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Case Details (Sorted by Age)

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VAERS ID:279269 (history)  Vaccinated:2007-02-03
Age:39.0  Onset:2007-02-03, Days after vaccination: 0
Gender:Male  Submitted:2007-02-03, Days after onset: 0
Location:California  Entered:2007-05-22, Days after submission: 107
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma exacerbation
Preexisting Conditions: ASTHMA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2193AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0886F0IMRA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Oxygen saturation decreased, Oxygen supplementation
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Difficulty breathing - resolved by 3L O2 and Albuterol breathing treatment vital signs stable, O2 Sat 94% on room air after 1 hour.

VAERS ID:280215 (history)  Vaccinated:2007-05-15
Age:39.0  Onset:2007-05-17, Days after vaccination: 2
Gender:Male  Submitted:2007-06-01, Days after onset: 15
Location:Arizona  Entered:2007-06-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None reported by patient
Current Illness: None reported by patient
Preexisting Conditions: None reported by patient
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0183U SCLA
Administered by: Public     Purchased by: Public
Symptoms: Ear pain, Pain in jaw
SMQs:, Osteonecrosis (broad)
Write-up: Patient called on 5/31/07 in pm to report that after receiving MMR on 5/15/07 he began having problems with "intense jaw pain" and "pain near his ears." States that the pain started about 48 hrs. after receiving the vaccine. He reported no other symptoms, but stated that the pain has remained persistent and has not seemed to improve. I called our Chief Medical Officer, who didn''t feel the problem was vaccine-related, but suggested that I file a VAERS report. Patient stated that he had not yet sought medical treatment. I advised him to contact his primary care physician about pain.

VAERS ID:280280 (history)  Vaccinated:2007-05-16
Age:39.0  Onset:2007-05-17, Days after vaccination: 1
Gender:Female  Submitted:2007-05-23, Days after onset: 6
Location:Kansas  Entered:2007-06-04, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2638AA IMUN
Administered by: Public     Purchased by: Private
Symptoms: Ear pain, Fatigue, Neck pain, Pain in jaw, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Osteonecrosis (broad), Arthritis (broad)
Write-up: 05-17-07 Sore throat and ear pain. 05-18-07 Progressed to jaw and neck pain. 5-18-07 was seen by her family physician. Treated with "a shot" and antibiotics (unknown what the shot was.) 05-19-07 fever and fatigue.

VAERS ID:283382 (history)  Vaccinated:2006-03-28
Age:39.0  Onset:2006-04-01, Days after vaccination: 4
Gender:Female  Submitted:2007-05-30, Days after onset: 423
Location:Illinois  Entered:2007-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0605USA02513
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Myalgia, Pain, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Information has been received from a registered nurse concerning a 39 year old female with an allergy to aspirin and no other pertinent medical history who on 28-MAR-2006 was vaccinated SC in the right arm with a 0.5 mL dose of MMR II. There was no concomitant medication. It was noted that the patient was not immunized at the reporting nurse''s facility and that the vaccine was given due to college requirements and an unknown vaccination history. On an unspecified date (approximately April 2006), the patient experienced muscle pain for three and a half weeks after vaccination. The patient described her symptoms as "tender to the touch and movement" and "a lot of pain." Unspecified medical attention was sought. No diagnostic laboratory tests were performed. The patient recovered on an unspecified date. A product quality complaint was not involved. Muscle pain was considered to be disabling by the reporter. No further information is available. Other business partner numbers include E2006-02659.

VAERS ID:281066 (history)  Vaccinated:2007-05-22
Age:39.0  Onset:2007-06-01, Days after vaccination: 10
Gender:Male  Submitted:2007-06-09, Days after onset: 8
Location:Wisconsin  Entered:2007-06-09
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: Penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1021SCRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ0663220IMRA
Administered by: Military     Purchased by: Military
Symptoms: Blister, Swelling
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 01June07 seen in ER for severe reaction to smallpox including blisters and swelling. Given erythromycin and Ibuprofen, follow up at the Clinic on 04June07 with improvement noted to site.

VAERS ID:281545 (history)  Vaccinated:2007-05-16
Age:39.0  Onset:2007-05-17, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2007-06-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of vaccination and was on no other medications.
Diagnostic Lab Data:
CDC Split Type: 200701818
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2207A SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Incorrect route of drug administration, Injection site erythema, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: A 39-year-old female patient had received a left arm, subcutaneous (not recommended route of administration for this product) injection of Menactra, lot number 02207AA, on 16 May 2007. The following day, she experienced redness, itching and swelling at the injection site. The event required medical examination, and the patient was treated with Tylenol and hydrocortisone cream. At the time of this report, the patient has not recovered.

VAERS ID:282990 (history)  Vaccinated:2007-06-18
Age:39.0  Onset:2007-06-19, Days after vaccination: 1
Gender:Female  Submitted:2007-06-19, Days after onset: 0
Location:Michigan  Entered:2007-06-27, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid, Libox
Current Illness: None
Preexisting Conditions: Hyperthyroidism, IBS
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1333F1UNRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythematous over site

VAERS ID:283267 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2007-06-21
Location:Unknown  Entered:2007-06-29, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: Born by C-sec, on O2 x 4 days for "hard breathing". Asthma. Pneumonia.
Diagnostic Lab Data: labs and Diagnostics: BUN slightly high, alk phos low, CBC WNL, UA (-), urine amino acid screen (-), Urine formucopolysccharide (-), buccal smear, chromosome studies, EEG normal for age. X-ray skull with unusual shape. CXR probably normal. Hands and wrists for bone age: Bone age ~2 yrsto 2yrs 4 mon compared to chronological age of 3.5 yrs.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Abnormal behaviour, Aphasia, Autism, Blood alkaline phosphatase, Blood urea increased, Chest X-ray, Childhood disintegrative disorder, Convulsion, Diarrhoea, Disturbance in social behaviour, Ear infection, Electroencephalogram normal, Full blood count, Grand mal convulsion, Head banging, Hyperreflexia, Lack of spontaneous speech, Low set ears, Mental retardation, Nervous system disorder, Prominent epicanthal folds, Psychomotor hyperactivity, Skull X-ray abnormal, Smear buccal, Social avoidant behaviour, Urine amino acid level normal, Urine analysis normal
SMQs:, Acute renal failure (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Pseudomembranous colitis (broad), Akathisia (broad), Drug abuse and dependence (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Depression (excl suicide and self injury) (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad)
Write-up: Diagnosed with childhood autism at age 3 (approx.). Began to get seizures at about 16 (?). Had a few grand mal seizures soon after. 07/16/2007 MR received for admission 10/4-7/1971. Much is difficult to read due to copy quality from microfilm, however D/C Summary from evaluation admission is intact and readable. Child admitted for assessment of active problem list: Loss of Speech, Abnormal behavior: head banging and rocking motions, and Hyperactivity. Child had a vocab of 4 words at age 2 when he suddenly stopped uttering any audible sounds. With loss of speech the child with drew socially and began rockin and spinning motions as well as head banging. Difficult for mother to control. PE: Significant for low set ears, epicanthal folds, eye contact avoidance, no social smile, repetitive mannerisms, and bilateral hyperreflexia. Final DX: Infantile Autism. Probable central nervous system disease with autisitic behavior. Follow-up: Hospital of Birth of pt has been sold to new hospital and person says all records destroyed. She said they were only required to keep records maximum of 30 yrs. The doctor, only 7rs. We are sending only copy of any records of shots, but don''t know where this is from. Diarrhea, ear infection, autism, retardation, loss of speaking ability at 1 1/2 yrs. Seizures at 14 years of age until now. 1/11/2010 Diagnosed with autism at about 3 yrs old at hospital.

VAERS ID:283609 (history)  Vaccinated:2007-06-22
Age:39.0  Onset:2007-06-23, Days after vaccination: 1
Gender:Female  Submitted:2007-07-02, Days after onset: 9
Location:Oklahoma  Entered:2007-07-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 75mcg
Current Illness: None
Preexisting Conditions: hypothyroid
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR  IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Body temperature increased, Chills, Dizziness, Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: Vaccinated approx 11:15am on 6/22/07. Around 02:00am on 6/23/07 experienced severe chills and joint pain (ankles and wrist). Put on robe, turned off fan, no difference in chills. Unable to locate thermometer at this time. Went back to sleep around 04:45am. Around 06:00am Woke at with high fever, headache, nausea, and continued joint pain - took 800mg ibuprofen, removed excess blankets/covers. Continued fever and lightheadedness. Thermometer found, temperature taken at 12:00pm, temp = 100.2F. Continued 800mg ibuprofen q 8 hours x 3 additional doses. Fever resolved by 07:00am on 6/24/07.

VAERS ID:284020 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Unknown  Submitted:2007-07-06
Location:New Mexico  Entered:2007-07-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 1st one 1 month later 4th one 1 week and 5th one 6 weeks later. Each time I reported asking about the shot I was told this was not a reaction to the shot.
Preexisting Conditions: Also in 99 I had a lump in my breast removed. 00, had another lump in breast removed and 04 had a lump on side of chest removed. All were noncancerous.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV048B3IDLA
Administered by: Military     Purchased by: Unknown
Symptoms: Arthralgia, Mass, Musculoskeletal stiffness, Pain
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: First Shot 1 month later hands were stiffening during needle point, crocheting and knitting. 4th Shot, my elbows and hands were aching 1 week after shot. 5th shot 4Jun04 6 weeks later had lump on baby finger. Ached all over body and I still do I am seeing a Rheumatologist now. 06 Got a lump on knee and they don''t know what''s causing this. Also in 99 I had a lump in my breast removed. 00, had another lump in breast removed and 04 had a lump on side of chest removed. All were noncancerous, but I never had any of this before. I ached constantly and am taking medicines for inflammation.

VAERS ID:284058 (history)  Vaccinated:2007-06-07
Age:39.0  Onset:2007-06-07, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 7
Location:West Virginia  Entered:2007-07-06, Days after submission: 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU1624BA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Influenza like illness, Nausea, Pain in extremity, Pharyngolaryngeal pain, Rhinorrhoea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Donor reported flu-like symptoms (H/A, N, runny nose, sore throat, aching arm) the evening after receiving Tet. immunization. Symptoms lasted approximately 24 hours (no difficulty swallowing/breathing).

VAERS ID:284607 (history)  Vaccinated:2007-05-17
Age:39.0  Onset:2007-05-22, Days after vaccination: 5
Gender:Female  Submitted:2007-07-06, Days after onset: 45
Location:Pennsylvania  Entered:2007-07-13, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2730AA0IM 
Administered by: Public     Purchased by: Private
Symptoms: Body temperature, Injection site pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Site pain, swelling, temp

VAERS ID:284612 (history)  Vaccinated:2007-05-20
Age:39.0  Onset:2007-05-22, Days after vaccination: 2
Gender:Female  Submitted:2007-07-06, Days after onset: 45
Location:Pennsylvania  Entered:2007-07-13, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2734AA0IM 
Administered by: Public     Purchased by: Private
Symptoms: Cellulitis
SMQs:
Write-up: LUE cellulitis large on antibiotic resolved 6/4/07

VAERS ID:285256 (history)  Vaccinated:2007-07-12
Age:39.0  Onset:2007-07-12, Days after vaccination: 0
Gender:Female  Submitted:2007-07-19, Days after onset: 7
Location:Washington  Entered:2007-07-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Estradiol
Current Illness: None
Preexisting Conditions: PCN - hives, nose bleed; Sulfa-hives, Erythromycin - hives
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB412AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Diarrhoea, Pruritus, Stomach discomfort, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: 7-12-07 - employee c/o itching immediately after injection. After 20 min. no worsening - actually improved. Employee went home. 7-19-07 / 4:00 Employee calls to say that on 7-12-07 2-3 hours after inj. c/o itching and hives - took her Allegra, went home from work - had stomach upset and diarrhea - resolved by morning 7-13-07.

VAERS ID:285694 (history)  Vaccinated:2003-04-16
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2007-07-15
Location:North Carolina  Entered:2007-07-24, Days after submission: 9
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None 8/15/07-records received-Bilateral leg pain begin in 9/9/05 after a motor vehicle accident during military service
Diagnostic Lab Data: see hospital records 8/15/07-records received EMG:abnormal study. Evidence of chronic right L5 radiculopathy with evidence of re-inervation.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 3UNUN
Administered by: Military     Purchased by: Military
Symptoms: Adjustment disorder, Anxiety, Arthralgia, Back pain, Bone pain, Convulsion, Electromyogram abnormal, Headache, Hypertriglyceridaemia, Hypoaesthesia, Lumbar radiculopathy, Meniscus lesion, Migraine, Nervous system disorder, Nervousness, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Dyslipidaemia (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Lipodystrophy (broad), Osteonecrosis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Headaches-migraine headaches bones pains-nervous conditions receiving treatment at hospital 8/15/07-records received DX: Back pain. Adjustment reaction with anxious mood. Derangement of lateral meniscus. Pain in knee. Lumbar Radiculopathy. Pure Hyperglyceridemia. 8/15/07-records received DX: Back pain. Adjustment reaction with anxious mood. Derangement of lateral meniscus. Pain in knee. Lumbar Radiculopathy. Pure Hyperglyceridemia. EMG:abnormal study. Evidence of chronic right L5 radiculopathy with evidence of re-inervation. Bilateral leg pain begin in 9/9/05 after a motor vehicle accident during military service. 1/11/2010 I have seizure headaches. Itching on my skin. Right arm pain and numbness, also E.D. and depression. 02/02/2010 Headaches, a lot of pain in BOHES, nose and right arm hurts.

