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Found 493323 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:441142 (history)  Vaccinated:2011-10-19
Age:42.0  Onset:2011-10-20, Days after vaccination: 1
Gender:Female  Submitted:2011-11-02, Days after onset: 13
Location:Florida  Entered:2011-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Cough, Diarrhoea, Dyspnoea, Eye irritation, Eye pruritus, Fatigue, Headache, Lacrimation increased, Nasal congestion, Nausea, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: Started with nausea, headache, diarrhea. This lasted a few days. Then on 10/28/11 started feeling achy and feverish. By 10/29/11 patient had a very sore throat, fever, body aches, extreme fatigue, stuffy/running nose, congestion, sneezing, itching/burning/watery eyes, coughing, sob. Has gotten no better as of today, 11/2/11.

VAERS ID:441239 (history)  Vaccinated:2011-10-07
Age:42.0  Onset:2011-10-07, Days after vaccination: 0
Gender:Female  Submitted:2011-10-11, Days after onset: 4
Location:Nebraska  Entered:2011-11-03, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH456AB IMRA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Extreme exhaustion, achy joints/muscles.

VAERS ID:441283 (history)  Vaccinated:2011-10-18
Age:42.0  Onset:2011-10-18, Days after vaccination: 0
Gender:Female  Submitted:2011-10-20, Days after onset: 2
Location:Pennsylvania  Entered:2011-11-03, 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:
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH478AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:441368 (history)  Vaccinated:2011-07-11
Age:42.0  Onset:2011-07-14, Days after vaccination: 3
Gender:Female  Submitted:2011-08-10, Days after onset: 27
Location:Maine  Entered:2011-11-04, Days after submission: 86
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1045Z SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1185Z SCLA
Administered by: Private     Purchased by: Public
Symptoms: Pruritus, Urticaria, Wrong drug administered
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Wrong immunizations given to pt/ ER visit 7/14/2011 urticaria and itching to bilateral forearms. Treated with ADRENALIN 0.3cc/SC BENADRYL 50 mg/po prednisone 40 mg/po; PEPCID 40 po continued BENADRYL, PEPCID and prednisone at home.

VAERS ID:441389 (history)  Vaccinated:2011-11-03
Age:42.0  Onset:2011-11-03, Days after vaccination: 0
Gender:Female  Submitted:2011-11-04, Days after onset: 1
Location:New Hampshire  Entered:2011-11-04
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: She was informed to call her doctor.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT492AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Activities of daily living impaired, Blood pressure increased, Chest discomfort, Cough, Dysphonia, Fatigue, Headache, Lacrimation increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Parkinson-like events (broad), Hypertension (narrow), Lacrimal disorders (narrow)
Write-up: Increased BP - (134/91), fatigue, watery eyes, "heavy feeling in chest", cough, hoarseness, headache - on 11/3/11 4 hours after vaccine was given. She was evaluated by APRN and given 25 mg BENADRYL. One hour later she reported she felt better but very tired. On 11/4/11 she came to work c/o feeling very fatigued - had to leave work.

VAERS ID:441629 (history)  Vaccinated:2011-11-04
Age:42.0  Onset:2011-11-04, Days after vaccination: 0
Gender:Male  Submitted:2011-11-07, Days after onset: 3
Location:Kentucky  Entered:2011-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none reported
Preexisting Conditions: seasonal allergies reported
Diagnostic Lab Data: Rec''d Evaluation and IV therapy in ER facility per report of pt to medical asst by phone.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH486AE IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Pt called reporting SOB, tightness in chest and sensation like ''throat is closing up''. Pt was advised to go immediately to the hospital ER for evaluation. Pt verbalized understanding.

VAERS ID:442005 (history)  Vaccinated:2011-11-04
Age:42.0  Onset:2011-11-06, Days after vaccination: 2
Gender:Female  Submitted:2011-11-08, Days after onset: 2
Location:Wisconsin  Entered:2011-11-09, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1102601 UNRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt. called back 3 days after receiving a flu shot stating a 1 1/2" x 2" red area surrounding injection area. Pt. unconcerned I suggested informing MD. She stated she would, MD told pt. to use BENADRYL. Called pt. back - BENADRYL solved problem.

VAERS ID:442129 (history)  Vaccinated:2011-10-14
Age:42.0  Onset:2011-10-15, Days after vaccination: 1
Gender:Female  Submitted:2011-11-10, Days after onset: 26
Location:Connecticut  Entered:2011-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Extreme allergy to codeine and Bactrim
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNLA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Pain, Pain in extremity
SMQs:, Arthritis (broad)
Write-up: Pain in arm shooting down to fingers. Pain arthritic and moved around to forearm. Very painful. Still in pain after one month of receiving this shot in fingers and forearm.

VAERS ID:442161 (history)  Vaccinated:2011-11-10
Age:42.0  Onset:2011-11-10, Days after vaccination: 0
Gender:Female  Submitted:2011-11-11, Days after onset: 1
Location:Florida  Entered:2011-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Cough, Eye pruritus, Eye swelling, Headache, Nausea, Pharyngeal oedema, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Headache, Throat swelling, eyes itchy and swelling, nausea, vomiting, chills, cough, fever.

VAERS ID:442243 (history)  Vaccinated:0000-00-00
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2011-11-11
Location:Michigan  Entered:2011-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA616AA IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3984AA UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:442297 (history)  Vaccinated:2011-10-28
Age:42.0  Onset:2011-11-09, Days after vaccination: 12
Gender:Female  Submitted:2011-11-11, Days after onset: 2
Location:Michigan  Entered:2011-11-14, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA616AA IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3984AA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: (L) deltoid area was red, hot and sore to the touch since 11.9.11. Rx for cephalexin 500 mg 1 QID given.

VAERS ID:442565 (history)  Vaccinated:2011-11-10
Age:42.0  Onset:2011-11-10, Days after vaccination: 0
Gender:Female  Submitted:2011-11-15, Days after onset: 5
Location:Pennsylvania  Entered:2011-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH446AA1 LA
Administered by: Private     Purchased by: Other
Symptoms: Dysphonia, Fatigue, Pain, Pyrexia, Throat irritation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Started with fatigue, scratchy throat and hoarseness that night. Over the next 2 days developed a fever of 101, aches and pains and continued hoarseness.

VAERS ID:442660 (history)  Vaccinated:2011-08-16
Age:42.0  Onset:2011-08-17, Days after vaccination: 1
Gender:Female  Submitted:2011-11-02, Days after onset: 77
Location:New York  Entered:2011-11-16, 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: PCN; Hydrocodone
Diagnostic Lab Data: (Recommendation ACIP) Note patient using accelerated program due to unsure departure date for mission work to 3rd world country.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB211BA IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU3846AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Pt stated she had fever of 102 degrees and achiness.

VAERS ID:442671 (history)  Vaccinated:2011-11-09
Age:42.0  Onset:2011-11-10, Days after vaccination: 1
Gender:Female  Submitted:2011-11-16, Days after onset: 6
Location:Vermont  Entered:2011-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA636BA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Contusion, Pain, Pain in extremity, Palpitations, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (broad)
Write-up: 24 hours after the vaccine was administered, patient developed a low grade fever and sore arm. She took Advil. At 3:30 pm she spiked a fever and had chills. 6:30 pm her heart was racing, temp 103.5. She called her MD on call. He recommended Benadryl (patient did not have any) and cold compresses. 8:30 pm Temp 102. 11-11-11 2 Am Had chills and temp 102. Took Tylenol. Woke in am with achiness and continued painful right arm. Temp now gone but arm painful with resistence. She said the arm does not have redness or swelling but there is a bruise. She said it does not appear infected. I recommended she follow up with her provider if the arm does not improve and could try warm compresses or ice (which ever felt better to her to help decrease the pain. On a scale of 1-10, at it''s worst the pain was a 7 and now is a 2.

VAERS ID:443040 (history)  Vaccinated:2011-11-17
Age:42.0  Onset:2011-11-18, Days after vaccination: 1
Gender:Male  Submitted:2011-11-18, Days after onset: 0
Location:Ohio  Entered:2011-11-19, 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:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11021010IMUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1241AA0IMUN
Administered by: Other     Purchased by: Private
Symptoms: Inflammation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Inflammation under armpit of left arm and raised horizontal welts day after vaccination given. Dr. referred patient to Urgent Care, lasted 1-2 days.

VAERS ID:443136 (history)  Vaccinated:2011-10-06
Age:42.0  Onset:2011-10-06, Days after vaccination: 0
Gender:Female  Submitted:2011-11-11, Days after onset: 36
Location:California  Entered:2011-11-21, 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: The patient''s medical history was not reported.
Diagnostic Lab Data: Not reported
CDC Split Type: 201110937
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4163BA IDLA
Administered by: Private     Purchased by: Unknown
Symptoms: Hypersensitivity, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Initial report received from a health care professional on 09 November 2011. A female patient received an intradermal injection (site not reported) of FLUZONE Intradermal, sanofi pasteur lot number not reported, on an unknown date. The patient''s medical history was not reported. On an unknown date, the patient had a severe allergic reaction with severe wheezing to the FLUZONE intradermal. The patient required treatment with epinephrine and steroids. The outcome was not reported. Documents held by sender: None.

VAERS ID:443187 (history)  Vaccinated:2011-11-09
Age:42.0  Onset:2011-11-09, Days after vaccination: 0
Gender:Female  Submitted:2011-11-14, Days after onset: 5
Location:Oregon  Entered:2011-11-21, 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: ibuprofen
Diagnostic Lab Data: None done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS11092P3IMLA
Administered by: Other     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Approx 10 hrs after IM in left arm developed hives on entire body. Not allergic to latex. Took BENADRYL & hives resolved in 2 days.

VAERS ID:443210 (history)  Vaccinated:2011-11-10
Age:42.0  Onset:2011-11-10, Days after vaccination: 0
Gender:Female  Submitted:2011-11-21, Days after onset: 11
Location:Massachusetts  Entered:2011-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Eye pruritus, Eye swelling, Fatigue, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Wheezing, swollen and itchy eyes, fatigue lasting days.

VAERS ID:443336 (history)  Vaccinated:2011-11-17
Age:42.0  Onset:2011-11-17, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Nebraska  Entered:2011-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: See #7 above
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT499AB1UNLA
Administered by: Private     Purchased by: Other
Symptoms: Crying, Emotional disorder, Fatigue, Feeling abnormal, Headache, Insomnia, Oropharyngeal pain, Pain, Respiratory tract congestion, Sensation of heaviness
SMQs:, Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Depression (excl suicide and self injury) (broad)
Write-up: Sore throat, congestion, severe achiness all over, arms feel heavy like weights, headaches, fatigue. Occurred the next day after receiving the vaccination; states she did not sleep all night and "feels terrible". Is crying and upset.

VAERS ID:443351 (history)  Vaccinated:2011-11-21
Age:42.0  Onset:2011-11-21, Days after vaccination: 0
Gender:Female  Submitted:2011-11-22, Days after onset: 1
Location:Washington  Entered:2011-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Migraines, Depression, ADD, Asthma, Muscle Spasm, Arthritis, Rosacea, HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1103001 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1200AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Neuralgia
SMQs:, Peripheral neuropathy (narrow), Arthritis (broad)
Write-up: Patient reports severe nerve and joint pain following Pneumovax and flu vaccines. Advised to seek urgent medical care.

VAERS ID:443773 (history)  Vaccinated:2011-06-27
Age:42.0  Onset:2011-07-11, Days after vaccination: 14
Gender:Male  Submitted:2011-11-23, Days after onset: 135
Location:North Carolina  Entered:2011-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to shellfish
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B069F UNLA
Administered by: Private     Purchased by: Other
Symptoms: Conjunctivitis, Erythema, Feeling hot, Joint swelling, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: 7-10 days after receiving MMR & TDAP developed redness and swelling of hands and progressed to ankles with warmth and fevers of 102 degrees and bilateral conjunctivitis.

VAERS ID:443709 (history)  Vaccinated:2011-11-23
Age:42.0  Onset:2011-11-23, Days after vaccination: 0
Gender:Female  Submitted:2011-11-28, Days after onset: 5
Location:Minnesota  Entered:2011-11-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: peripheral neuropathy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Muscle tightness, Pain
SMQs:, Dystonia (broad)
Write-up: I am aware that it is expected to have soreness at insertion site/ redness. However for 6 days I have had muscle tightness/ knots and soreness on my entire left side (my back up into my neck). I have been taking ibuprofen 800mg every 6 hrs with minimal relief.

VAERS ID:443737 (history)  Vaccinated:2011-09-21
Age:42.0  Onset:2011-09-21, Days after vaccination: 0
Gender:Female  Submitted:2011-10-25, Days after onset: 34
Location:California  Entered:2011-11-28, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4159DA IMRA
Administered by: Public     Purchased by: Private
Symptoms: Activities of daily living impaired, Pain, Pain in extremity, Poor quality sleep
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (broad)
Write-up: Pain in arm has not dissipated since receiving vaccine. Unable to lift using (R) arm. Experienced pain in every day activities and pain wakes me up at night.

VAERS ID:444176 (history)  Vaccinated:2011-11-19
Age:42.0  Onset:2011-11-20, Days after vaccination: 1
Gender:Male  Submitted:2011-11-20, Days after onset: 0
Location:Unknown  Entered:2011-11-28, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH453AB0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: 5cm diameter area of erythema & warmth. Shortly tender to palpitation.

VAERS ID:443810 (history)  Vaccinated:2011-11-28
Age:42.0  Onset:2011-11-28, Days after vaccination: 0
Gender:Male  Submitted:2011-11-29, Days after onset: 1
Location:Nebraska  Entered:2011-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergies: nuts from trees, ragweed; Asthma; penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 0IJLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Fatigue, Headache, Injection site swelling, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: 8:00 PM - Large swelling on left arm where shot administered; 6:15 AM on 11/29/2011 - severe fatigue, headache, muscle ache, dizziness, shortness of breath upon exercise.

VAERS ID:443869 (history)  Vaccinated:2011-10-14
Age:42.0  Onset:2011-11-14, Days after vaccination: 31
Gender:Female  Submitted:2011-11-29, Days after onset: 15
Location:Washington  Entered:2011-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: h/o developmental delay, DM type 2, HTN, HLD, anemia, past h/o provoked PE (2000) with a h/o lower extremity numbness and weakness. She is experiencing difficulty walking, having difficulty with urination (has urge but difficulty voiding) for the past 3 days. She has no recent fever, diarrhea, respiratory illness. She had a flu shot a month ago.
Diagnostic Lab Data: Results Laboratory. 11/14/2011 16:30 Prothrombin Time Patient 12.9 sec Prothrombin Time INR 1.0 PTT Patient 28 sec PTT X-Mean To calculate the PTT X Mean divide PTT value by 29. 11/14/2011 10:50 Color, URN Yellow Clarity, URN Clear Specific Gravity, URN 1.013 g/mL pH, URN < or =5.0 Protein (Albumin Semi-Quant), URN Negative mg/dL Glucose Qual, URN Negative mg/dL Ketones, URN 10-3
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT480AB1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Activated partial thromboplastin time, Activated partial thromboplastin time shortened, Albumin urine, Anion gap normal, Anticonvulsant drug level decreased, Bacterial test negative, Bilirubin urine, Blood calcium decreased, Blood chloride normal, Blood creatinine normal, Blood glucose increased, Blood magnesium normal, Blood phosphorus normal, Blood potassium normal, Blood sodium normal, Blood urea decreased, Blood urine absent, Carbon dioxide abnormal, Chromaturia, Dysuria, Ehrlichia test, Gait disturbance, Glomerular filtration rate, Glucose urine absent, Haematocrit decreased, Haemoglobin decreased, International normalised ratio normal, Laboratory test, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume normal, Nitrite urine absent, Platelet count decreased, Protein urine, Prothrombin time prolonged, Red blood cell count decreased, Red blood cells urine negative, Red cell distribution width increased, Specific gravity urine normal, Urinary sediment present, Urine ketone body present, Urine leukocyte esterase, Urobilinogen urine decreased, White blood cell count increased, White blood cells urine negative, pH urine, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (broad), Liver-related coagulation and bleeding disturbances (narrow), Haematopoietic erythropenia (narrow), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad)
Write-up: h/o developmental delay, DM type 2, HTN, HLD, anemia, past h/o provoked PE (2000) with a h/o lower extremity numbness and weakness. She is experiencing difficulty walking, having difficulty with urination (has urge but difficulty voiding) for the past 3 days. She has no recent fever, diarrhea, respiratory illness. She had a flu shot a month ago.

VAERS ID:443978 (history)  Vaccinated:2011-09-23
Age:42.0  Onset:2011-09-23, Days after vaccination: 0
Gender:Female  Submitted:2011-11-24, Days after onset: 62
Location:Unknown  Entered:2011-11-30, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Highly reactive to medicine
Diagnostic Lab Data:
CDC Split Type: 2011030395
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IJAR
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IJAR
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug administered at inappropriate site, Influenza like illness, Injection site cellulitis, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous consumer report (initial receipt 08-Nov-2011) concerns a 42-year old female patient who was highly reactive to medicine. On 23-Sep-2011 the patient received a flu shot injection. She also received PNEUMOVAX 23 injection in the same at the same time for vaccination. On 23-Sep-2011 the patient stated that the nurse ''missed the deltoid by injecting too low. That evening the patient developed pain, swelling and cellulitis at the site, with a possible infection. She also had flu like symptoms. She went to a local emergency room and was started on cephalexin. She was not admitted to hospital. The symptoms lasted for two weeks.

