It was reported that he felt nervous and edgy and became argumentative. He also had a very sore left arm at the site of injection. He was seen by a physician and had not yet recovered from these events at the time of this report.

VAERS ID:238696 (history)  Vaccinated:2004-10-18
Age:50.0  Onset:2004-10-18, Days after vaccination: 0
Gender:Female  Submitted:2005-05-16, Days after onset: 210
Location:Unknown  Entered:2005-06-01, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cardizem, Premarin, Synthroid, Prinivil, Prilosec.
Current Illness:
Preexisting Conditions: hypertension; diabetes; drug hypersensitivity.
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0410USA02660
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0574N   
Administered by: Other     Purchased by: Other
Symptoms: Medication error, Pain
SMQs:
Write-up: Information has been received from a 50 yr old female registered nurse with hypertension, diabetes and allergies to codeine and acetaminophen (hydrocodone bitartrate (Vicodin) who on 18Oct04 was splashed in the eye with varicella virus vaccine live during administration. Concomitant therapy included diltiazem hydrochloride (Cardizem), lisinopril 9 (manf unk), estrogens, conjugated (Premarin), levothyroxine sodium (Synthroid) and omeprazole (Prilosec). The nurse experienced a slight stinging sensation in her eye and rinsed her eye with water as an intervention. She did not seek medical attention. There was no product quality complaint involved. Additional information is not expected.

VAERS ID:239296 (history)  Vaccinated:2005-01-24
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-05-16
Location:California  Entered:2005-06-07, Days after submission: 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:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': waes0502usa02278
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular, Skin ulcer
SMQs:, Hypersensitivity (narrow)
Write-up: Information was received from a registered nurse concerning a 50 year old female who on 24 JAN 2005 was vaccinated with a dose of Varicella live virus. Subsequently the patient developed ten vesicular lesions on her body mostly at teh injection site. Not other symptoms were noted. Unspecified medical attetntion was sought. The outcome was repoted as recovered. There was no product quality complaint. Additional ifnormation was requested.

VAERS ID:240132 (history)  Vaccinated:2004-03-24
Age:50.0  Onset:2004-03-25, Days after vaccination: 1
Gender:Female  Submitted:2004-07-06, Days after onset: 102
Location:California  Entered:2005-06-10, Days after submission: 339
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': 200401651
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1018BA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: From initial information received on 4/20/04 from a health care professional regarding an adverse event occurring in the USA, it was reported that a 49 year old female patient received a dose of TD ADS ADULT, lot number U1018AA, administered IM in the deltoid. The following day, the patient experienced body aches as well as redness, swelling and soreness at the site of injection. Reportedly, the symptoms lasted one week and the patient recovered from these events. The reporter of this case is the same reporter of case 200401652. No further information is anticipated, this case is considered closed.

VAERS ID:240133 (history)  Vaccinated:2004-02-13
Age:50.0  Onset:2004-02-14, Days after vaccination: 1
Gender:Female  Submitted:2004-07-08, Days after onset: 144
Location:California  Entered:2005-06-10, Days after submission: 337
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': 200401652
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1018BA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: From initial information received on 4/20/04 from a health care professional regarding an adverse event occurring in the USA, it was reported that a 49 year old female patient received a dose of TD ADS ADULT, lot number U1018BA, administered IM in the deltoid on 2/13/04. The following day, on 2/14/04, the patient experienced swelling and redness at the injection site and could not lay on her arm. The symptoms resolved after persisting for seven days. The reporter of this case is the same reporter of case 200401651.

VAERS ID:240137 (history)  Vaccinated:2004-05-23
Age:50.0  Onset:2004-05-23, Days after vaccination: 0
Gender:Female  Submitted:2004-12-06, Days after onset: 197
Location:Connecticut  Entered:2005-06-10, Days after submission: 185
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': 2004020210
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1019AA IMLA
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: From initial info received on 5/26/04 from a physician''s assistant regarding an adverse event occurring in the USA, it was reported that a 50 year old female pt received a dose of TD ADS ADULT, lot U1019AA, IM, in the left deltoid on 5/23/04. Within 6 hours, the pt''s left deltoid area became red, swollen and tender to touch. She was seen 36 hours later, on 5/25/04, and given Benadryl, Motrin and cool compresses. The pt''s recovery status was unknown at the time of the report.

VAERS ID:240150 (history)  Vaccinated:2004-09-24
Age:50.0  Onset:2004-09-25, Days after vaccination: 1
Gender:Female  Submitted:2005-01-21, Days after onset: 118
Location:Unknown  Entered:2005-06-10, Days after submission: 139
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin
Current Illness:
Preexisting Conditions: The patient had no illnesses at the time of vaccination. The patient has a history of a skin lesion above her left eyebrow. Her last tetanus booster was more than five years ago and the actual date is unknown.
Diagnostic Lab Data:
CDC 'Split Type': 200403263
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1347AA  LA
Administered by: Private     Purchased by: Unknown
Symptoms: Feeling hot, Injection site erythema, Injection site swelling, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: From initial information received on 09/30/2004 from a healthcare professional regarding an adverse event occurring in the USA, it was reported that a 49 year old female patient received a TD ADS adult vaccination, lot number U1347AA, administered in the left deltoid on 09/24/2004. The route of administration was not reported. The following day, on 09/25/2004, the patient developed a local reaction of redness and swelling measuring 3 x 3.5cm at the injection site. The area was also warm and tender. The patient was seen by a physician on 09/28/2004. At the time of this report the patient had not recovered from these events.

VAERS ID:240553 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-06-17
Location:Tennessee  Entered:2005-06-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The pt''s medical history, concurrent conditions, and concurrent medications were not reported.
Diagnostic Lab Data: Hep B antibody Dec2003 Negative.
CDC 'Split Type': A0443567A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a pharmacist and described a 50 year old female pt who did not respond to the hep B vaccine recombinant (Engerix B) immunization series. The pt received her first dose of Engerix B on an unspecified date in 2000. She then received her second dose on an unspecified date in June 2003, followed by her third dose on an unspecified date in Oct 2003. Subsequently in Dec 2003 lab work indicated that the pt did not respond.

VAERS ID:240581 (history)  Vaccinated:2004-01-27
Age:50.0  Onset:2004-01-27, Days after vaccination: 0
Gender:Male  Submitted:2005-06-17, Days after onset: 506
Location:Arkansas  Entered:2005-06-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: Information about medical history, concurrent medical conditions and medications were not provided. This is 1 of 4 reports from this site.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0496323A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG5465A62  
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a nurse and described the occurrence of injection site reaction in a 50 year old male pt who received Engerix-B. On 1/27/04, the pt received the 3rd dose of Engerix-B. At the time of vaccination, the pt experienced an injection site reaction characterized by "sever" injection site pain. The events were associated with a potential product complaint. On an unspecified date, the events resolved. The nurse considered the events to possibly be related to vaccination with Engerix-B.

VAERS ID:240604 (history)  Vaccinated:2004-03-09
Age:50.0  Onset:2004-03-12, Days after vaccination: 3
Gender:Male  Submitted:2005-06-17, Days after onset: 461
Location:Kentucky  Entered:2005-06-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No Concurrent medication
Current Illness: Unknown
Preexisting Conditions: The patient''s medical history and concurrent conditions were not reported.
Diagnostic Lab Data: Unknown
CDC 'Split Type': A0507209A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5389A4   
Administered by: Public     Purchased by: Private
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: This case was reported by a medical assistant and described the occurrence of itching on bottom of feet in a 49 year old male patient who received hepatitis B vaccine recombinant (Engerix-B). On 03/09/2004, the patient received the first dose of Engerix-B. Approximately 3 days after administration of Engerix-B, on 03/12/2004, the patient experienced itching on bottom of feet. On an unspecified date, the event resolved. The medical assistant considered the event to probably be related to vaccination with Engerix-B.

VAERS ID:240608 (history)  Vaccinated:2004-04-06
Age:50.0  Onset:2004-04-06, Days after vaccination: 0
Gender:Female  Submitted:2005-06-17, Days after onset: 437
Location:Connecticut  Entered:2005-06-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multivitamin, soya protein, magnesium salt, vitamin b, fish oil, guggulipid, aspirin
Current Illness: Unknown
Preexisting Conditions: adenotonsillectomy, appendectomy, arthritis, family history of coronary heart disease, hypercholesterolemia, hysterectomy, osteopenia. Family history of thyroid problems; the patient''s concurrent conditions were not reported.
Diagnostic Lab Data: Unknown
CDC 'Split Type': A0507860A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS5507AY   
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Influenza like illness, Muscular weakness, Myalgia, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: This case was reported by a health professional and described the occurrence of muscular ache of the thigh in a 49 year old female patient who received hepatitis B vaccine recombinant (Engerix-B). The patient''s past medical history included adenotonsillectomy, appendectomy, arthritis, hypercholesterolemia, hysterectomy and ostepenia. The patient also had family history of coronary heart disease and unspecified thyroid problems. Concurrent medications included Multivitamin, Soy, Magnesium, Vitamin B, Fish Oil, Guggulipid, Baby aspirin, Actonel, Flax seed oil and calcium. On 04/06/2004, the patient received the first dose of Engerix-B in her left arm. At an unspecified time after the administration of Engerix-B on 04/06/2004, the patient experienced muscular aches in her thighs, joint aches, fatigue, muscle weakness, rash on her neck and forearms, and flu-like symptoms. The events resolved on 04/08/2004. The immunization series with Engerix-B was discontinued. The health professional considered the events to possibly be related to vaccination with Engerix-B.

VAERS ID:240631 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-06-17
Location:Ohio  Entered:2005-06-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The pt''s medical history, concurrent conditions and concurrent medications were not reported. The nurse reported that another pt received an expired dose of Engerix B. Please see case A0516878A.
Diagnostic Lab Data: Hep B surface antibody Apr04: test result 6.
CDC 'Split Type': A0516579A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Private     Purchased by: Other
Symptoms: Drug ineffective, Medication error
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a nurse and described a 50 yr old female pt who did not respond to immunization with hep B vaccine recombinant (Engerix B). On unspecified dates, the pt received the full series of Engerix B (dose numbers not specified). At an unspecified time following the admin of the Engerix B series, on an unspecified date in Apr 2004, a hep B surface antibody test revealed a titer of six. On 18Jun04, the pt received a booster dose of Engerix B (lot ENG5379A4). The expiration date for this lot of Engerix B is 18May04. No adverse event occurred following the 18Jun04 booster dose.

VAERS ID:240495 (history)  Vaccinated:2004-06-19
Age:50.0  Onset:2004-07-04, Days after vaccination: 15
Gender:Female  Submitted:2005-02-01, Days after onset: 212
Location:Illinois  Entered:2005-06-27, Days after submission: 145
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroid, Nexium
Current Illness:
Preexisting Conditions: The patient has a history of an underactive thyroid and acid reflux. She has no known allergies. She did not have any illnesses at the time of vaccination.
Diagnostic Lab Data: Biopsy showed cells associated with erythema nodosum.
CDC 'Split Type': 2004036880
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEUR  IM 
Administered by: Private     Purchased by: Private
Symptoms: Erythema nodosum, Pain, Subcutaneous nodule, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: From the initial information received on 11/06/2004 from the patient regarding an adverse event occurring in the USA, it was reported that this 49 year old female received a dose of Tetanus Toxoid ADS on 06/19/2004. The lot number and site of administration were not reported. During the week of 07/04/2004, the patient noticed some nodules which progressively developed into very painful, purplish nodules under the skin on her shins and lower legs. This was accompanied by swollen legs and ankles. In August 2004, she was diagnosed with erythema nodosum. At the time of this report, the symptoms were persisting and the patient had not recovered from the events.