VAERS ID:285909 (history)  Vaccinated:2007-05-02
Age:39.0  Onset:2007-07-06, Days after vaccination: 65
Gender:Female  Submitted:2007-07-21, Days after onset: 15
Location:Iowa  Entered:2007-07-25, 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: None
Preexisting Conditions: Allergic rhinitis, overactive bladder PMH: chronic low platelets
Diagnostic Lab Data: LABS: platelets 132
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0091U0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Contusion, Eye swelling, Eyelid ptosis, Facial palsy, Fatigue, Hypoaesthesia, Inappropriate schedule of drug administration, Off label use, Paraesthesia oral, Platelet count decreased, Rhinitis, Sinus congestion, Thrombocytopenia, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haematopoietic thrombocytopenia (narrow), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow)
Write-up: Diagnosed with Bells Palsy (paralysis on left side of face) Acyclovir 400 mg-1 tab 5 times a day Prednisone 20mg-2 tabs for 3 days 1.5 3 days, 1.0 3 days, 0.5 3 day. 8/14/07 Received vax record & VAERS database updated w/same. 9/11/07 Received medical records from clinic for visit on 7/6/07 which reveals patient experienced left eye swelling, left tongue numbness & left lower lip numbness. Had URI for approx 10 days, sinus congestion, rhinitisfatigued & easy bruising. Exam revealed left side eyelid drooping, inability to completely close left eye, flattening of nasal labial fold & left side lip drooping. Tx w/antiviral, prednisone. Referred to hematology. FINAL DX: Bell''s palsy, thrombocytopenia.

VAERS ID:286073 (history)  Vaccinated:2007-06-29
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2007-06-15
Location:New Jersey  Entered:2007-07-26, Days after submission: 41
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: NA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1091UNRA
Administered by: Military     Purchased by: Military
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Itchy rash started over waist spreading downward then up trunk. Resolved w/ Benadryl 25mg IM and PO Benadryl.

VAERS ID:286144 (history)  Vaccinated:1999-05-27
Age:39.0  Onset:1999-11-01, Days after vaccination: 158
Gender:Male  Submitted:2007-07-27, Days after onset: 2824
Location:Pennsylvania  Entered:2007-07-27
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: ACNE, ALCOHOL CONSUMPTION, ALLERGIC RHINITIS, ANKLE INJURY, ANKLE SWELLING, ARTHRITIS, BENIGN POSITIONAL VERTIGO, CHRONIC OTITIS MEDIA, CHRONIC SINUSITIS, DEGENERATIVE CHANGES OF ANKLE, ENURESIS, GRASS ALLERGY, HERNIORRHAPY, HIP DEGERNERATION, IRRITABLE BOWEL SYNDROME, LOW BACK PAIN, MENIERE''S DISEASE, MONONUCLEOSIS, NONSMOKER, OSTEOARTHRITIS OF HIP, PAIN IN HIP, POLLEN ALLERGY, PR
Diagnostic Lab Data: Erythrocyte Sedimentation Rate 16Feb2001 1mm/hr. 14 May 2000: Magnetic resonance imaging of the brain and internal auditory canals showed 1) no internal auditory canal masses or abnormal enhancement, 2) minimum subcortical white matter lesi
CDC Split Type: a0604570a
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 1UNUN
Administered by: Private     Purchased by: Other
Symptoms: Activities of daily living impaired, Amnesia, Arthralgia, Autoimmune disorder, Borrelia burgdorferi serology, Chronic sinusitis, Cognitive disorder, Cough, Dizziness, Ear discomfort, Fatigue, Headache, Influenza like illness, Insomnia, Joint stiffness, Joint swelling, Muscle atrophy, Muscular weakness, Musculoskeletal pain, Musculoskeletal stiffness, Myalgia, Nausea, Nervous system disorder, Nuclear magnetic resonance imaging brain normal, Paraesthesia, Postnasal drip, Radiculitis brachial, Red blood cell sedimentation rate decreased, Red blood cell sedimentation rate normal, Rhinorrhoea, Rotator cuff syndrome, Swelling, Tendonitis, Tinnitus, Vertigo, Weight decreased, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (narrow), Arthritis (broad)
Write-up: This case was reported by a lawyer and described the occurrence of joint pain in a male subject of unspecified age who was vaccinated with LYMErix, GlaxoSmithKline for prophylaxis. A physician or other health care professional has not verified this report. On an unspecified date the subject received unspecified dose of LYMErix (unknown). On an unspecified date after vaccination with LYMErix, the subject experienced joint pain, swelling, stiffness, flu-like symptoms, headaches, fatigue, dizziness, tingling in extremities, possible memory loss, decreased activities of daily life, and rheumatologic, neurologic, and/or cognitive impairment of an autoimmune, immune-mediated or other mechanism, all reported to be caused by vaccination with LYMErix. At the time of reporting the outcome of the events was unspecified. This information was received via a Statement of Injuries. Follow up information was received on 23 July 2007 via medical records. The subject was a 39-year-old male who was vaccinated with Lyme disease vaccine recombinant OspA (Lymerix, GlaxoSmithKline) on 29 April 1999 and 27 May 1999. The subject''s medical history included ankle injury and ankle swelling, arthritis, benign positional vertigo, chronic otitis media, chronic sinusitis, degenerative changes of ankle, enuresis, grass allergy, hip degeneration, low back pain, Meniere''s disease, osteoarthritis of hip (diagnosed August 1998) and hip pain, pollen allergy, pronated feet, shoulder dislocation, shoulder tendonitis, and bilateral subtalar fusion due to congenital bone abnormality. In November 1999, six months after vaccination with LYMErix, the subject experienced fatigue. Magnetic resonance imaging (MRI) of the brain on 14 May 2000 showed minimal subcortical white matter lesions. On 23 October 2000, he was evaluated for fatigue that limited his activity." Additional symptoms included headache, facial pressure, post nasal drainage, ear fullness and clicking, and cough. On 30 November 2000, the subject presented with a five day history of fairly severe

VAERS ID:286179 (history)  Vaccinated:2007-07-24
Age:39.0  Onset:2007-07-25, Days after vaccination: 1
Gender:Female  Submitted:2007-07-28, Days after onset: 3
Location:North Carolina  Entered:2007-07-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Amnesia, Arthralgia, Asthenia, Chest pain, Confusional state, Cough, Dehydration, Diarrhoea, Disorientation, Headache, Injection site erythema, Injection site pain, Injection site swelling, Myalgia, Pyrexia, Vomiting, Weight decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Severe diarrhea, severe dehydration, high fever, muscle and joint pain, vomiting, extreme weakness, headache, redness at injection site, swollen injection site, extreme soreness and tenderness at injection site and at portion of arm between shoulder and elbow, disorientation, confusion, loss of short term memory, cough, and minor chest/lung pain. Called doctor at onset of symptoms (diarrhea was the first symptom experienced approximately twenty one hours post vaccination). Was told that was not a likely symptom of an adverse reaction to a vaccination. Was not offered any help or assistance as doctor was moving his office. Called doctor on call on Friday, July 27. Was offered sympathy, but nothing more. Patient self treated with motrin and two Phenergren tablets supplied by a friend (one taken the evening of 7/25, the second taken the evening of 7/26). At time of vaccination, no consent form was signed by patient, none was offered by doctor, nor was any description of any adverse effects of vaccination given by doctor to patient. Patient has lost ten pounds since onset of symptoms.

VAERS ID:286375 (history)  Vaccinated:2007-07-26
Age:39.0  Onset:2007-07-27, Days after vaccination: 1
Gender:Male  Submitted:2007-07-30, Days after onset: 3
Location:Arizona  Entered:2007-07-30
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB443AA2IDLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0183U1SCRA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Dyspnoea, Joint stiffness, Lymphadenopathy, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: PT C/O OF FEVER 103,BODY ACHES,SOB,STIFFNESS IN JOINTS AND DIZZINES, SWOLLEN GLANDS

VAERS ID:286365 (history)  Vaccinated:2007-06-01
Age:39.0  Onset:2007-07-13, Days after vaccination: 42
Gender:Male  Submitted:2007-07-26, Days after onset: 13
Location:Unknown  Entered:2007-07-31, 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: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV106 SCLA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Dizziness
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Dizziness and chest pain

VAERS ID:286386 (history)  Vaccinated:2007-07-25
Age:39.0  Onset:0000-00-00
Gender:Unknown  Submitted:2007-07-31
Location:California  Entered:2007-07-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none~ ()~NULL~~In Patient
Other Medications: oral birth control
Current Illness: none
Preexisting Conditions: ampicillin
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB412AA5IMLA
Administered by: Public     Purchased by: Public
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: pt given 2nd series(2006-7) of 3 Hep B vac 6 years after 1st series completed (1999-2000)

VAERS ID:286596 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:2006-06-09
Gender:Female  Submitted:2007-07-30, Days after onset: 416
Location:Illinois  Entered:2007-08-02, 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: PPD
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0606USA01745
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Wrong drug administered
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a physician concerning a 39 year old female who on an unspecified date, "inadvertently received Pneumovax 23 vaccine intradermally instead of a Tuberculin Purified Protein Derivative injection". On 09-JUN-2006, the patient developed an erythematous area at the injection site which was several inches in diameter. The patient sought unspecified medical attention. The patient was treated with diphenhydramine hydrochloride (BENADRYL) and ibuprofen (MOTRIN). At the time of this report, the outcome of the event was unknown. The physician considered the event to be an other important medical event. Additional information has been requested.

VAERS ID:286600 (history)  Vaccinated:2006-06-14
Age:39.0  Onset:2006-06-14, Days after vaccination: 0
Gender:Female  Submitted:2007-07-30, Days after onset: 411
Location:Florida  Entered:2007-08-02, 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: Unknown
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: electrocardiogram normal
CDC Split Type: WAES0606USA02841
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Cough, Electrocardiogram normal, Injection site erythema, Pain in extremity, Wrong drug administered
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a physician''s assistant concerning a 39 year old female with an allergy to ofloxacin (FLOXIN) who on 14-JUN-2006 received a 0.1 mL dose of Pneumovax 23 intradermally instead of tuberculin purified protein derivative skin testing in error. When the patient woke up the morning of 15-JUN-2006, the patient''s arm was very sore. The patient had a 5 cm erythematous area at the injection site. She felt tightness on her chest and started coughing by lung time. The patient sought unspecified medical attention. An electrocardiogram was normal. The patient''s inflammation resolved in 72 hours, and the patient subsequently recovered. No additional information is expected.

VAERS ID:287250 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2007-07-30
Location:Unknown  Entered:2007-08-02, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0612USA01215
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Skin reaction
SMQs:, Hypersensitivity (narrow)
Write-up: This report was received form agency and was assigned manufacturer report number SR1-38257463 concerning a 39 year old female who on an unspecified date was vaccinated with Pneumovax 23. Subsequently, the patient developed a skin reaction at injection site. At the time of the event, the patient was also taking REBIF. At the time of this report, the outcome of the event was unknown. This was originally reported by a consumer. No further information is available.

VAERS ID:286771 (history)  Vaccinated:2005-07-12
Age:39.0  Onset:2005-07-13, Days after vaccination: 1
Gender:Male  Submitted:2007-08-05, Days after onset: 753
Location:New York  Entered:2007-08-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: peripheral neuropathy left leg
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Private     Purchased by: Private
Symptoms: Disorientation, Dyspnoea, Heart rate irregular, Hyperhidrosis, Nausea, Palpitations, Paralysis flaccid
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: 24 hours after injection:both arms and legs experienced flacid paralysis, breathing became labored, heart beat became erratic and pounding, nauseous, lump formed in my throat, sweated profusely all for 30 minutes. All symptoms subsided immediately after except for disorientation. I immediately called doctors office to inform them of the side effects. I walked four blocks to the doctors office and they informed me they were unaware of any side effects and if I became symptomatic again to go to the emergency room.