VAERS ID:443979 (history)  Vaccinated:2011-11-15
Age:42.0  Onset:2011-11-15, Days after vaccination: 0
Gender:Female  Submitted:2011-11-18, Days after onset: 3
Location:Missouri  Entered:2011-11-30, 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: None - yearly flu vaccine
Preexisting Conditions: allergic to latex; PCN; COMPAZINE
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH477AD IMLA
Administered by: Other     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:444193 (history)  Vaccinated:2011-10-20
Age:42.0  Onset:2011-10-21, Days after vaccination: 1
Gender:Female  Submitted:2011-12-01, Days after onset: 41
Location:North Dakota  Entered:2011-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: RA, OPEN HEART SURGERY JAN 2011
Diagnostic Lab Data:
CDC Split Type: ND1130
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.139720IMLA
Administered by: Private     Purchased by: Private
Symptoms: Axillary pain, Breast pain, Breast swelling, Erythema, Fatigue, Injection site erythema, Injection site swelling, Oedema peripheral, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Hypersensitivity (broad)
Write-up: LEFT ARM SWOLLEN AND RED, SPREAD TO WHOLE ARM FROM FINGER TO SHOULDERS AND SWOLLEN LEFT ARMPIT AND BREAST, VERY PAINFUL. BODY ACHES, FEVER, FATIGUE.

VAERS ID:444667 (history)  Vaccinated:2011-01-21
Age:42.0  Onset:2011-01-21, Days after vaccination: 0
Gender:Male  Submitted:2011-11-04, Days after onset: 286
Location:Texas  Entered:2011-12-02, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No concomitant medications. No relevant medical history was reported. No allergies. No adverse events were reported with previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0910755A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB207AC0UNLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURD0674 UNUN
Administered by: Other     Purchased by: Private
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site haematoma, Injection site pain, Injection site swelling
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of injection site swelling in a 42-year-old male subject who was vaccinated with TWINRIX (GlaxoSmithKline). Previous and/or concurrent vaccination included IPOL (non-gsk); non-GSK manufacturer; unknown; unknown given on 21 January 2011. Concurrent medications included (Non-GSK) Yellow fever. On 21 January 2011 the subject received 1st dose of TWINRIX (1 ml, unknown, left arm). On 21 January 2011, immediately after vaccination with TWINRIX, the subject experienced injection site swelling, injection site redness, and injection site pain; the size was described as a fourth to half a dollar size. Intervention to prevent further swelling was performed at the physician''s office and included application of ice. On an unspecified date in January 2011, three days after vaccination with TWINRIX, the subject reported having pain and a little bruising at injection site. The healthcare professional considered the events were clinically significant (or requiring intervention). The subject was treated with Ice pack. At the time of reporting the outcome of the injection site swelling, injection site redness, pain and bruising at injection were unspecified. This is the first of two cases reported by the healthcare professional; for the second case see A0910940A. Follow-up information was received on 16 February 2011 via healthcare professional who reported as of 24 January 2011 the injection site swelling and injection site redness injection site pain and bruising at injection site had improved. The immunization series was not delayed or discontinued.

VAERS ID:444552 (history)  Vaccinated:2011-11-28
Age:42.0  Onset:2011-11-28, Days after vaccination: 0
Gender:Female  Submitted:2011-12-05, Days after onset: 7
Location:Washington  Entered:2011-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: PCN, Sulfa allergy
Diagnostic Lab Data: I have an appointment with a doctor tomorrow since I was only able to see the nurse in employee health today.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4163BA1IDLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Hypoaesthesia, Neck pain, Oedema peripheral, Pain in extremity, Paraesthesia
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: I had my flu shot and developed bad joint pain the day after and over the last two days, I have developed neck, hand, and foot pain. My hands and feet develop numbness and tingling through the night and are swollen by the morning.

VAERS ID:444688 (history)  Vaccinated:2011-12-05
Age:42.0  Onset:2011-12-05, Days after vaccination: 0
Gender:Female  Submitted:2011-12-06, Days after onset: 1
Location:Pennsylvania  Entered:2011-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH475AB1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye swelling, Pruritus, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Wheezing in chest, swollen eyes, itching.

VAERS ID:444759 (history)  Vaccinated:2011-08-30
Age:42.0  Onset:2011-09-01, Days after vaccination: 2
Gender:Female  Submitted:2011-09-01, Days after onset: 0
Location:Texas  Entered:2011-12-07, Days after submission: 97
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No/none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3922AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Two days after receiving Tdap vaccine employee was feeling slight pain in left deltoid along with redness approximately 2 inches in length and warm to touch. Dr prescribed antibiotic medication for symptoms on 09-01-11.

VAERS ID:444906 (history)  Vaccinated:2011-12-02
Age:42.0  Onset:2011-12-03, Days after vaccination: 1
Gender:Male  Submitted:2011-12-08, Days after onset: 5
Location:D.C.  Entered:2011-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH486AF1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pt experienced bumps by injection site that spread to chest. After review signs of anaphylaxis & medical history, recommended BENADRYL 2 at 6 hour x 24 hours, then 1 Q 6 pm.

VAERS ID:445155 (history)  Vaccinated:2011-10-27
Age:42.0  Onset:2011-10-28, Days after vaccination: 1
Gender:Female  Submitted:2011-12-06, Days after onset: 39
Location:Montana  Entered:2011-12-12, 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: hypothyroid; anxiety; depression; bee sting allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH476AB IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chapped lips, Lip swelling, Paraesthesia oral
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: 11-23-11 T.C. from patient. Patient states 1-2 days after receiving flu shot lips felt swollen & puffy with tingling sensation, lips felt chapped. Sx have persisted x 4 weeks. Patient has tried OTC chapstick & other lip balm but no relief. Advised evaluation evaluation by own MD & will conduct f/u call in one week. Pt has MD appt on 12-2-11. 12-6-11 per pt, MD said sx not R/T flu vaccine. MD advised continuing with chapstick & trying BENADRYL for relief.

VAERS ID:445199 (history)  Vaccinated:2011-10-31
Age:42.0  Onset:2011-11-01, Days after vaccination: 1
Gender:Female  Submitted:2011-12-12, Days after onset: 41
Location:Illinois  Entered:2011-12-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Throat Strep test done 11/4/11 due to pharyngitis; strep test negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR474163AA0IDLA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Diarrhoea, Fatigue, Lymph node pain, Lymphadenopathy, Myalgia, Oropharyngeal pain, Pharyngitis, Streptococcus test negative
SMQs:, Rhabdomyolysis/myopathy (broad), Agranulocytosis (broad), Pseudomembranous colitis (broad), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea, sore throat, muscle aches, fatigue, chills, swollen, painful glands on neck and under arms.

VAERS ID:445297 (history)  Vaccinated:2011-10-04
Age:42.0  Onset:2011-10-04, Days after vaccination: 0
Gender:Female  Submitted:2011-12-08, Days after onset: 65
Location:Texas  Entered:2011-12-13, 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:
Diagnostic Lab Data: N/A to date
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA618AB20UNAR
Administered by: Unknown     Purchased by: Other
Symptoms: Mobility decreased, Musculoskeletal pain, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad)
Write-up: Severe arm/shoulder pain (from onset to 1 month later), immobility in arm movement limited (2 months), dull, aching pain (to present).

VAERS ID:445591 (history)  Vaccinated:2010-01-13
Age:42.0  Onset:2010-02-28, Days after vaccination: 46
Gender:Female  Submitted:2011-12-15, Days after onset: 655
Location:Iowa  Entered:2011-12-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to penicillin, amoxicillin, erythromycin
Diagnostic Lab Data: I have gone to a neurologist with Clinic. I have had a lumbar puncture, several EMG and nerve conduction studies, and extensive blood work to rule out other causes of CIDP. I have also seen an infectious disease doctor with Clinic, in August/September 2011. That is when they had finally completed all of the tests.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (CSL)CSL LIMITEDL306120IMLA
Administered by: Other     Purchased by: Other
Symptoms: Blood test, Computerised tomogram normal, Electromyogram, Hypoaesthesia, Laboratory test, Lumbar puncture, Nerve conduction studies, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: The left side of my face was numb. My tongue was also tingly. The numbness felt like I had gone to the dentist and had a shot of novocaine that didn''t go away. It was a Sunday when I noticed this. I waited for an hour or two, and then I went to the ER. The ER doctor had a CT done. It didn''t show anything. He told me to take ibuprofen. If it didn''t get better, I was to go see my family doctor.

VAERS ID:445652 (history)  Vaccinated:2011-12-14
Age:42.0  Onset:2011-12-14, Days after vaccination: 0
Gender:Female  Submitted:2011-12-16, Days after onset: 2
Location:Washington  Entered:2011-12-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hx of asthma
Preexisting Conditions: allergies stated on immunization health history: prednisone loversol amoxicillin sulfa
Diagnostic Lab Data: Peak flow x3 averaging 300 per MD report
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC018BA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 12/14/11- Patient was seen this am for immunization review. No record of hep B and patient wished to recieve it so administered first dose in series. Patient stated had an asthma attack after receiving pneumococcal vaccine in past. No contraindications noted on questionnaire. Had patient wait in waiting room after immunization due to history of asthma attack induced by prior vaccination. Minutes after vaccination patient stated that breathing was becoming more difficult. Lungs noted to have expiratory wheeze. Had patient take two puffs of inhaler and escorted to ER. Evaluated and treated with no lasting adverse effects per MD note. VAERS completed.

VAERS ID:446403 (history)  Vaccinated:2011-09-12
Age:42.0  Onset:2011-09-12, Days after vaccination: 0
Gender:Male  Submitted:2011-10-11, Days after onset: 29
Location:Nevada  Entered:2011-12-28, Days after submission: 78
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.0630AA1UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B074CA1UNRA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: From PCP note: He has had some chills and fever. He has a rash over leg and into groin. He had a PNEUMOVAX on the right side, and it is fine.

VAERS ID:446550 (history)  Vaccinated:2011-12-30
Age:42.0  Onset:2011-12-31, Days after vaccination: 1
Gender:Male  Submitted:2011-12-31, Days after onset: 0
Location:Nebraska  Entered:2011-12-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Slight upper respiratory infection--likely viral
Preexisting Conditions: None confirmed--possible immunocompromise.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1IMRA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Feeling hot, Oedema, Swelling, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Large area of raised redness and moderate-severe tenderness and warmth. Area approximately 6 to 8 inches in diameter. Some edema also present.

VAERS ID:446559 (history)  Vaccinated:2011-12-23
Age:42.0  Onset:2011-12-31, Days after vaccination: 8
Gender:Male  Submitted:2012-01-02, Days after onset: 2
Location:New Jersey  Entered:2012-01-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDN554060IMRA
Administered by: Other     Purchased by: Private
Symptoms: Herpes zoster, Pain
SMQs:
Write-up: Shingles type sensitivity on left side (lower back and upper leg), continuing for several days, followed by shingles-type pain on third day. Identical to symptoms patient had when shingles was diagnosed several years earlier. Began anti-viral drug treatment upon advice of physician. Extent of shingles outbreak remains to be seen.

VAERS ID:446627 (history)  Vaccinated:2011-11-03
Age:42.0  Onset:2011-11-03, Days after vaccination: 0
Gender:Male  Submitted:2012-01-03, Days after onset: 61
Location:South Carolina  Entered:2012-01-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Other     Purchased by: Private
Symptoms: Anxiety, Rash macular, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Received vaccine at 1:08 PM. At approximately 1:30 PM participant came back to training room wanting to know if it was normal to feel like her throat was tight and tongue swollen. The nurse told her no that it was not normal and that the nurse would need to administer an epinephrine injection. Participant was conscious, alert and oriented. Appeared anxious, face red splotchy. Nurse sat participant down and administered epinephrine 1:1000 0.3mL SQ Right Upper Arm. EMS called. Pulse 84. Respirations 28. Skin warm and dry. Transported by EMS to ER. Per EMS O2 98% Room Air, BP 150/90. Patient states feeling better on EMS departure.

VAERS ID:446894 (history)  Vaccinated:2010-10-04
Age:42.0  Onset:2010-11-23, Days after vaccination: 50
Gender:Female  Submitted:2012-01-05, Days after onset: 408
Location:Wisconsin  Entered:2012-01-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: lasix, doxycylcline
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Intestinal obstruction
SMQs:, Gastrointestinal obstruction (narrow)
Write-up: Bowel obstruction; hospitalization.

VAERS ID:446919 (history)  Vaccinated:2012-01-03
Age:42.0  Onset:2012-01-04, Days after vaccination: 1
Gender:Female  Submitted:2012-01-06, Days after onset: 2
Location:Maryland  Entered:2012-01-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma; Rhinitis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH453AB0UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0453AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURAC52B073AA0UNLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Mobility decreased, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Vaccine administered 1/3/2012 at 1450. Initial symptoms pain, soreness and unable to raise arm, then redness and swelling on 1/4/2012. Fever 101.6 1/5/2012. (ALEVE) OTC and TYLENOL OTC.

VAERS ID:447110 (history)  Vaccinated:2011-10-11
Age:42.0  Onset:2011-10-12, Days after vaccination: 1
Gender:Female  Submitted:2012-01-10, Days after onset: 90
Location:New York  Entered:2012-01-10
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: Had a HX of pneumonia 18 months prior
Diagnostic Lab Data: Chest Xray. Follow up CXR 1/9/11. Need another course of antibiotics
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Chest X-ray abnormal, Chest pain, Chills, Feeling abnormal, Pain, Pleurisy, Pneumonia
SMQs:, Systemic lupus erythematosus (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Aches and pains. I attibuted it to getting both the flu and pneumonia vaccine the day before and normal side effects. I got progressively worse over the following week and a half. I had chills, aches, pains and then finally chest pain. I returned to the MD office and was treated with Medrol dose pack for suspected pleurisy. I still did not improve. I returned again around 10/27. A Chest Xray was done at that time and I got a call a couple of days later stating that I did indeed have Pneumonia. I do believe that I got it from the vaccine as I was FINE when I got the vaccine and very next day started feeling poorly.

VAERS ID:447221 (history)  Vaccinated:2012-01-08
Age:42.0  Onset:2012-01-09, Days after vaccination: 1
Gender:Male  Submitted:2012-01-09, Days after onset: 0
Location:Washington  Entered:2012-01-11, 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: Allergic to Cephalexin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT491AA UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0453AA UNLA
Administered by: Other     Purchased by: Other
Symptoms: Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Nausea, vomiting, fever, body aches.

VAERS ID:447321 (history)  Vaccinated:2011-11-16
Age:42.0  Onset:2011-11-16, Days after vaccination: 0
Gender:Female  Submitted:2012-01-12, Days after onset: 57
Location:Oklahoma  Entered:2012-01-13, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Thyroid Nodule; Allergic Rhinitis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH467AA11IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Electrocardiogram, Pruritus, Tremor
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad)
Write-up: Pruritus, internal tremors, began 2 hours after injection - BENADRYL 12.5mg IM, DECADRON IM - then c/o chest discomfort. EKG done.

VAERS ID:447472 (history)  Vaccinated:2012-01-04
Age:42.0  Onset:2012-01-10, Days after vaccination: 6
Gender:Female  Submitted:2012-01-17, Days after onset: 7
Location:Alaska  Entered:2012-01-17
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: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0870AA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Oropharyngeal pain, Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Back started itching, noticed red bumps all over back, sore throat tried oatmeal baths, Benadryl.

VAERS ID:447728 (history)  Vaccinated:2011-10-23
Age:42.0  Onset:2011-10-23, Days after vaccination: 0
Gender:Female  Submitted:2012-01-20, Days after onset: 89
Location:Louisiana  Entered:2012-01-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: pending
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Immediate post-injection reaction, Pain in extremity
SMQs:, Hypersensitivity (narrow)
Write-up: Immediate burning pain down left arm when injected. Pain continues to radiate to hand. The pain is constant with no relief from over the counter meds, heat or cold compresses.

VAERS ID:447732 (history)  Vaccinated:2011-12-18
Age:42.0  Onset:2012-01-12, Days after vaccination: 25
Gender:Female  Submitted:2012-01-21, Days after onset: 9
Location:Alaska  Entered:2012-01-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No.
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MER: MEASLES + RUBELLA (MR-VAX II)MERCK & CO. INC. 1IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Blepharospasm, Oropharyngeal pain, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow)
Write-up: Have red bumps on chest, stomach, back, shoulders. Have a few red bumps on arms, legs, face. Bumps itch and are still present. Had sore throat, left eye began twitching and is still twitching. Not doing this previously, just had eye exam beginning of December. Not exactly sure of vaccine dates or beginning of symptoms.

VAERS ID:448123 (history)  Vaccinated:2011-12-19
Age:42.0  Onset:2011-12-20, Days after vaccination: 1
Gender:Female  Submitted:2012-01-19, Days after onset: 30
Location:Massachusetts  Entered:2012-01-26, 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: Depression; Dyspepsia; G1P1; Gastroesophageal reflux; Thymic hyperplasia; Ulcerative colitis; Perioral dermatitis; All. Sulfa
Diagnostic Lab Data: Enclosed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4023AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Hypoaesthesia, Injection site pain, Injection site swelling, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A 42-year-old female here because she had some pins and needles, sharp pains in her left arm and left leg after receiving a Tdap vaccine on December 19. It was in the left upper arm. On Monday, she got it, the next day she felt arm pain and tingling on the lateral three fingers and up the forearm to the site where she got the vaccine and that area was very swollen and painful. Also, developed numbness in the bottom of the foot up the calf in the lateral aspect of the calf. That is continuing. The numbness in the arm has gotten much better since swelling from the vaccine site has gotten better. Came and saw Dr. who thought it was not from the vaccine. She has taken no new medications, except doxycycline for two days, which she stopped, but that was well after she had gotten this problem. No headache, neck pain, rash, back pain. Never had this problem before.