VAERS ID:241032 (history)  Vaccinated:2005-06-20
Age:50.0  Onset:2005-06-20, Days after vaccination: 0
Gender:Female  Submitted:2005-06-21, Days after onset: 1
Location:Washington  Entered:2005-07-06, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline, paroxetine, Verazolam, Esklith, Valtrex
Current Illness: NONE
Preexisting Conditions: penicillin, sulfa allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBYB052AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Dizziness, nausea, room spinning 1 to 5 mins after shot. Pt was monitored, rest, seated with feet elevated, ice compress behind head/neck as needed, water. Monitored 90 mins. Driven home. Follow-up call, pt felt fine.

VAERS ID:241202 (history)  Vaccinated:2004-09-11
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2005-07-11
Location:Wisconsin  Entered:2005-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0866SCUN
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Eye disorder, Fatigue, Headache, Libido decreased, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Arthritis (broad)
Write-up: SINCE LAST ANTHRAX IMMUNIZATION SHOT. I HAVE SEEN A SIGNIFICANT HEALTH DECLINE. IN MARCH 2005, WHILE DEPOLYED I WAS EXPERIENCING PAIN IN BOTH MY ACHILES TENDONS AND I SAW A DOCTOR AT MEDICAL FACILITY. I WAS PRESCRIBED MOTRIN AND EXERCISES WHICH HELPED A LITTLE. SINCE THAT TIME I HAVE BEEN EXPERIENCING MORE AND MORE JOINT PAIN AND MUSCLE ACHES, ESPECIALLY IN THE ANKLES, BACK, NECK AND WRIST. ALSO DRAMATIC FATIGUE, TIREDNES, AND LOW SEXUAL LIBIDO CHANGES AND MORE FREQUENT HEADACHES. ALL THIS IN A SHORT PERIOD OF TIME. ALSO EYES GOING BAD.

VAERS ID:241247 (history)  Vaccinated:2005-06-27
Age:50.0  Onset:2005-07-09, Days after vaccination: 12
Gender:Female  Submitted:2005-07-12, Days after onset: 3
Location:Illinois  Entered:2005-07-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Adderall 10 mg
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None/ Negative Ruella titer prior to Vaccine administration
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.056P0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Musculoskeletal stiffness, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Administered MMR Vaccine following Negative result for Rubella IgG Titer on 6/27/2005. Received 2nd Hepatitis B Vaccine on July 6, 2005. Began to experience fever, headache, mucsle soreness and neck stiffness on July 9 and 10. Notified Clinic on 7/11/2005 at 5Pm Advised to take Tylenol for fever and pain and come to clinic in Am. Today feeling much improved with resolving neck stiffness.

VAERS ID:241551 (history)  Vaccinated:2005-06-02
Age:50.0  Onset:2005-06-06, Days after vaccination: 4
Gender:Male  Submitted:2005-07-20, Days after onset: 44
Location:Massachusetts  Entered:2005-07-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The subject''s medical history, concurrent conditions, and concurrent medications were not reported.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0566783A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB005AA0 LA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVA38AA0 RA
Administered by: Public     Purchased by: Public
Symptoms: Blood urine, Urinary tract infection
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)
Write-up: This case was reported by a nurse and described the occurrence of a urinary tract infection in a 49 year old male subject who was vaccinated with hepatitis A vaccine inactivated plus a separate injection of hepatitis B vaccine recombinant for prophylaxis. On 6/2/05, the subject received the first dose of Havrix in the right arm and the first dose of Engerix B in the left arm. On 6/6/05, 4 days after vaccination with Engerix B and Havrix, the subject experienced blood in his urine and was hospitalized. The subject was subsequently diagnosed on 6/6/05 with urinary tract infection. The outcome of the events was not reported.

VAERS ID:241586 (history)  Vaccinated:2005-07-05
Age:50.0  Onset:2005-07-07, Days after vaccination: 2
Gender:Female  Submitted:2005-07-07, Days after onset: 0
Location:Louisiana  Entered:2005-07-21, Days after submission: 14
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': CA050043
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1210DA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left upper arm pain/redness at upper arm with 4 x 4 cm indurated erythematous area. T 98.4.

VAERS ID:241739 (history)  Vaccinated:2005-07-07
Age:50.0  Onset:2005-07-07, Days after vaccination: 0
Gender:Female  Submitted:2005-07-19, Days after onset: 12
Location:Virginia  Entered:2005-07-26, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS005AA   
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURY0240   
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000687   
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR538AA   
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Body temperature decreased, Diarrhoea, Disturbance in attention, Dizziness, Ear pain, Myalgia, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea extreme 12+ times/day, liquid, dizziness, weakness, lack of concentration, body temp dropped 1-2 degrees below normal. Used Immodium to slow to 5-10 times/day; painful skin areas; face, neck, head, back; shooting pains in ears and neck; painful aching.

VAERS ID:241859 (history)  Vaccinated:2005-07-06
Age:50.0  Onset:2005-07-07, Days after vaccination: 1
Gender:Female  Submitted:2005-07-27, Days after onset: 20
Location:Florida  Entered:2005-07-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: effexor, wellbutrin, glucophage, lisinopril/HCTZ, amaryl, celebrex, multivitamin with iron, dulcolax stool softener
Current Illness: none
Preexisting Conditions: penicillin allergy adult onset diabetes osteoarthritis of knees
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Hyperhidrosis, Injection site mass, Injection site pain, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: I had the injection in my left upper arm on July 6, 2005. The next day I experienced site symptoms of heat, swelling and tenderness. The 2nd day I experienced fever and severe joint pain in all my joints. On the third and 4th day I had fevers up to 102 degrees, diaphoresis severe enough to soak the bed, and the site developed a hard lump. The fever left the 5th day but heat swelling and pain continued in the injection site. By the 9th day the pain and heat had decreased but a large 2-3 inch x 1 inch hard mass remained under the skin in the injection site. The mass persists to this date - 21 days later- but it is much smaller in size about 1 inch long and 1/2 inch wide. The injection site occasionally itches.

VAERS ID:242113 (history)  Vaccinated:2004-05-27
Age:50.0  Onset:2004-05-28, Days after vaccination: 1
Gender:Female  Submitted:2005-07-29, Days after onset: 427
Location:Unknown  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Premarin, Levoxyl, Zocor, Diovan, Ambien
Current Illness:
Preexisting Conditions: Cholesterol high, Thyroid disorder, Blood pressure high, Migraine, Bronchitis, Mycotic allergy, House dust allergy, pollen allergy, food allergy, Sulfonamide allergy, Drug Hypersensitivity, Adhesive tape allergy
Diagnostic Lab Data: body temperature 05/28/2004 fever
CDC 'Split Type': WAES0406USA00124
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.UNK  UN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Hypersensitivity, Injection site hypersensitivity, Injection site reaction, Pyrexia
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Information has been received from a female consumer in her 50''s with a mold allergy, a dust allergy, pollen allergy, many food allergies, sulfa drug allergy, terbinafine (Lamisil) allergy, itraconazole (Sporanox) allergy, celecoxib (Celebrex) allergy, Saldine allergy and an allergy to adhesive strips and medical tapes and a history of high cholesterol, unspecified thyroid condition, high blood pressure, severe migraines and bronchitis who on May 27 2004 was vaccinated IM in the right hip with a 0.5 dose of pneumococcal 23v polysaccharide vaccine. Concomitant therapy included estrogens, conjugated (Premarin), simvastatin (Zocor), cetirizine hydrochloride (Zyrtec), Valsartan (Diovan), zolpidem tartrate (Ambien), Cilan and levothyroxine Na (Levoxyl). On May 28 2004 the patient developed an injection site reaction described as a red circle six inches in circumference. She also developed a reddish streak along her thigh that was near the the injection site. The streak was one inch wide and six inches long. the patient also reported joint pain and fever. She consulted with her physician who administered a shot of triamcinolone acetonide (Kenalog) to compensate for symptoms. The patient also increased her use of cetirizine hydrochloride (Zyrtec) from one a day to three times daily. Symptoms have abated and the patient is recovering. It was also reported that the patient was recovering with Sequa lea. No product quality complaint was involved. No other information was available. Additional information has been requested.

VAERS ID:242124 (history)  Vaccinated:2004-06-21
Age:50.0  Onset:2004-06-21, Days after vaccination: 0
Gender:Male  Submitted:2005-07-29, Days after onset: 403
Location:Texas  Entered:2005-08-04, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0406USA02228
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0009P  UN
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Information has been received from a woman in a medical office concerning a male patient over 50 years old who on June 21 2004 was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine (lot 648139/0009P). Subsequently that week on approximately June 21 2004, the patient called the medical office and reported redness around the injection site and fever, Unspecified medical attention was sought. A product quality complaint was not involved. the reported also mentioned two female patients who had a similar experiences post vaccination with pneumococcal 23v polysaccharide vaccine (WAES0406USA02561). Additional information has been requested.

VAERS ID:242170 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-07-29
Location:Unknown  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Body temp 103F
CDC 'Split Type': WAES0409USA01176
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0987N   
Administered by: Other     Purchased by: Other
Symptoms: Decreased appetite, Diarrhoea, Feeling hot, Injection site swelling, Malaise, Pyrexia
SMQs:, 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)
Write-up: Information has been received from a RN and follow up information from a nurse practitioner concerning an approx 50 yr old female pt who in 2004 (exact date not specified) was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine (lot647797/0987N). Within 24 hrs of receiving the vaccination, the pt experienced injection site reaction with 4cm raised hot area on arm. The pt also developed temp of 103 F, malaise, poor appetite and the pt felt ill. Follow up information noted the pt also developed diarrhea. Unspecified medical attention was sought. The pt was treated with diphenhydramine hydrochloride (Benadryl). The nurse practitioner reported it took approx 1 week for the events to recover. The nurse practitioner felt that the events were related to the pneumococcal 23v polysaccharide vaccine. The nurse also reported a pt (age and gender not reported) experienced similar symptoms with raised hot area at site with fever (WAES0409USA01096) and a male pt who experienced similar symptoms (WAES0409USA01642). Additional information has been requested.