VAERS ID:287988 (history)  Vaccinated:2007-08-02
Age:39.0  Onset:2007-08-05, Days after vaccination: 3
Gender:Female  Submitted:2007-08-13, Days after onset: 8
Location:New Jersey  Entered:2007-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Injury to head
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2769AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Chills, Cough, Injection site erythema, Injection site pain, Wrong drug administered
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient developed pain, erythema and tenderness of r arm at site of vaccine injection. Patient also reported cough, temp of 100 F and chills.

VAERS ID:288036 (history)  Vaccinated:2007-08-08
Age:39.0  Onset:2007-08-08, Days after vaccination: 0
Gender:Female  Submitted:2007-08-13, Days after onset: 5
Location:Michigan  Entered:2007-08-14, Days after submission: 1
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOLOFT
Current Illness: None
Preexisting Conditions: Bee stings, Rye bread, Morphine, Compazine, Thorazine, Flexeril, Norflex. PMH: Anxiety, Ectopic Pregnancy, Migraine H/A, Stroke, Alpha-1-anti-trypsin deficiency cirrhosis, tonsillectomy, appendectomy, laparoscopy. Allergic to Kefles, Norflex, Thorazine, Compazine, morphine.
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB443AA1 RA
Administered by: Private     Purchased by: Private
Symptoms: Dysphagia, Dyspnoea, Hypersensitivity, Immunisation reaction, Oedema peripheral, Oxygen supplementation, Sensation of foreign body, Tachypnoea, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: C/O hives approximately 17 minutes after injection. Progressed to difficult breathing and difficult swallowing. EMS summoned, Epi pen used, O2, Benadryl. 10/22/2007 MR received for ER visit 8/8/2007 for DX allergic Reaction-drug. Within 15 of receiving Hep B vax pt had SOB, trouble swallowing, and swelling of arm. Similar reaction to bee stings. Pt used own epipen and was given po Benadryl. Transported by EMS to ER. Still feeling lump in throat and SOB upon arrival to ER. PE (+) for distress and tachypnea. Txd with solumedrol with improvement and short steroid burst with ranitidine for home. Weaned to RA and d/cd home.

VAERS ID:288040 (history)  Vaccinated:2007-08-09
Age:39.0  Onset:2007-08-10, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2007-08-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Severe local reaction~Td Adsorbed (no brand name)~~0~In Patient
Other Medications: BCP; Zoloft
Current Illness: No
Preexisting Conditions: Severe local reaction 1990s Td; allergic to seafood, Wellbutrin
Diagnostic Lab Data: Warm soaks, ice prn. Pt declines anything for pain, using OTC Motrin
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2759AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Haematoma, Injection site haemorrhage, Injection site pain, Subcutaneous nodule, Vaccine positive rechallenge
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Tenderness to site lt arm 7x4cm ecchymosis superficial, 2.5x2.5cm subcutaneous nodule ? hematoma - no cellulitis. Office appt 8-14-07 for above.

VAERS ID:288423 (history)  Vaccinated:2007-08-18
Age:39.0  Onset:2007-08-18, Days after vaccination: 0
Gender:Female  Submitted:2007-08-18, Days after onset: 0
Location:Texas  Entered:2007-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE AS STATED BY PATIENT
Preexisting Conditions: NONE AS STATED BY PATIENT
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0508F1IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2731AA0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ0572 IMRA
Administered by: Military     Purchased by: Military
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: After recieving vaccinations, pt stated she "feel like passing out". She sat down and moments later had a syncope episode with returning to consiousness apprx 1-2 min later. Oxygen was given, she was positioned supine with legs elevated, cool towels were applied and she was evaluated by the physician.

VAERS ID:288511 (history)  Vaccinated:2007-07-21
Age:39.0  Onset:2007-08-04, Days after vaccination: 14
Gender:Male  Submitted:2007-08-13, Days after onset: 9
Location:South Carolina  Entered:2007-08-20, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Chest pain, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Maculo papular rash across back and upper arms. Feeling chest pain/pressure. Rx: Antihistamine and Zantac. Had similar Sx after a previous anthrax vaccine.

VAERS ID:288864 (history)  Vaccinated:2007-08-15
Age:39.0  Onset:2007-08-16, Days after vaccination: 1
Gender:Female  Submitted:2007-08-17, Days after onset: 1
Location:Arizona  Entered:2007-08-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: DM, hyperlipidemia, Allergic Rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0038U UNUN
Administered by: Private     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: PPV 23 vaccine administered on 8/15/07 in (R) arm SQ. On 8/16/07 pt developed erythema, pain, and increased heat over int. (R) arm. Pt seen today 8/17/07. (R) arm 6.4 cm L x 5.6 cm W erythema

VAERS ID:289179 (history)  Vaccinated:2007-07-31
Age:39.0  Onset:2007-08-01, Days after vaccination: 1
Gender:Female  Submitted:2007-08-07, Days after onset: 6
Location:Washington  Entered:2007-08-28, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa 40 mg qd Ambien 5 mg at hs
Current Illness: None
Preexisting Conditions: sulfa-allergy-hives; itching; shellfish depression insomnia anaphylaxis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2731AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Headache, Injection site erythema, Injection site induration, Injection site pain, Injection site warmth, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: 8-1-07 25 mm x 20 mm red, indurated, heat and painful at injection site with body aches, HA. 8-2-07 c/o nausea, dizziness, induration decreased, still red at inj site. 8-3-07 induration decreased 10 x 15 mm: erythema 25 x 20-same. Still dizzy; nausea off/on

VAERS ID:289209 (history)  Vaccinated:2007-08-21
Age:39.0  Onset:2007-08-22, Days after vaccination: 1
Gender:Female  Submitted:2007-08-23, Days after onset: 1
Location:D.C.  Entered:2007-08-28, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2730AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site swelling, Lymphadenopathy, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Severe swelling to left deltoid region extending to anterior region of axilla.

VAERS ID:289334 (history)  Vaccinated:2007-08-03
Age:39.0  Onset:2007-08-06, Days after vaccination: 3
Gender:Female  Submitted:2007-08-29, Days after onset: 23
Location:New York  Entered:2007-08-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: none~ ()~NULL~~In Patient
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.104LF0SCRA
Administered by: Public     Purchased by: Private
Symptoms: Pyrexia, Varicella
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Several days after adminstration, fever broke out 102-103 degrees followed by full blown outbreak of chickenpox.

VAERS ID:289599 (history)  Vaccinated:2007-08-27
Age:39.0  Onset:2007-08-28, Days after vaccination: 1
Gender:Female  Submitted:2007-08-31, Days after onset: 3
Location:Connecticut  Entered:2007-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CYMBALTA, SYNTHROID, ADVIL, MULTI-VITAMIN
Current Illness:
Preexisting Conditions: CEPHALOSPORINS, E-MCYIN, PENICILLIN, SULFA DRUG, TETRACYCLINE, VANCOMYCIN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2759AA  LA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Erythema, Pyrexia, Rash maculo-papular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Day 1 - Fever, chills, rash; day 2 "hives" - seen day 2 and treated with Diphenhydramine 25mg q 6 hours, Ranitidine 75mg q 12 hours. Patient had fine maculo-papular rash over trunk and proximal limbs and erythematous patches, irregular and up to 6-8 cm diameter. Day 3 Patient reported Benadryl ineffective prescribed hydroxyzine in past was effected - patient switched to Hydroxyzine 25mg q 6 and day 4 almost completely resolved.

VAERS ID:289991 (history)  Vaccinated:2007-08-22
Age:39.0  Onset:2007-08-22, Days after vaccination: 0
Gender:Female  Submitted:2007-08-23, Days after onset: 1
Location:New York  Entered:2007-09-06, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac 40mg q d
Current Illness: Migraine headache
Preexisting Conditions: Depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2771AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Urticaria over arms, scalp, .5cm lesions. Tx: Benadryl 50mg IM, Allegra 180mg q d, Vistoril 50mg q 6h.

VAERS ID:290329 (history)  Vaccinated:2005-09-10
Age:39.0  Onset:2005-09-25, Days after vaccination: 15
Gender:Male  Submitted:2007-09-05, Days after onset: 710
Location:New Jersey  Entered:2007-09-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PMH: recurrent sinus infections Family hx: 3 sisters all w/chronic fatigue syndrome
Diagnostic Lab Data: Blood, CT Scan, Bone scans, X-rays, MRIs LABS: CBC, EKG all WNL. EGD revealed esophagitis, erosive gastritis & gastric ulcer. CT of sinuses revealed sinusitis. Total & direct bilirubin (H). Urine & blood c/s neg. C. diff (-). Serum
CDC Split Type:
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RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS3560111IMRA
Administered by: Other     Purchased by: Private
Symptoms: Aldolase increased, Anorexia, Arthralgia, Asthenia, Bilirubin conjugated, Blood bilirubin increased, Blood culture negative, Blood immunoglobulin E increased, Blood test, Blood testosterone decreased, Bone scan, Chest X-ray abnormal, Clostridium difficile toxin test, Computerised tomogram, Computerised tomogram abnormal, Culture urine negative, Depression, Diarrhoea, Echocardiogram normal, Electrocardiogram normal, Electroencephalogram normal, Exposure to communicable disease, Fatigue, Full blood count normal, Gastric ulcer, Gastritis, Immunoglobulins, Inflammation, Insomnia, Myalgia, Myositis, Night sweats, Nuclear magnetic resonance imaging, Oesophagitis, Oesophagogastroduodenoscopy, Pain, Pulmonary function test abnormal, Rash, Restrictive pulmonary disease, Sinusitis, Swelling, Ultrasound abdomen abnormal, Weight decreased, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal ulceration (narrow), Biliary system related investigations, signs and symptoms (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Pain, inflammation, swelling, weight loss, rashes, fatigue, insomnia, weakness, depression since onset have seen several specialists (from 9/25/05 to present) (multiple treatments). 10/2/07 Reviewed hospital medical records which reveal patient experienced diffuse body myalgias, arthralgias, pain in left subcostal area,intermittent diarrhea, night sweats, anorexia & weight loss of 52 # since 9/2005. Admitted 2/3/06-2/9/06. Had exposure to bat w/?rabies 9/2005 & received IVIG. GI, ENT, cardiology, pain management & psych consults done. Remain stable in hospital & d/c to home. FINAL DX: nonspecific myalgias & myositis; depression; mild restrictive lung disease; gastric ulcer disease; intermittent diarrhea; gastritis; esophagitis.

VAERS ID:291357 (history)  Vaccinated:2007-09-06
Age:39.0  Onset:2007-09-17, Days after vaccination: 11
Gender:Female  Submitted:2007-09-18, Days after onset: 1
Location:Indiana  Entered:2007-09-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Penicillin, asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0411U SCLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Local reaction, Nodule
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Local reaction left upper arm erythema nodule

VAERS ID:291710 (history)  Vaccinated:2007-08-30
Age:39.0  Onset:2007-09-02, Days after vaccination: 3
Gender:Female  Submitted:2007-10-01, Days after onset: 29
Location:Minnesota  Entered:2007-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: birth control pills
Current Illness: none
Preexisting Conditions: Allergic to penicillin & amoxicillin
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0762U0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pin point rash developed first on wrist and then spread from neck down to the rest of the body. The rash lasted one week. Patient did NOT seek medical care but just took OTC Benedryl.

VAERS ID:291991 (history)  Vaccinated:2007-09-04
Age:39.0  Onset:2007-09-13, Days after vaccination: 9
Gender:Female  Submitted:2007-10-03, Days after onset: 20
Location:California  Entered:2007-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.9722404 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2775AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injected limb mobility decreased
SMQs:
Write-up: On 9/4/07 Tdap and Hep B vaccines given in left deltoid. On 9/13/07 the patient''s husband called and reported that patient was unable to move left arm and had an appointment with a specialist. No further information available.

VAERS ID:292175 (history)  Vaccinated:2007-06-15
Age:39.0  Onset:2007-06-23, Days after vaccination: 8
Gender:Male  Submitted:2007-10-04, Days after onset: 103
Location:Unknown  Entered:2007-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CHEST X-RAY, CBC, UA, CMP, CHEM7.
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Military     Purchased by: Military
Symptoms: Body temperature increased, Chest X-ray, Cough, Full blood count, Injection site cellulitis, Injection site rash, Joint stiffness, Laboratory test, Malaise, Metabolic function test, Myalgia, Pneumonia, Rash maculo-papular
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: DAY 8 POST VACCINATION: ELEVATED TEMPERATURE x3 DAYS, GENERAL MALAISE, NON-PRODUCTIVE COUGH, JOINT TIGHTNESS, MUSCLE ACHES x3 DAYS. Rx:IBUPROFEN 800mg, AZITHROMYCIN 250mg. POSSIBLE PNEUMONIA Dx BY CHEST X-RAY. DAY 11 POST VACCINATION: RASH / CELLULITIS AROUND VACCINATION SITE ON LEFT UPPER EXTREMITY, MACULOPAPULOPUSTULAR LESIONS 1mm IN SIZE ON BOTH UPPER EXTREMITIES. TREATED IN E.R.; 2L, NS, TYLENOL, ROCEPHIN 1gr IM, Rx FOR SEPTRA. DAY 13 POST VACCINATION: SEEN IN CLINIC, A FEW NEW LESIONS NOTED. rX FOR RIFAMPIN 300mg.