VAERS ID:448216 (history)  Vaccinated:2012-01-18
Age:42.0  Onset:2012-01-19, Days after vaccination: 1
Gender:Female  Submitted:2012-01-20, Days after onset: 1
Location:Wisconsin  Entered:2012-01-27, 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: No
Preexisting Conditions: Allergy to peanuts
Diagnostic Lab Data: None. Client presented to Health Department on 1/20 to show nurse the welt.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0352AA0SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0819AA0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 1/19/12 about 4:00 pm: Per client, she discovered a red welt about half dollar size in location of MMR vaccine. Red welt was slightly itchy and warm w/no pain. On 1/20/12 - welt was not as red, still itches, and area is slightly larger per client. Client encouraged to see her physician.

VAERS ID:448437 (history)  Vaccinated:2012-01-26
Age:42.0  Onset:0000-00-00
Gender:Male  Submitted:2012-01-26
Location:Florida  Entered:2012-01-31, 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
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB824CA1IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB493BA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:448558 (history)  Vaccinated:2012-01-09
Age:42.0  Onset:2012-01-09, Days after vaccination: 0
Gender:Male  Submitted:2012-02-01, Days after onset: 23
Location:Washington  Entered:2012-02-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH453AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cough, Eye pain, Fatigue, Myalgia, Ocular hyperaemia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad)
Write-up: 2-3 hours after vaccination he started to develop muscle aches, dry cough, red sore eyes, fatigue these signs and symptoms lasted 3 days.

VAERS ID:448597 (history)  Vaccinated:2011-10-14
Age:42.0  Onset:2011-11-01, Days after vaccination: 18
Gender:Male  Submitted:2012-01-18, Days after onset: 78
Location:Montana  Entered:2012-02-02, Days after submission: 15
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: RA
Preexisting Conditions: Fish allergy; RA
Diagnostic Lab Data: MRI; Spinal Fluid; Blood
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA694AA0UNLA
Administered by: Public     Purchased by: Other
Symptoms: Blood test, CSF test, Chills, Hypoaesthesia, Myelitis transverse, Night sweats, Nuclear magnetic resonance imaging
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Demyelination (narrow)
Write-up: Transverse myelitis, numbness chest, feet, legs, arms chills, night sweats.

VAERS ID:448629 (history)  Vaccinated:2011-10-27
Age:42.0  Onset:2011-10-29, Days after vaccination: 2
Gender:Female  Submitted:2012-01-30, Days after onset: 93
Location:California  Entered:2012-02-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Illness at the time of vaccination was not reported. From new information received, the patient had upper respiratory infection (URI) at the time of vaccination with FLUZONE Intradermal on 27 October 2011.
Diagnostic Lab Data: Not reported
CDC Split Type: 201110556
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4163AA2IDLA
Administered by: Private     Purchased by: Private
Symptoms: Swelling, Type III immune complex mediated reaction
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This is a non-serious cluster of 2 patients who experienced adverse events following administration of FLUZONE Intradermal (lot number not reported). Initial report was received on 31 October 2011 from a health care provider. Two patients (age and date of birth not reported) had received FLUZONE Intradermal, (lot number, route and site of administration were not reported). One of the patients an employee at a dental clinic experienced a bad reaction to the intradermal injection. The second patient ended up in the emergency room (ER) with swelling down to the elbow. No further informational was available at the time of the report. The patient''s outcome was not reported. Follow-up information received from a health care professional on 20 January 2012. It was clarified by the reported that a cluster of 4 patients (previously reported as 2 patients) had received FLUZONE Intradermal (lot number UT4163AA) on different days and experienced reactions. This case will now be the case of reference for 1 of the 4 patients who had been identified as a 43 year-old female patient who is discussed below. Due to the follow-up information received on this patient this case now meets seriousness criteria and has been upgraded to serious. Information regarding the other 3 patients (all non-serious cases) are captured in case numbers 2012-00783, 00784, 00785. A 43-year-old female patient who had concurrent illnesses of upper respiratory infection (URI), had received a left arm injection of FLUZONE Intradermal (lot number UT4163AA) on 27 October 2011 at 3 pm, and 2 days later on 29 October 2011 at 3:30 pm reported swelling down to the elbow. The patient presented to the emergency room and was administered steroid injection and antibiotics for arthus reaction. Concomitant medications included B12 injection. The patient recovered on an unspecified date. Documents held by sender: none.

VAERS ID:449040 (history)  Vaccinated:2012-01-24
Age:42.0  Onset:2012-01-27, Days after vaccination: 3
Gender:Female  Submitted:2012-02-06, Days after onset: 10
Location:New York  Entered:2012-02-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Pt reports previous MMR reaction but did not disclose on consent sheet.
Diagnostic Lab Data: CBC; BMP; Hepatic; PT/INR; Total CPK; MRI head; MRA head & neck
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0852AA1SCRA
Administered by: Public     Purchased by: Public
Symptoms: Angiogram, Blood creatine phosphokinase, Dizziness, Full blood count, Hemiparesis, Hypoaesthesia, International normalised ratio, Metabolic function test, Muscle spasms, Nuclear magnetic resonance imaging brain, Paraesthesia, Paralysis, Prothrombin time
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (narrow), Vestibular disorders (broad)
Write-up: Lt sided weakness tingling & numbness with episodes of paralysis. Positive dizziness. Muscle spasm in buttocks & back.

VAERS ID:449353 (history)  Vaccinated:2011-11-14
Age:42.0  Onset:2012-01-07, Days after vaccination: 54
Gender:Male  Submitted:2012-02-10, Days after onset: 34
Location:Florida  Entered:2012-02-10
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: MRI, Cat Scan, Spinal Tap, Blood work
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA668AA UNUN
Administered by: Other     Purchased by: Public
Symptoms: Blood test, Computerised tomogram, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Intensive care, Lumbar puncture, Nuclear magnetic resonance imaging, Paralysis
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Legs went numb at 10 am by 6:30 PM paralysis up to stomach. Responded to Medical Center diagnosed with Guillain-Barre treated for 6 days in ICU with ? Globulin IV still affected.

VAERS ID:449484 (history)  Vaccinated:2012-02-03
Age:42.0  Onset:2012-02-03, Days after vaccination: 0
Gender:Female  Submitted:2012-02-13, Days after onset: 10
Location:Vermont  Entered:2012-02-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 7IMLA
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 12IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Injection site pain, Oedema, Pruritus, Skin discolouration
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Soreness at injection site; edema (size of a palm/hand); itchy; skin discoloration.

VAERS ID:449550 (history)  Vaccinated:2012-02-01
Age:42.0  Onset:2012-02-02, Days after vaccination: 1
Gender:Female  Submitted:2012-02-03, Days after onset: 1
Location:Georgia  Entered:2012-02-14, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA684AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Dyspnoea, Erythema, Oedema peripheral, Skin warm, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 24 hrs after receiving INFLUENZA vaccine, around 7 pm, (L) arm was swollen, red, hives, hot to touch. Dizziness and SOB.

VAERS ID:450003 (history)  Vaccinated:2012-02-08
Age:42.0  Onset:2012-02-09, Days after vaccination: 1
Gender:Male  Submitted:2012-02-21, Days after onset: 12
Location:Hawaii  Entered:2012-02-21
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
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B073AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Insomnia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Deep lingering ache in muscle - right deltoid, never went away after vaccine given 2 weeks ago. Can''t sleep at night due to pain. Took Advil. Employee referred to primary care physician for follow up - appointment still pending as of 2/21/12.

VAERS ID:450044 (history)  Vaccinated:2011-11-19
Age:42.0  Onset:2011-11-21, Days after vaccination: 2
Gender:Male  Submitted:2012-02-21, Days after onset: 92
Location:Unknown  Entered:2012-02-22, 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:
Current Illness:
Preexisting Conditions: Ptosis; Eye operation
Diagnostic Lab Data: Computed axial, 11/21/11, unremarkable; Diagnostic urinalysis, 11/21/11, urine clear; Chest X-ray, 11/21/11, normal; Computed axial, 11/21/11, repeat scan entirely negative; WBC count, 11/21/11, 16.9; WBC count, 11/23/11, normal; Temperature measurement, 11/21/11, 101.6; Blood culture, 11/26?/11, no growth
CDC Split Type: WAES1112USA00435
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMLA
Administered by: Public     Purchased by: Other
Symptoms: Bacteraemia, Blood culture negative, Blood glucose increased, Chest X-ray normal, Chills, Computerised tomogram normal, Feeling abnormal, Headache, Injection site erythema, Injection site induration, Injection site joint inflammation, Injection site pain, Malaise, Musculoskeletal pain, Nausea, Pain, Pyrexia, Urine analysis normal, Vomiting, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (narrow)
Write-up: Information has been received from a pharmacist concerning a patient who on an unspecified date in November 2011 was vaccinated with a dose of PNEUMOVAX 23 (Lot# not reported). In November 2011 (reported as "2 days later after vaccination") the patient experienced fever, chills, pain and redness around the injection site. The patient was admitted to the hospital for an unknown period of time, treated and released. At the time of reporting, the patient''s outcome was unknown. Follow-up information has been received from medical records regarding a 42 year old male with a history of appendectomy for acute appendicitis (hospitalized 18-NOV-2011) who on 19-NOV-2011, was given a dose of PNEUMOVAX 23 intramuscularly in the left arm (also reported as left shoulder). It was noted that on 20-NOV-2011, the patient felt good. On 21-NOV-2011, the patient presented to a physician''s office with a complaint of general malaise, headache, generally not feeling well, felt "horrible". The physician sent the patient to the emergency room where his white count was found to be elevated at 16.9 with a shift. It was noted the patient had had a normal white count with his appendicitis with a small shift. The patient''s urine was clear, chest x-ray was normal, CAT scan of his abdomen was unremarkable. The patient''s SMA7 revealed a mildly elevated glucose. Physical examination was essentially benign except for a red, tender, somewhat indurated patch on the patient''s left arm where the PNEUMOVAX 23 was administered. The patient complained of intermittent fever, chills, headache, nausea with an episode of vomiting, and body aches. Temperature in the emergency room was low grade, however, the patient indicated it was 101.6 at home. Impression included possible bacteremia secondary to inoculation from the pneumococcal vaccine versus a viral syndrome. Plan included less than 24 hour admission for observation. Repeat CAT scan was entirely negative. The only etiology for the patient''s pain was a reddened arm located around his pneumococcal shot (also reported as shoulder pain). The patient was hospitalized. Infectious disease was consulted, impression from which included inflammatory focus on the left shoulder, most likely the source of the patient''s fever, chills, and systemic symptoms. It was noted this could all be a local reaction to the pneumococcal inoculation the patient received recently. "Would however, be concerned about the possibility of a bacterial superinfection, most likely a gram-positive organism, staph aureus or beta strep, and this too could be causing the systemic symptoms he is describing." The patient seemed to have a transient shedding of toxin and a transient bacteremia. He was placed on vancomycin and switched over to (UNASYN). Blood culture at five days showed no growth. Over the next two days, the patient began to feel much better and returned to his normal state. The redness in his arm went down; there was no fluctuance to suggest abscess. The patient''s white count returned to normal, and the patient felt fine. On 23-NOV-2011, the patient was discharged on AUGMENTIN with a heating pad to his arm. All available medical records will be provided upon request. No further information is expected.

VAERS ID:450283 (history)  Vaccinated:2012-02-20
Age:42.0  Onset:2012-02-21, Days after vaccination: 1
Gender:Female  Submitted:2012-02-24, Days after onset: 3
Location:Texas  Entered:2012-02-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1706Z1SCRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site nodule, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Erythema and swelling measuring 110 mm on right subcutaneous area of right arm. Warm to touch. Large knot.

VAERS ID:450907 (history)  Vaccinated:2012-02-28
Age:42.0  Onset:2012-02-28, Days after vaccination: 0
Gender:Female  Submitted:2012-03-01, Days after onset: 2
Location:Minnesota  Entered:2012-03-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses at time of vaccination.
Preexisting Conditions: The patient had no existing physician-diagnosed allergies, birth defects, or medical conditions at time of vaccination.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0104AA SCRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B066AA IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0450AA SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site swelling, Injection site warmth, Skin tightness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: After the Varivax vaccine was administered in patient''s left arm, the site where the Varivax was given became swollen and was more stiff compared to the skin surrounding the injection. No pain was stated from the patient after the vaccine was given. Patient told of symptoms indicating a severe adverse reaction and to seek medical care if they did occur. Current VIS was given in two languages (3/13/08). Two days later on 3/01/2012 at 2;40 patient came to have her Mantoux skin test read and the PHN assessed the vaccine administration site. The erythema was measured, horizontally the erythema was 70mm and vertically it was 50mm. Client stated no pain was felt. Just that it was itchy and swollen. Client put ice on the area as well as Benedryl cream, which she stated helped to relieve the swelling and itching. The site where the Varivax was given was warm to the touch. PHN again educated client of severe allergic reaction and what to do if those symptoms were to occur. On 3/01/2012 Dr. was called and the PHN reported the reaction. The Dr. told the PHN to advise the patient to not get another Varivax vaccine. Also if the site gets worse to go and see a doctor. Dr. also advised the patient to take oral Benadryl 25mg three times per day. Client has no primary physician. Merck & Co. is the manufacturer of Varivax. Lot#: 0450AA. Expiration date: 3/28/13. Additional vaccines given on 02/28/2012 were the Tdap vaccine in her Left Deltoid and the MMR vaccine in her Right Arm.

VAERS ID:451192 (history)  Vaccinated:2012-01-27
Age:42.0  Onset:2012-02-07, Days after vaccination: 11
Gender:Female  Submitted:2012-03-06, Days after onset: 28
Location:Nevada  Entered:2012-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Public     Purchased by: Unknown
Symptoms: Abdominal pain upper, Headache, Heart rate increased, Pharyngeal oedema, Trismus, Vomiting
SMQs:, Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (narrow), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Rapid heart rate, throat swelled, jaw locked, stomach pain, headache, vomiting.

VAERS ID:451346 (history)  Vaccinated:2012-03-07
Age:42.0  Onset:2012-03-09, Days after vaccination: 2
Gender:Female  Submitted:2012-03-09, Days after onset: 0
Location:Michigan  Entered:2012-03-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0231AA2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Itching and hives on chest and arms.

VAERS ID:451504 (history)  Vaccinated:2011-01-25
Age:42.0  Onset:2011-01-27, Days after vaccination: 2
Gender:Female  Submitted:2012-02-02, Days after onset: 371
Location:Kansas  Entered:2012-03-12, 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: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Muscle spasms, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Joint & muscle pain. Severe muscle cramps in feet & hands. Foot cramps still continue 1 year later.

VAERS ID:451964 (history)  Vaccinated:2010-01-26
Age:42.0  Onset:0000-00-00
Gender:Male  Submitted:2012-03-15
Location:New York  Entered:2012-03-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Anal/penile dysplasia
Preexisting Conditions: HPV infection
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1487Y2IMUN
Administered by: Private     Purchased by: Private
Symptoms: Vitiligo
SMQs:
Write-up: Patient reports a rapid onset of progressive vitiligo. Following a 3-part course of GARDASIL, per dosing schedule. Condition persists. Patient is in treatment through a number of modalities. Sx began within 2-3 weeks of administration of the vaccine.

VAERS ID:452054 (history)  Vaccinated:2011-02-23
Age:42.0  Onset:2011-02-23, Days after vaccination: 0
Gender:Female  Submitted:2012-03-15, Days after onset: 385
Location:New York  Entered:2012-03-19, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccination and no reported adverse events to prior vaccinations. The patient received no other vaccinations within four weeks of ADACEL and took no concomitant medications. The patient''s past medical history included allergies to sulfa, codeine, ibuprofen and PROCARDIA.
Diagnostic Lab Data: Not reported
CDC Split Type: 201202656
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR 0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Initial report was received from a consumer, who was also the patient, on 06 March 2012. A 43-year-old female patient had received a dose one intramuscular injection in the left deltoid of ADACEL, sanofi pasteur Ltd. (lot number not reported) on 23 February 2012. On 23 February 2012, the patient experienced muscle soreness in the left arm for a few days after the vaccine and went to the emergency room (ER). The patient had no movement/severe pain in the left arm since then and was getting worse so the patient went back to the ER. There was no redness at the injection site. The patient had no illness at the time of vaccination and no reported adverse events to prior vaccinations. The patient received no other vaccinations within four weeks of ADACEL and took no concomitant medications. The patient''s past medical history included allergies to sulfa, codeine, ibuprofen and PROCARDIA. No further information was available at the time of the report. The patient''s outcome was not recovered. Documents held by sender: None.

VAERS ID:452210 (history)  Vaccinated:2012-03-02
Age:42.0  Onset:2012-03-12, Days after vaccination: 10
Gender:Male  Submitted:2012-03-21, Days after onset: 9
Location:North Carolina  Entered:2012-03-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: SEASONAL ALLERGIES
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3057IMLA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0OTRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURE05761IMLA
Administered by: Military     Purchased by: Military
Symptoms: Drug administration error, Lymphadenopathy
SMQs:
Write-up: DURING VACCINATION, ADMINISTRATOR SEEMED RUSHED. PUSHING PRE-SCREENING PAPERWORK IN ORDER TO BEGIN VACCINE PROCESS. ADMINISTRATOR DID NOT CLEAN AREA WITH ALCOHOL PRIOR TO ADMINISTERING TYPHOID, ANTHRAX BOOSTER, AND SMALLPOX. WAS BRIEFED THAT SMALLPOX VACCINE WOULD CONSIST OF 15 SMALL PRICKS, BUT SEVERAL OTHERS WERE ADMINISTERED. " WITHIN SEVERAL DAYS, SWOLLEN GLANDS UNDER SMALLPOX ARMPIT WITH ACHY FEELING AND STREAKING. SYMPTOMS PROGRESSIVELY WORSENED OVER TIME. SAW MEDICAL PERSONNEL FOR STREAKING AND WAS SENT TO ER. WAS ADMINISTERED VANCOMYCIN (2 GRAMS) VIA IV WITH PERSCRIPTION FOR CLINDAMYCIN 150 MG 2 CAPSULES EVERY 6 HOURS. (# 56 CAPSULES) MAINTAINING FOLLOW UP WITH MEDICAL DOCTORS EVERY 2-3 DAY IN ORDER TO MONITOR SITE AND TREATMENT PLAN.