VAERS ID:242378 (history)  Vaccinated:2004-10-05
Age:50.0  Onset:2004-10-05, Days after vaccination: 0
Gender:Female  Submitted:2005-07-29, Days after onset: 297
Location:Iowa  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Hypertension, Type II Diabetes Mellitus, Rheumatic heart disease
Diagnostic Lab Data: body weight measurement 195 pounds
CDC 'Split Type': WAES0411USA01577
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1212M0IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Insomnia, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a licensed practical nurse concerning a 50 year old white female homemaker with hypertension, diabetes mellitus type 2, and rheumatic heard disease, who on the morning of Oct 05 2004 was vaccinated intramuscularly into the left deltoid muscle with a first dose of pneumococcal 23v polysaccharide vaccine (lot 645255/1212M. That same day, the patient developed a sore shoulder, and the area of injection was red, swollen, and sore for two days, it was reported that the patient was unable to sleep on her left side for two nights because her shoulder hurt. in two days, the patient recovered. Unspecified medical attention was sought. The nurse also reported 2 other patients who has similar symptoms post vaccination with pneumococcal 23v polysaccharide vaccine (lot 645255/1212M) (WAES0410USA00811, WAES0411USA01576). Additional information has been requested.

VAERS ID:242537 (history)  Vaccinated:2004-11-17
Age:50.0  Onset:2004-11-17, Days after vaccination: 0
Gender:Female  Submitted:2005-07-29, Days after onset: 253
Location:Idaho  Entered:2005-08-04, 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: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0411USA03170
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERUNK  UN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0371P  UN
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Influenza like illness, Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Information has been received from licensed practical nurse concerning a 50 year old female who on Nov 17 2004 was vaccinated with pneumococcal 23v polysaccharide vaccine (lot 649692/0371P). Concomitant therapy that day and in the same arm included influenza virus vaccine (unspecified, manufacture unknown). On Nov 17 2004 the patient experienced soreness, redness in injection are, flu like symptoms and fatigue, Over the counter anti inflammatory medication and ice were prescribed, The patient called the office on Nov 18 2004 with no improvement. It was reported that another patient had a similar reaction (WAES0412USA00149). Additional information has been requested.

VAERS ID:242582 (history)  Vaccinated:2004-10-31
Age:50.0  Onset:2004-10-31, Days after vaccination: 0
Gender:Male  Submitted:2005-07-29, Days after onset: 271
Location:Unknown  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Meclizine
Current Illness:
Preexisting Conditions: Penicillin allergy; drug hypersensitivity.
Diagnostic Lab Data: tuberculin skin test 10/31/04
CDC 'Split Type': WAES0412USA02107
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Fatigue, Hypersensitivity, Malaise, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a 50 yr old male pt with penicillin allergy and allergies to some antibiotics and no relevant medical history who at the end of Oct 2004 was vaccinated with a dose of pneumococcal 23v polysaccharide vaccine (lot unk). Concomitant suspect therapy administered on the same day included an unspecified tuberculosis test (manf unk). Additional concomitant suspect therapy included "meklazine" (meclizine) (dates, dose and indication not reported). The consumer reported that he began to feel feverish, nauseated, drained of energy and weird on the inside right after pneumococcal 23v polysaccharide vaccine was administered. The consumer also stated that he believes that he may be having an allergic reaction with the polysaccharide content. No outcome was reported. There was no product quality complaint involved. Additional information is not expected.

VAERS ID:242724 (history)  Vaccinated:2005-02-14
Age:50.0  Onset:2005-02-15, Days after vaccination: 1
Gender:Female  Submitted:2005-07-29, Days after onset: 163
Location:Illinois  Entered:2005-08-04, 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: Vicodin; Fiorinal; Z-Pak; Calcium; Estradiol; Levaquin; Lisinopril; Protonix; Zoloft
Current Illness: Acute sinusitis, Cerumen impaction, Pain in thoracic spine
Preexisting Conditions: COPD; Obstructive Sleep apnea syndrome; Mitral Valve disease; Depression; Nicotine addiction; Sulfonamide allergy; Penicillin allergy; Hypersensitivity; Cardiomegaly.
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0502USA02162
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1500AA0IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0529P0IM 
Administered by: Private     Purchased by: Private
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: Information has been received from a licensed practical nurse concerning a 50 year old white female with chronic obstructive pulmonary disease, obstructive sleep apnea, mitral valve disorder, cardiomegaly, depression, tobacco addiction, sulfa allergy, amoxicillin allergy, and cefazolin sodium allergy, who on 2/14/05 at 13:30 was vaccinated IM into the right deltoid with a 0.5ml first dose of pneumococcal 23v polysaccharide vaccine (lot # 649912/0529P). Illnesses at the time of vaccination were acute sinusitis, impacted cerumen, and pain in thoracic spine. Concomitant therapy included an IM dose into the left deltoid of influenza virus whole virion 3v vaccine inactivated (batch # U1500AA), azithromycin, pantoprazole sodium, sertraline HCl, estradiol, lisinopril, calcium, levofloxacin, acetaminophen/hydrocodone bitartrate, aspirin/butalbital/caffeine, and Sitrex. On 2/15/05, the patient was seen in the doctor''s office with redness, swelling, and pain at the pneumococcal 23v polysaccharide vaccine injection site (right upper arm). She was treated with diphenhydramine hydrochloride, ice packs, and elevation of her arm. The patient''s outcome was unknown. No product quality complaint was involved. The LPN considered the patient''s adverse experiences to be other important medical events (OMIC). Additional information has been requested.

VAERS ID:242768 (history)  Vaccinated:2004-10-01
Age:50.0  Onset:2004-10-01, Days after vaccination: 0
Gender:Female  Submitted:2005-07-29, Days after onset: 301
Location:Unknown  Entered:2005-08-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0504USA02716
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Initial and follow-up information has been received from a female pharmacist, also the pt, "in her 50s" who "in October or November 2004" was vaccinated with a dose of Pneumovax 23 (lot # unknown). Subsequently, the pt developed "swelling and pain at the injection site which subsided without treatment." The pt sought unspecified medical attention. The pt recovered on an unspecified date. There was no product quality complaint involved. Follow-up information from the pharmacist indicated that there was "no problem". Additional information is not expected.

VAERS ID:242304 (history)  Vaccinated:2004-10-12
Age:50.0  Onset:2005-05-11, Days after vaccination: 211
Gender:Female  Submitted:2005-07-28, Days after onset: 78
Location:Kentucky  Entered:2005-08-05, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Fosamax 70mg q wk.
Current Illness: Health was good
Preexisting Conditions: NONE; Medical records received 08/17/05 states Pt Hx of allergy and depression.
Diagnostic Lab Data: Increased WBC; Physical therapy rehab; Diagnosis GBS; Lumbar puncture done approximately 5/24/05 - findings GBS. Medical records received 08/17/05 states CSF protein 66(H), hyponatremia, & EMG/NCS abnormal.
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1476AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Blood product transfusion, CSF protein increased, Constipation, Electromyogram abnormal, Fatigue, Gait disturbance, Guillain-Barre syndrome, Hypoaesthesia, Hyponatraemia, Intensive care, Lumbar puncture abnormal, Muscular weakness, Neck pain, Nerve conduction studies abnormal, Pain, Pain in extremity, Paraesthesia, Pharyngolaryngeal pain, Respiratory failure, Shoulder pain, Urinary retention, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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), Parkinson-like events (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Demyelination (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Diagnosis: G.B. Syndrome. 5/11/05 Sore throat, fatigue. 5/14/05 Numbness and tingling to hands and fingers. 5/15/05 Numbness/tingling to feet. 5/15/05 Deep throbbing, pain in arms up to elbows, pain in shoulders, increased NBC. 5/18/05 Difficulty with gait. 5/19/05 Hospitalized. 5/23/05 Transferred to another hospital and placed in ICU; Condition critical for 4 days. 5/24/05 Lumbar puncture. 5/25/05 LP findings, Guillain Barre. 5/30/05 Step down from ICU. 6/3/05 Admitted to physical therapy rehab facility. 7/28/05 As of this date, discharged planned for 8/2/05. Received hospital medical records for 5/19-6/3/2005. FINAL DX: acute inflammatory demyelinating polyneuropathy Records reveal patient experienced bilat ext numbness & tingling w/progressige arm/neck pain x 10 days prior to admit. Had sore throat & fatigue approx 3 wks prior to onset of s/s. Transferred from outlying hospital. On admit to ICU, had weakness of all extremities, urinary retention, constipation, respiratory insufficiency. Neuro consult done. Tx w/IVIG x 4. Slow improvement & transferred to inpt rehab. Per follow up report-Continued muscle weakness, numbness, tingling and pain to lower extremities. Muscle instability. Unsteady array gait. Per annual report-Continues to have numbness and tingling to lower extremities (feet & toes), balance is offset by this (numbness and tingling). Physical stamina has not returned to pre-illness level. Has decreased muscle strength in thighs and those muscles fatigue more easily.

VAERS ID:243051 (history)  Vaccinated:2005-07-06
Age:50.0  Onset:2005-07-21, Days after vaccination: 15
Gender:Female  Submitted:2005-08-16, Days after onset: 26
Location:Massachusetts  Entered:2005-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium; Vitamin D and E; Multivitamin; B complex; Aspirin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD1060IM 
Administered by: Private     Purchased by: Other
Symptoms: Bursitis, Joint range of motion decreased
SMQs:, Arthritis (broad)
Write-up: Range of motion loss in left arm. Appeared towards latter part of July. Doctors diagnosis of deltoid bursitis (visual and touch exam only). Physical therapy referral for comprehensive exam and treatment.

VAERS ID:243105 (history)  Vaccinated:2005-08-11
Age:50.0  Onset:2005-08-12, Days after vaccination: 1
Gender:Female  Submitted:2005-08-15, Days after onset: 3
Location:Nevada  Entered:2005-08-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pain, swelling;Td Adsorbed, Adult (unknown mfr);1;35;In Patient
Other Medications: Ocuvite, Prilosec, Diovan HCTz, Zantac, Singular, Allegra, Tylenol, Atrovent
Current Illness:
Preexisting Conditions: PMV
Diagnostic Lab Data:
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1209DA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Pain, swelling, Erythema

VAERS ID:243356 (history)  Vaccinated:2005-08-22
Age:50.0  Onset:2005-08-22, Days after vaccination: 0
Gender:Female  Submitted:2005-08-24, Days after onset: 2
Location:Virginia  Entered:2005-08-24
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: Previous hives when penicillin IM and Td IM given together $g20 years ago.
Diagnostic Lab Data: none
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HEPA: HEP A (VAQTA)MERCK & CO. INC.0872N0IDRA
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUE159AB0SCLA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU1370AA IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX08620IMLA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Flushing, Pruritus
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Flushing and subjective pruritus 1 hour after vaccination. Some lightheadedness, but stable blood pressure and no dyspnea or LOC.

VAERS ID:243420 (history)  Vaccinated:2005-08-24
Age:50.0  Onset:2005-08-24, Days after vaccination: 0
Gender:Female  Submitted:2005-08-25, Days after onset: 1
Location:Virginia  Entered:2005-08-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 0.125 Tamoxifen 10 mg Fosamax, Calcium, Vitamins
Current Illness: None
Preexisting Conditions: Enviromental allergies, hypothyroid.
Diagnostic Lab Data:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0748P1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain, Swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pain, swelling, approx 3 hours after receiving vaccine worsening later in day. This AM arm more swollen and painful developing hives about noon.