VAERS ID:292182 (history)  Vaccinated:2007-10-01
Age:39.0  Onset:2007-10-01, Days after vaccination: 0
Gender:Female  Submitted:2007-10-04, Days after onset: 3
Location:Texas  Entered:2007-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denies
Preexisting Conditions: anemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2842AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache
SMQs:
Write-up: Reports significant headachce unrelieved by analgesics.

VAERS ID:292437 (history)  Vaccinated:2007-09-18
Age:39.0  Onset:2007-09-18, Days after vaccination: 0
Gender:Male  Submitted:2007-10-08, Days after onset: 20
Location:Oklahoma  Entered:2007-10-08
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
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB449AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash, Reaction to preservatives
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash and itching began approximately 2 hours after vaccine administration. It spread to entire body within 3 days. Patient was seen in Hospital emergency room with diagnosis of vaccine reaction on 9/21/07. He received diphenhydramine 50mg, rantidine 50mg, promethazine 50mg, methyl sod suc 125mg. He was discharged with RX for hydroxyzine 25mg, Prednisone 40mg, Zantac 150mg.

VAERS ID:292477 (history)  Vaccinated:2004-02-04
Age:39.0  Onset:2004-02-06, Days after vaccination: 2
Gender:Male  Submitted:2007-10-05, Days after onset: 1336
Location:Unknown  Entered:2007-10-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Reports has had MRIs, EMGs, EEG and multiple labs
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER 2SCUN
Administered by: Military     Purchased by: Military
Symptoms: Activities of daily living impaired, Amnesia, Arthralgia, Autonomic neuropathy, Back pain, Chronic fatigue syndrome, Cognitive disorder, Depression, Dizziness, Dysuria, Electroencephalogram, Electromyogram, Exercise tolerance decreased, Fibromyalgia, Insomnia, Kyphosis, Major depression, Malaise, Migraine, Muscle contractions involuntary, Muscle spasms, Myalgia, Nausea, Nuclear magnetic resonance imaging, Oral discomfort, Paraesthesia, Pollakiuria, Sleep disorder, Temporomandibular joint syndrome, Tinnitus, Vision blurred
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Osteoporosis/osteopenia (broad), Arthritis (narrow)
Write-up: Has new onset generalized fasciulations, migraine headaches and arthralgias since AVA # 5 (States the 1st 2 doses were given in 1991). Is on neurotin which has helped fasciulations to the point that he can now sleep. In on amitriptylene which have diminished migraine headaches to 2/week. Condition has caused abrupt change in lifestyle loss of flight status and ability to exercise. Symptom: Fatigue, Malaise, <60 Days Symptom: Abnormal sleep patterns, NOS Symptom: Headache, Migraine Symptom: Joint Pain, multiple joints Symptom: Tinnitus Symptom: Fasciculation Symptom: Dizziness Symptom; Depression Symptom: Memory loss, short term Has gone to develop autonomic neuropathy with involvement of the bladder, GI tract and CNS. 11/8/07-records received-received Anthrax vaccine #2 and simultaneously prescribed Ciprofloxacin for severe loose stools, while deployed. Resulting impairments and disability are temporally associated with his receipt of anthrax #2 and ciprofloxacin. His physical, mental and emotional impairment profoundly and significantly affect his personal, professional, social and economic status. He has constant pain and dizziness associated with medications for pain. Cognitive testing revealed cognitive functioning with normal limits. His performance tests of muscle strength and fine motor functioning fall in mildly impaired range. DX: cognitive disorder NOS, major depressive disorder, single episode in remission, migraine headaches, chronic fatigue syndrome, joint pain, myofascial pain/fibromyalgia. Tinnitus, nausea, burning sensation in mouth, insomnia NEC, blurred vision, vertigo central origin, lower back pain, TMJ syndrome, bilateral. Fasciculations, muslce spasms, tingling in extremities, dysuria, urinary frequency, osteoporosis, kyphosis, hyperlipdemia, constipation. These signs and symptoms have progressively worsened leading to serious and significant impact on the quality of life with probable permanent disability. Per 60 day follow up: Remains seriously ill & gradually worsening. Has autonomic neuropathy involving multiple body systems. Is 100% disabled.

VAERS ID:292529 (history)  Vaccinated:2007-10-08
Age:39.0  Onset:2007-10-08, Days after vaccination: 0
Gender:Female  Submitted:2007-10-09, Days after onset: 1
Location:Florida  Entered:2007-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB skin test given on 10/8/07.
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2488AA IMRA
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Got flu vaccine and PPD on 10/8/07 about 11am, Around 1pm noticed red spots around abdomen area, spreading to back, no itching, no swelling, no difficulty breathing. Rash gone by morning of 10/9/07

VAERS ID:292763 (history)  Vaccinated:2007-10-01
Age:39.0  Onset:2007-10-06, Days after vaccination: 5
Gender:Female  Submitted:2007-10-11, Days after onset: 5
Location:Florida  Entered:2007-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2451AA0UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Patient was vaccinated on 10-01-2007 and began to feel ill on 10-06-07.Patient missed work on 10-10-2007 and as of today is running a 103 fever. As of 10-10-2007 patient is drinking advil liquid gel, if fever persist patient will be taken to hospital tonight.

VAERS ID:293313 (history)  Vaccinated:2007-10-08
Age:39.0  Onset:2007-10-08, Days after vaccination: 0
Gender:Female  Submitted:2007-10-08, Days after onset: 0
Location:Utah  Entered:2007-10-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: said had cold, 1x vomiting 2 days ago
Preexisting Conditions: Seizures from traumatic brain
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2443AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Feeling drunk, Feeling jittery, Gait disturbance, Headache, Hypoaesthesia, Nervousness, Paraesthesia oral, Speech disorder
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad)
Write-up: "Woozy", hard time walking tongue feels "funny", headache, nervous, jittery, "drunk" hard time speaking, numbness in left pinkie.

VAERS ID:293428 (history)  Vaccinated:2007-08-22
Age:39.0  Onset:2007-08-25, Days after vaccination: 3
Gender:Male  Submitted:2007-10-17, Days after onset: 53
Location:Texas  Entered:2007-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: deep puncture wound left hand
Preexisting Conditions: psoriasis PMH: genital warts. Laceration of hand from barbed wire fence 2 wks prior to admit & received tetanus shot. Hyperlipidemia. Tobacco abuse.
Diagnostic Lab Data: lumbar puncture. MRI''s head, cervical, thoracic, and lumbar spine. LABS: MRI of c-spine revealed hyperintensity C3-4. MRI of thoracic & LS spine revealed mild disk disease. CT & MRI of head WNL.
CDC Split Type:
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TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD-156 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Hypoaesthesia, Lumbar puncture, Muscular weakness, Myelitis transverse, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging abnormal, Paraesthesia, Type 2 diabetes mellitus, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: Transverse myelitis, etiology unknown. Had weakness and numbness rising to mid chest level. Admitted to hospital 9/7/07. Discharged 9/12/07. Attending physician MD. Treated with steroids. Almost completely resolved at present. 10/19/07 Reviewed hospital medical records which reveal patient experienced progressive ascending paresthesias & weakness of lower extremities x approx 2 wks. Neurosurgery & neurology consults done. Admitted 9/7-9/12/2007. Tx w/high dose IV steroids. Improved on titrating oral steroids to pcp & neuro f/u. FINAL DX: Transverse myelitis; type 2 DM secondary to steroids; elevated WBC due to steroids.

VAERS ID:293643 (history)  Vaccinated:2007-10-02
Age:39.0  Onset:2007-10-02, Days after vaccination: 0
Gender:Female  Submitted:2007-10-18, Days after onset: 16
Location:Georgia  Entered:2007-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
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Dose
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1168F0SCRA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia, Hypoaesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Went numb on left side - beginning with tongue and lips - up into eye and ear - then into arm and leg and hand and foot. Stayed like that for about 3 hours. Days after - same effects occurred when consuming Triscuits, wheat thins, Deli Ham and Toco Bell

VAERS ID:293724 (history)  Vaccinated:2007-10-11
Age:39.0  Onset:2007-10-11, Days after vaccination: 0
Gender:Female  Submitted:2007-10-19, Days after onset: 8
Location:South Carolina  Entered:2007-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Protonix, Wellbutrin, Effexor, Zyrtec
Current Illness: None
Preexisting Conditions: Penicillin, Bactrim, Everything outside
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: Private
Symptoms: Erythema, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelled up the size of an egg, red, and very itchy. The itching drove me nuts because it hurt to touch it so I didn''t want to scratch it. The swelling, redness and pain have gone away but it still itches.

VAERS ID:293759 (history)  Vaccinated:2007-10-17
Age:39.0  Onset:2007-10-19, Days after vaccination: 2
Gender:Male  Submitted:2007-10-19, Days after onset: 0
Location:Pennsylvania  Entered:2007-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Denies
Current Illness: Denies illness and complaints
Preexisting Conditions: Denies. 6 months post-partem
Diagnostic Lab Data: None at this time
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA052AA IMLA
Administered by: Unknown     Purchased by: Public
Symptoms: Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 3 inch diameter area of erythema to left deltoid region. Warm to touch. No streaking. No drainage. Minimal swelling. Good, full range of motion. No changes in sensation or use of extremity. No rash, hives, respiratory complaints or itching.

VAERS ID:293834 (history)  Vaccinated:2007-09-10
Age:39.0  Onset:2007-09-20, Days after vaccination: 10
Gender:Male  Submitted:2007-10-18, Days after onset: 28
Location:Illinois  Entered:2007-10-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB183AA0IMRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURERTD-1620IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain, Rash pruritic, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Received vaccines on 9/10/07 before trip to abroad. Noticed subcutaneous bumps surfacing around 9/20/07. Had ~ 10 of these spread diffusely over torso. Reports pain and slight itching comparable to an acne breakout. Reports also a whitish drainage before the bumps healed. Acute stage bumps lasted about 1 week and then turned into scabbed bumps and healed. Denies fever associated with the bumps.

VAERS ID:294003 (history)  Vaccinated:2007-10-19
Age:39.0  Onset:2007-10-20, Days after vaccination: 1
Gender:Female  Submitted:2007-10-22, Days after onset: 2
Location:Virginia  Entered:2007-10-22
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: Asthma, ADD. HX FluMist administration in 2006 and gagged
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS 1IMLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Dizziness, Fear, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth, Pain, Pain in extremity, Tunnel vision
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Retinal disorders (narrow), Vestibular disorders (broad)
Write-up: Pt reported body aches and sore arm on Sat with egg size swelling, heat, redness to site on Sun and itching. Today swelling less but s/s persists. Denies n/v/d, dizziness, weakness, fever, sob, cp, or paresthesia. Did have episode of tunnel vision and weakness x 1 hr post vaccine attributed to fear of needles. Had white light in periphery as if going to faint, felt like was "sweating ice", but not diaphoretic, no airway obstruct or distress, no dysphagia. Onset about 5 min post vac lasting 1 hour then resolved. Was alone in office. Had never had reaction to vac/injection like this before. Denied any anaphylactic reactions. Works with newborns and is a nurse. Will come to HC for documentation purposes. Has allergy to chicken feathers, down pillows, all feathers (tested as child by pediatrician- pt never had skin testing), cats, long haired dogs...eyes swell and can''t breathe. Can eat eggs w/o problems. Did note this felt like Versed reaction when BP dropped out 66/42, sweating, distant hearing.

VAERS ID:294077 (history)  Vaccinated:2007-06-18
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2007-10-17
Location:New York  Entered:2007-10-22, 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: N/A
Current Illness: Nothing acute
Preexisting Conditions: HIV/AIDS, Kaposi Sarcoma, Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Private
Symptoms: Wrong drug administered
SMQs:
Write-up: Tdap ordered, DTaP given.

VAERS ID:294153 (history)  Vaccinated:2007-10-23
Age:39.0  Onset:2007-10-23, Days after vaccination: 0
Gender:Female  Submitted:2007-10-23, Days after onset: 0
Location:Wisconsin  Entered:2007-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin
Current Illness: none
Preexisting Conditions: Penicillin, seasonal
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA302BA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia facial
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: numbness in upper lip and lower nose

VAERS ID:294184 (history)  Vaccinated:2007-10-12
Age:39.0  Onset:2007-10-12, Days after vaccination: 0
Gender:Female  Submitted:2007-10-16, Days after onset: 4
Location:Kentucky  Entered:2007-10-23, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2464AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 1 1/2 - 2 1/2" red, raised area at injection site, warm to touch, itching. Injection on Friday - had to use inhaler q 4-6 hours until Sun PM - took chlortrimeton q 12 hours all weekend.