VAERS ID:453135 (history)  Vaccinated:2012-04-03
Age:42.0  Onset:2012-04-04, Days after vaccination: 1
Gender:Female  Submitted:2012-04-06, Days after onset: 2
Location:New Jersey  Entered:2012-04-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: celiac disease
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Injection site erythema, Injection site pain, Injection site swelling, Lethargy, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Pain in entire arm requiring pain relief, redness and swelling at injection site, lethargy, dizziness.

VAERS ID:453243 (history)  Vaccinated:2012-04-04
Age:42.0  Onset:2012-04-05, Days after vaccination: 1
Gender:Female  Submitted:2012-04-09, Days after onset: 4
Location:New York  Entered:2012-04-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4023AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Mobility decreased, Pain, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Hypersensitivity (broad)
Write-up: Received ADACEL injection 4/4/12 and awoke next day with fever, arm soreness and unable to move x 2 days. Today reporting pain to touch, redness. 4-9-12 office visit, dx cellulitis, treated KEFLEX.

VAERS ID:453280 (history)  Vaccinated:2012-03-13
Age:42.0  Onset:2012-03-14, Days after vaccination: 1
Gender:Female  Submitted:2012-04-10, Days after onset: 27
Location:Indiana  Entered:2012-04-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4305BA IMLA
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: Pain, redness, and swelling at injection site 5cm circumferential area of light erythema, swelling, tenderness on exam. Treatment: MEDROL dose pak and cephalexin 500mg x 7 days.

VAERS ID:454042 (history)  Vaccinated:2012-04-05
Age:42.0  Onset:2012-04-06, Days after vaccination: 1
Gender:Male  Submitted:2012-04-20, Days after onset: 14
Location:Wisconsin  Entered:2012-04-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Newly diagnosed with hyperthyroidism
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4304AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Fatigue, Hyperhidrosis, Injection site induration, Injection site pruritus, Injection site swelling, Pain, Skin warm
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt. experienced severe fatigue, chills, 3" x 3" raised, area which is hot to the touch, approx. 24 hrs. after receiving the ADACEL. After 12 hours woke up in full body sweat with improvement of body aches. Injection site not as sensitive to the touch, but remains swollen, firm to the touch & itchy.

VAERS ID:454376 (history)  Vaccinated:2012-04-24
Age:42.0  Onset:2012-04-25, Days after vaccination: 1
Gender:Female  Submitted:2012-04-25, Days after onset: 0
Location:Indiana  Entered:2012-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness at time of vaccine
Preexisting Conditions: none known
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1883AA1SCRA
Administered by: Other     Purchased by: Private
Symptoms: Dysphagia, Oropharyngeal pain
SMQs:, Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Patient had eaten at a Mexican Restaraunt at 5:00 PM after having received the MMR vaccine at 2:20 PM. She experienced a feeling of having needles poking at her throat with some difficulty swallowing at 6:30 PM. She called the Health Nurse line at 7:30 pm and was encouraged to take Diphenhydramine and be seen at an Urgent Care. She came to the Health Clinic today (4/25/2012) at 2:20 PM after finishing work, but reports having taken Diphenhydramine 25 mg at 8:00 PM last night. She was treated with Prednisone for safety. This patient had an appointment for a different matter today and mentioned while here "by the way, after I got my MMR shot yesterday, I started having throat pain like the start of a sore throat later on last evening. It felt like needles in my throat & I had a little trouble swallowing". The next box labeled event outcomes is marked as none of the above because the patient would not have come in for the throat symptoms had it not been for an already scheduled appointment.

VAERS ID:454662 (history)  Vaccinated:2012-03-09
Age:42.0  Onset:2012-03-09, Days after vaccination: 0
Gender:Male  Submitted:2012-04-30, Days after onset: 51
Location:Kentucky  Entered:2012-04-30
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: MR; Intermittent explosive disorder; Psychiatric disorder, NOS; Seizure disorder; DM; HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC004AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4023AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Condition aggravated, 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: On 3-9-12, at 12:40 pm, Tdap & Hepatitis B vaccines were administered. At 3:13pm, patient experienced a seizure in excess of 6 minutes, (7 min). Our client was transferred to local hospital where he stayed 5 days. He does have a seizure disorder & experienced another seizure on 3-10-12 & one more on 3-11-12. His seizure meds were adjusted & he was released from hospital back to our facility. Our P & T committee reviewed this case as a possible ADR from the vaccines (most probably Tdap).

VAERS ID:454797 (history)  Vaccinated:2012-04-18
Age:42.0  Onset:2012-04-18, Days after vaccination: 0
Gender:Female  Submitted:2012-05-01, Days after onset: 13
Location:Virginia  Entered:2012-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: REACTION TO ANTHRAX VACCINE, ENDOCRINE SYSTEM SIDE AFFECT ONLY ADVERSITIES HAVE COME FROM VACCINES- OTHERWISE THE IMMUNE SYSTEM IS HEALTHIER WITHOUT VACCINES- THAT ONLY SEEMS TO DAMAGE HEALTHY PATIENT
Diagnostic Lab Data: PENDING MEDICAL APPOINTMENT...PATIENT STILL DOES NOT FEEL RECOVERED 12 DAYS AFTER VACCINATION DATE...INCREASED SYMPTOMS IN DIGESTIVE BEHAVIOR AT THIS DATE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Other     Purchased by: Other
Symptoms: Chest pain, Fatigue, Gastrointestinal disorder, Insomnia, Muscle spasms
SMQs:, Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: EXTREME FATIGUE INVOLUNTARY MUSCLE CRAMPING CHEST PAINS FOCUS ISSUES INTERRUPTIONS IN SLEEP UNABLE TO SLEEP FOR MORE THAN 3 HOURS OR LESS AT A TIME...

VAERS ID:455464 (history)  Vaccinated:2012-05-03
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-05-07
Location:Florida  Entered:2012-05-14, 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:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1940AA0IMUN
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Pain in right deltoid, moving up towards collar bone bone. Pt admits to taking TYLENOL OTC (5/3/2012) without any relief.

VAERS ID:455521 (history)  Vaccinated:2012-04-19
Age:42.0  Onset:2012-04-30, Days after vaccination: 11
Gender:Female  Submitted:2012-05-14, Days after onset: 14
Location:New York  Entered:2012-05-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions:
Diagnostic Lab Data: CBC and varicella zoster virus testing.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0601AA1SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1206AA0SCLA
Administered by: Other     Purchased by: Private
Symptoms: Full blood count, Headache, Malaise, Oropharyngeal pain, Pyrexia, Rash papular, Rash pruritic, Rash vesicular, Varicella virus test
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: <20 scattered pruritic lesions, some vesicular, others mostly papular, over the course of 14 days so far. Also c/o fever, headache, malaise, brief sore throat. Treated with acetaminophen and Benadryl.

VAERS ID:455558 (history)  Vaccinated:2012-04-24
Age:42.0  Onset:0000-00-00
Gender:Male  Submitted:2012-04-27
Location:Virginia  Entered:2012-05-14, Days after submission: 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
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0 LA
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: Expired Smallpox given with positive reaction, no clinical adverse effect noted.

VAERS ID:455914 (history)  Vaccinated:2012-05-14
Age:42.0  Onset:2012-05-14, Days after vaccination: 0
Gender:Female  Submitted:2012-05-16, Days after onset: 2
Location:Maine  Entered:2012-05-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC with diff - NL findings
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1706AA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B076AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Differential white blood cell count normal, Erythema, Full blood count normal, Injection site erythema, Local swelling, Pain, Tenderness, Vaccination site pain, Vaccination site swelling, Vaccination site warmth
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Within 1 hour of vaccine had "grapefruit" size swelling at vaccine site (did not observe), redness, heat, severe pain. 4 hours later severe chills & body aches, increased swelling. Used Ibuprofen. I saw patient 24 hours later - large, red, tender 10-15cm swelling. Treated with pain meds, cool compresses.

VAERS ID:455936 (history)  Vaccinated:2012-05-18
Age:42.0  Onset:2012-05-19, Days after vaccination: 1
Gender:Female  Submitted:2012-05-21, Days after onset: 2
Location:Minnesota  Entered:2012-05-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Abdominal discomfort, Erythema, Feeling cold, Headache, Injection site pruritus, Injection site rash, Injection site swelling, Pain, Pain in extremity, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Headache, sick to stomach, tired, loss of appetite, body ached all over, felt chilled, swollen at injection sight these symptoms lasted for about 36 hours then on 5/21/2012. My arm started hurting more and a red, itchy rash started at injection site going down arm the area of the redness is about a 6 inch by 6 inch area. Was advised if it gets worse I should be seen.

VAERS ID:456397 (history)  Vaccinated:2012-05-18
Age:42.0  Onset:2012-05-18, Days after vaccination: 0
Gender:Male  Submitted:2012-05-19, Days after onset: 1
Location:Connecticut  Entered:2012-05-29, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Shortness of breathe related to smoking
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0239AE0UNLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site reaction, Injection site swelling, Injection site warmth, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pt returned next day with localized redness, swelling, stiff, hot injection site. Pt does not complain of other allergic sx or fever not involvement with tongue or ability to swallow.

VAERS ID:456575 (history)  Vaccinated:2012-05-22
Age:42.0  Onset:2012-05-23, Days after vaccination: 1
Gender:Female  Submitted:2012-05-24, Days after onset: 1
Location:Arizona  Entered:2012-05-31, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1411AA1SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site nodule, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, warmth, pain, swelling, and "knot" left upper arm. Pt instructed to apply ice to site, and return to clinic pm.

VAERS ID:456965 (history)  Vaccinated:2012-05-29
Age:42.0  Onset:2012-06-01, Days after vaccination: 3
Gender:Female  Submitted:2012-06-04, Days after onset: 3
Location:Washington  Entered:2012-06-07, 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: None
Preexisting Conditions: Erythromycin; Adhesive allergies; Hx of thyroid disorder
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3957BA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Hypersensitivity, Malaise, Mobility decreased, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 1st RXN couldn''t move arm few days. Fever x 4-5 days. Sick on 5th (maybe 4th) day & swelled up twice site with redness - entire arm. Next to urgent care & diagnosed with allergic RXN. Areas of arm appeared burned. Tx - steroids.

VAERS ID:457459 (history)  Vaccinated:2012-05-14
Age:42.0  Onset:2012-05-14, Days after vaccination: 0
Gender:Female  Submitted:2012-06-14, Days after onset: 31
Location:Mississippi  Entered:2012-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: DM2, HTN, Obesity
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Military     Purchased by: Other
Symptoms: Injection site oedema, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 15 x12 cm of an urticarial lesion on R upper arm surrounding injection site. +edema +warmth, No erythema. No wheezing and lungs clear to auscultation bilaterally.

VAERS ID:458324 (history)  Vaccinated:2012-06-20
Age:42.0  Onset:2012-06-21, Days after vaccination: 1
Gender:Female  Submitted:2012-06-25, Days after onset: 4
Location:Virginia  Entered:2012-06-28, 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: None
Preexisting Conditions: See list on the back; Acetaminophen; Codeine; Propoxyphene nafsyl; Sulfacetamide; Hypertension, benign; OA of knee and lumbar spine
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4188AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The site of injection with induration, swelling, redness, warmth & tenderness. Healing gradually with BENADRYL & cold compresses.

VAERS ID:458606 (history)  Vaccinated:2011-07-23
Age:42.0  Onset:2011-07-24, Days after vaccination: 1
Gender:Male  Submitted:2012-06-22, Days after onset: 334
Location:Wyoming  Entered:2012-07-03, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH453AB0UNUN
Administered by: Military     Purchased by: Military
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever. Rash over torso & legs. Saw dr. No remedies. Except BENADRYL.

VAERS ID:458793 (history)  Vaccinated:2012-06-21
Age:42.0  Onset:2012-06-21, Days after vaccination: 0
Gender:Female  Submitted:2012-07-07, Days after onset: 16
Location:Virginia  Entered:2012-07-07
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
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Inflammation, Muscle spasms, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Guillain-Barre syndrome (broad)
Write-up: Within one day, pain developed throughout left arm, and increased in intensity. Reported severe arm pain to health department nurse after one week (06/28/2012) and was told that reactions to TDAP vary widely. On 06/29/2012, went to urgent care center where doctor said my reaction was uncommon, was likely inflammation due to tensing the muscle during administration of vaccine, and prescribed 5-day steroid. Began steroid on 6/29/2012 and completed on 07/03/2012. Pain subdued but not relieved. Pain increased after steroid was completed. 07/04/2012 began having spasms in left elbow. 07/05, developed numbness and tingling in arm, mostly from elbow to fingertips. Have been taking acetaminophen and ibuprofen for pain management since onset, with minimal benefit.

VAERS ID:460034 (history)  Vaccinated:2012-07-18
Age:42.0  Onset:2012-07-20, Days after vaccination: 2
Gender:Female  Submitted:2012-07-24, Days after onset: 4
Location:Texas  Entered:2012-07-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Psoriasis. Has been diagnosed with spastic heart. She did have a scheduled cardiac stress test completd on 7-19-2012.
Preexisting Conditions: Allergic to PCN and Rocephin
Diagnostic Lab Data: Unknown at this time. Waiting for her to see primary MD.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0491AE0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Cardiac stress test, Erythema, Induration, Lymphadenopathy, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Large swollen area above left clavical bone. 3mm round hard area. Tender to touch. Warm and Red. 7-21-2012 she reported lymph node under right arm swollen. Referred to Primary MD.

VAERS ID:460393 (history)  Vaccinated:2012-07-20
Age:42.0  Onset:2012-07-20, Days after vaccination: 0
Gender:Female  Submitted:2012-07-23, Days after onset: 3
Location:Texas  Entered:2012-07-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4304AA SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Aphagia, Injection site erythema, Injection site pain, Nausea, Pain in extremity, Pain in jaw, Vaccination complication
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Osteonecrosis (broad)
Write-up: Patient complained of pain in jaw, arm - nausea couldn''t eat because of pain in jaw - arm was red & sore at injection sight went to PCP stated poisoning from Tdap???

VAERS ID:460505 (history)  Vaccinated:2012-07-11
Age:42.0  Onset:2012-07-11, Days after vaccination: 0
Gender:Female  Submitted:2012-07-26, Days after onset: 15
Location:Ohio  Entered:2012-07-30, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: (? if MD diagnosed) Codeine; PERCOCET; Atenolol; Tramadol
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B085CA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Pain in extremity, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Intense left arm pain. (L) arm hot to touch oral temp 99 degrees. Swelling in the left subacromial region the morning after injection given. BACTRIM BID #20 & VICODIN 5/500 1 q 6 hours PRN pain #20. Follow-up Tues with health services. Go to ED if symptoms worsen.

VAERS ID:460518 (history)  Vaccinated:2012-07-19
Age:42.0  Onset:2012-07-19, Days after vaccination: 0
Gender:Female  Submitted:2012-07-30, Days after onset: 11
Location:North Carolina  Entered:2012-07-30
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: Psoriasis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B079BA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Adverse reaction, Diarrhoea, Headache, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Pt reported moderate reaction on 7/30/12. Pt states symptoms started on 7/19/12 aprox 1 hour after getting Tdap. Pt states she developed severe HA, fever (not measured), diarrhea, & vomiting. Symptoms lasted aprox. 1/2 hour then subsided. Pt has had no other symptoms.

VAERS ID:461668 (history)  Vaccinated:2011-11-03
Age:42.0  Onset:2011-11-03, Days after vaccination: 0
Gender:Female  Submitted:2012-06-18, Days after onset: 228
Location:New Jersey  Entered:2012-08-08, 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:
Current Illness: Allergy to fish; Allergy to molds
Preexisting Conditions: The subject reported that she had a flu shot approximately a year ago and experienced a weird feeling in her throat and she took BENADRYL as treatment. See A0952703B for details regarding this second case.
Diagnostic Lab Data: UNK
CDC Split Type: A0952703A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Private     Purchased by: Private
Symptoms: Heart rate increased, Myalgia, Nasal congestion, Pain in extremity, Rhinorrhoea, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: This case was reported by a consumer (also the subject) and described the occurrence of throat closing up in a 42-year-old female subject who was vaccinated with Flu vaccine (GlaxoSmithKline). A physician or other health care professional has not verified this report. Concurrent medical conditions included allergy to fish and allergy to molds. On 3 November 2011 at 14:00 the subject received a dose of Flu vaccine (unknown route, left arm). On 3 November 2011, 10 minutes after vaccination with Flu vaccine, the subject experienced throat closing up and rapid pulse. Less than a day after vaccination with Flu vaccine on 03 November 2011, the subject experienced arm soreness and gluteal muscle pain. She also experienced runny nose and stuffy nose. The subject stated that at 24 hours post vaccination, all the events were resolved. She stated that she knows that she received a GSK flu vaccine, but does not know which brand. The subject was treated with liquid BENADRYL. On 4 November 2011, the events were resolved. The subject reported that she had a flu shot approximately a year ago and experienced a weird feeling in her throat and she took BENADRYL as treatment. See A0952703B for details regarding this second case.

VAERS ID:461674 (history)  Vaccinated:2011-10-28
Age:42.0  Onset:2011-11-02, Days after vaccination: 5
Gender:Female  Submitted:2012-06-18, Days after onset: 229
Location:Unknown  Entered:2012-08-08, Days after submission: 51
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Concomitant vaccination and relevant medical history information was not provided. Subject stated on adverse events following previous vaccinations. The subject also reported "made me ill", headache, body ache reaction with flu shot (unknown manufacturer) in 2000 (see case A0953793B).
Diagnostic Lab Data: UNK
CDC Split Type: A0953793A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Migraine
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: This case was reported by a consumer (also the subject) and described the occurrence of migraine in a 42-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. Concurrent medications included Lamotrigine. The subject also reported "mad me ill", headache, body ache reaction with flu shot (unknown manufacturer) in 2000 (see case A0953793B). On 28 October 2011 at 08:00 the subject received a dose of Influenza vaccine unspecified 2011-12 season (unknown route, unknown site). On 2 November 2011, 5 days after vaccination with Influenza vaccine unspecified 2011-12 season, the subject experienced migraine, dizziness and lightheadedness. The subject went to the emergency room for these events. At the time of reporting the events were unresolved.