VAERS ID:244505 (history)  Vaccinated:2004-10-02
Age:50.0  Onset:2004-10-23, Days after vaccination: 21
Gender:Female  Submitted:2005-09-23, Days after onset: 335
Location:Illinois  Entered:2005-09-23
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: Positive patch test for thimerosal.
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 4  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Eyelid oedema, Hypersensitivity, Injection site erythema, Laboratory test abnormal, Pharyngolaryngeal pain, Pruritus
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Client reports that she has received the flu vaccine for the past 5 years. Other than the flu vaccine the only other vaccine that she has received was a Td booster given by our Health Dept on 7/31/03. 3 weeks after she received the flu vaccine last year she developed redness, itching, puffiness of her eyelids. She also complained of a irritated throat and a dry cough. She sought medical attention as these symptoms persisted. She finally saw a dermatologist on 9/20/05 for a patch test and received the results today showing a high sensitivity to thimerosal. She called today to report this and ask about the duration of this in her system. I gave her the telephone number for CDC and manufacturer.

VAERS ID:244563 (history)  Vaccinated:1999-02-04
Age:50.0  Onset:2003-02-27, Days after vaccination: 1484
Gender:Female  Submitted:2005-09-26, Days after onset: 941
Location:West Virginia  Entered:2005-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None known
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: None Known
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSENG2606A42IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cyst
SMQs:
Write-up: Complained of cyst in left arm after injection in 1999

VAERS ID:244578 (history)  Vaccinated:2005-09-16
Age:50.0  Onset:2005-09-16, Days after vaccination: 0
Gender:Female  Submitted:2005-09-26, Days after onset: 10
Location:Minnesota  Entered:2005-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Epexon, Singular
Current Illness: NONE
Preexisting Conditions: Allergy Ceclor vs Amoxicillin - shock, depression, asthma
Diagnostic Lab Data: NONE
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0706P0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow)
Write-up: The evening after pt received Pneumovax she had her first major motor seizure.

VAERS ID:244832 (history)  Vaccinated:2005-09-28
Age:50.0  Onset:2005-09-29, Days after vaccination: 1
Gender:Female  Submitted:2005-10-03, Days after onset: 4
Location:Texas  Entered:2005-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1215AA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Feeling hot, Injection site pain, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: 9/29/05 left arm pain, progressed to generalized aches 9/30 with possible fever. On 10/1/05 left arm 2" above elbow to shoulder neck area red, swollen; slight crepitus at neck 10/3/05. Area warm and painful to touch. Referred to PCP.

VAERS ID:244852 (history)  Vaccinated:2005-09-13
Age:50.0  Onset:2005-09-14, Days after vaccination: 1
Gender:Female  Submitted:2005-09-19, Days after onset: 5
Location:New Jersey  Entered:2005-10-03, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Coumadin, Symbolta, Vasotec, Nevacor, Vasaprimal ER
Current Illness: NONE
Preexisting Conditions: PCN, erythromycin, HIV, Hep C, DVT RLE
Diagnostic Lab Data: Cl NEN ly Dx HIV +/ T-cell 865.
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0752P IM 
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, HIV test positive, Injection site reaction, Laboratory test abnormal
SMQs:
Write-up: Cellulitis at injection site right deltoid.

VAERS ID:244897 (history)  Vaccinated:2005-09-27
Age:50.0  Onset:2005-09-27, Days after vaccination: 0
Gender:Female  Submitted:2005-09-28, Days after onset: 1
Location:Arizona  Entered:2005-10-04, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Tinnitus~Hep B (unknown mfr)~1~35~In Patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB02AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Headache, Hyperhidrosis, Nausea, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Symptoms started approx 9PM 9/27/05. Symptoms included sweating progressively, nausea, headache, slight cough. No change during today (9/28/05) except nausea worse. Had trouble sleeping last night. Temp on 9/28/05 normal.

VAERS ID:245078 (history)  Vaccinated:2005-08-15
Age:50.0  Onset:2005-08-27, Days after vaccination: 12
Gender:Male  Submitted:2005-10-04, Days after onset: 38
Location:Connecticut  Entered:2005-10-07, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771 LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anxiety, Cardiomegaly, Discomfort
SMQs:, Cardiac failure (broad), Cardiomyopathy (broad)
Write-up: Stressed at work experienced discomfort jaw, no other s/s. Person paramedic did owe EKG showed left atrial enlargement. Resolved did not see MD. No previous cardiac condition advised to MD refused. (copy attached).

VAERS ID:245079 (history)  Vaccinated:2005-08-15
Age:50.0  Onset:2005-08-24, Days after vaccination: 9
Gender:Female  Submitted:2005-10-04, Days after onset: 41
Location:Connecticut  Entered:2005-10-07, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypertension
Preexisting Conditions: Mitral Valve Prolapse, not identified to MD
Diagnostic Lab Data:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200771  
Administered by: Public     Purchased by: Unknown
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Pt history of mitral valve prolapse not identified to Dr at time of vaccine administration. On Aug 24th experienced some chest pain and discomfort which she expressed happened regularly about 3x a month. After being stung by a bee experienced increased chest pain visited ER, no EKG changes.

VAERS ID:245228 (history)  Vaccinated:2005-09-27
Age:50.0  Onset:2005-09-29, Days after vaccination: 2
Gender:Female  Submitted:2005-10-07, Days after onset: 8
Location:Michigan  Entered:2005-10-12, 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: UNK
Current Illness:
Preexisting Conditions: Sulfonamide allergy; Drug hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0510USA00660
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0791P SCUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Information has been received from a physician and a healthcare worker concerning a 50 year old female with sulfa and amoxicillin (+) clavulanate potassium allergies who on 9/27/05 was vaccinated SC in the left arm with a 0.5ml dose of pneumococcal 23v polysaccharide vaccine (lot # 650453/0791P). On 9/29/05, the patient presented to the physician''s office with a right upper extremity that was red, warm, and patchy. The healthcare worker noted a discrepancy in the documentation because the client was vaccinated in the left arm, but the adverse event was documented in the right arm. The patient was treated with a methylprednisolone dose pack. No diagnostic laboratory tests were performed. The physician requested a lot check. Results are pending. Right upper extremity that was red, warm and patchy was considered to be an other important medical event by the reporter (OMIC). Additional information has been requested.

VAERS ID:245483 (history)  Vaccinated:2005-10-10
Age:50.0  Onset:2005-10-11, Days after vaccination: 1
Gender:Female  Submitted:2005-10-11, Days after onset: 0
Location:Washington  Entered:2005-10-17, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 99.7F, 50x50mm erythema, heat.
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1818AB  RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Dyspnoea, Erythema, Feeling hot, Injection site erythema, Injection site pain, Myalgia, Pharyngolaryngeal pain, Pyrexia, Respiratory disorder, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Redness and soreness at the site, upper respiratory symptoms like diff breathing, sore throat, running nose and sneezing non stop, aches, dizziness.

VAERS ID:245607 (history)  Vaccinated:2005-10-11
Age:50.0  Onset:2005-10-11, Days after vaccination: 0
Gender:Female  Submitted:2005-10-17, Days after onset: 6
Location:Texas  Entered:2005-10-19, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1764AA0  
Administered by: Private     Purchased by: Private
Symptoms: Emotional disorder, Injection site oedema, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Emotional, nausea, swelling at injection area.

VAERS ID:245661 (history)  Vaccinated:2005-10-14
Age:50.0  Onset:2005-10-14, Days after vaccination: 0
Gender:Male  Submitted:2005-10-19, Days after onset: 5
Location:New York  Entered:2005-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: SYNTHROID TOPROL XL FLECAINIDE
Diagnostic Lab Data: NONE
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1753AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Eye irritation, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: EMPLOYEE RECEIVED FLUZONE VACCINE 0.5 ML AT APPROX 12PM. AT APPROX 4 PM DEVELOPED WHEEZE, COUGH, EYE IRRITATION. SEEN IN ED, RECEIVED NEBULIZER TREATMENT AND RX FOR MEDROL DOSE PACK.

VAERS ID:245679 (history)  Vaccinated:2005-10-18
Age:50.0  Onset:2005-10-19, Days after vaccination: 1
Gender:Female  Submitted:2005-10-19, Days after onset: 0
Location:Ohio  Entered:2005-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BP med, Tramadol.
Current Illness:
Preexisting Conditions: egg allergy
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1773AA2 LA
Administered by: Private     Purchased by: Private
Symptoms: Flushing, Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 10/18/2005 C?O flushing at home in evening, 10/19/2005 generalized erythematous rash with pruritus scattered over arms, legs, torso. Lungs - no difficulty Resp, Treatment Benadryl, Hydrocortisone cream.

VAERS ID:245733 (history)  Vaccinated:2005-10-13
Age:50.0  Onset:2005-10-13, Days after vaccination: 0
Gender:Female  Submitted:2005-10-19, Days after onset: 6
Location:Michigan  Entered:2005-10-20, 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: Calcium, Vitamins
Current Illness:
Preexisting Conditions: There are no pre existing medical conditions and no known allergies. The patient takes vitamins and calcium.
Diagnostic Lab Data: Relevant diagnostic laboratory test were not reported.
CDC 'Split Type': 200502097
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1752LA0 LA
Administered by: Private     Purchased by: Private
Symptoms: Eye swelling, Headache, Pain, Pruritus, Stomatitis, Throat tightness
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Initial report received from a patient who is a health care provider on Oct 14 2005. A 50 year old female patient with no pre existing medical history received in the left deltoid, an injection of Fluzone no preservation 2005 2006, lot number U1752LA, on Oct 13 2005. Within one hour, she experienced a feeling that something was stuck in her throat, a stinging sensation in her mouth and puffy and itchy eyes. She also complained of headache. The patient indicated this was her first vaccination with flu vaccine. The patient has no known allergies and takes vitamins and calcium. Illness at the time of vaccination was not specified. The next morning she was feeling better but the puffy and itchy eyes persisted. She took Claritin that am. Per the reporter, the patient was not evaluated by a physician. At the time of this report, the patient had not recovered.

VAERS ID:245863 (history)  Vaccinated:2005-06-27
Age:50.0  Onset:2005-07-13, Days after vaccination: 16
Gender:Female  Submitted:2005-10-21, Days after onset: 100
Location:Missouri  Entered:2005-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Takes a thyroid medication once a day
Current Illness: None
Preexisting Conditions: Underactive thyroid
Diagnostic Lab Data:
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0608P0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Lethargy, Rash
SMQs:, Anaphylactic reaction (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 6/27/05- MMR given. &/13/05- Called to report a fine rash on chest, back and legs. Also c/o some lethargy and achy joints. no meds had been taken. Suggested she avoid ASA products. May take acetaminophen for discomfort. Stay in contact. 7/17/05- Called to report rash gone. Feeling much better.

VAERS ID:245875 (history)  Vaccinated:2005-10-12
Age:50.0  Onset:2005-10-13, Days after vaccination: 1
Gender:Female  Submitted:2005-10-22, Days after onset: 9
Location:Virginia  Entered:2005-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dyspnoea, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Difficulty breathing, hives, weakness, high fever.