VAERS ID:294259 (history)  Vaccinated:2007-10-02
Age:39.0  Onset:2007-10-02, Days after vaccination: 0
Gender:Female  Submitted:2007-10-05, Days after onset: 3
Location:Texas  Entered:2007-10-24, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin 500mg
Current Illness: None
Preexisting Conditions: Tape allergy, diabetes, palpitations
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2731AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Site of administration is hot, red, very painful for 3 days +.

VAERS ID:294475 (history)  Vaccinated:2007-10-19
Age:39.0  Onset:2007-10-19, Days after vaccination: 0
Gender:Female  Submitted:2007-10-22, Days after onset: 3
Location:Pennsylvania  Entered:2007-10-25, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: hives~Hep B (no brand name)~2~34~In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2491AA UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Throat irritation, Tongue disorder, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: hives/urticarial w/in 15 minutes ER within 1 hr throat weird sensation tongue thick AL Alavert 10 mg 3 Epinephrine Rx Medrol dose pk IV fluids IV steroid Pepcid

VAERS ID:294712 (history)  Vaccinated:2007-10-26
Age:39.0  Onset:2007-10-26, Days after vaccination: 0
Gender:Female  Submitted:2007-10-29, Days after onset: 3
Location:Texas  Entered:2007-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa; Xanax; Ambien
Current Illness:
Preexisting Conditions: Depression
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2406AA1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: High fever, shivering, swollen at site of injection, redness to injection site, hard to touch.

VAERS ID:294765 (history)  Vaccinated:2007-10-10
Age:39.0  Onset:2007-10-10, Days after vaccination: 0
Gender:Female  Submitted:2007-10-11, Days after onset: 1
Location:Indiana  Entered:2007-10-29, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: COUMADIN; B12; VITAMIN B; MVI; LAMICTAL; CITRACEL; ELAVIL; CHANTIX
Current Illness: None
Preexisting Conditions: Protein S +C; PCOS; Hyperlipidemia; seizure disorder; sulfa; PCN; adhesive
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR42442AA2IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.099101IMRA
Administered by: Private     Purchased by: Private
Symptoms: Angioedema, Cellulitis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (narrow), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Angioedema right upper extremity, syncope, cellulitis

VAERS ID:295153 (history)  Vaccinated:2007-10-23
Age:39.0  Onset:2007-10-25, Days after vaccination: 2
Gender:Male  Submitted:2007-10-25, Days after onset: 0
Location:Nebraska  Entered:2007-10-31, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0411U SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1257U0SCRA
Administered by: Public     Purchased by: Unknown
Symptoms: Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Felt tenderness L upper arm while showering 10/25/07. Then, felt warmth and tenderness and area raised approx size of orange in Left upper arm.

VAERS ID:295250 (history)  Vaccinated:2007-10-31
Age:39.0  Onset:2007-10-31, Days after vaccination: 0
Gender:Female  Submitted:2007-10-31, Days after onset: 0
Location:Ohio  Entered:2007-11-01, 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: Remicaid; Advair; Lemp; Corgard; Folic acid
Current Illness: None
Preexisting Conditions: Allergy - Tylenol; Crohn''s disease; SVT; Asthma
Diagnostic Lab Data: - none - Have to continue Prednisone for 4 days
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Public     Purchased by: Private
Symptoms: Eye swelling, Loss of consciousness, Pruritus, Throat irritation, Urticaria, Wheezing
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Injection around 9:30 am began itching at 10:00 am. Full hives around 10:30, swollen eyes scratchy throat, wheezing. Took over counter Benadryl - no help. Passed out taken to ER - rev''d Epi-pen, IV Prednisone, Benadryl breathing at treatments

VAERS ID:295355 (history)  Vaccinated:2007-10-25
Age:39.0  Onset:2007-11-02, Days after vaccination: 8
Gender:Male  Submitted:2007-11-03, Days after onset: 1
Location:Unknown  Entered:2007-11-03
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: Manufacturer "MIP"
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV1141IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site swelling, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Large local reaction. Area of redness and swelling around site of injection 9.5cm X 11.5cm on upper right arm. Patient expected some swelling and redness, but became concerned 8 days after immunization when reaction seemed larger than he expected. Reaction site itches. No fever/chills, no other rash, no treatment needed.

VAERS ID:295560 (history)  Vaccinated:2007-10-03
Age:39.0  Onset:2007-10-05, Days after vaccination: 2
Gender:Female  Submitted:2007-10-28, Days after onset: 23
Location:California  Entered:2007-11-05, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CT scan; Blood panel and urine tests
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Other
Symptoms: Blood test, Computerised tomogram, Dizziness, Urine analysis, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Awakened by dizziness at 3:00am on Friday October 5. Dizziness and vomiting for 13 hours. Went to the emergency room at hospital. Dizziness lasted through October 7. with occasional dizzy spells the following week.

VAERS ID:295703 (history)  Vaccinated:2007-10-22
Age:39.0  Onset:2007-10-22, Days after vaccination: 0
Gender:Female  Submitted:2007-11-05, Days after onset: 14
Location:Georgia  Entered:2007-11-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2506AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Immediate post-injection reaction, Injected limb mobility decreased, Muscle spasms, Pain, Rotator cuff syndrome
SMQs:, Retroperitoneal fibrosis (broad), Dystonia (broad), Hypersensitivity (narrow)
Write-up: PATIENT STATES INJECTION DID NOT FEEL RIGHT FROM THE TIME IT WAS GIVEN. ACUTE ONSET OF PAIN @ 1PM BY EVENING WAS HAVING BACK SPASMS & BACK PAIN. COULD NOT LIFT LEFT ARM, PATIENT CALLED NFP NEXT DAY & INSTRUCTED TO CALL PRIMARY CARE PHYSICIAN. SEEN BY PCP 11/2/07 DX WITH INFLAMED ROTATOR CUFF, GIVEN IBUPROPHEN 800MG TID, ICE BID,& REFERRED TO PT. UNABLE TO GO @ PRESENT DOING HOME EXERCISES PER PCP''S INSTRUCTIONS.

VAERS ID:295713 (history)  Vaccinated:2007-10-30
Age:39.0  Onset:2007-10-30, Days after vaccination: 0
Gender:Male  Submitted:2007-11-06, Days after onset: 7
Location:Washington  Entered:2007-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2498AA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Pruritus, Throat irritation, Tongue oedema, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Pt complained fo itching and hives 20 minutes after receiving influenza vaccine. Pt was given Diphenhydramine 50mg po, 40min later pt had wheeezing, tingling in throat with some SOB and mild edema of tongue noted. Pt was given 125mg IV methylprednisolone and trasported to E.D. Pt kept over night and given a prednisone taper.

VAERS ID:295830 (history)  Vaccinated:2007-10-10
Age:39.0  Onset:2007-10-30, Days after vaccination: 20
Gender:Male  Submitted:2007-10-31, Days after onset: 1
Location:New York  Entered:2007-11-06, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: ordered Varicella titers; dermatology consult - agrees with above findings.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0806F1SCUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.118240SCUN
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Patient received Varicella vaccine on 10/10/07 and developed Varicella-like vesicular rash over face, trunk, back on 10/30/07.

VAERS ID:295895 (history)  Vaccinated:2007-11-03
Age:39.0  Onset:2007-11-03, Days after vaccination: 0
Gender:Female  Submitted:2007-11-07, Days after onset: 4
Location:Ohio  Entered:2007-11-07
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: Allergy to latex
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2505AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Injection site erythema, Sensory disturbance, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Shot given at 10:30a-on 11/3/07. Arm started feeling "funny" about 6p.m. Took Advil. Had red rash at site of bandaid. Woke up next morning with hives on torso. Had a "reverse sunburn" in bra area.

VAERS ID:296315 (history)  Vaccinated:2007-11-09
Age:39.0  Onset:2007-11-09, Days after vaccination: 0
Gender:Female  Submitted:2007-11-10, Days after onset: 1
Location:Kentucky  Entered:2007-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: n/a
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA049AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site swelling, Injection site vesicles, Injection site warmth, Local reaction, Similar reaction on previous exposure to drug, 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: Pt stated that had an event with flu vaccination 17 years ago, but has had several flu shots without incident since then. I verified 2 shots in the system. On 11/9/2006, at approximately 0900, after consulting me, I advised to give it. She received it, but within several minutes had a local reaction, with a 1 cm wheal (dark complexion makes for more difficult assessment). Noted swelling, redness, warm to touch, and blister at site of injection. Requested that the patient wait. I arrived approximately 0930 am with a frozen cold pack wrapped in a blue chucks. She applied this to the site. I advised that normal protocol would be to be monitor for 4 hours following the injection. Pt states that she felt better and that she was remaining on post. I instructed her to seek immediate care should she note symptome worsening or respiratory involvement. She called me at approximately 1700 to confirm that she is feeling fine.

VAERS ID:296526 (history)  Vaccinated:2007-11-09
Age:39.0  Onset:2007-11-10, Days after vaccination: 1
Gender:Female  Submitted:2007-11-13, Days after onset: 3
Location:Washington  Entered:2007-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Nickel allergie
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2515AA 6.30.08 IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Erythema, Feeling hot, Headache, Influenza like illness, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth, Skin irritation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: 11.09.07 12:30pm soreness, redness, swelling, hot where the shot was given, headaches; 11.10.07 am where the shot was given Skin irritation growth up to 3 x 3 cm and very hard, headaches, hot feeling, redness on skin of head and dekolte, light flu like symptoms - 4:00 pm weakness; 11.11.07 same symptoms as day before,where the shot was given Skin irritation growth up to 5 x 5 cm and very hot and hard, pm hives, strong flu like symptoms, 8:30 pm dizziness for about 5 minutes, nearly felt down; 11.12.07 same symptoms but less then the day before, no dizziness, pm - skin irritation shrinks and is less red and hot; 11.13.07 skin irritation nearly gone , not red and not hot, not hard anymore, hives, light flu like symptoms - feel much better. From 11.09.07 until 11.12.07 4 times a day 400mg Paracetamol, 300mg Ascorbins„ure, 50mg Coffein, 5mg Chlorphenaminhydrogenmaleat, 1 once a day, 1000mg Vitamin C, 35 drops of Umckaloabo = Perlargonium reniforme/sidoides 80,0g; 11.13.07 2 times a day 400mg Paracetamol, 300mg Ascorbins„ure, 50mg Coffein, 5mg Chlorphenaminhydrogenmaleat, 1 once a day, 1000mg Vitamin C, 35 drops of Umckaloabo = Perlargonium reniforme/sidoides 80,0g.

VAERS ID:296557 (history)  Vaccinated:2007-10-23
Age:39.0  Onset:2007-11-01, Days after vaccination: 9
Gender:Male  Submitted:2007-11-13, Days after onset: 12
Location:Virginia  Entered:2007-11-13
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to Sulfa medications; Hayfever. PMH: stomach virus 10/2007.
Diagnostic Lab Data: 11/5/07 CBC with Differential, CMP with cGFR, TSH and Lipid Panel all normal. 11/6/07 Nerve Conduction Studies and Needle EMG suggestive of an acute peripheral neuropathy with predominant demyelinative involvement of the motor fibers in the proximal and distal muscles. Labs and Diagnostics: EMG reveals mild acute denervation in proximal and distal muscles. NCS suggestive of acute peripheral neuropathy with predominant demyelinative involvement of motor fibers. CK 310. Borrelia burgdofii IGG (-) with Western Blot with 2 reactive bands. IGM (-).
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS812705IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Back pain, Blood creatine phosphokinase increased, Blood thyroid stimulating hormone normal, Borrelia burgdorferi serology negative, Chills, Electromyogram abnormal, Fatigue, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Hyporeflexia, Immunoglobulins, Laboratory test normal, Lipids normal, Muscular weakness, Nerve conduction studies abnormal, Pain, Pain in extremity, Pyrexia, Sensory loss
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow)
Write-up: 11/1/07. Initially had lower back pain and left arm pain. Following day low-grade fevers and chills x 24 hrs followed by pain/weakness in both thighs interfering with walking and achy, sharp pain in both forearms with bilateral hand weakness. Muscle weakness and pain interfered with his ability to walk, climb stairs, brush teeth, open a can, button a shirt and writing. No double vision, chewing difficulty, swallowing or shortness of breath. Muscle weakness and pain progressed. Saw PCP 11/5/07 who referred patient to neurologist r/o Guillain-Barre syndrome secondary to influenza vaccine. 11/6/07 evaluated by Neurologist who concluded patients'' clinical presentation and EPS findings (Needle EMG & Nerve Conduction)are suggestive of AIDP aka Guillain-Barre Syndrome. Neurologist recommended outpatient IVIG therapy, serum testing for Lyme titers, TSH, Campylobacter jejuni titers, vitamin B12 level and IgA level. After IVIG therapy, Physical Therapy for muscle strengthening and gait training is recommended. 11/14/2007 296557 -per nurse- pt has received flu vax for the past 5yrs with no reaction. Used different manufacturer this year. 11/19/2007 MR received from neurologist for OV of 11/06/2007. Pt presented with progressive muscle weakness x 3 days. Pt first noted back pain and L arm pain with low grade fever and chills. Pt then noted pain in thighs which interfered with walking and ability to climb stairs. Achy sharp pain noted in forearms and weakness in hands bilat. Difficulty with ADLs noted. PE (+) for muscle weaknes in extremities bilat. DTRs are decreased in arms and legs. Sensation decreased in stocking-glove distribution bilat. Mild walking difficulty. Txd with IVIG, PT and gait training. DX: Guillain-Barre Syndrome (AIDP). 1/19/2010 Able to ADL effortlessly. Continues to have muscles weakness and fatigue in legs and to lesser extent his arms.