VAERS ID:461927 (history)  Vaccinated:2012-08-12
Age:42.0  Onset:0000-00-00
Gender:Male  Submitted:2012-08-14
Location:Texas  Entered:2012-08-14
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:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1102700UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:461934 (history)  Vaccinated:2012-08-12
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-08-14
Location:Texas  Entered:2012-08-14
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:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1102700UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Wrong drug administered
SMQs:
Write-up: Patient received FLUVIRIN 2011-2012 instead of FLUVIRIN 2012-2013.

VAERS ID:462688 (history)  Vaccinated:2012-07-01
Age:42.0  Onset:2012-07-02, Days after vaccination: 1
Gender:Female  Submitted:2012-07-04, Days after onset: 2
Location:Washington  Entered:2012-08-21, Days after submission: 48
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B8074A IMUN
Administered by: Other     Purchased by: Private
Symptoms: Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: High fever (102 degrees), body aching 3 days after administration. 7/5/12 pt feeling about 50% better.

VAERS ID:462862 (history)  Vaccinated:2012-08-20
Age:42.0  Onset:2012-08-22, Days after vaccination: 2
Gender:Male  Submitted:2012-08-22, Days after onset: 0
Location:Pennsylvania  Entered:2012-08-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105150IMRA
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: Tenderness erythema and swelling at the injection site.

VAERS ID:463072 (history)  Vaccinated:2012-08-20
Age:42.0  Onset:2012-08-20, Days after vaccination: 0
Gender:Female  Submitted:2012-08-22, Days after onset: 2
Location:Massachusetts  Entered:2012-08-23, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT4470BA0SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Feeling hot, Injection site erythema, Injection site swelling, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red swollen arm around injection site. Pain upon exertion. Radiates heat - cellulitis appearance.

VAERS ID:463222 (history)  Vaccinated:2012-08-13
Age:42.0  Onset:2012-08-13, Days after vaccination: 0
Gender:Female  Submitted:2012-08-23, Days after onset: 10
Location:New Jersey  Entered:2012-08-27, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccination and an allergy to sulfa.
Diagnostic Lab Data: Not reported
CDC Split Type: 201207605
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEUR 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Chills, Diarrhoea, Haematochezia, Injection site pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow)
Write-up: Initial report was received from a consumer, who was also the patient, on 15 August 2012. A 42-year-old female patient had received a dose one intramuscular injection in the left deltoid of IMOVAX Rabies, Sanofi Pasteur SA (lot number not reported) on 13 August 2012 for pre exposure. Right after the vaccination, the patient felt soreness at arm at the injection site. On 14 August 2012 at 3:00AM, the patient experienced severe abdominal pain, diarrhea, blood in stool, fever and chills. Corrective treatments included rest and fluids. The patient was to return to the physician if symptoms continued. The patient had no illness at the time of vaccination and an allergy to sulfa. The patient''s outcome was unknown. Documents held by sender: None.

VAERS ID:463308 (history)  Vaccinated:2012-08-18
Age:42.0  Onset:2012-08-18, Days after vaccination: 0
Gender:Female  Submitted:2012-08-20, Days after onset: 2
Location:California  Entered:2012-08-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4470AA0IDLA
Administered by: Other     Purchased by: Public
Symptoms: Dizziness, Headache, Injection site erythema, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad)
Write-up: Redness of injection site (about 1.5 inches radius). Headache. Dizziness. Soreness of arm.

VAERS ID:468926 (history)  Vaccinated:2012-08-20
Age:42.0  Onset:2012-08-20, Days after vaccination: 0
Gender:Female  Submitted:2012-08-21, Days after onset: 1
Location:California  Entered:2012-08-27, 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: PCN
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0414AE1SCUN
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Local reaction, Oedema peripheral, Tenderness, Vaccination complication
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: (L) arm, erythema, swelling, tender to touch. Local Rxn to vaccine.

VAERS ID:463408 (history)  Vaccinated:2012-07-11
Age:42.0  Onset:2012-07-21, Days after vaccination: 10
Gender:Female  Submitted:2012-08-28, Days after onset: 38
Location:Colorado  Entered:2012-08-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Normal Blood tests August 14th
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Blood test normal, Lymphadenopathy, Odynophagia, Oropharyngeal pain, Tenderness
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Lymph nodes in neck, jaw, under collar bone and in right breast swelled, caused pain on swallowing and tenderness to the touch, soreness on overuse of voice.

VAERS ID:463627 (history)  Vaccinated:2012-08-15
Age:42.0  Onset:2012-08-15, Days after vaccination: 0
Gender:Female  Submitted:2012-08-30, Days after onset: 15
Location:Texas  Entered:2012-08-30
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: Patient states was told over the phone that it was an allergic reaction to one of the vaccines, and to use BENADRYL.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AD0UNRA
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1111AA0UNLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0403AA1UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Eye irritation, Hypersensitivity, Influenza like illness, Nasal discomfort, Neck pain, Pain in extremity, Rash generalised, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Corneal disorders (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Received telephone call from pt. on 8/16/12, c/o eyes and nose burning, neck pain and sore legs and arms. She also (pt.), c/o rash on arms and body. Pt. was advised to go to ER or call her pvt. Dr. Pt. called her Dr. and was advised to take BENADRYL. Telephone attempts to reach pt. on 8/16/12, 8/17/12, 9/20/12 and 8/21/12 were unanswered but LMOM. Pt. was reached per phone on 8/23/12, states she felt like she had the flu x 3 days but all symptoms relieved now after use of BENADRYL.

VAERS ID:463749 (history)  Vaccinated:2012-08-30
Age:42.0  Onset:2012-08-30, Days after vaccination: 0
Gender:Female  Submitted:2012-08-31, Days after onset: 1
Location:D.C.  Entered:2012-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole; Clonazepam; Baclofen; Benztropine mesylate; TEGRETOL
Current Illness: No - recently had UTI, CIPRO x 7 days
Preexisting Conditions: Asthma; Glioma; Rt sided weakness; Genetic torsion dystonia; Palpitations; Allergies: BENADRYL, IV contrast
Diagnostic Lab Data: None done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4384AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Aphasia, Condition aggravated, Dysarthria, Dystonia, Immediate post-injection reaction, Unresponsive to stimuli, VIIth nerve paralysis
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Dystonia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Immediately following injection pt had a dystonic reaction - slurred speech, rt sided facial droop, followed by no speech, unresponsive to verbal & tactile stimulation. VS: BP 139/87 P 131 R 20 O2 100% transported to ED, then to floor on observation status.

VAERS ID:468568 (history)  Vaccinated:0000-00-00
Age:42.0  Onset:0000-00-00
Gender:Male  Submitted:2012-08-31
Location:Unknown  Entered:2012-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1208USA000165
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered
SMQs:
Write-up: This spontaneous report was received from a licensed practical nurse refers to a patient of unknown age and gender who on an unknown date was vaccinated with a dose of (Merck) VARIVAX (dose, route and lot number not reported) that was expired. The vaccine expired on 20-JUL-2011. The patient was not experiencing any known symptoms. Additional information has been requested.

VAERS ID:464232 (history)  Vaccinated:2012-08-24
Age:42.0  Onset:2012-08-31, Days after vaccination: 7
Gender:Male  Submitted:2012-09-06, Days after onset: 6
Location:Washington  Entered:2012-09-06
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
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0412AE0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Lymphadenopathy, Neck pain, Pain, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Fever, HA, neck pain, body aches. Fever broke Tuesday 9/4/12. Rash started on chest & back Wed. night 9/5/12. Glands are also swollen.

VAERS ID:464549 (history)  Vaccinated:2012-09-04
Age:42.0  Onset:2012-09-04, Days after vaccination: 0
Gender:Female  Submitted:2012-09-10, Days after onset: 6
Location:Massachusetts  Entered:2012-09-10
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: None
Diagnostic Lab Data: CBC; Metabolic Panel ordered 9/10/12
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4188AA IMLA
Administered by: Military     Purchased by: Private
Symptoms: Full blood count, Lymph node palpable, Metabolic function test, Pain in extremity
SMQs:
Write-up: Extreme pain left arm extending up to neck, palpable lymph node, left supra clavicular, seen 9/7/12, refused medical attention. Seen by PCP 9/10/12 labs ordered, pending at present time.

VAERS ID:464863 (history)  Vaccinated:2012-08-06
Age:42.0  Onset:2012-08-19, Days after vaccination: 13
Gender:Male  Submitted:2012-09-12, Days after onset: 24
Location:Unknown  Entered:2012-09-12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: GERD; Allergiy to PCN, Vicoden and Percocet
Diagnostic Lab Data: Cardiac Catheterization; Chest x-rays; Cardiac MRI; EKG''s; Lab draws; Cardiac ultrasound
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A1IDLA
Administered by: Military     Purchased by: Military
Symptoms: Back pain, Cardiac imaging procedure, Catheterisation cardiac, Chest X-ray, Chest pain, Electrocardiogram, Laboratory test, Pain in extremity, Ultrasound scan
SMQs:, Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Pain across back radiating to chest, down left arm.

VAERS ID:465350 (history)  Vaccinated:2012-06-27
Age:42.0  Onset:2012-06-27, Days after vaccination: 0
Gender:Female  Submitted:2012-09-04, Days after onset: 69
Location:Virginia  Entered:2012-09-16, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diabetic
Preexisting Conditions: PCN - allergy
Diagnostic Lab Data: None yet (pt self reported 9/4/12)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC034AA2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: TC from pt 9/4/12 to report she has had pain in (L) deltoid since 6/27/12. Denies having any redness, swelling, hematoma or any marks on arm after injection. Has not sought medical care. Pt referred to urgent care ctr for assessment by MD, Pt seen 9/5/12 at urgent care.

VAERS ID:465548 (history)  Vaccinated:2012-09-05
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-09-07
Location:New York  Entered:2012-09-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHAVC064AD2IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1797AA1SCRA
Administered by: Private     Purchased by: Other
Symptoms: Vaccination site erythema
SMQs:
Write-up: Developed local erythema at vaccine site approximately 7 x 4 cm. Advised ice/TYLENOL.

VAERS ID:465491 (history)  Vaccinated:2012-09-18
Age:42.0  Onset:2012-09-19, Days after vaccination: 1
Gender:Male  Submitted:2012-09-19, Days after onset: 0
Location:Arkansas  Entered:2012-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204501 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Headache
SMQs:
Write-up: Uncontrollable shivering lasting 3-4 hours and headache.

VAERS ID:465623 (history)  Vaccinated:2012-09-13
Age:42.0  Onset:2012-09-15, Days after vaccination: 2
Gender:Female  Submitted:2012-09-19, Days after onset: 4
Location:North Carolina  Entered:2012-09-19
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: BIAXIN; Clarithromycin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP588070UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0098260UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4147AA1UNRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Erythema, Oedema peripheral, Pyrexia, Vaccination complication
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Reaction to Influenza immunization. Left arm is swollen and red. Started after Flu shot on 9/13/2012, fever, chills. Naproxen 500mg 1 tablet 2 times daily as needed. Ice 10 minutes 3-4 times a day.

VAERS ID:465740 (history)  Vaccinated:2012-09-14
Age:42.0  Onset:2012-09-14, Days after vaccination: 0
Gender:Female  Submitted:2012-09-20, Days after onset: 6
Location:Maryland  Entered:2012-09-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Hypoaesthesia, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad)
Write-up: Pain in arm that radiates down to the wrist, hand, fingers. Tingling and numbers in hand/fingers that has lasted continuously since the shot was administered.

VAERS ID:465792 (history)  Vaccinated:2011-10-08
Age:42.0  Onset:2011-10-08, Days after vaccination: 0
Gender:Female  Submitted:2012-09-21, Days after onset: 349
Location:Michigan  Entered:2012-09-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergies; Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Other     Purchased by: Private
Symptoms: Drug administered at inappropriate site, Injection site joint movement impairment, Injection site joint pain
SMQs:, Arthritis (broad)
Write-up: Left shoulder joint pain and limited mobility for 4 months. Treatment consisted of 400-800 mg Ibuprofen every 6-8 hours (dose was dependent on pain level that day). Also: the vaccine was given very high on the arm, close to the shoulder joint.

VAERS ID:465943 (history)  Vaccinated:2010-03-15
Age:42.0  Onset:2010-03-22, Days after vaccination: 7
Gender:Female  Submitted:2012-09-22, Days after onset: 915
Location:New Mexico  Entered:2012-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS    
Administered by: Military     Purchased by: Other
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Guillain Barre.

VAERS ID:466102 (history)  Vaccinated:2012-09-17
Age:42.0  Onset:2012-09-18, Days after vaccination: 1
Gender:Female  Submitted:2012-09-24, Days after onset: 6
Location:Kansas  Entered:2012-09-24
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: HBP; Hypothyroid; Alpha intrusion sleeping disorder; Seasonal allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4527AA0UNAR
Administered by: Public     Purchased by: Private
Symptoms: Axillary pain, Erythema, Induration, Local swelling, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Deep pain radiating to armpit. Local swelling/hard & hot to touch & red.

VAERS ID:466278 (history)  Vaccinated:2012-09-24
Age:42.0  Onset:2012-09-24, Days after vaccination: 0
Gender:Male  Submitted:2012-09-25, Days after onset: 1
Location:Texas  Entered:2012-09-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dizziness, Fatigue, Headache, Hyperhidrosis, Influenza like illness, Insomnia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Dizzyness, headaches, flu-like symptons, sleeplessness, cold chills, sweaty, exhaustion.

VAERS ID:466436 (history)  Vaccinated:2012-09-10
Age:42.0  Onset:2012-09-12, Days after vaccination: 2
Gender:Female  Submitted:2012-09-26, Days after onset: 14
Location:Michigan  Entered:2012-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal discomfort, Cough, Diarrhoea, Lethargy, Pyrexia, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: LETHARGY, COUGH, RUNNY NOSE, LOW GRADE FEVER, DIARRHEA, UPSET STOMACH.

VAERS ID:466537 (history)  Vaccinated:2012-09-18
Age:42.0  Onset:2012-09-18, Days after vaccination: 0
Gender:Female  Submitted:2012-09-26, Days after onset: 8
Location:Washington  Entered:2012-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sore Throat
Preexisting Conditions: Asthma; Chronic bronchitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12045211IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105151IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Limb discomfort, Oedema peripheral, Pyrexia, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Has been sick with sore throat but feeling beter when she got her flu shot. Left arm is swollen. Pt noted reddened area about 2 inches in diameter. Warm to touch. Pt states she feels a little feverish. Arm is uncomfortable.

VAERS ID:466551 (history)  Vaccinated:2012-09-18
Age:42.0  Onset:2012-09-26, Days after vaccination: 8
Gender:Female  Submitted:2012-09-26, Days after onset: 0
Location:Colorado  Entered:2012-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Diagnostic Lab Data: Patient refused exam or treatment.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)SANOFI PASTEURU4329AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt sent to hospital by public health office, she has two red areas on left deltoid. RN suggested she be seen by ER physician, patient refused exam or treatment. States she will see a primary care physician.

VAERS ID:469642 (history)  Vaccinated:2012-09-05
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-09-26
Location:Unknown  Entered:2012-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1209USA002365
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1332Y0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse reporting on a patient of unknown age and gender who on an unspecified date was vaccinated with an expired dose of GARDASIL (lot# not reported, exp June/July 2012). No other co-suspects were reported. No concomitant medications were reported. No adverse reaction was reported. Additional information has been requested.

VAERS ID:466621 (history)  Vaccinated:2012-09-18
Age:42.0  Onset:2012-09-18, Days after vaccination: 0
Gender:Female  Submitted:2012-09-27, Days after onset: 9
Location:Minnesota  Entered:2012-09-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none that reporter is aware of
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4470AA0IDLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Lymphadenopathy
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Experienced numbness in face on lt side as well as in pinky and ringer finger. Also experienced swollen lymph nodes in arm pit region.

VAERS ID:466744 (history)  Vaccinated:2012-09-24
Age:42.0  Onset:2012-09-25, Days after vaccination: 1
Gender:Female  Submitted:2012-09-27, Days after onset: 2
Location:California  Entered:2012-09-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No- But my son had a viral infection.
Preexisting Conditions: Allergic Asthma, pet dander, pollen..... No none food allergies
Diagnostic Lab Data: Dr administered antibiotics and I am on day 1 of taking them- Keflex- using generic version- 500 mgs 4x1 day.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 6IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.23-VALENT0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURIM0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site swelling, Injection site urticaria, Injection site warmth, Insomnia, Musculoskeletal stiffness, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (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), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Started w/pain at injection site kept waking me up during the night. Day 2- Arm stiffened up, injection site was very warm, unable to raise it above my breast area, constant ache, mild headache, nausea. Day 3- Woke w/a large red welt/swollen patch approximately 3" x 3", 3 smaller welts lengthwise around the injection site, hot to the touch, major headache, slight nausea, barely sleeping from pain.

VAERS ID:466835 (history)  Vaccinated:2012-09-09
Age:42.0  Onset:2012-09-10, Days after vaccination: 1
Gender:Female  Submitted:2012-09-28, Days after onset: 18
Location:Georgia  Entered:2012-09-28
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204201 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Arm is swollen with red streak from injection site to elbow and it''s painful. Patient went to urgent care.