VAERS ID:246053 (history)  Vaccinated:2005-10-24
Age:50.0  Onset:2005-10-24, Days after vaccination: 0
Gender:Female  Submitted:2005-10-25, Days after onset: 1
Location:California  Entered:2005-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin, losartin, metformin, glucatrol, ezetimibe, fish oil, Synthroid, Zyrtec, Prilosec, Flonase, Celebrex
Current Illness:
Preexisting Conditions: Diabetic
Diagnostic Lab Data:
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0486P0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Hypokinesia, Injection site reaction, Injection site swelling, Injection site warmth, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Large local reaction swelled to the size of palm at injection site. Hot to the touch and patient had difficulty moving arm. Applied ice to site with little relief.

VAERS ID:246125 (history)  Vaccinated:2005-09-12
Age:50.0  Onset:2005-09-13, Days after vaccination: 1
Gender:Female  Submitted:2005-10-17, Days after onset: 34
Location:Massachusetts  Entered:2005-10-26, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB052AA0 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0031R0 LA
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD121  RA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Cellulitis, Fatigue, Hypersensitivity, Malaise, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 9/12/05 Client received hepatitis B vaccine and MMR in her left arm and Td in her right arm. 9/13/05 Client''s right deltoid was sore, she had joint pain, tired, and general malaise. 9/14/05 Right arm was red and swollen. 9/17/05 She was seen by doctor. Diagnosis questionable cellulitis/allergic reaction. Placed on Benadryl and Keflex 500mg QID for 7 days. 9/19/05 She felt better.

VAERS ID:246482 (history)  Vaccinated:2005-10-16
Age:50.0  Onset:2005-10-16, Days after vaccination: 0
Gender:Female  Submitted:2005-10-24, Days after onset: 8
Location:Ohio  Entered:2005-11-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1753AA IM 
Administered by: Public     Purchased by: Private
Symptoms: Chest discomfort, Dizziness, Pain
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Dizziness, chest discomfort, chest pain and bilateral arm pain.

VAERS ID:246578 (history)  Vaccinated:2005-10-22
Age:50.0  Onset:2005-10-23, Days after vaccination: 1
Gender:Female  Submitted:2005-11-01, Days after onset: 9
Location:North Carolina  Entered:2005-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE At present sulfate
Current Illness: NONE
Preexisting Conditions: PCN, Darvon, Demerol. Borderline DM, TBS, Thyroid obesity
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1763AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Shot administered on 10/22/05. Redness at injection site on posterior upper L arm began next day. Diagnosed with cellulitis on 10/27/05. Started on oral cef.. Recheck on 10/31/05 showed vast improvement. Will complete 7-day course

VAERS ID:246575 (history)  Vaccinated:2005-10-13
Age:50.0  Onset:2005-10-14, Days after vaccination: 1
Gender:Female  Submitted:2005-11-02, Days after onset: 19
Location:Virginia  Entered:2005-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin Zocor Cozaar Enabelex
Current Illness: Type 1 Diabetes
Preexisting Conditions: Type 1 diabetes PCN allergic
Diagnostic Lab Data: none
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA160AF0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Influenza Vaccine given SQ. Local reaction w/ 10 cm of indurated erythema developed around injection site. This reaction persisted for ~ 7 days.

VAERS ID:246628 (history)  Vaccinated:2005-10-22
Age:50.0  Onset:2005-10-22, Days after vaccination: 0
Gender:Female  Submitted:2005-11-02, Days after onset: 11
Location:New York  Entered:2005-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Pulmicort Inhaler Seravent Inhaler
Current Illness: None
Preexisting Conditions: Ashtma Benign Positional Vertigo
Diagnostic Lab Data: Physical exam by NP in office: right ear canal conpletely occluded with cerumen. BP 148/88 Possible benign positional vertigo, HTN. Employee followed up with visit to her PMD (see section 7 of this form)
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR1833BA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Condition aggravated, Fatigue, Hypertension, Vertigo
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow), Vestibular disorders (narrow)
Write-up: Employee states she started to experience fatigue, positional vertigo within 24 hours of vaccination. Continued to feel dizzy and was seen by her PMD. Employee states doctor feels that the "flu vaccine exacerbated previous condition of vertigo." Employee was diagnosed with HTN (consistant with finding in exam by NP in employee health office: see section 9 of this form) and was given a Rx for Hydrochlorothiazide.

VAERS ID:246634 (history)  Vaccinated:2005-10-31
Age:50.0  Onset:2005-11-02, Days after vaccination: 2
Gender:Female  Submitted:2005-11-02, Days after onset: 0
Location:Illinois  Entered:2005-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES613230IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0790P0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Discomfort, 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: Left arm swelling and redness at injection site and extending distally. Discomfort and warmth at the site.Seen by own Md who suggested she show to health dept staff.

VAERS ID:246650 (history)  Vaccinated:2005-10-28
Age:50.0  Onset:2005-10-28, Days after vaccination: 0
Gender:Female  Submitted:2005-11-02, Days after onset: 5
Location:Iowa  Entered:2005-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Enalapril;Synthroid;Clarinex;Lipitor;Furosemide;Aciphex;Sulfasalazine Over the counter eye caps & multivitamins
Current Illness: NONE
Preexisting Conditions: Demerol & Neomycin Sulfate
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1775AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Lymphadenopathy, Pyrexia, Rash, Tongue disorder, Tongue oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Swollen glands in neck, rash all over body, fever, tongue burned, swollen. Went to private doctor 10/9/05 put on steroid, received injection - pt not subjection has had flu shots in the past w/out reaction.

VAERS ID:246721 (history)  Vaccinated:2005-11-01
Age:50.0  Onset:2005-11-01, Days after vaccination: 0
Gender:Female  Submitted:2005-11-02, Days after onset: 1
Location:Ohio  Entered:2005-11-03, 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: Nexium, Glucophage
Current Illness: NO
Preexisting Conditions: Allergy to codeine, floaquin.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0749P  RA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site induration, Injection site pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Erythema, slight induration at site of injection. Sore at site of injection.

VAERS ID:246734 (history)  Vaccinated:2005-11-03
Age:50.0  Onset:2005-11-03, Days after vaccination: 0
Gender:Female  Submitted:2005-11-03, Days after onset: 0
Location:Maryland  Entered:2005-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None Known
Current Illness: No
Preexisting Conditions: Asthma, PCN Allergy, Roscea
Diagnostic Lab Data: None at time of report
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1904AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient received flu shot around 8:30 this morning. This afternoon around 4:00pm after awakening from a nap she noticed a rash on face and stomach. Patient has never had the flu shot before. Advised to take benadryl and if it does not get better to visit the ED ASAP. Advised of symptoms of servere allergic reaction.

VAERS ID:246813 (history)  Vaccinated:2005-10-24
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-11-03
Location:Virginia  Entered:2005-11-04, 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: Trazodone;Ativan
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1850AA  RA
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Quarter size redness; no pruritus;no pain

VAERS ID:246861 (history)  Vaccinated:2005-09-29
Age:50.0  Onset:2005-09-30, Days after vaccination: 1
Gender:Female  Submitted:2005-11-01, Days after onset: 32
Location:California  Entered:2005-11-04, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol PM, Carosoprodol, Topomax
Current Illness:
Preexisting Conditions: Chronic Migraines, Spinal pain due to back injury. Allergies to imitrex, codiene, mobic, celebrex, mold, dust.
Diagnostic Lab Data: NONE
CDC 'Split Type':
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DT: DT ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1208DA  LA
Administered by: Public     Purchased by: Unknown
Symptoms: Pain
SMQs:
Write-up: Sore left arm, outer muscle, near shoulder and deep pain in socket of shoulder as well as knotted trapezius muscles in left shoulder and back, starting 09/30/2005. On 10/20 the doctor prescribed that sore muscles be treated with daily muscle relaxers patient had from a previous doctor, and with hot compresses for 10 days, then return.

VAERS ID:246890 (history)  Vaccinated:2005-11-04
Age:50.0  Onset:2005-11-06, Days after vaccination: 2
Gender:Female  Submitted:2005-11-07, Days after onset: 1
Location:Colorado  Entered:2005-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Elavil 150 mg q hs propranolol 10 mg q am Maxide q am colace 100 mg bid mobic
Current Illness: none
Preexisting Conditions: macrodantin-low BP betadine/iodine dye-rash migraines hypertension endometriosis
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1930AA2IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Itching at injection site 2 days after, itching torso, scalp, face 3 days after, still itching at 5 days after injection.

VAERS ID:247064 (history)  Vaccinated:2005-11-04
Age:50.0  Onset:2005-11-04, Days after vaccination: 0
Gender:Female  Submitted:2005-11-08, Days after onset: 4
Location:Ohio  Entered:2005-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril 1 mg po, every day Lasix 20 mg po every day Synthroid 75 mcg po every day
Current Illness: Reported having a sinus infection the week before, but nothing at the time of the Flu Vaccination
Preexisting Conditions: Known allergy to Betadine No reactions to any other vaccines including the Flu vaccine which she has had for at least 10 years. Fibromyalgia, sinus problems, spinal stenosis, and degenerative disc disease
Diagnostic Lab Data: Exam by ER physician
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINES613210IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Face oedema, Pain, Pyrexia, Rash pruritic, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Patient noted that several hours after receiving the Flu Vaccine, 11/04/05. She broke out with an itching rash,and hives. She called the ER and they recommended that she take benadryl and and cool bath. The next day,11/05/05 she still had the hives and again called the Er. They advised her to continue taking the benadryl, which she did and then slept most of the day and night. On 11/06/05, she woke with a fever(100), aches all over, a swollen upper lip, and broken out further with hurtful hives. Her family took her to the ER about 3:30 P.M. At the ER she as given SoluMedrol 250mg.I.M. She had decreased itching and was given a second dose of SoluMedrol 250mg I.M. She at no time had any respiratory problems or evidence of Hives in her mouth. She was considered stable and was discharged about one and one/half hours after admission. She was prescribed Prednisone 20mg; six(6) tablets;take twice a day for three days. She was also to followup with her family physician in two days, A telephome call was made to the patient 11/08/05 to check her status. The hives have diminished and she can only see the outlines at this time. Has an appointment with her family physician 11/08/05 in the P.M.

VAERS ID:247243 (history)  Vaccinated:2005-10-31
Age:50.0  Onset:2005-10-31, Days after vaccination: 0
Gender:Female  Submitted:2005-11-10, Days after onset: 10
Location:Virginia  Entered:2005-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: History of hypertension; other medical history unknown. Client stated she has had previous reaction to flu shot, and was told by private MD to continue to receive the vaccine but take Benadryl PO before getting it. Did not tell the nurse this before receiving the vaccine. Other details of previous reaction unknown.
Diagnostic Lab Data: Unknown
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA141BA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash, Throat tightness, Tongue disorder
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Returned to see RN about 30 minutes after receiving flu shot, c/o throat tightening, tongue thickening & rash around throat. BP 160/110,HR 80. Benadryl 50 mgm IM administered, transported via 911 to ER, adrenalin adminsitered by 911. Pt. stated (after Benadryl given by RN) that she has had a reaction in the past and had taken 25 mgm Benadryl PO at 8:30 AM, which was approximately 45 minutes prior to receiving her shot. She had not told the RN this during the pre-adminsitration screening. Returned to work at 1415 after treatment in ED (details of treatment unknown - ?solumedrol?)