VAERS ID:296881 (history)  Vaccinated:2007-11-12
Age:39.0  Onset:2007-11-14, Days after vaccination: 2
Gender:Male  Submitted:2007-11-15, Days after onset: 1
Location:Connecticut  Entered:2007-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Vaccine MFR 65K, Lot AFZZAO87AA
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERAFZZAO87AA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Injection site pain, Laryngitis, Productive cough, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: mild soreness at vaccination site (Right deltoid, note form says Left Deltoid). 2 days later, developed "closing of throat" sensation, followed by Laryngitis same day. Next day, voice was all but gone, and coughing up yellow mucus.

VAERS ID:296991 (history)  Vaccinated:2007-08-29
Age:39.0  Onset:2007-08-29, Days after vaccination: 0
Gender:Female  Submitted:2007-11-14, Days after onset: 77
Location:Virginia  Entered:2007-11-15, 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: Imitrex, Prozac, Singular, Relafen
Current Illness: NONE
Preexisting Conditions: Migranes, arthritis, chronic cough, depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TDAP: TDAP (ADACEL)SANOFI PASTEURC26769AA IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Cellulitis, Erythema, Local reaction, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Developed swelling, pain, redness to L arm late afternoon. Had received TDAP injection that morning. States swelling and redness increased seen in emergency department; 9/1/07 v.s. 98.7-90-18 116/70, Given vicodin, keflex, atarax Rx; Dx. Cellulitis of L Arm, Local Reaction To Vaccine Reported 11/14/07 on visit to office.

VAERS ID:297315 (history)  Vaccinated:2007-10-03
Age:39.0  Onset:2007-10-03, Days after vaccination: 0
Gender:Female  Submitted:2007-11-15, Days after onset: 43
Location:Texas  Entered:2007-11-19, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA042AA5IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pain, Pain in extremity
SMQs:
Write-up: Very uncomfortable aching all the way down my arm to finger tips lasted about 12-14 hrs.

VAERS ID:297732 (history)  Vaccinated:2007-11-26
Age:39.0  Onset:2007-11-26, Days after vaccination: 0
Gender:Male  Submitted:2007-11-26, Days after onset: 0
Location:Louisiana  Entered:2007-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB413AA3IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Chest discomfort, Hypoaesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Tightness in chest and weakness and numbness in right side. Symptoms occurred about 15 minutes after injection.

VAERS ID:298025 (history)  Vaccinated:2007-11-09
Age:39.0  Onset:2007-11-11, Days after vaccination: 2
Gender:Female  Submitted:2007-11-13, Days after onset: 2
Location:California  Entered:2007-11-28, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type: CA070037
Vaccination
Manufacturer
Lot
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TDAP: TDAP (ADACEL)SANOFI PASTEURA02759AA IM 
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Nodule, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient complained of red swollen arm; with nodules at the base of her left neck arm swollen from shoulder to elbow. Band of red about 4 inches wide around arm.

VAERS ID:298161 (history)  Vaccinated:2007-11-23
Age:39.0  Onset:2007-11-25, Days after vaccination: 2
Gender:Female  Submitted:2007-11-29, Days after onset: 4
Location:Colorado  Entered:2007-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Bentyl 40 mg TID; Tenormin 100mg HS
Current Illness: None
Preexisting Conditions: Irritable Bowl Syndrome; IHSS
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS808220IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Lymph node pain, Lymphadenopathy, Pain in extremity
SMQs:
Write-up: I recieved the vaccine at 4:30 pm on 11-23-07 in my left arm. On 11-25-07 I woke up with a baseball size lump under in my armpit. The lump was very tender and I was unable to use my arm or to move my arm without pain all day. My lymph nodes were also swollen and very tender. This condition has continued and as of this date I am still able to feel a lump in my armpit and I am unable to touch my armpit without pain. My lymph nodes remain swollen and on 11-26-07 the lymph nodes in my neck were swollen and very tender to touch. I have been taking tylenol but it does not help the pain. I also have been taking benedryl to try to decrease the swelling.

VAERS ID:298327 (history)  Vaccinated:2007-10-09
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2007-11-26
Location:Arizona  Entered:2007-11-30, Days after submission: 4
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: RST (+); treated 10/28 for strep throat with penicillin
Preexisting Conditions: None PMH: parental arthritis, CHF & HTN. Patient''s son w/JRA. Uncle w/GBS.
Diagnostic Lab Data: LABS in ER: ESR (H), CRP 84.1(H), (+) RST, ASO 491 (H), RA factor (-), throat c/s neg. LABS in hospital: CXR WNL. Sed rate max 111. CSF WBC 0, RBC 5, protein 54, glucose 49. Blood & csf c/s neg. MRI brain c/w demyelinating disease. MRI LS spine revealed L1-L2 DDD. Echocardiogram WNL.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2454AA IMUN
Administered by: Public     Purchased by: Public
Symptoms: Blood culture negative, C-reactive protein increased, CSF culture negative, CSF protein increased, Chest X-ray normal, Culture throat negative, Demyelination, Dyspnoea, Echocardiogram normal, Gait disturbance, Guillain-Barre syndrome, Hyperlipidaemia, Immunoglobulins, Joint swelling, Muscular weakness, Nuclear magnetic resonance imaging brain abnormal, Oedema peripheral, Pain in extremity, Paraesthesia, Pyrexia, Rash erythematous, Red blood cell sedimentation rate increased, Red blood cells CSF positive, Rheumatoid factor negative, Skin warm, Streptococcus identification test, Systemic inflammatory response syndrome, Transaminases increased, Urinary tract infection, Vitamin B12 deficiency
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Dyslipidaemia (narrow), Peripheral neuropathy (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Lipodystrophy (broad), Hypersensitivity (narrow), Arthritis (broad), Tumour lysis syndrome (broad)
Write-up: Pt got flu shot at outlying clinic 10/9/07. Presented to our facility 11/1/07 w/ lower extremity weakness and transferred to hospital - hospitalized there and w/u was consistent with Guillain-Barre syndrome - treated w/ IVIG w/ improvement. 12/7/07 Reviewed ER medical records which reveal patient experienced ankle swelling & pain, bilateral LE weakness, difficulty walking & fever. W/u for rheumatic fever & tx w/penicillin & high dose ASA w/o improvement. Transferred to higher level of care for further w/u of systemic inflammatory process, felt to be unlikely GBS due to (+) DTRs. 12/7/07 Reviewed hospital medical records which reveal patient experienced bilateral leg pain. Saw PCP, dx w/UTI & started antibiotics. Leg pain worsened & developed SOB, warmth & bilateral LE edema, weakness & flat red rash over the next 10 days. ER dx w/possible rheumatic fever. Tx w/penicillin & ASA. Had some imiprovement but when stopped ASA fever returned. Continued w/tingling of bilateral LEs. Returned to ER & transferred to higher level of care. Admitted 11/1-11/8/2007. Neuro consult obtained. Tx w/IVIG x 5 days. Improved & d/c to home. FINAL DX: Bilateral LE weakness, suspect Guillain-Barre syndrome; elevated transaminases; vitamin B12 deficiency; hyperlipidemia; elevated sed rate. CDC''s CISA staff has reviewed VAERS 298327 and concluded it is not GBS. Follow-up Information 16-DEC-2008: By chart review, no persistent neuro symptoms. I do not see this patient personally. Follow-up Information 18-DEC-2007: Pt was seen for problem on 1/1/07 - symptoms started several days prior.

VAERS ID:299201 (history)  Vaccinated:2007-11-15
Age:39.0  Onset:2007-11-15, Days after vaccination: 0
Gender:Male  Submitted:2007-12-07, Days after onset: 22
Location:Wisconsin  Entered:2007-12-10, 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:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS81111 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Unevaluable event
SMQs:
Write-up: None stated

VAERS ID:299214 (history)  Vaccinated:2007-12-08
Age:39.0  Onset:2007-12-08, Days after vaccination: 0
Gender:Male  Submitted:2007-12-11, Days after onset: 3
Location:Texas  Entered:2007-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1586SCLA
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500496P2IN 
Administered by: Military     Purchased by: Military
Symptoms: Dyspnoea, Erythema, Feeling abnormal, Injection site rash, Pharyngeal oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Received anthrax vaccination late morning Dec 8, 2007. Started feeling bad approx 2230 with "facial redness, shortness of breath, puffiness around throat, and rash around injection site. Member took Advil 400 mg. When speaking with Dr., member states he feels "back to normal."

VAERS ID:299740 (history)  Vaccinated:2007-11-14
Age:39.0  Onset:2007-11-15, Days after vaccination: 1
Gender:Female  Submitted:2007-12-14, Days after onset: 29
Location:Pennsylvania  Entered:2007-12-14
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
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2610AA0IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Local erethemya, swelling, hot to touch

VAERS ID:300033 (history)  Vaccinated:2007-12-10
Age:39.0  Onset:2007-12-10, Days after vaccination: 0
Gender:Male  Submitted:2007-12-17, Days after onset: 7
Location:Arizona  Entered:2007-12-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: HIV
Preexisting Conditions:
Diagnostic Lab Data: ER Visit
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Private     Purchased by: Public
Symptoms: Immediate post-injection reaction, Infection, Injection site discolouration, Injection site discomfort, Injection site erythema, Injection site induration, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Highly atypical Influenza vaccine. Vaccine felt like fire going in, and I could feel pain as the serum seeped through the muscle. Vaccination lasted longer than usual flu vaccine. Injection site turned red from the moment of injection and began to harden and get warm. Site closed and never abscessed, but around injection site and satellite areas were painful, hot and red. I went to the ER. The next morning still in level 3 pain. I started Cephalexin, and they gave me a prescription for Bactrim. I also covered the area with Bactroban ointment and a bandage. ER staff told me to draw a circle around redness which was about the diameter of a quarter. I was instructed to start the Bactrim immediately if it escaped the border. Within hours it had grown beyond the border. I started the Bactrim along with the Cephalexin. I felt an extreme level of tiredness, as if my body was having to fight with all it had. The next day the antibiotics had arrested the growth of the bacteria, and the area started turning a dark purple healing color and redness, tenderness, hardness, and heat went away from main lesion and satellite ones. I believe that this was an invasive soft tissue infection with no drain that could have become quite serious if the antibiotics had not been started one day after the infection. I have had many shots, administered allergy shots to myself. I have never had a shot be so sore for so long, and react the way that did. If it had only been bacteria from the skin, it probably would have abscessed and not had sub-dermal satellite areas that also never abscessed. I believe that that shot was contaminated with MRSA. I don''t know if Merck manufacture it, but there is contamination being reported in another of their vaccines. I feel lucky to be alive.

VAERS ID:300057 (history)  Vaccinated:2007-12-13
Age:39.0  Onset:2007-12-13, Days after vaccination: 0
Gender:Female  Submitted:2007-12-17, Days after onset: 4
Location:Minnesota  Entered:2007-12-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft, Singulair, Flovent, Nasonex, Klonopin, Tylenol, Advil, Excedrin, Maxair.
Current Illness:
Preexisting Conditions: Question hypothroidism, Question adrenal insufficiency, chronic insomnia, Eczema, Chronic headache, Question irritable bowel syndrome, Depression, Anxiety disorder, S/p tonsillectomy and adenoidectomy, S/p D & C.
Diagnostic Lab Data: none
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA311AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1084U0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injected limb mobility decreased, Lymphadenopathy, Oedema peripheral, Pain in extremity, Rash macular, Sleep disorder, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: 13 Dec 4 pm received injection; by 10 pm right arm was painful and it was difficult to sleep. 14Dec 6:30 am Advil not helping the pain; swelling started; couldn''t raise arm above shoulder. Through out that evening and night pain and edema worsened. 15 Dec early morning red, blotchy marks appeared over upper forearm and into shoulder area. Pain radiated down the arm, up into shoulder and across the back. Later that am was seen by local MD; right axillary lymphnodes were reportedly swollen, afebrile, Omnicef started. Continued to take Advil to help with pain. Red blotchy marks were gone after two days of Omnicef (17 Dec). Today (17 Dec) Still continues Advil. Pain and edema are still present but improving.