VAERS ID:466980 (history)  Vaccinated:2012-09-27
Age:42.0  Onset:2012-09-28, Days after vaccination: 1
Gender:Female  Submitted:2012-09-28, Days after onset: 0
Location:Wisconsin  Entered:2012-09-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Back pain
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1206701 SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Mobility decreased
SMQs:, Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Sore/pain at injection site. Can''t move /lift left hand.

VAERS ID:466948 (history)  Vaccinated:2012-09-28
Age:42.0  Onset:2012-09-30, Days after vaccination: 2
Gender:Female  Submitted:2012-10-01, Days after onset: 1
Location:North Carolina  Entered:2012-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Abdominal discomfort, Chills, Diarrhoea, Headache, Myalgia, Nausea, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Noninfectious diarrhoea (narrow)
Write-up: Severe nausea, vomiting, severe headache, sick in stomach, sensation of diarrhea but no actual diarrhea happen, chills, shoulder muscle ache. Had an acupuncture treatment.

VAERS ID:467062 (history)  Vaccinated:2012-09-18
Age:42.0  Onset:2012-09-19, Days after vaccination: 1
Gender:Female  Submitted:2012-10-01, Days after onset: 12
Location:North Carolina  Entered:2012-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204101 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia, Injected limb mobility decreased, Myalgia, Nasopharyngitis, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Upper arm muscle started with extreme pain. Could not use or lift my arm. Fingers would tingle and go numb. Doctor gave me pain meds...took for 1 1/2 weeks symptoms are much better but arm is still a little sore and I have a hard time lifting it above my head. Still on pain meds. Also got a very bad cold that I still have and can''t seem to get rid of!

VAERS ID:467350 (history)  Vaccinated:2012-10-02
Age:42.0  Onset:2012-10-03, Days after vaccination: 1
Gender:Female  Submitted:2012-10-03, Days after onset: 0
Location:South Dakota  Entered:2012-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No current signs of illness
Preexisting Conditions: History of frequent abdominal pain and diarrhea however no exacerbation of this at this time.
Diagnostic Lab Data: WBC 14.5,
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH714AA IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Cough, Headache, Pain, Vaccination complication, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad)
Write-up: Arrived to ED stating achy all over and has developed a cough and mild headache. States that current episode started 12 to 24 hours ago after getting flu shot. Diagnosis Vaccine Reaction.

VAERS ID:467601 (history)  Vaccinated:2012-09-10
Age:42.0  Onset:2012-09-12, Days after vaccination: 2
Gender:Female  Submitted:2012-10-02, Days after onset: 20
Location:Virginia  Entered:2012-10-04, Days after submission: 2
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: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA688BB IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Paraesthesia oral, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Tightness in throat, tingling in tongue and lips within minutes of injection. BP, HR, O2 saturation, physical exam - Normal symptoms improved with po BENADRYL.

VAERS ID:467842 (history)  Vaccinated:2012-09-28
Age:42.0  Onset:2012-09-28, Days after vaccination: 0
Gender:Female  Submitted:2012-10-05, Days after onset: 7
Location:Illinois  Entered:2012-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cheilitis, Cough, Dry throat, Hypoaesthesia oral, Ocular hyperaemia, Rash, Rash erythematous, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Throat became dry and irritated lips became numb started to cough was wheezing eyes became very very red the next day had a red rash over my neck and trunk.

VAERS ID:468208 (history)  Vaccinated:2012-10-01
Age:42.0  Onset:2012-10-01, Days after vaccination: 0
Gender:Female  Submitted:2012-10-05, Days after onset: 4
Location:Massachusetts  Entered:2012-10-05
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: NKDA; HTN; DM
Diagnostic Lab Data: WBC, NL; C-reactive protein, 11.9 increased
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA710AA IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: C-reactive protein increased, Hypoaesthesia, Injection site pain, Lymph node pain, Lymphadenopathy, White blood cell count normal
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient received flu vaccine 10/1/12 - (R) upper arm became sore later that day, 10/2/12 - (R) axillary node enlarged & painful, 10/3/12 right 3rd & 4th fingertips numb.

VAERS ID:468029 (history)  Vaccinated:2012-10-01
Age:42.0  Onset:2012-10-01, Days after vaccination: 0
Gender:Female  Submitted:2012-10-06, Days after onset: 5
Location:Kentucky  Entered:2012-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: The next day when I got out of the bed I was so dizzy that I couldnt walk. I had hives all over my body the night that I got the vaccination it all started around 8pm that night on the 10/01/2010. I have been told to keep taking Benadryl and Antivert for the itching and dizziness. I also became very hoarse, my eyes were swollen, and lips were swollen.
Preexisting Conditions: I am allergic to tree nuts, grass products, white potatoes, onions, and garlic: At the time of the vaccination I was fine
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0 RA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Dysphonia, Eye swelling, Gait disturbance, Lip swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Dizziness, itching, hives, lips and eyes swollen, and hoarseness.

VAERS ID:468432 (history)  Vaccinated:2012-09-29
Age:42.0  Onset:2012-09-29, Days after vaccination: 0
Gender:Female  Submitted:2012-10-08, Days after onset: 9
Location:Pennsylvania  Entered:2012-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy -$g Erythromycin & Amoxicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH756AA UNLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Headache, Lacrimation increased, Ocular hyperaemia, Pain, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Lacrimal disorders (narrow), Hypersensitivity (broad)
Write-up: Throat closing - cough, red, watery eyes, headache, aches (body).

VAERS ID:468440 (history)  Vaccinated:2012-09-19
Age:42.0  Onset:2012-09-19, Days after vaccination: 0
Gender:Female  Submitted:2012-10-09, Days after onset: 20
Location:Georgia  Entered:2012-10-09
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: Asthma; Chronic sinusitis; Hypertension; Migraines; Reflux; Muscle spasms
Diagnostic Lab Data: Chest x-ray
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP597081IMLA
Administered by: Military     Purchased by: Military
Symptoms: Chest X-ray, Chills, Injection site erythema, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Chills, fever, severe body aches, 3mm erythema at injection site (left deltoid).

VAERS ID:468658 (history)  Vaccinated:2012-10-01
Age:42.0  Onset:2012-10-03, Days after vaccination: 2
Gender:Female  Submitted:2012-10-09, Days after onset: 6
Location:Ohio  Entered:2012-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12042010IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Lymphadenopathy, Oedema peripheral, Tenderness, Vaccination complication
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Vaccinated 10/1/12 Lot # 1204201 FLUVIRIN Lt. deltoid. 10/3/12 Reports to nurses station c/o redness, tender to touch, edematous arm with lymph node enlargement. Sent to EF. Rx pain med and antibiotic given. Dx "reaction to flu vaccine".

VAERS ID:468808 (history)  Vaccinated:2012-10-09
Age:42.0  Onset:2012-10-10, Days after vaccination: 1
Gender:Female  Submitted:2012-10-10, Days after onset: 0
Location:Texas  Entered:2012-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH745AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Lt. upper arm with 5cm x 8cm oval - red, raised, and warm - tender to touch.

VAERS ID:469117 (history)  Vaccinated:2012-10-01
Age:42.0  Onset:2012-10-01, Days after vaccination: 0
Gender:Male  Submitted:2012-10-05, Days after onset: 4
Location:Michigan  Entered:2012-10-10, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP503080UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Fatigue, Pruritus, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling, redness, area was warm and itchy (4 days). Very tired for 2 days.

VAERS ID:468975 (history)  Vaccinated:2012-09-27
Age:42.0  Onset:2012-10-01, Days after vaccination: 4
Gender:Female  Submitted:2012-10-11, Days after onset: 10
Location:Indiana  Entered:2012-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Reported to be well on day of vaccination
Preexisting Conditions: History of back surgery, allergic to penicillin and steroids
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA728AA IMRA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Headache, Hypoaesthesia, Injection site pain, Musculoskeletal pain, Neck pain, Pain in extremity, Paraesthesia, Peripheral coldness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Initial complaint was of a headache with achiness through shoulder and neck area, ibuprofen was taken at home. Later underside of arm felt like pins and needles at area, injection site unremarkable with only general soreness for a day or two. 10/11/12 wake with leg numbness and achiness that included numbness and cold feeling to toes on the left side and the feeling of just not wanting to get moving.

VAERS ID:469347 (history)  Vaccinated:2012-10-09
Age:42.0  Onset:2012-10-10, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 2
Location:Texas  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: Hypertension, asthma, GERD
Diagnostic Lab Data: visual examination by Dr
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4181AA IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Injection site pain, Injection site swelling, Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Wed evening started with swelling and soreness at site. Friday 10/12 in the morning woke up and arm red, swollen in area 2X2 inches, warm to touch.

VAERS ID:469394 (history)  Vaccinated:2012-10-10
Age:42.0  Onset:2012-10-11, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 1
Location:Washington  Entered:2012-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness and hotness at sight/painful when bumps it.

VAERS ID:469650 (history)  Vaccinated:2012-10-09
Age:42.0  Onset:2012-10-09, Days after vaccination: 0
Gender:Female  Submitted:2012-10-10, Days after onset: 1
Location:Minnesota  Entered:2012-10-15, 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: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AC0UNLA
Administered by: Public     Purchased by: Private
Symptoms: Cough, Discomfort, Dyspnoea, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Apprx 4 hours following flu shot administration client was experiencing, sore throat, cough & SOB a discomforting sensation.

VAERS ID:469708 (history)  Vaccinated:2012-10-09
Age:42.0  Onset:2012-10-10, Days after vaccination: 1
Gender:Female  Submitted:2012-10-15, Days after onset: 5
Location:Louisiana  Entered:2012-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No relevant medical history. The subject had previously received influenza vaccinations and no adverse events were reported.
Diagnostic Lab Data: UNK
CDC Split Type: A0997338A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA732AA UNRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site joint pain, Injection site joint swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of injection site joint swelling in a 42-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). Concurrent medications included SYNTHROID and Losartan. On 9 October 2012 at 10:00 the subject received unspecified dose of FLULAVAL (.5 ml, unknown, right arm). On 10 October 2012, 1 day after vaccination with FLULAVAL, the subject experienced injection site joint swelling and injection site joint pain. The subject received the same vaccine last year and was fine. She received the vaccine on 09 October 2012 and reported local joint swelling and joint pain. The subject was treated with TYLENOL, two tablets on 10 October 2012. The healthcare professional considered the events were clinically significant (or requiring intervention). At the time of reporting the injection site joint swelling and injection site joint pain were unresolved.

VAERS ID:469774 (history)  Vaccinated:2012-10-05
Age:42.0  Onset:2012-10-06, Days after vaccination: 1
Gender:Female  Submitted:2012-10-12, Days after onset: 6
Location:New York  Entered:2012-10-15, 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: None
Preexisting Conditions: Received steroid injection to left shoulder about 3 weeks prior to vaccine.
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4152AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Vaccine given to left deltoid on 10/5, 10/6 - left upper arm was found to be red, swollen, hard, hot to touch and painful. S/S lasted through until today - still have swelling, firmness & soreness about the size of a quarter.

VAERS ID:469899 (history)  Vaccinated:2012-10-04
Age:42.0  Onset:2012-10-05, Days after vaccination: 1
Gender:Female  Submitted:2012-10-08, Days after onset: 3
Location:Texas  Entered:2012-10-15, 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: None
Preexisting Conditions: HTN; Allergic rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU48384AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Axillary pain, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever, pain, swelling, heat, redness of (L) shoulder & pain & swelling (L) axilla.

VAERS ID:469931 (history)  Vaccinated:2012-09-26
Age:42.0  Onset:2012-09-27, Days after vaccination: 1
Gender:Female  Submitted:2012-10-11, Days after onset: 14
Location:Louisiana  Entered:2012-10-15, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: ASA; Ibuprofen
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH751AB IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypersensitivity, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Allergic reaction 5-6 days after getting Flu vaccine. Rash to neck and arms. Urticaria, DECADRON and BENADRYL given in ER.

VAERS ID:470276 (history)  Vaccinated:2012-10-03
Age:42.0  Onset:2012-10-03, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 13
Location:Pennsylvania  Entered:2012-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH747AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Musculoskeletal stiffness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Employee (physician) states following flu shot she developed a stiff neck, left upper extremity muscular pain and headache.

VAERS ID:470072 (history)  Vaccinated:2012-10-04
Age:42.0  Onset:2012-10-05, Days after vaccination: 1
Gender:Female  Submitted:2012-10-17, Days after onset: 12
Location:Maine  Entered:2012-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergies, Thyroid CA with thyroidectomy, DM (diet controlled), Asthma (well controlled haven''t used my inhaler in 3 years)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 10IMLA
Administered by: Public     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on arms-extremely itchy and raised. After several days started taking Benadryl and Pepcid. Still itchy and it has been almost 2 weeks.

VAERS ID:470075 (history)  Vaccinated:2012-09-24
Age:42.0  Onset:2012-09-26, Days after vaccination: 2
Gender:Female  Submitted:2012-10-17, Days after onset: 21
Location:Ohio  Entered:2012-10-17
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Factor V Leiden heterozygote
Diagnostic Lab Data: IgE tests negative for all foods eaten the day the hives began. ANA, ESR, rheumatoid factor, TSH, thyroid & peroxidase antibody, C1 esterase inhibitor, CBC, comprehensive metabolic panel, complement tests, and CA 125 tumor antigen immunoassay: all negative / within normal limits.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4470AA0IDLA
Administered by: Public     Purchased by: Other
Symptoms: Anti-thyroid antibody negative, Antinuclear antibody negative, Blood immunoglobulin E normal, Blood thyroid stimulating hormone normal, C1 esterase inhibitor test, Carbohydrate antigen 125 normal, Complement factor normal, Eye swelling, Full blood count normal, Hypotension, Lip swelling, Metabolic function test, Metabolic function test normal, Oedema peripheral, Red blood cell sedimentation rate normal, Rheumatoid factor negative, Swollen tongue, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 9/26/12- onset of hives 9/27/12 - hypotension (BP 78/40) requiring IV steroids, fluids, and antihistamines in ED. Started on PO steroids and antihistamines. 9/29/12 - continued hives and eye swelling leading to ED visit, despite continued PO steroids and antihistamines 10/6/12 - continued hives and lip/tongue swelling leading to ED visit, despite continued PO steroids, antihistamines, and ranitidine. 10/17/12 - hand and finger swelling despite continued PO steroids, antihistamines, and ranitidine (hives remitted) Currently under care of an allergist. IgE tests negative for all foods eaten the day the hives began. ANA, ESR, rheumatoid factor, CBC, comprehensive metabolic panel, complement tests all negative / within normal limits.

VAERS ID:474703 (history)  Vaccinated:2011-07-15
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-09-21
Location:Florida  Entered:2012-10-17, 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: Unknown
Preexisting Conditions: Muscle problem; The subject had not experienced adverse events following previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0940399A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS  UNLA
Administered by: Private     Purchased by: Private
Symptoms: Muscle twitching
SMQs:, Dyskinesia (broad), Dystonia (broad)
Write-up: This case was reported by a consumer (the subject) and described the occurrence of muscle twitching in a 42-year-old female subject who was vaccinated with BOOSTRIX (GlaxoSmithKline). A physician or other health care professional has not verified this report. The subject''s medical history included muscle "issues". Concurrent medications included SYNTHROID. On 15 July 2011 at 19:00 the subject received a dose of BOOSTRIX (.5 cc, unknown route, left arm) due to stepping on a nail. On an unspecified date in July 2011, within 2 to 3 days after vaccination with BOOSTRIX, the subject experienced muscle twitching. The muscle twitching started in her index finger and at the time of reporting was occurring between where her torso and leg meets, right foot, left shoulder and right thigh. The subject reported that her finger bothers her most during the day, but when she lies down at night she notices the other areas within her body. At the time of reporting the event was worse.

VAERS ID:474734 (history)  Vaccinated:2011-11-18
Age:42.0  Onset:2011-11-18, Days after vaccination: 0
Gender:Male  Submitted:2012-09-21, Days after onset: 307
Location:Illinois  Entered:2012-10-17, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: There were no concomitant vaccinations or medications and no relevant medical history.
Diagnostic Lab Data: UNK
CDC Split Type: A0954374A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B075AA SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of injection site redness in a 42-year-old male subject who was vaccinated with BOOSTRIX (GlaxoSmithKline). On 18 November 2011 at 13:00 the subject received a booster dose of BOOSTRIX (unknown route, left arm). On 18 November 2011 (around 14:00 to 14:30) approximately one hour after vaccination with BOOSTRIX, the subject experienced injection site redness, swelling at injection site, and flu like symptoms. At the time of reporting the events were worse. The healthcare professional considered the events were probably related to vaccination with BOOSTRIX.

VAERS ID:470293 (history)  Vaccinated:2012-10-18
Age:42.0  Onset:2012-10-18, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 0
Location:Oklahoma  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient had runny nose at time of vaccination.
Preexisting Conditions: Migraines
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP589071IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Headache, Hyperhidrosis, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Reports headache, nausea, sweating, dizziness, lightheadedness.

VAERS ID:470368 (history)  Vaccinated:2012-09-20
Age:42.0  Onset:2012-10-14, Days after vaccination: 24
Gender:Female  Submitted:2012-10-18, Days after onset: 4
Location:Texas  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: CT scan - only been four days since onset and no improvements yet.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
Administered by: Other     Purchased by: Private
Symptoms: Computerised tomogram, Facial paresis, VIIth nerve paralysis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: Bell''s Palsy - weakness on left side of face. Went to ER and treated with steroids and anti-viral medication.

VAERS ID:470374 (history)  Vaccinated:2012-10-18
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-18
Location:Unknown  Entered:2012-10-18
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) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA711AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Feeling hot, Injection site vesicles
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient stated she felt faint, dizzy and hot after immunization was administered. Had what appeared to be a pinpoint blister appearing above injection site.