VAERS ID:247409 (history)  Vaccinated:2005-10-28
Age:50.0  Onset:0000-00-00
Gender:Male  Submitted:2005-11-18
Location:Texas  Entered:2005-11-14, 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:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1904AA IM 
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Infection, Joint range of motion decreased, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Wife reported patient had generalized hives, joint pain, decreased range of motion of arms due to pain, secondary skin infection due to scratching.

VAERS ID:247569 (history)  Vaccinated:2005-11-09
Age:50.0  Onset:2005-11-09, Days after vaccination: 0
Gender:Female  Submitted:2005-11-15, Days after onset: 6
Location:Texas  Entered:2005-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxil/Armour compound (30/60)
Current Illness: None
Preexisting Conditions: Probable Hashimoto''s Thyroiditis
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1817AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Cardiac flutter, Chest discomfort, Cough, Dyspnoea, Fatigue, Headache, Pain
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow), Arthritis (broad)
Write-up: First flu vaccine, ever. Evening of vaccine, approx 7:30, sudden onset of fatigue, aches and joint pain (wrists, ankles, hips,knees, shoulders...all over). Tightness in chest, breathing discomfort, and coughing when trying to take deep breath. Feeling like heart flutters. Headache (inc neck and ears). Symptoms have continued for 6 days now with a little improvement. Seeing Dr Thursday: 11/17.

VAERS ID:247667 (history)  Vaccinated:2005-10-31
Age:50.0  Onset:2005-10-31, Days after vaccination: 0
Gender:Female  Submitted:2005-11-03, Days after onset: 3
Location:California  Entered:2005-11-17, Days after submission: 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:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1802AA  UN
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Hypoaesthesia, Oedema, Pain, Peripheral coldness, Pruritus, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: 12 hours later very painful, 24 hours whole left arm swollen, numbness down left arm from armpit to palm. 2 large red welts with itching. Extremely painful 72 hours left hand tingly and cooler than right side. 1 welt still visible 6" under injection site.

VAERS ID:247894 (history)  Vaccinated:2005-11-03
Age:50.0  Onset:2005-11-03, Days after vaccination: 0
Gender:Female  Submitted:2005-11-09, Days after onset: 6
Location:Alabama  Entered:2005-11-21, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ;Influenza (unknown mfr);;0;In Sibling
Other Medications: Tricor, Zetial, Cymbuta, Trazadone
Current Illness:
Preexisting Conditions: Diabetes, depression
Diagnostic Lab Data:
CDC 'Split Type': AL0514
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1817AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Dyspnoea, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Pt states - temp 104 degrees at 10 pm 11/03/05 chills, headache, sob - did not go to ER or see MD. States she had fever and felt bad until 11/08/2005

VAERS ID:247927 (history)  Vaccinated:2005-11-11
Age:50.0  Onset:2005-11-11, Days after vaccination: 0
Gender:Female  Submitted:2005-11-14, Days after onset: 3
Location:Oklahoma  Entered:2005-11-21, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Sulfa;Keflex;Bactrim;PCN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION615033 LA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Nausea, Paraesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Approx 1 hours and 20 min after receiving vaccine patient c/o nausea, dizziness and tingling to right side of her tongue.

VAERS ID:248127 (history)  Vaccinated:2005-11-15
Age:50.0  Onset:2005-11-15, Days after vaccination: 0
Gender:Female  Submitted:2005-11-23, Days after onset: 8
Location:California  Entered:2005-11-23
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: Allergies, asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Unknown
Symptoms: Dysphonia, Injection site erythema, Injection site oedema, Pain, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Redness, swelling where the shot was given, soreness, aches. Hoarseness, wheezing, hives ( mild ) Shot was given on 11/15/05 I still have

VAERS ID:248251 (history)  Vaccinated:2005-11-22
Age:50.0  Onset:2005-11-22, Days after vaccination: 0
Gender:Female  Submitted:2005-11-22, Days after onset: 0
Location:Florida  Entered:2005-11-28, 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: Sensitive to adhesives
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1935AA IM 
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Flu vaccine given at 3 pm. 4 pm noted itchy around right side of neck. Given Benadryl 25mg PO and then took Benadryl 25mg PO on arrival at her home. 5:00 pm call to employee, home safe, no further redness.

VAERS ID:248362 (history)  Vaccinated:2005-11-01
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2005-11-03
Location:Unknown  Entered:2005-11-29, Days after submission: 26
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: Rheumatologic panel is negative normal
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HBPV: HIB POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURERU1803AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None Stated

VAERS ID:248572 (history)  Vaccinated:2005-10-15
Age:50.0  Onset:2005-10-15, Days after vaccination: 0
Gender:Male  Submitted:2005-10-17, Days after onset: 2
Location:Louisiana  Entered:2005-12-02, Days after submission: 46
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': MEDI0003751
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Military     Purchased by: Military
Symptoms: Medication error
SMQs:
Write-up: A nurse reported that a 49 year old male received FluMist vaccine at an inappropriate site. At approximately 3:45pm on Oct 15 05, a nurse administered FluMist vaccine to the patient via intramuscular injection. The nurse reported that he was unfamiliar with FluMist and was unaware that it is approved for intra nasal use only. Not noticing the label that said for intra nasal use only, he broke off the tip of the FluMist syringe and aspirated the 0.5ml content using a different syringe with needle and injected it to the patient. As of Oct 24 2005, the patient did not report any adverse events but was advised to inform the nurse or call for emergency help if there need be. The reporter causality is not provided. Information received 06/23/2006. Lot # not available. Lost during act of nature.

VAERS ID:248701 (history)  Vaccinated:2005-11-21
Age:50.0  Onset:2005-11-21, Days after vaccination: 0
Gender:Male  Submitted:2005-11-28, Days after onset: 7
Location:Minnesota  Entered:2005-12-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: Blood test;Chest X-ray;EKG
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1870AA1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Chest pain, Chills, Cough, Dyspnoea, Hyperhidrosis, Myalgia, Pyrexia, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Severe chest pain, tightness of breath, wheezing, cough with phlegm. Chills and fever (up to 40 degrees C) pain at muscle site joints. Patient came to EOHS with a slip from urgent care. Patient state he did the flu shot at EOHS on Mon noon. A cough of his later restarted experiencing chest pain and sob. This was followed with hot/cold sweats into the evening after dinner. He called the triage nurse at emergency room. She advised him to go to the urgent care - he did this. A copy of the report is in file. "Vaccine Adverse Reporting System." He said the Dr on the slip said this was a reaction to the flu shot. Patient said however eh had a sore throat and cold for 2 wks prior to getting the flu shot. At Urgent Care he had blood test done which he indicated his white blood count was very high. He was put on an antibiotic and state he felt better after taking this. He had coughing with phlegm prior to the flu shot. Advised since he is on antibiotic he should follow-up with his PMD before the antibiotics is gone as if needs to cont. with antibiotic and be evaluated. 11/25/05 call patient - completed medications but was unable to talk on cell phone will call me back to discuss current health state. 11/28/05 Symptoms 2 wk prior to when rec''d flu vaccine includes cough, mild sore throat, felt fine the day of vaccinations. Advised patient to consult PMD concerning future vaccines and allow them to administer if still recommended. 11/28/05 no symptoms. 11/29/05 Appt with Primary MD.

VAERS ID:248737 (history)  Vaccinated:2005-10-22
Age:50.0  Onset:2005-10-22, Days after vaccination: 0
Gender:Male  Submitted:2005-11-17, Days after onset: 26
Location:Tennessee  Entered:2005-12-05, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ESRD
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1763AA0IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1038P0IM 
Administered by: Other     Purchased by: Public
Symptoms: Medication error
SMQs:
Write-up: Flu and Pneumonia vaccine given in same syringe currently in process of re-vaccinating Per CDC

VAERS ID:248822 (history)  Vaccinated:2005-11-30
Age:50.0  Onset:2005-11-30, Days after vaccination: 0
Gender:Male  Submitted:2005-12-05, Days after onset: 5
Location:California  Entered:2005-12-05
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
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1868AA0 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.038P0 RA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B001AA0 LA
Administered by: Private     Purchased by: Other
Symptoms: Medication error
SMQs:
Write-up: The patient was given the incorrect vaccine. Patient should of been given Tdap ( Adacel ). He was given Tdap ( Boostrix ) for adolescent use only

VAERS ID:248917 (history)  Vaccinated:2005-12-01
Age:50.0  Onset:2005-12-01, Days after vaccination: 0
Gender:Female  Submitted:2005-12-01, Days after onset: 0
Location:Ohio  Entered:2005-12-07, 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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1911AA   
Administered by: Private     Purchased by: Unknown
Symptoms: Dry throat, Eye irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (broad)
Write-up: Pt called to report "burning in both eyes and "scratchy" throat several hours after influenza vaccine administered. Denies tightness in throat or chest or difficulty breathing. Has taken vaccine in past with no problems. Relieved with PO Benadryl within 24hrs.

VAERS ID:249160 (history)  Vaccinated:2005-12-01
Age:50.0  Onset:2005-12-01, Days after vaccination: 0
Gender:Male  Submitted:2005-12-09, Days after onset: 8
Location:New York  Entered:2005-12-12, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Singular, Metformin, Topamas, Lipitor, Lexapro, Clonazepan, Nexium, Accupril, Methadone, Imitrex, Codeine, Nasacort, Mucinex, Predinsone, Dicyclomine, Diflucan
Current Illness: NONE
Preexisting Conditions: Chronoic fatigue syndrome, fibromyalgia, diabetes, growth hormone deficinecy, Immune system problems, Krontiyhoid, Hepatitis C.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Cough, Fungal infection, Headache, Injection site inflammation, Pain in extremity, Sinusitis
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Injection site sore. By weekend semi productive cough began and took Mucinex which helped. On Monday 12/5, felt panicky; woke up in middle of night feeling cold and shivering uncontrollablly. Also had a burning headache. On Tuesday was in bed all day feeling sick. At night shivering , shakes began again as well as headache. On Wednesday was seen by chronic fatigue specialist who gave him a gammoglobulin, B-12 and vitamin intravenous drip. Mentioned it was a neuropathy because had intense pain on feet. Wednesday night slept much better but was either too hot or cold coughing to the point of chest pains. Took Prednisone. Yesterday felt better had sinus irritation, brown discharge when coughing. Today felt roughness on mouth and discovered a fungal infection, began to take Diflucan and clotrimazole.

VAERS ID:249189 (history)  Vaccinated:2005-12-01
Age:50.0  Onset:2005-12-01, Days after vaccination: 0
Gender:Male  Submitted:2005-12-08, Days after onset: 7
Location:New York  Entered:2005-12-13, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Seasonal Allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1936AA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Arthralgia, Asthenia, Dyspnoea, Headache, Hyperhidrosis, Influenza like illness, Injection site pain, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: Arm pain (injection site and gravitating to left elbow), generalized weakness, severe headache, breathing difficulty (mild wheezing), flu-like symptoms, joint pain and increased sweating, on set of symptoms, one hour to twelve hours after injection.