VAERS ID:300609 (history)  Vaccinated:2007-12-18
Age:39.0  Onset:2007-12-19, Days after vaccination: 1
Gender:Female  Submitted:2007-12-20, Days after onset: 1
Location:California  Entered:2007-12-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU2059AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Induration, 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), Hypersensitivity (broad)
Write-up: Redness, induration, swelling Right upper are. Laterally 3"X2" adenopathy; mild; fever. treated with Motrin; rest & reassurance

VAERS ID:300798 (history)  Vaccinated:2007-10-19
Age:39.0  Onset:2007-10-26, Days after vaccination: 7
Gender:Female  Submitted:2007-12-21, Days after onset: 56
Location:New York  Entered:2007-12-21
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 known allergies. The subject was unsure, but thought she did not have any adverse events following previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0700330A
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS 0UNUN
Administered by: Private     Purchased by: Private
Symptoms: Eye discharge, Eye irritation, Facial paresis, Ocular hyperaemia, Skin turgor decreased, Weight decreased
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Corneal disorders (broad)
Write-up: This case was reported by a consumer and described the occurrence of facial muscle weakness in a 39-year-old female subject who was vaccinated with Havrix for prophylaxis. A physician or other health care professional has not verified this report. Concurrent medications included DTP vaccine given the same day as Havrix. On 19 October 2007 at 12:00 the subject received 1st dose of Havrix (unknown, left arm) because she was traveling abroad. On 26 October 2007, 7 days after vaccination with Havrix, the subject experienced muscle weakness, loose skin, eye irritation, eye redness, eyes oozing and weight loss. This case was assessed as medically serious. At the time of reporting the events were unresolved.

VAERS ID:301655 (history)  Vaccinated:2007-10-04
Age:39.0  Onset:2007-10-05, Days after vaccination: 1
Gender:Female  Submitted:2007-10-17, Days after onset: 12
Location:Mississippi  Entered:2007-12-26, Days after submission: 70
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism
Diagnostic Lab Data: X-ray of left shoulder was normal.
CDC Split Type: 200703416
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2770A UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site pain, Musculoskeletal pain, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: A 39 year old female patient received on 04 October 2007 a dose of Adacel (Lot #C2770AA) intramuscular into the left arm. The next day, on 05 October 2007, she experienced injection site pain and pain in the entire left shoulder. The patient had full range of motion. X-ray of left shoulder was normal. Anti-inflammatory medication was prescribed. The patient''s medical history included hypothyroidism and the patient''s concomitant medications included Synthroid. The patient''s outcome was not reported.

VAERS ID:302105 (history)  Vaccinated:2007-10-04
Age:39.0  Onset:2007-10-04, Days after vaccination: 0
Gender:Male  Submitted:2007-12-21, Days after onset: 78
Location:Pennsylvania  Entered:2007-12-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0710USA01167
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Unevaluable event, Wrong drug administered
SMQs:
Write-up: Information has been received from a health professional concerning a 39 year old male who was vaccinated with zoster vaccine live (Oka/Merck) instead of VARIVAX. This was an error. The reporter did not know zoster vaccine live (Oka/Merck) was in the freezer and picked up the wrong vial. Medical attention was sought. The patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.

VAERS ID:301492 (history)  Vaccinated:2007-11-08
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2007-12-21
Location:Unknown  Entered:2008-01-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1104SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered, No adverse reaction
SMQs:
Write-up: Anthrax Lot # FAV110 administered after expired date due to administrative oversight. No adverse reaction at this time. Report submitted per milvax direction.

VAERS ID:301535 (history)  Vaccinated:2007-11-07
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2007-12-21
Location:Unknown  Entered:2008-01-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV110 SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: Anthrax lot #FAV110 administered after expired date due to administrative oversight. No adverse reaction at this time. Report submitted per milvax direction.

VAERS ID:301536 (history)  Vaccinated:2007-11-07
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2007-12-21
Location:Unknown  Entered:2008-01-02, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1104SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:
Write-up: Anthrax lot #FAV110 administered after expired date due to administrative oversight. No adverse reaction at this time. Report submitted per authority direction.

VAERS ID:301941 (history)  Vaccinated:2008-01-06
Age:39.0  Onset:2008-01-07, Days after vaccination: 1
Gender:Female  Submitted:2008-01-08, Days after onset: 1
Location:Washington  Entered:2008-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Soft tissue wound
Preexisting Conditions: Latex
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD1705IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Fatigue, Local reaction, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Local reaction plus system complaints of fatigue, myalgias and arthralgias.

VAERS ID:302203 (history)  Vaccinated:2008-01-07
Age:39.0  Onset:2008-01-09, Days after vaccination: 2
Gender:Female  Submitted:2008-01-10, Days after onset: 1
Location:Oklahoma  Entered:2008-01-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN 250 MG BID, MOTRIN 400MG PRN
Current Illness: DIFFUSED ABDOMINAL PAIN
Preexisting Conditions: PATIENT REQUESTED WANTS TO GET ANY ADULT IMMUNIZATIONS NEEDED, SHE DID NOT HAVE ANY VACCINATIONS AS A CHILD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR2863AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: PATIENT RECEIVED Tdap VACCINE ON 01/07/2008 IN RIGHT UPPER ARM. ON 01/09/2008 PATIENT CALLED CLINIC REPORTING SHE HAD REDNESS AND SWELLING AT THE INJECTION SITE "THE SIZE OF A BASEBALL"AND FEVER.

VAERS ID:303026 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2008-01-08
Location:Unknown  Entered:2008-01-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Hepatitis B antibody 2007 negative
CDC Split Type: A0657006A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 2UNLA
Administered by: Other     Purchased by: Other
Symptoms: Hepatitis B antibody negative, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of hepatitis b antibody negative in a 39-year-old female subject who was vaccinated with hepatitis B vaccine (manufacturer unspecified) for prophylaxis. On an unspecified date the subject completed the hepatitis B vaccine series. When tested in 2007, the subject''s titers came back showing non-protective levels for hepatitis B. No additional details were provided.

VAERS ID:303104 (history)  Vaccinated:2006-07-20
Age:39.0  Onset:2007-04-11, Days after vaccination: 265
Gender:Male  Submitted:2008-01-08, Days after onset: 272
Location:Iowa  Entered:2008-01-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: This case was reported by the same reporter in junction with another case of a subject not responding to therapy, case ID A0655093A.
Diagnostic Lab Data: On 11 April 2007, a titer was negative for immunity against hepatitis B.
CDC Split Type: A0655082A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB248BA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Laboratory test, No therapeutic response
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of not responding to therapy in a 39-year-old male subject who was vaccinated with Engerix B (GlaxoSmithKline) for prophylaxis. On 20 July 2006, 19 August 2006 and 26 January 2007 the subject received 1st dose, 2nd dose and 3rd dose of Engerix B (20 mcg, intramuscular, right and left deltoids). On 11 April 2007, 75 days after the 3rd vaccination with Engerix B, the subject had a titer drawn which was negative for immunity against hepatitis B. At the time of reporting the outcome of the event was unspecified. This case was reported by the same reporter in junction with another case of a subject not responding to therapy, case ID A0655093A.

VAERS ID:302975 (history)  Vaccinated:2008-01-11
Age:39.0  Onset:2008-01-11, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Texas  Entered:2008-01-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2493AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Dizziness, Immediate post-injection reaction, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Immediate dizziness, weakness, nausea-recovered in 1/2 hour. Head between knees and cold pack to neck were only treatment.

VAERS ID:302988 (history)  Vaccinated:2008-01-15
Age:39.0  Onset:2008-01-15, Days after vaccination: 0
Gender:Female  Submitted:2008-01-17, Days after onset: 2
Location:Indiana  Entered:2008-01-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergic to sulfa, Flagyl
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB443BA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Disorientation, Fall, Hot flush, Rash, Tremor, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hypersensitivity (narrow)
Write-up: 4 hours after injection developed red raised hive like rash on neck, under arms, groin area. 24 hours after injection became shaky, hot disoriented-fell forward at desk. Did not lose consciousness. Another episode about 4 hours later and third episode while at ER. Says episodes now less frequent. Had one this AM. On Benadryl.

VAERS ID:302962 (history)  Vaccinated:2007-09-17
Age:39.0  Onset:2007-09-18, Days after vaccination: 1
Gender:Male  Submitted:2008-01-18, Days after onset: 122
Location:California  Entered:2008-01-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: HTN
Diagnostic Lab Data: ESR 21 (0-10)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1100UNLA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Joint swelling, Malaise, Musculoskeletal pain, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pain, swelling and stiffness in wrist, fingers, knees and shoulders; Malaise.

VAERS ID:303236 (history)  Vaccinated:2008-01-02
Age:39.0  Onset:2008-01-03, Days after vaccination: 1
Gender:Female  Submitted:2008-01-14, Days after onset: 11
Location:North Carolina  Entered:2008-01-22, 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: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2720AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Breast pain, Breast swelling, Nipple pain
SMQs:, Angioedema (broad), Lipodystrophy (broad)
Write-up: Patient presents to clinic complaint of left sided soreness under arm and left breast and nipple soreness and swelling since 1/3/08. Observed left nipple soreness. Patient guarding during palpation of breast and under arm. Denies nipple discharge.

VAERS ID:303250 (history)  Vaccinated:2007-11-14
Age:39.0  Onset:2007-11-14, Days after vaccination: 0
Gender:Female  Submitted:2007-11-16, Days after onset: 2
Location:Indiana  Entered:2008-01-22, Days after submission: 67
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2497AA7UNLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: C/O itching (L) anterior arm below elbow. Approximately 1hr 15 minutes after receiving injection. No rash, swelling or discoloration noted. Redness not as signs of scratching at site. Ice pk applied with relief noted. Injection site no visible signs. Only slight redness where band aid was.

VAERS ID:303598 (history)  Vaccinated:2008-01-03
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-01-25
Location:Michigan  Entered:2008-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Patient was unsure of which tests completed.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB236AA0IMLA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01700SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2844AA0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA02210IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt received vaccines on 01-03-08, on 01-05-08, he began experiencing numbness to bilateral feet. By Sunday night his symptoms worsened, he went to ER on 01-07-08 at 1-2am at Health Center. The physician ran various lab test, all which came back normal. Patient left for a trip on 01-08-08 for 10 days. During his visit, his numbness traveled up his legs, by 01-16-08, his numbness had reached to his waist. On 01-18-08, I received a call from pt''s wife, who explained this adverse event to me and thought that maybe the vaccinations he had received early in the month had caused his symptoms. I spoke with pt. after he returned from his trip. Pt. states that he plans to go to his family doctor, at clinic. I received a call from pt. on 01-21-08, he stated that his Dr. was unsure if the tetanus vaccine had caused these symptoms, but thought it may be a possibility of the vaccine and the medication, Malarone that he is currently taking for Malaria prevention. Pt. states that he has begun to have some feeling return to his feet. He also said the Dr. did some back x-rays, as the numbness was also in his back. I talked to Pt''s wife on 01-25-08 and she states that his symptoms have not changed.

VAERS ID:303646 (history)  Vaccinated:2007-12-21
Age:39.0  Onset:2007-12-21, Days after vaccination: 0
Gender:Female  Submitted:2007-12-24, Days after onset: 3
Location:California  Entered:2008-01-26, Days after submission: 33
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: Allergic to seafood.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2771AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Large, painful swelling at vaccine site 10 x 13 cm over 3 days with joint pain on L arm & shoulder x $g3 days. Given Benadryl & local ice.

VAERS ID:304316 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:2007-10-17
Gender:Female  Submitted:2008-01-16, Days after onset: 91
Location:Oregon  Entered:2008-01-29, Days after submission: 13
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: The subject had received influenza virus vaccine in previous years with no subsequent adverse events. The subject''s medical history, concurrent conditions, and concurrent medications were not reported. The healthcare professional reported that 2 other subjects experienced injection site pain following administration of Flulaval. Please see cases A0691342A and A0691343A.
Diagnostic Lab Data: UNK
CDC Split Type: A0691341A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA066AA UNUN
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Pain in extremity, Pharmaceutical product complaint
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of injection site pain in an adult subject of unspecified gender who was vaccinated with Flulaval (GlaxoSmithKline) for prophylaxis. The subject''s medical history, concurrent conditions, and concurrent medications were not reported. No other vaccinations were administered on the date of Flulaval administration. The subject had received influenza virus vaccine in previous years with no subsequent adverse events. On an unspecified date the subject received unspecified dose of Flulaval (.5 ml, unknown, unknown arm). At an unspecified time after vaccination with Flulaval, the subject experienced injection site pain and product complaint. The subject returned to the clinic for further evaluation. The healthcare professional considered the events were disabling. The clinic used a 1 inch, 30 gauge needle to administer the vaccinations. The office is very concerned about using additional doses of this vaccine and believe there is a quality issue associated with it. The healthcare professional reported that the injection site pain lasted greater than two weeks. The outcome of the events was unspecified. Follow-up information received on 27 November 2007 indicated that the subject was a 39 year old female. The event of left arm pain was documented and the date of the earliest sign or symptom onset was recorded as 17 October 2007. The events were reportedly improved and considered by the reporter to be related to treatment with Flulaval. The events were initially reported as disabling and on follow-up, indicated to not be disabling. No other details were reported.