VAERS ID:470487 (history)  Vaccinated:2012-10-17
Age:42.0  Onset:2012-10-17, Days after vaccination: 0
Gender:Female  Submitted:2012-10-17, Days after onset: 0
Location:Rhode Island  Entered:2012-10-18, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12262P0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Pharyngeal oedema, Pulmonary function test
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Patient experienced throat swelling and trouble breathing while at home. She went to walk in clinic and pulmonary function test.

VAERS ID:470508 (history)  Vaccinated:2012-10-18
Age:42.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Wisconsin  Entered:2012-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204301 IMLA
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:470543 (history)  Vaccinated:2012-09-26
Age:42.0  Onset:2012-09-27, Days after vaccination: 1
Gender:Male  Submitted:2012-09-28, Days after onset: 1
Location:Tennessee  Entered:2012-10-18, 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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  SYRLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site warmth, Nodule, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Localized warmth at injection site, 2 lumps appeared in armpit area of arm of injection site, patient felt feverish.

VAERS ID:470531 (history)  Vaccinated:2012-10-16
Age:42.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Male  Submitted:2012-10-19, Days after onset: 3
Location:Massachusetts  Entered:2012-10-19
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: Amoxicillin allergy -$g rash; Rheumatoid arthritis; Increased chol.; PH urticaria with angioedema
Diagnostic Lab Data: WBC, 10/18/12, 20,000
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4482AB UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010916 UNLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site pain, Nausea, Pyrexia, Tremor, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt received flu vaccine in his (L) deltoid and PNEUMOVAX in his (L) deltoid late afternoon of 10/16/12. That evening he developed shaking chills. He developed a fever off & on up to 101.5. Developed shaking chills again 10/18am. (+) Nausea, (-) vomiting, (-) HA. Seen in PCPs office 10/18 - 13-15cm area of erythema with tenderness & induration noted (L) lateral deltoid. Pt. admitted for IV antibiotics & hydration 10/18.

VAERS ID:470570 (history)  Vaccinated:2012-10-09
Age:42.0  Onset:2012-10-09, Days after vaccination: 0
Gender:Female  Submitted:2012-10-19, Days after onset: 10
Location:Texas  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None other than asthma and allergies
Preexisting Conditions: Asthma, allergies
Diagnostic Lab Data: Urinalysis completed 10/15/12 with yeast growing rapidly, became viral. Diagnosis: Adverse reaction to flu vaccine.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12050018IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dry mouth, Lip swelling, Nausea, Oral mucosal blistering, Pyrexia, Rash, Urine analysis abnormal, Viral test positive
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 10/09/12 lightheaded, nauseated. 10/10/12 lightheaded, nauseated. 10/11/12 lightheaded, nauseated, tongue developed rash and dry mouth. 10/12/12, blisters around mouth, ran fever, lips began swelling. 10/14/12 began taking Benadryl for swelling. 10/15/12 went to private physician.

VAERS ID:470592 (history)  Vaccinated:2012-09-28
Age:42.0  Onset:2012-10-05, Days after vaccination: 7
Gender:Female  Submitted:2012-10-19, Days after onset: 14
Location:Indiana  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cough/upper respiratory illness, mold
Preexisting Conditions: None
Diagnostic Lab Data: Biopsy pending to confirm psoriasis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR  IDRA
Administered by: Public     Purchased by: Private
Symptoms: Psoriasis, Rash erythematous, Rash pruritic, Skin plaque
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash. Erythematous, plaques, pruritic, on extensor surfaces of elbows, anterior ankles, extensor knees, wrists, and medial fingers, suspect psoriasis. No previous hx.

VAERS ID:470597 (history)  Vaccinated:2012-10-15
Age:42.0  Onset:2012-10-16, Days after vaccination: 1
Gender:Female  Submitted:2012-10-19, Days after onset: 3
Location:New York  Entered:2012-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Environmental Allergies, Asthma
Diagnostic Lab Data: Blood test was done at ER to show the mass was not a blood clot.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0709A30UNRA
Administered by: Private     Purchased by: Other
Symptoms: Blood test normal, Headache, Oedema peripheral, Pain in extremity, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Large swelling and very painful inside arm above elbow pit. Slight Fever. Headache. Pain got worse and after advice of helpline decided to go to Emergency Room.

VAERS ID:470969 (history)  Vaccinated:2012-10-01
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-22
Location:California  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4466BA IDRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site nodule, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This patient is one of a cluster of 15 patients that had an injection site reaction characterized by erythema, pruritus & nodule at the injection site. Lasted 24 hrs to 1 week. No treatment given.

VAERS ID:470976 (history)  Vaccinated:2012-09-28
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-22
Location:California  Entered:2012-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4466BA IDRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site nodule, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This patient is one of a cluster of 15 patients that had an injection site reaction characterized by erythema, pruritus & nodule at the injection site. Lasted 14 hrs to 1 week. No treatment given.

VAERS ID:470951 (history)  Vaccinated:2012-10-08
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-10-19
Location:New Mexico  Entered:2012-10-23, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no physician diagnosed allergies, medical conditions or illness at the time of vaccination. The patient has a history of receiving yearly flu vaccinations in the past.
Diagnostic Lab Data: None
CDC Split Type: 201209483
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH717AC IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Malaise, Rash generalised, 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: Initial case received from a health care professional on 11 October 2012. The female patient, age 42, with no pre-existing allergies or medical conditions had received a dose of FLUZONE vaccine intramuscularly on 08 October 2012 (lot number UH717AC, expiry 30 June 2013) into the left deltoid. Concomitant medications were not reported. It was reported that the patient received yearly flu vaccinations in the past. The patient developed hives and generalized body rash with redness, swelling and itching at the injection site and generalized malaise at an unspecified time. The patient was self treated with BENADRYL 50 mg every 6 hours, duration not specified. The patient was administered an unspecified steroid shot by their physician on an unreported date. No further information was available at the time of report. The symptoms were reported as beginning to resolve on 09 October 2012. Documents held by sender: None.

VAERS ID:471073 (history)  Vaccinated:2012-10-20
Age:42.0  Onset:2012-10-22, Days after vaccination: 2
Gender:Female  Submitted:2012-10-23, Days after onset: 1
Location:California  Entered:2012-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: Celiac Sprue, Restless Leg Syndrome
Diagnostic Lab Data: I have not been to the MD yet. I am waiting to see if it goes away.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0 LA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Joint swelling, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Both hands and the joints in the hands were swollen and painful and they continue to feel swollen and painful. Other joints have hurt, but have gone away. The hands swelling and pain in the hands has remained.

VAERS ID:471098 (history)  Vaccinated:2012-10-13
Age:42.0  Onset:2012-10-13, Days after vaccination: 0
Gender:Male  Submitted:2012-10-24, Days after onset: 11
Location:New Hampshire  Entered:2012-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED0000006IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Injection site pruritus, Injection site reaction, Muscular weakness, Paraesthesia, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Instantaneous burning and pain during injection. Numbness, tingling and weakness in arm to wrist x 3 days. Itchy welt at injection site size of silver dollar x 5 days. Pain at injection site ongoing.

VAERS ID:471667 (history)  Vaccinated:2012-10-16
Age:42.0  Onset:2012-10-16, Days after vaccination: 0
Gender:Female  Submitted:2012-10-16, Days after onset: 0
Location:Virginia  Entered:2012-10-25, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1205501 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: After Flu shot was given, injection site became swollen, hard bump and injection site turned red. Instructed patient to take BENADRYL for the swelling.

VAERS ID:471670 (history)  Vaccinated:2012-09-26
Age:42.0  Onset:2012-09-26, Days after vaccination: 0
Gender:Female  Submitted:2012-10-11, Days after onset: 15
Location:North Dakota  Entered:2012-10-25, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50208 UNLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Chills, Hypoaesthesia oral, Pyrexia, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Throat tightness, tongue numb/swelling, fever, chills, ache/joint for 12 hours.

VAERS ID:471652 (history)  Vaccinated:2012-09-26
Age:42.0  Onset:2012-09-27, Days after vaccination: 1
Gender:Female  Submitted:2012-10-26, Days after onset: 29
Location:Colorado  Entered:2012-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204001 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pain, Pain in extremity
SMQs:
Write-up: Sore upper arm beginning day after administration, becoming increasingly painful over the last 4 weeks. Hurts to lift arm.

VAERS ID:471855 (history)  Vaccinated:2012-10-23
Age:42.0  Onset:2012-10-25, Days after vaccination: 2
Gender:Female  Submitted:2012-10-26, Days after onset: 1
Location:Massachusetts  Entered:2012-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AJ2025 IN 
Administered by: Private     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:471717 (history)  Vaccinated:2012-10-24
Age:42.0  Onset:2012-10-25, Days after vaccination: 1
Gender:Female  Submitted:2012-10-27, Days after onset: 2
Location:Alabama  Entered:2012-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Arthritis, grass allergies, and sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYR 
Administered by: Unknown     Purchased by: Private
Symptoms: Decreased appetite, Headache, Injection site discolouration, Injection site nodule, Oropharyngeal pain, Pain, Pallor, Pyrexia, Swelling, Urinary tract inflammation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Swelling of body, feet, hands, legs, fever, full body ache, kidneys inflamed, hurts to move, throat sore, hurts to try and talk, severe head ache, pale, can''t keep food down, don''t want to eat. Knots and arm turn white at injection site.

VAERS ID:472057 (history)  Vaccinated:2012-10-27
Age:42.0  Onset:2012-10-28, Days after vaccination: 1
Gender:Female  Submitted:2012-10-30, Days after onset: 2
Location:Massachusetts  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Patient is still being treated. MRI does not show abscess or myositis.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0162951IMLA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Chills, Injection site erythema, Injection site induration, Injection site swelling, Nuclear magnetic resonance imaging normal, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling, induration of site, continued expansion despite antibiotics, fever and chills and generalized weakness.

VAERS ID:472269 (history)  Vaccinated:2012-10-14
Age:42.0  Onset:2012-10-15, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Kentucky  Entered:2012-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICS  SYRLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS  SYRLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Nodule, Oedema peripheral, Pain in extremity, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pain in left arm like a knot. Kind of swollen red - like fever on the knot, hurts when touched.

VAERS ID:472397 (history)  Vaccinated:2012-10-27
Age:42.0  Onset:2012-10-29, Days after vaccination: 2
Gender:Female  Submitted:2012-10-31, Days after onset: 2
Location:Arizona  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: ASTHMA, HYPERTENSION
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07549211A IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H009826 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4313AA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Mobility decreased, Nausea, Pain in extremity
SMQs:, Acute pancreatitis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient called clinic, left word that she had a reaction to vaccine received 2 days prior. States she felt pain at time of flu injection, two days later arm became very painful, unable to raise arm, very red and swollen at injection site. She received flu and pneumonia vaccines in left deltoid but believed it was the flu she reacted to. (Received Tdap in right deltoid). Saw PCP 10/29/12, he prescribed Tylenol with Codeine for pain, ibuprofen for inflammation, promethazine for nausea.

VAERS ID:472399 (history)  Vaccinated:2012-10-28
Age:42.0  Onset:2012-10-30, Days after vaccination: 2
Gender:Male  Submitted:2012-10-31, Days after onset: 1
Location:Massachusetts  Entered:2012-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU11714AD0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Headache, Nausea, Pain, Pyrexia, Rhinorrhoea, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 10/30: 2pm - Sinus congestion, headache, runny nose, body ache; 6pm - same as 2pm with fever. 10/31: 7am - sinus congestion, runny nose, cough, headache, body ache; 9am - same as 7am with nausea. Treated on 10/30 at 10pm with Acetaminophen (650mg), Chlorpheniramine maleate 4mg, Dextromethorphan HBr 20mg, Phenylephrine HCl 10mg. Treated on 10/31 at 8am and every 4 hours with Acetaminophen (650mg), Dextromethorphan HBr 20mg, Phenylephrine HCl 10mg.

VAERS ID:472686 (history)  Vaccinated:2012-09-28
Age:42.0  Onset:2012-09-29, Days after vaccination: 1
Gender:Male  Submitted:2012-09-29, Days after onset: 0
Location:Missouri  Entered:2012-10-31, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS12054011UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0135811UNLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site nodule, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Both shots administered in (L) deltoid 9/28/12 pt. has pain, swelling, erythema at injection site "hard knot, hot to the touch" will try ice pack, BENADRYL / NSAIDS first. May seek further treatment. Pt went to urgent care and received antibiotic.

VAERS ID:472639 (history)  Vaccinated:2012-10-04
Age:42.0  Onset:2012-10-16, Days after vaccination: 12
Gender:Female  Submitted:2012-10-26, Days after onset: 10
Location:Indiana  Entered:2012-11-02, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: D-Dimer$g1.5 mg/dl, CMV-negative HIV, Hepatitis B&C negative, CSF - Glu 52, Protein 78
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA726AA0IMAR
Administered by: Public     Purchased by: Private
Symptoms: Bradycardia, CSF glucose normal, CSF protein increased, Cardiac pacemaker insertion, Cytomegalovirus test negative, Diplopia, Dysphagia, Fibrin D dimer, Guillain-Barre syndrome, HIV test negative, Hepatitis B test negative, Hepatitis C test negative, Mechanical ventilation, Muscular weakness, Pneumonia aspiration, Tracheostomy
SMQs:, Rhabdomyolysis/myopathy (broad), Angioedema (broad), Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Demyelination (narrow), Ocular motility disorders (broad), Hypersensitivity (broad)
Write-up: Developed Guillain-Barre Syndrome - progressive muscle weakness, lower extremities and upper extremities, bulbar area with failure to swallow, diplopia, aspiration pneumonia, BP 180/95. Now on ventilator, trached, bradycardia requiring pacemaker insertion. Hospitalized from 10/16/12 to current 11/2/12.

VAERS ID:477093 (history)  Vaccinated:2012-10-05
Age:42.0  Onset:0000-00-00
Gender:Male  Submitted:2012-11-02
Location:New York  Entered:2012-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1210USA012968
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013847 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Axillary pain, Dizziness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: This spontaneous report was received from a physician refers to a 41 year old male patient. The patient was vaccinated with a dose of 0.5 ml PNEUMOVAX 23. On an unknown date, the patient experienced high fever of 104 degrees, aches and pain, dizziness and excruciating pain in the armpit are after receiving the vaccination. The outcome of the events were unknown at the time of this report. This is one of the several reports received by the same reporter. Additional information has been requested.

VAERS ID:473419 (history)  Vaccinated:2012-11-01
Age:42.0  Onset:2012-11-01, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 6
Location:Illinois  Entered:2012-11-07
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: CT Scan Brain, MRI, 2D Echo, Carotid Doppler, EEG, CXR Many labs taken all normal
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUH759AA IDLA
Administered by: Private     Purchased by: Private
Symptoms: Aphasia, Chest X-ray normal, Computerised tomogram head, Computerised tomogram normal, Diarrhoea, Echocardiogram normal, Electroencephalogram normal, Fatigue, Feeling abnormal, Headache, Laboratory test normal, Nuclear magnetic resonance imaging normal, Speech disorder, Transient ischaemic attack, Ultrasound Doppler, Ultrasound Doppler normal, Visual impairment
SMQs:, Ischaemic cerebrovascular conditions (narrow), Dementia (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, arterial (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Noninfectious diarrhoea (narrow)
Write-up: 11/1/2012, started with severe diarrhea and headache, on 11/2/2012 had Visual problem for approx 5 minutes felt like my eyes were looking in another direction and everything was real far away, on 11/3/2012 had difficulty speaking for approx 45 minutes, went to ER, was worked up for a stroke, DX: TIAs possible MS. To date my brain is foggy, difficulty speaking on occasion getting words out can''t remember what to say, headaches and very tired.

VAERS ID:473421 (history)  Vaccinated:2012-10-23
Age:42.0  Onset:2012-10-30, Days after vaccination: 7
Gender:Male  Submitted:2012-11-07, Days after onset: 8
Location:Washington  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Dysgraphia, Dyskinesia, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dyskinesia (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: Felt ferverish (without a fever). Muscle soreness, muscle weakness, lack of fine muscle control (had trouble writing/typing). Symptoms got worse and gradually subsided by 11/06/2012 (1 week).

VAERS ID:473484 (history)  Vaccinated:2012-08-15
Age:42.0  Onset:2012-08-15, Days after vaccination: 0
Gender:Female  Submitted:2012-11-07, Days after onset: 84
Location:New Jersey  Entered:2012-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergies to Zyban, Birch, Pet dander and grass
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS581600826521IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blister
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Blister like rash developed on the arm of the injection site. Spread to neck and abdomen.

VAERS ID:474037 (history)  Vaccinated:2012-10-27
Age:42.0  Onset:2012-10-27, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 12
Location:Pennsylvania  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH716AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Patient received Flu shot on 10/27/12 and noticed pain in shoulder shortly following administration. Patient called today to inquire since pain still exists and may be getting worse with difficulty raising arm - no rash present.

VAERS ID:474039 (history)  Vaccinated:2012-09-24
Age:42.0  Onset:2012-09-25, Days after vaccination: 1
Gender:Female  Submitted:2012-11-08, Days after onset: 44
Location:Arizona  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1203901 UNRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0367AE0UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0105150UNRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Grip strength decreased, Injected limb mobility decreased, Injection site rash, Nausea, Nodule, Pain in extremity, Pyrexia, Skin warm
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: (R) arm sore - next day - increased pain 9/25 / 7 AM - chills - difficulty with grip strength - afternoon 99.8 Temp. at 6:30 - feeling feverish, nauseated. Hard to move (R) arm. 9-27 - feeling much better. 10/1 - still hot with small knot. Rash 9/25/12 $ size below injection site. Hot to touch.