VAERS ID:249253 (history)  Vaccinated:2005-11-29
Age:50.0  Onset:2005-11-29, Days after vaccination: 0
Gender:Female  Submitted:2005-12-07, Days after onset: 8
Location:Missouri  Entered:2005-12-13, 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: Xanox prn, Hyzaar, Benicar, Metoprolol, Meclizine prn, Tegretol
Current Illness: NONE
Preexisting Conditions: schizophrenic disorder, hypertension, "Vertigo"
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Crying, Schizophreniform disorder
SMQs:, Psychosis and psychotic disorders (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Pt c/o "feeling mean" "unreasonable" unable to control actions. C/O homicidical ideation''s for 1st 24hrs. 2nd 24hrs c/o uncontrollable crying-sport resolved-reported to Dr. on 12/6/05. Pt feels that it is r/t rabies vaccine.

VAERS ID:249330 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:2005-12-14
Gender:Female  Submitted:2005-12-13, Days after onset: 1
Location:Indiana  Entered:2005-12-15, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1044P0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Injection site oedema, Injection site pain, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt C/o arm at injection site being warm to touch, swollen and somewhat painful. Pt seen in office on 12/14/2005 redness almost gone. No further treatment per Dr.

VAERS ID:249459 (history)  Vaccinated:2005-11-30
Age:50.0  Onset:2005-12-07, Days after vaccination: 7
Gender:Female  Submitted:2005-12-14, Days after onset: 7
Location:California  Entered:2005-12-19, 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
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1865AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Mild muscular pain (at rest) with moderate pain on movement days 2-4 following flu shot. Resolved on day 4. One week post flu shot, following light workout, left arm with moderate to severe pain radiating to socket and occasionally down left arm. Left arm pain subsided over next 4 days. Pain somewhat relieved by 400 mg ibuprofen. Resolved 12/11/05

VAERS ID:249478 (history)  Vaccinated:2005-10-25
Age:50.0  Onset:2005-10-26, Days after vaccination: 1
Gender:Female  Submitted:2005-10-27, Days after onset: 1
Location:Michigan  Entered:2005-12-19, Days after submission: 53
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: Recovering from Breast Cancer
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1746AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0749P0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site reaction, Oedema, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Left arm swollen, red down to elbow. Tender at injection site. Used Ibuprofen and cold compresses the first 24 hrs but didn''t go away. Pharmacist called her MD and advised pt to got to urgent care.

VAERS ID:249517 (history)  Vaccinated:2005-12-13
Age:50.0  Onset:2005-12-14, Days after vaccination: 1
Gender:Male  Submitted:2005-12-15, Days after onset: 1
Location:Maine  Entered:2005-12-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1049P0 LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Left arm biceps injection site red, raised, hive like rash at injection site.

VAERS ID:249685 (history)  Vaccinated:2005-11-18
Age:50.0  Onset:2005-11-18, Days after vaccination: 0
Gender:Female  Submitted:2005-12-26, Days after onset: 38
Location:Michigan  Entered:2005-12-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID ZOLOFT
Current Illness: NONE.
Preexisting Conditions: HASHIMOTO THYROIDITIS.
Diagnostic Lab Data: NONE AT THIS TIME.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA151AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Hypokinesia, Injection site pain, Neuritis, Tenderness
SMQs:, Peripheral neuropathy (narrow), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow)
Write-up: FLU VACCINE RECEIVED AT PLACE OF EMPLOYMENT. ACTUAL INJECTION WS NON-EVENTFUL HOWEVER, THE ADMINSTRATION OF THE VACCINATION MEDICATION WAS QUITE PAINFUL. APPROXIMATELY TWO (2) HOURS AFTER INJECTION ARM STARTED BECOMING QUITE SORE. HAVING RECEIVED FLU VACCINATIONS YEARLY FOR MANY YEARS, IT WAS NOT UNUSUAL TO EXPERIENCE SOME TENDERNESS IN THE HOURS AFTER THE INJECTION. THAT EVENING, I EXPERIENCED EXTREME PAIN IN THE ARM AND WAS BARELY ABLE TO MOVE IT. THIS CONTINUED THROUGHOUT THE NIGHT KEEPING ME AWAKE MOST OF THE NIGHT. AFTER A FEW DAYS IT DAYS IT WAS FEELING BETTER. A LITTLE SORE BUT NOTHING SEVERE SO I ASSUMED MY ARM WAS RECOVERING. HOWEVER, JUST AS I THOUGHT IT WAS IMPROVING, THE PAIN AGAIN BECAME QUITE SEVERE (THIS OCCURRED APPROX SEVEN (7) DAYS AFTER THE INJECTION. OVER THE FOLLOWING WEEKS, THE LEVEL OF PAIN FLUCTUATED BETWEEN MILD (TOLERABLE) AND SEVERE (MOVEMENT CAUSED ME TO GASP). ON DECEMBER 14, 2005, I VISITED MY PRIMARY CARE PHYSICIAN. HE TOLD ME HE FELT THAT THE SYMPTOMS WERE NOT CAUSED BY NEEDLE, BUT DIAGNOSED IT AS A NEURITIS CAUSED BY THE VACCINE. HE PRESCRIBED NEUROTININ (GABAPENTIN 300 MG TWICE DAILY FOR TWO WEEKS). I WAS UNABLE TO CONTINUE WITH THAT TREATMENT BECAUSE IT CAUSED SEVERE DIARRHEA AND GAS. I HAVE AN APPOINTMENT SCHEDULED WITH AN ORTHOPAEDIC SPECIALIST FOR DECEMBER 30, 2005.

VAERS ID:249694 (history)  Vaccinated:2005-10-20
Age:50.0  Onset:2005-10-20, Days after vaccination: 0
Gender:Female  Submitted:2005-12-07, Days after onset: 48
Location:Illinois  Entered:2005-12-27, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': A0580342A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS120AA1 LA
Administered by: Other     Purchased by: Private
Symptoms: Feeling abnormal, Herpes zoster
SMQs:, Dementia (broad)
Write-up: This case reported by a pharmacist and described the occurrence of shingles in a 50 year old female subject who was vaccinated with influenza virus vaccine for prophylaxis. On 10/20/05 the subject received a dose of Fluarix. The pharmacist reported that the suject received influenza virus vaccine, "in the past without incident." At an unspecified time following the administration of Fluarix, on 10/20/05, the subject "did not feel well." The subject was seen at a physician''s office on 10/21/05 and was diagnosed with shingles. The subject was treated with anti-viral medication. The events had improved as of the time of initial reporting. 10/05 the pharmacist considered the events to possibly be related to vaccination with fluarix. On follow up received 11/22/05, the pharmacist reported the events had resolved with treatment unspecified anti-viral medication. The pharacist considered the events to be unrelated to vaccination with Fluarix.

VAERS ID:249707 (history)  Vaccinated:2005-11-09
Age:50.0  Onset:2005-11-09, Days after vaccination: 0
Gender:Female  Submitted:2005-12-07, Days after onset: 28
Location:North Carolina  Entered:2005-12-27, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine;Multivitamin
Current Illness: Hypertension;
Preexisting Conditions: The subject had no illness at the time of vaccination with Fluarix.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0583094A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA120AA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a nurse and described the occurrence of injection site pain in a 50 year old female subject who was vaccinated with influenza virus vaccine (Fluarix) for prophylaxis. The subject''s medical history included hypertension. Concurrent medications included Amlodipine (Norvasc) and Multivitamins (Multivitamin). The subject had no illness at the time of vaccination with Fluarix. On 09 November 2005 at 9:00 a.m., the subject received a dose of Fluarix in the left deltoid (lot AFLUA120AA). A previous dose of influenza virus vaccine (unknown manufacturer) was administered on 04 December 2003. On 09 November 2005, 10 minutes after vaccination with Fluarix, the subject experienced "a constant dull pain (4 on a pain scale of 1-10) in the left deltoid and shooting pain (5 on a pain scale of 1-10) on the left side of neck with flexion." The subject "took 600 mg ibuprofen (Motrin)." On 11 November 2005, at an unspecified time in the morning, the subject awoke with "dull pain." The subject "took 400 mg Motrin and was pain free by the afternoon" of 11 November 2005. The nurse considered the events to be related to vaccination of Fluarix.

VAERS ID:249710 (history)  Vaccinated:2005-11-09
Age:50.0  Onset:2005-11-09, Days after vaccination: 0
Gender:Female  Submitted:2005-12-07, Days after onset: 28
Location:New York  Entered:2005-12-27, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No concurrent medication
Current Illness: UNK
Preexisting Conditions: Tendonitis. The subject''s concurrent conditions were not reported. The nurse reported that 2 other subjects experienced a limited range of arm motion following immunization with Fluarix. Please see cases A0583911A and A0583913A.
Diagnostic Lab Data: UNK
CDC 'Split Type': A0583912A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS 0 LA
Administered by: Private     Purchased by: Private
Symptoms: Discomfort, Joint range of motion decreased
SMQs:, Arthritis (broad)
Write-up: This case was reported by a nurse and described the occurrence of limited rang of motion in arm in a 50 year old female subject who was vaccinated with influenza virus vaccine (Fluarix) for prophylaxis. Medical history included tendonitis. There were no concurrent medications. On 09 November 2005 the subject received 1st dose of Fluarix in the left arm (lot number not provided). On 09 November 2005, less than one day after vaccination with Fluarix, the subject experienced limited range of motion and discomfort in the left arm. At the time of initial reporting, 29 November 2005, the outcome of the events was not provided. The nurse considered the events to possible be related to vaccination with Fluarix.

VAERS ID:249711 (history)  Vaccinated:2005-11-04
Age:50.0  Onset:2005-11-04, Days after vaccination: 0
Gender:Female  Submitted:2005-12-07, Days after onset: 33
Location:New York  Entered:2005-12-27, Days after submission: 20
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': A0583913A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS 0 LA
Administered by: Private     Purchased by: Private
Symptoms: Joint range of motion decreased
SMQs:, Arthritis (broad)
Write-up: This case was reported by a nurse and described the occurrence of limited range of motion in arm in a 50 year old female subject who was vaccinated with influenza virus vaccine for prophylaxis. There were no concurrent medications. On 11/04/05 the subject received 1st dose of Fluarix in the left arm. On 11/04/05, less than one day after vaccination with Fluarix, the subject experienced limited range of motion in the left arm. At the time of initial reporting, 11/29/05, the outcome of the event was not provided. The nurse considered the event to possibly be related to vaccination with Fluarix.

VAERS ID:249771 (history)  Vaccinated:2005-12-14
Age:50.0  Onset:2005-12-16, Days after vaccination: 2
Gender:Female  Submitted:2005-12-20, Days after onset: 4
Location:Wisconsin  Entered:2005-12-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION62217 IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site reaction, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 10 cm elevated rash at injection site. 3 cm purple area in center.

VAERS ID:250073 (history)  Vaccinated:2005-12-07
Age:50.0  Onset:2005-12-08, Days after vaccination: 1
Gender:Female  Submitted:2006-01-05, Days after onset: 28
Location:Pennsylvania  Entered:2006-01-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, ASA
Current Illness: Hypertension
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1827AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Erythema, Injection site swelling
SMQs:, Anaphylactic reaction (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Left arm red raised area 2 1/2 x 3 3/4, chest tight went to ER Keflex 500mg x 2 Benadryl 25mg BID.