VAERS ID:476460 (history)  Vaccinated:2012-11-05
Age:42.0  Onset:2012-11-05, Days after vaccination: 0
Gender:Female  Submitted:2012-11-08, Days after onset: 3
Location:Pennsylvania  Entered:2012-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Diabetes; Asthma; Hyperlipidemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC061AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013878 IMRA
Administered by: Public     Purchased by: Other
Symptoms: Chest discomfort, Chest pain, Immediate post-injection reaction
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt stated she felt tightness and pain in her chest immediately after receiving hepatitis B vaccine, in which that was the last injection given. A second set of vitals were taken and were normal, Dr was informed, pt was monitored for 15 min.

VAERS ID:474016 (history)  Vaccinated:2012-11-07
Age:42.0  Onset:2012-11-07, Days after vaccination: 0
Gender:Female  Submitted:2012-11-09, Days after onset: 2
Location:California  Entered:2012-11-09
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: Unknown
Diagnostic Lab Data: None
CDC Split Type:
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.AH21090IN 
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt. states experienced itching and hives all over body after receiving live-virus influenza vaccine. Pt. denies taking any medications for symptoms.

VAERS ID:475894 (history)  Vaccinated:2011-12-01
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-06-07
Location:New Jersey  Entered:2012-11-09, Days after submission: 155
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: No reported medical history and concomitant medications.
Diagnostic Lab Data: Not reported
CDC Split Type: 201204616
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEUR  UNAR
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Injection site nodule, Injection site pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Initial report received from Non-Health Care Professional on 24 April 2012. A 42-year-old female patient, whose medical history and concomitant medications were not reported, had received dose of FLUZONE HD vaccine (lot number and site of administration- not reported) in December 2011. The patient reported that she had a knot in her arm where the injection was given, the arm was still sore (soreness had been got worse and down below to the elbow). The patient also had continuous cough. The physician suggested that the events were related to the flu shot. The outcome of the events was reported as not recovered. Documents held by sender: none.

VAERS ID:474154 (history)  Vaccinated:2012-11-12
Age:42.0  Onset:2012-11-12, Days after vaccination: 0
Gender:Male  Submitted:2012-11-14, Days after onset: 2
Location:Wisconsin  Entered:2012-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURU4462AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Chills, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Fever/chills, headache, fatigue, joint pain.

VAERS ID:474512 (history)  Vaccinated:2012-10-01
Age:42.0  Onset:2012-10-01, Days after vaccination: 0
Gender:Female  Submitted:2012-10-18, Days after onset: 17
Location:California  Entered:2012-11-14, Days after submission: 27
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: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA711AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Insomnia, Pruritus, Rhinorrhoea, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 2 hrs after vax admin her face began to swell & itch. Also difficulty sleeping a few days. Also clear runny nose. No neuro or resp sxs. Has similar reaction to flu vax yearly; no reaction to other vax. Still itchy face 4 days later.

VAERS ID:474172 (history)  Vaccinated:2012-10-30
Age:42.0  Onset:2012-11-08, Days after vaccination: 9
Gender:Male  Submitted:2012-11-15, Days after onset: 7
Location:Ohio  Entered:2012-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: I had past immunization reaction, received steroid with childhood vaccines
Diagnostic Lab Data: None as of yet. Have communicated with my employee health department he vaccinated and will contact personal MD.
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEUR 1IDLA
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: I have had a headache not resolved by medication since this date. It is nearly unbearable at times. I have just recently contacted my employee health department. Another employee who received her shot the same day is also complaining of a headache.

VAERS ID:474231 (history)  Vaccinated:2011-11-28
Age:42.0  Onset:2011-12-05, Days after vaccination: 7
Gender:Female  Submitted:2012-11-12, Days after onset: 343
Location:North Carolina  Entered:2012-11-15, 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: Viral illness 3 days post inactivated, preservative-free, seasonal influenza vaccine
Preexisting Conditions: None
Diagnostic Lab Data: Exhaustive neuro testing w/o evidence of cord compression- MRI''s with and w/o contrast of L-Spine, T-Spine, C-Spine, Normal EMG. Evaluated by multiple specialties with no evidence of diagnostic data c/w sx. Bone scan revealed osteopenia and pt has well-documented hx of pre-existing orthopedic trauma (stress fx''s femur, tibia, metatarsal left foot) which can account for pain and difficulty in ambulation at onset of sx.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDN566060IMLA
Administered by: Military     Purchased by: Military
Symptoms: Gait disturbance, Monoplegia, Muscular weakness, Pain in extremity, Viral infection
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: 43 y/o F requests vaccine causality eval of persistent lower extremity pain & weakness (bilat), w/ difficulty ambulating & onset of intermittent paralysis of LE''s 10 days s/p receipt of AFLURIA inactivated IM (single dose, preservative-free) influenza vaccine on 28NOV11. No other vaccinated rec''vd on same day or w/in 30-days prior. (09FEB10) Missed step getting off bus "fell on knees & face-planted on ground." No LOC. Attributes onset of bilat LE pain to rucksacking during BT & AIT "carried a 97-lb ruck sack, wearing boots that were 2 sizes too big." Pt denies hx of osteopenia prior to age 40 on 28DEC09. Her entry WT was 113 lbs-a petite-framed F, s/p surgical menopause in 2000- only took 3 months HRT. (21APR10) Eval by Phys Therapy c/o bilat leg numbness & pain. (MAY 2010) Dx Bilat Tibial (Grade II), Femoral shaft & 5th MT (L$gR) Stress Fx''s. A&P: Based on bone scan & physical sx $g$g$g NO RUNNING PROFILE x 3 months. Upon graduation AIT, assigned to Broadcast Journalism. REC f/u at MC q4-6wk. (15JUL10) MC FAM MED c/o leg pain 1. Hx stress fx''s- pain in legs below knees; 2. Screening exam: depression/mental or development disorders (NEG). (14DEC10, Phys Ther) c/o will no longer honor profile. (21DEC10) MC ORTHOPEDICS. Extension profile by FAM MED till eval by PODIATRY on (26JAN11) dx''d w/ Morton''s Neuroma (L) foot. Steroid injections x 2 w/ cellulitis after 2nd injection; (04MAR11) rx''d w/ Levaquin; (06APR11) (L) SURGICAL RESECTION Neuroma (L) foot 3rd interspace; (23MAY11) f/u PODIATRY (L) foot swelling; (03JUN11) 8 wk f/u PODIATRY pt concerned she will not be able to deploy; PROFILE UPDATED PT AT OWN PACE; (27JUN11) REPEAT BONE SCAN: NO FEMORAL STRESS FX''s / POSSIBLE STRESS vs. POST-TRAUMATIC CHANGES OF THE KNEE, ANKLES & FEET. (01JUL11) MC FAM MED f/u Bone Scan- NO FX / MINIMAL STRESS REACTION ONLY IN TIBIA. PCM explained to pt that her bones had healed. Pt worried that unit making her run too far too soon- made her run 4 miles yesterday & was to ruck w/ 60 lbs this morning. PCM told her if she does that, she will get new fx. Needs to PROGRESS SLOWLY. PCM wrote note detailing profile for unit. PCM presumptively rx''d w/ 50,000 IU Vit D weekly x 4, then monthly x 5. (01JUL11) pt''s commander contacts PODIATRY re pt''s physical limitations. (06JUL11) f/u PODIATRY 3 months s/p neuroma excision. Pt c/o minimal to no pain to (L) foot. (06JUL11) FAM MED Command needs more info re pt''s profile & non-deployment status; (12JUL11) FAM MED Acute Visit PCM cc "I''m here to beg for an MEB." PCM told pt she does not meet criteria for DVT as she is improving & will gradually improve if she follows current profile. Pt states that command is not following profile & making her run/ruck march. PCM speaks w/ commander who says that is what they are doing & that pt does not want to do anything, even activities allowed on profile. They feel she is malingering to get out of deployment. (08AUG11) Ref. SPORTS MEDICINE-gave shin splint, rec stretching & strengthening exercises. Ref back to PODIATRY for orthotics. (30AUG11) FAM MED c/o anxiety/difficulty sleeping; Ref FAM MED PSYCH Resident, then to BEH Health for "Adjustment Disorder." (20OCT11) MED EVAL ORTH "her painful lower limbs interfere w/ successful performance of duty" MED REC. Pt has since been eval at length by WTU PCM''s. Eval by multiple specialties, including MC Neurology, Pain Clinic, Physical Therapy, Podiatry, Orthopedics, Sports Medicine, Occupational Therapy & Behavioral Health. Neurological c/o''s were unsubstantiated by MC Neuro after multiple diagnostics (see below), which were essentially negative & did not correlate w/ physical sx, leading to CONSENSUS DX of CONVERSION DISORDER. Second Neuro opinion requested by pt. Ref to another Neurosurgery who concurred. In July of 2010, she personally requested an evaluation by the healthcare center for possible vaccine causality of her sx. Medical Director (at the time) requested an approval by her PCM to begin this evaluation. At her initial in

VAERS ID:476939 (history)  Vaccinated:2012-10-12
Age:42.0  Onset:2012-10-13, Days after vaccination: 1
Gender:Female  Submitted:2012-10-18, Days after onset: 5
Location:California  Entered:2012-11-15, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Was recovering from URI wk prior
Preexisting Conditions: Unknown
Diagnostic Lab Data: None reported
CDC Split Type:
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Balance disorder, Headache
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Day following vax, she had sensation of things around her moving/disequilib. Later had headache that has persisted.

VAERS ID:474627 (history)  Vaccinated:2012-11-14
Age:42.0  Onset:2012-11-14, Days after vaccination: 0
Gender:Female  Submitted:2012-11-16, Days after onset: 2
Location:North Carolina  Entered:2012-11-16
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
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 19IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Abdominal pain upper, Back pain, Burning sensation, Chills, Eye irritation, Headache, Neck pain, Oedema peripheral, Pain, Pyrexia, Skin warm, Vaccination complication
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Corneal disorders (broad), Arthritis (broad)
Write-up: Chills initially. 24 hours after the shot: fever 101, severe body pain, headache, stomach pain, neck and back pain, severe eye burning and body felt to be on fire. Arm was very swollen and feverish. This continued 48 hours after the shot. Saw a doctor at Urgent Care today who diagnosed as a reaction to the shot.

VAERS ID:474890 (history)  Vaccinated:2012-11-05
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-19
Location:Texas  Entered:2012-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204521 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Contusion, Nodule
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)
Write-up: Patient described as a knot on arm and became bruised, contacted her doctor who said it was an adverse reaction, has doctor appointment today 11/19/12.

VAERS ID:478503 (history)  Vaccinated:2012-11-14
Age:42.0  Onset:2012-11-14, Days after vaccination: 0
Gender:Female  Submitted:2012-11-22, Days after onset: 8
Location:Unknown  Entered:2012-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions: Vertigo; Migraine; Penicillin (unspecified)
Diagnostic Lab Data:
CDC Split Type: WAES1211USA007057
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013847 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Oedema peripheral, Wrong drug administered
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a Physician Assistant refers to a 42 years old female patient with allergy to penicillin. The patient''s medical history included migraines and vertigo. The patient was vaccinated with PNEUMOVAX23 (0.1 ml, intradermal, left forearm, lot # was reported as H013847, expiration date was 15-MAR-2014) on 14-NOV-2012. No other co-suspects were reported. Unspecified medication for migraines as needed. On 14-NOV-2012 the patient received 0.1 ml of PNEUMOVAX23 administered intradermally. PNEUMOVAX23 was inadvertently administered instead of a tuberculin purified protein derivative (PPD) related to an error by a staff member. The patient was experiencing significant left hand and left arm swelling (on 14-NOV-2012). The outcome of significant left hand and left arm swelling was reported as not recovered. No lab diagnostics studies performed. The patient sought medical attention via visiting office. Additional information has been requested.

VAERS ID:475136 (history)  Vaccinated:2012-11-10
Age:42.0  Onset:2012-11-10, Days after vaccination: 0
Gender:Female  Submitted:2012-11-24, Days after onset: 14
Location:Missouri  Entered:2012-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA733AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Limb discomfort
SMQs:
Write-up: Patient called and said she was still having discomfort in the arm, 2 weeks after her flu shot. I told her I thought that was a long time and suggested she call her MD.

VAERS ID:475163 (history)  Vaccinated:2012-10-13
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-26
Location:Unknown  Entered:2012-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylaxis; Drug hypersensitivity, to soy isoflavone; Rubber sensitivity
Preexisting Conditions: Soy isoflavones, Drug hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1211USA008209
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR  UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0106612IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: This spontaneous report as received from a pharmacist refers to a 42 years old female patient. The patient had allergies to soy isoflavone and latex. On 13-OCT-2012 the patient was vaccinated in her left deltoid by intramuscular injection with a single dose of 0.5 ml PNEUMOVAX23 (lot # H010661, expiration date reported as 02-FEB-2014). Concomitant medications included FLUVIRIN (Novartis) and MENACTRA (Sanofi), both of which were vaccinated in the patient''s right arm during the same visit, on 13-OCT-2012. The patient developed a case of cellulitis, described as "very large" and a fever described as "greater than 102 degrees Fahrenheit" at an unspecified time following vaccination. Pharmacist reported that this was the patient''s third lifetime dose of PNEUMOVAX23 and the patient had experienced similar, though milder reactions following prior doses of PNEUMOVAX23 (lot # not reported). Pharmacist did not know the patient''s prior medical history, but stated that the patient reported that her healthcare providers had urged her to get PNEUMOVAX23 every 5-10 years. The patient sought for unspecified medical attention. Antibiotics and oral steroids were given as treatment. Lab diagnostics studies performed were reported as none. The patient recovered on an unspecified date. Additional information has been requested.

VAERS ID:475173 (history)  Vaccinated:2012-11-15
Age:42.0  Onset:2012-11-17, Days after vaccination: 2
Gender:Male  Submitted:2012-11-26, Days after onset: 9
Location:Unknown  Entered:2012-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHHY2012US105247
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Lip swelling, Oedema peripheral, Pruritus generalised, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Case number PHHY2012US105247 is an initial spontaneous report received from a pharmacist on 19 Nov 2012: This report refers to a 42-years-old male patient. His medical history and concomitant medication was not reported. He was vaccinated with FLUVIRIN (batch number: not reported) on 15 Nov 2012. After vaccination on the next day, he complained that, he woke up in the middle of the night with hives and itching all over trunk, arms and legs. He was treated with BENADRYL. On 17 Nov 2012, he also experienced lips and hands swelled up. The outcome and causality of the events was not reported.

VAERS ID:475396 (history)  Vaccinated:2012-11-25
Age:42.0  Onset:2012-11-25, Days after vaccination: 0
Gender:Female  Submitted:2012-11-27, Days after onset: 2
Location:California  Entered:2012-11-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Very high temperature 101.8 from time of vaccine until present.

VAERS ID:475546 (history)  Vaccinated:2012-11-18
Age:42.0  Onset:0000-00-00
Gender:Female  Submitted:2012-11-27
Location:Virginia  Entered:2012-11-27
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
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IMUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Hypersensitivity
SMQs:, Angioedema (broad), Hypersensitivity (narrow)
Write-up: Allergic reaction resulted in E.R. visit. Drs office visit today (11-27-12) cellulitis.

VAERS ID:479660 (history)  Vaccinated:2012-08-23
Age:42.0  Onset:2012-08-23, Days after vaccination: 0
Gender:Female  Submitted:2012-11-05, Days after onset: 74
Location:Florida  Entered:2012-12-03, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No concomitant vaccinations or relevant medical history.
Diagnostic Lab Data: UNK
CDC Split Type: A0991343A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB251AA0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Dysgeusia, Hypoaesthesia, Hypoaesthesia oral, Immediate post-injection reaction
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of medicine-like taste in mouth in a 42-year-old female subject who was vaccinated with TWINRIX (GlaxoSmithKline). There were no concurrent medications. On 23 August 2012 the subject received 1st dose of TWINRIX (1 ml, unknown, right arm). On 23 August 2012, immediately after vaccination with TWINRIX, the subject experienced medicine-like taste in mouth. Within one minute of vaccination with TWINRIX, the subject experienced feeling of numbness of the nose and lip felt numb. The healthcare professional reported the subject experienced a medication taste in her mouth immediately after TWINRIX was administered on 23 August 2012. Within one minute, the subject complained of nose and lip numbness. The subject was monitored and symptoms resolved without sequalae within 15 to 20 minutes on 23 August 2012. No additional information was known at the time of the report.

VAERS ID:476721 (history)  Vaccinated:2012-10-15
Age:42.0  Onset:2012-10-15, Days after vaccination: 0
Gender:Female  Submitted:2012-12-04, Days after onset: 50
Location:Kansas  Entered:2012-12-05, 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:
Current Illness: Sinusitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH748AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Shoulder pain/soreness since injection refer to ortho, shoulder x-ray.

VAERS ID:479830 (history)  Vaccinated:2012-11-27
Age:42.0  Onset:2012-11-27, Days after vaccination: 0
Gender:Female  Submitted:2012-12-06, Days after onset: 9
Location:Illinois  Entered:2012-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1211USA011802
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IDAR
Administered by: Other     Purchased by: Other
Symptoms: Drug administered at inappropriate site, No adverse event
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 42 years old female patient. The patient was vaccinated with a 0.1 ml dose of PNEUMOVAX23 (lot number not provided) intradermally in the forearm on 27-NOV-2012. Unspecified which arm. No other co-suspects were reported. No concomitant medications were reported. No adverse effects reported at the reporting time. It was unspecified if the patient had sought unspecified medical attention. Additional information has been requested.

VAERS ID:477735 (history)  Vaccinated:2012-11-30
Age:42.0  Onset:2012-11-30, Days after vaccination: 0
Gender:Female  Submitted:2012-12-11, Days after onset: 11
Location:Massachusetts  Entered:2012-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Colitis / Crohn''s
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP587071IMLA
Administered by: Public     Purchased by: Other
Symptoms: Immediate post-injection reaction, Mobility decreased, Musculoskeletal pain, Pain, Pain in extre