VAERS ID:250074 (history)  Vaccinated:2005-12-01
Age:50.0  Onset:2005-12-01, Days after vaccination: 0
Gender:Female  Submitted:2006-01-05, Days after onset: 35
Location:Maryland  Entered:2006-01-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not reported
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURUA1833AA  LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Discomfort, Injection site mass, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Dime sized nodule in large adipose deposit of left upper arm where Fluzone injection reportedly given. Reports discomfort when lies on left side or pushes at site. Injection more than 30 days ago.

VAERS ID:250103 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:2005-10-20
Gender:Female  Submitted:2005-11-10, Days after onset: 21
Location:West Virginia  Entered:2006-01-06, Days after submission: 57
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Loratadine 10mg tab;Meclizine RCL 12 tab; Anastrozole 1mg tab
Current Illness:
Preexisting Conditions: Episode of CP and Shortness of Breath
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Muscle pain

VAERS ID:250116 (history)  Vaccinated:2005-11-09
Age:50.0  Onset:2005-11-10, Days after vaccination: 1
Gender:Female  Submitted:2005-11-10, Days after onset: 0
Location:Pennsylvania  Entered:2006-01-06, Days after submission: 57
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Sular, Advair, Aualide
Current Illness: NONE
Preexisting Conditions: Asthma, hypertension, metabolic syndrome, arthritis
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1900AA  LA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Reddened, tender, and warm area developed 12-16 hours after receiving the flu shot.

VAERS ID:250177 (history)  Vaccinated:2005-11-11
Age:50.0  Onset:2005-11-24, Days after vaccination: 13
Gender:Female  Submitted:2005-12-30, Days after onset: 36
Location:Connecticut  Entered:2006-01-09, Days after submission: 10
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: Hip dysplasia, osteopenia.
Diagnostic Lab Data: Exam/EKG negative, CBC/Chemo/TFTS/Lyme all negative.
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1778AA   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Borrelia burgdorferi serology negative, Dysphonia, Electrocardiogram normal, Electromyogram normal, Full blood count normal, Hyperreflexia, Immunisation reaction, Laboratory test normal, Muscle spasms, Muscle twitching, Muscular weakness, Neurological symptom, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal, Palpitations, Paraesthesia, Sensation of heaviness, Spinal osteoarthritis, Thyroid function test normal, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Arthritis (narrow)
Write-up: 2 weeks following shot: Arms feel heavy and strange, "buzzing behind knees, wrists", palpitations, residual left upper and lower extremities feelings of weakness, quivering voice, shaky legs, hands cramping.

VAERS ID:250288 (history)  Vaccinated:2005-11-15
Age:50.0  Onset:2005-11-22, Days after vaccination: 7
Gender:Female  Submitted:2006-01-11, Days after onset: 50
Location:Colorado  Entered:2006-01-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: RECOVERING FROM A COLD, NO FEVER
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1865AA2IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Flu vaccine given 11/15/05. Vaccine site had mild soreness, typical following any vaccine. 3-5 days later she hit the arm with force on a door jam. Client does not recall how soon the pain began following the hit on the door jam but she began to have severe pain with left arm motion (9-10 on a scale of 10). She was unable to lift her arm above her head with her elbow bent without severe pain. Pain with that motion has continued, but the pain has decreased to a 5-6. She is awakened at night with pain when sleeping on her left side. She has taken 1 Aleve per day for the last 2 weeks. She reported initial weakness in her left fingers with slight tingling, but that has resolved. She has not seen a doctor due to financial concerns.

VAERS ID:250500 (history)  Vaccinated:2005-12-13
Age:50.0  Onset:2005-12-13, Days after vaccination: 0
Gender:Female  Submitted:2005-12-16, Days after onset: 3
Location:New York  Entered:2006-01-18, Days after submission: 33
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Yellow dye MSO4-tye#3
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1046P0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Feeling hot, Injection site swelling, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: R deltoid. Circular red raised, warm, tender to touch, 3x4 circular area.

VAERS ID:250508 (history)  Vaccinated:2006-01-04
Age:50.0  Onset:2006-01-04, Days after vaccination: 0
Gender:Male  Submitted:2006-01-04, Days after onset: 0
Location:Florida  Entered:2006-01-18, Days after submission: 14
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-ragweed
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1936AA IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Itching, red, hive like rash on neck approx 90 minutes after injection, insidious onset

VAERS ID:250527 (history)  Vaccinated:2000-08-20
Age:50.0  Onset:2002-09-30, Days after vaccination: 771
Gender:Female  Submitted:2006-01-18, Days after onset: 1206
Location:New Jersey  Entered:2006-01-19, 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 relevant. Female HRTs only(Premarin, progesterone)
Current Illness: None, nothing known or suspected
Preexisting Conditions: Drug allergy to Sulfa antibiotics. Insect sting allergies (wasps, bees, a ants) June 1980 diagnosis of mitral valve prolapse.
Diagnostic Lab Data: all stated in #7 above Please note: date(s) of vaccine are approximate - I do not know the Lot Numbers of the three (3) injections received. I do not have my medical records from this physician, but can get them if requested. The doctor w
CDC 'Split Type':
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Back pain, Bronchitis, Chills, Epistaxis, Eye inflammation, Fatigue, Gastrointestinal disorder, Headache, Muscle twitching, Pyrexia, Rash, Urethral pain, Vertigo
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Corneal disorders (broad), Vestibular disorders (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: August 1989: Tick bites while hiking, rash 2-week course of tetracycline. Some persistent symptoms & problems from 1990 to present, but not suspected of being Lyme-related. May - August 2000: Received 3-injection course of LYMErix vaccine from family doctor. I requested vaccine because of possible exposure to ticks through sports & hobbies. January 2000: changed primary care physician because of move. Late 2002 (September?): joint pains, eye inflammation, facial muscles twitching,stabbing pains in costovertebral area, odd rash base of spine. Tested for Sjogren''s Syndrome, Lupus (both negative) Because of foreign travel history, tested for hepatitis (negative). Late 2004: Joint inflammations and immobility (R. shoulder, R. knee), severe sacroiliac pain, irritable bowel & urethretis, increased facial pain, eye inflammation and "bleeders", acute GI symptoms. Had complete physical,doctor still didn''t suspect Lyme. January 2005: Right shoulder immobile, Orthopedist ordered Xray that showed unexplainable calcifications in tendons. February-March 2005: Fever & chills, severe bronchitis, bleeding sinuses, joint pains. Prescribed Augmentin 2 weeks did not work. Prescribed 20 days of Ciprobay, bronchodilator & inhaler. Symptoms subsided but never entirely stopped. Late November 2005: Acute flare-up of joint pains, extreme fatigue & headaches, vertigo. December 10, 2005: Blood tests again for Brucella & Lupus (both negative), also tested for LYME - the IgG assay was VERY HIGH. Waited entire month for test results and return doctor visit because of Brucella cultures. January 12, 2006: Doctor reviewed test results, I was referred to an infectious disease specialist because of high Lyme result. January 18, 2006: Infectious disease specialist diagnosed Lyme disease, took blood sample for Western Blot test, I have started a long course of doxycycline hyclate 100mg 2x daily. I.D. physician will review after first month. Do not know if current disability (joint problems, IBS, neurological problems) will be resolved.

VAERS ID:250799 (history)  Vaccinated:2005-12-12
Age:50.0  Onset:2005-12-14, Days after vaccination: 2
Gender:Female  Submitted:2006-01-13, Days after onset: 30
Location:Florida  Entered:2006-01-24, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: Shoulder and Hip X-rays;CBC;BMP;Thyroid panel;Rheumatoid panel;CPIC;ESR
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1826AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: 2 days after shot, began with erratic muscle pain, after tingling chest, shoulder, arms and thighs. Initially treated with Advil x 2 weeks and partial relief of symptoms, got worse and visits to ER x 2 (times) within next week. Then my PCP and finally rheumatologist. All testing has been negative so far.

VAERS ID:250873 (history)  Vaccinated:2005-03-04
Age:50.0  Onset:2005-03-04, Days after vaccination: 0
Gender:Female  Submitted:2005-03-14, Days after onset: 10
Location:New York  Entered:2006-01-26, Days after submission: 318
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: redness at injection site, swelling~Td Adsorbed (no brand name)~~0~In Patient
Other Medications: NONE
Current Illness: Hypotension
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': AE0502
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD-110   
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Hypotension, Injection site rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: The patient developed light-headedness, hypotension and a transient rash at the site of vaccination immediately after receiving a Td vaccination while in the doctor''s office. The doctor administered IV fluids, and the patient recovered.

VAERS ID:250897 (history)  Vaccinated:2005-11-03
Age:50.0  Onset:2005-11-03, Days after vaccination: 0
Gender:Female  Submitted:2005-12-28, Days after onset: 55
Location:Kansas  Entered:2006-01-26, Days after submission: 29
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Hypertension, Oedema, Pruritus, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: That evening kept itching, could not stop. Next day light rashes, itching was uncontrollable. Went to pharmacy. Bought itch cream and allergy medication as suggested by pharmacist after I told her about the vaccine shot I received. Sunday I was swollen twice the size and could not breath. Went to ER and received a shot and medications from pharmacy, said my respiratory system could have shut down. Information from medical records state hypertension as finding. msv

VAERS ID:250967 (history)  Vaccinated:0000-00-00
Age:50.0  Onset:0000-00-00
Gender:Female  Submitted:2006-01-20
Location:Texas  Entered:2006-01-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Soma, Xanax, Doxepin (for itching)
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: Blood work
CDC 'Split Type':
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HEP: HEP B (FOREIGN)MERCK & CO. INC.0624N3 RA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Decreased appetite, Diarrhoea, Headache, Myalgia, Nausea, Pruritus, Sinus congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: 12-27-04-1st Hep B shot; 2-24-2005 2nd Hep B shot-nausea, muscle aches, abdominal cramps, diarrhea, loss of appetite, headaches, sinus problems. 7-8-05 3rd shot. Within 1.5 days approximate started itching. By 7-11-05 had a itching and knot between mild eyebrow area and eyelid like a cyst. Given hydrocortisone cream-told ___ to vaccine knot is gone itching persists. Dermatologist says internal allergy. Since mid Sept-right elbow extremely painful for no reason (except vaccine). Patient flew to California Kaiser clinic for blood work. Tests negative doc says could be vaccine related. 1st few doctors said would be rare.

VAERS ID:251009 (history)  Vaccinated:2005-11-18
Age:50.0  Onset:2005-11-18, Days after vaccination: 0
Gender:Female  Submitted:2006-01-29, Days after onset: 72
Location:D.C.  Entered:2006-01-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: Hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1914AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Had flu shot, developed pain, swelling and fever. Pain shooting up my shoulder and neck.

VAERS ID:251271 (history)  Vaccinated:2006-01-31
Age:50.0  Onset:2006-02-01, Days after vaccination: 1
Gender:Female  Submitted:2006-02-02, Days after onset: 1
Location:Colorado  Entered:2006-02-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Splenectomy-1988
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HIBV: HIB (ACTHIB)AVENTIS PASTEURUE807AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Balance disorder,