VAERS ID:303983 (history)  Vaccinated:2008-01-26
Age:39.0  Onset:2008-01-27, Days after vaccination: 1
Gender:Male  Submitted:2008-01-29, Days after onset: 2
Location:Unknown  Entered:2008-01-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: CBC; chem 30
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1326F1SCUN
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Cough, Eye pain, Full blood count, Headache, Laboratory test, Paraesthesia, Tremor
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad)
Write-up: Eye pain, tingling fingers, shakiness, dry cough, chills, headache.

VAERS ID:304530 (history)  Vaccinated:2008-01-31
Age:39.0  Onset:2008-02-01, Days after vaccination: 1
Gender:Female  Submitted:2008-02-07, Days after onset: 6
Location:Virginia  Entered:2008-02-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Latex allergy, banana allergy
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2766AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest discomfort, Injection site induration, Injection site pain, Lip swelling, Muscle spasms, Pruritus, Rash, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt developed pain at injection site approx. 36 hours after administration - hardened area without redness. Also had muscle spasms at site of injection. The next night she developed itching on her chest and trunk area, woke the morning after that with red rash on trunk and hives around her neck. Her throat was itchy, chest was tight, lips were swollen. Came to ER. Took a Clarinex, symptoms improved minimally but then got worse again. Later took a Zyrtec, went to bed. Woke feeling better.

VAERS ID:304838 (history)  Vaccinated:2007-12-18
Age:39.0  Onset:2008-01-09, Days after vaccination: 22
Gender:Female  Submitted:2008-02-13, Days after onset: 35
Location:California  Entered:2008-02-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper Respiratory Illness
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0808U0SCUN
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Patient received one dose of MMR on 12/18/07. She reports she had a minor URI at the time without fever and chills at the time of administration. She reports joint pain starting on 1/9/08, with joint swelling and pain that is transient and migrating. On 1/16/08, she reports to Occupational Health Services stating she had 2-7/10 pain of the right wrist. Pain was achy and did not radiate. Pain was exacerbated by lifting objects. She denied any rash or other issues. She had full range of motion of shoulders, wrists, fingers, hips, knees, and ankles at 1/16/08. Ibuporfen 600mg PO TID with food was prescribed. On 1/18/08, the patient reported that her symptoms had subsided. No residual findings referrable to vaccination were found during exam on 1/18/08.

VAERS ID:304994 (history)  Vaccinated:2008-02-04
Age:39.0  Onset:2008-02-08, Days after vaccination: 4
Gender:Female  Submitted:2008-02-12, Days after onset: 4
Location:Texas  Entered:2008-02-14, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: No~ ()~~0~In Patient|No~ ()~~0~In Sibling|No~ ()~~0~In Sibling
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2454AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Discomfort, Erythema, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: On 2-11-08 pt walks in to clinic to show Lt arm. Redness, warm to touch noted about 2 1/2 inches below injection site. Pt states felt discomfort the night of injection given. On (2/5/08) pt felt discomfort and took Tylenol & applied warm towel 3-5 min. at night. On 2-6 & 2-7-08 also felt discomfort but also itchy. On 2-8-08 pt noted redness & warm to touch below injection site only. On 2-9 & 2-10-08 with redness & warm to touch. On 2-11-08 redness decreased. Pt applied hydrocortisone cream for itching. On 2-12-08 redness & itching gone. On 2-13-08 pt denies any complaint. Denies numbness, tingling; good ROM; no distress voiced from pt.

VAERS ID:305178 (history)  Vaccinated:2007-12-28
Age:39.0  Onset:2008-01-01, Days after vaccination: 4
Gender:Female  Submitted:2008-02-19, Days after onset: 49
Location:Virgin Islands  Entered:2008-02-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Allergy: NSAIDS
Diagnostic Lab Data: Normal x-ray to wrist.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0526U SCRA
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, X-ray
SMQs:, Arthritis (broad)
Write-up: Joint pain right wrist.

VAERS ID:305477 (history)  Vaccinated:2008-02-21
Age:39.0  Onset:2008-02-21, Days after vaccination: 0
Gender:Male  Submitted:2008-02-22, Days after onset: 1
Location:Oregon  Entered:2008-02-22
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anger, Asthenia, Nausea, Pain, Throat irritation, Vertigo
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (narrow), Vestibular disorders (narrow)
Write-up: Same day loss of energy, next day scratchy throat, body aches, head spinning, disoriented, slight nuasea, making mistakes at work, easily upset (angry). Asked to sent home early.

VAERS ID:306580 (history)  Vaccinated:2007-10-25
Age:39.0  Onset:2007-10-29, Days after vaccination: 4
Gender:Female  Submitted:2008-03-06, Days after onset: 129
Location:Texas  Entered:2008-03-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Levoxyl 75 mcg
Current Illness: None
Preexisting Conditions: MVP, High ANA, allergies, Hashimoto''s Disease
Diagnostic Lab Data: 11/2 - Skin biopsy performed. Positive for shingles.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURY2492AA UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Biopsy skin abnormal, Herpes zoster
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Skin tumours of unspecified malignancy (broad)
Write-up: Flu shot given on 10/25/07. On 10/29/07 developed shingles. Treated with antiviral, made full recovery. I don''t think the flu shot "caused" the shingles, but may have resulted in a weakened immune system that would allow shingles to develop.

VAERS ID:306640 (history)  Vaccinated:2008-02-19
Age:39.0  Onset:2008-02-20, Days after vaccination: 1
Gender:Female  Submitted:2008-03-04, Days after onset: 13
Location:California  Entered:2008-03-07, Days after submission: 3
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
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB080C IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2864AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Diffuse arthralgias after TdAP onset 2/20/08. (Vaccination was 2/19/08).

VAERS ID:307059 (history)  Vaccinated:2007-10-30
Age:39.0  Onset:2007-10-30, Days after vaccination: 0
Gender:Female  Submitted:2008-03-04, Days after onset: 126
Location:New York  Entered:2008-03-14, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: The patient was on no other medications.
Current Illness: The patient had no illness at the time of vaccination.
Preexisting Conditions: The patient had no illness at the time of vaccination, was on no other medications, and had no past medical conditions.
Diagnostic Lab Data:
CDC Split Type: 200800634
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2862A IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site reaction, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: Localised muscle weakness, muscle pain, injection site reaction.

VAERS ID:307168 (history)  Vaccinated:2007-09-06
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2008-03-14
Location:Unknown  Entered:2008-03-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Gastrooesophageal reflux disease; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions: Depression PMH: allergies to erythromycin, biaxin & demerol. LGSIL 7/05. Interstitial cystitis.
Diagnostic Lab Data: Abdominal computed; X-ray; Echocardiography; Bone marrow biopsy; Body temperature $g100 deg LABS: pap smear 9/5 neg. LABS: CBC, CRP, ANA & chemistry WNL. Blood c/s neg. RA (-). Hep B surface AB (+). TSH 6.42 (H). Urine c/s (+) for enterococcus. Burgdorferi (-). Cancer antigen 125 16.9 (H). Echocardiogram WNL. EGD revealed colon polyps, biopsies of stomach, duodenum & esophagus done & revealed only mild reflux esophagitis. Abdomen/pelvis CT scan, CXR & pelvic US WNL.
CDC Split Type: WAES0803USA01222
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0530U0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal X-ray, Abdominal pain, Abnormal faeces, Activities of daily living impaired, Antinuclear antibody negative, Biopsy, Biopsy bone marrow, Blood culture negative, Blood thyroid stimulating hormone increased, Body temperature increased, Borrelia burgdorferi serology negative, Carbohydrate antigen 125 increased, Chest X-ray normal, Chills, Computerised tomogram normal, Culture urine positive, Echocardiogram normal, Enterococcal infection, Fatigue, Full blood count normal, Hepatitis B antibody, Insomnia, Laboratory test normal, Lethargy, Malaise, Oesophagogastroduodenoscopy, Pain, Polyp colorectal, Pyrexia, Reflux oesophagitis, Rheumatoid factor negative, Ultrasound pelvis, Ultrasound scan normal
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal premalignant disorders (narrow), Tumour markers (narrow), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypothyroidism (broad), Hyperthyroidism (broad), Uterine and fallopian tube malignant tumours (broad), Noninfectious diarrhoea (broad)
Write-up: Information has been received from a physician, concerning herself, a 40 year old female with gastrooesophageal reflux disease, drug hypersensitivity to meperidine (DEMEROL), erythromycin and clarithromycin (BIAXIN), and a history of depression, who on 05-SEP-2007 was vaccinated IM with the first dose of Gardasil (lot # not reported). Concomitant therapy included esomeprazole magnesium (NEXIUM), mirtazapine (REMERON) and alprazolam (XANAX). In approximately September 2007 ("following the vaccination"), the physician felt lethargic and couldn''t sleep. On 06-NOV-2007 she was vaccinated IM with the second dose of Gardasil (lot #655154/1210U). Following the second dose, she developed fevers greater than 100 degrees F, which have continued for 4 months, along with body pain and rigors. She had diagnostic labs and testing performed, including a computed axial tomography (CAT) scan of the chest and abdomen, x-ray, echocardiogram and bone marrow biopsy (dates and results not provided). The physician stated she hadn''t been able to work for 3 months, due to her significant malaise. She reported seeing another physician (details not provided). At the time of this report, the physician had not recovered from the events. The physician indicated that the events were serious as disabling. Additional information has been requested. 4/11/08 Received OB/GYN medical records of 8/23/07 & labs of 9/5/07. 4/15/08 Received primary GYN record of 11/6/07 where received HPV #2, 1210U left deltoid. Reported no side effects from HPV #1. 5/30/08 Reviewed PCP medical records from 7/2007-3/2008 which reveal patient experienced depression & under psych care. Unable to work. In 11/2007, had fever x 5 days, abdominal cramping & increased stools. Tx w/meds & improved until fever returned 12/2007 W/HA & severe fatigue. Meds adjusted & felt better by 1/2008. Fever recurred 2-3/2008 PCP felt could be related to psych meds. Meds adjusted. ID & GYN consult done. No dx stated. Felt better & was able to return to work 4/2008.

VAERS ID:307220 (history)  Vaccinated:2008-02-28
Age:39.0  Onset:2008-02-29, Days after vaccination: 1
Gender:Female  Submitted:2008-03-05, Days after onset: 5
Location:Florida  Entered:2008-03-17, 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: Kaletra; Sustra; Acyclovir; Epivir; Ambien; Ecasa; Paxil
Current Illness: Cellulitis of injection site
Preexisting Conditions: Ziagen; Levaquin; PCN; Sulfa; Clinaril; Duricef; Doxycycline; Dapsene
Diagnostic Lab Data: CBC done at hospital.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1132U3IMRA
Administered by: Public     Purchased by: Private
Symptoms: Cellulitis, Erythema, Full blood count, Lymphangitis, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: High fevers (102.8 F); localized erythema right deltoid with lymphangitis and cellulitis. Came to clinic 3/3/08 and was sent directly to ED where she was kept overnight on Vancomycin and released home the next morning on P.O. antibiotics. T.C. to patient 3/6/08 "feeling fine. Just a little tired."

VAERS ID:307770 (history)  Vaccinated:2006-12-11
Age:39.0  Onset:2006-12-30, Days after vaccination: 19
Gender:Female  Submitted:2008-03-23, Days after onset: 448
Location:Florida  Entered:2008-03-23
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none. PMH: smoker, 2 miscarriages. NKDA.
Diagnostic Lab Data: Creatine Kinase levels were in the 7,000''s in June of 2006. Elevated AST levels (74) Bone Density test showed bone loss in neck and femurs, spine was at 0. PET scan showed no signs of cancer. All Hepatitis tests were negative along with HIV. Muscle Bioposy shows muscle damage of unknown kind, Labs and Diagnostics: EMG abnormal: severe myopathy with fibrillation potentials suggestive of ongoing mild necrosis or fiber splitting. Muscle biopsy abnormal: Myopathy, active, severe type undetermined w/o evidence of inflammation. Type 2B Fiber atrophy. Denervation atrophy. PET scan No evidence of hypermetabolic foci. CK 2831-5000. AST 190. ALT 165. Creatinine 0.4. Aldolase 104.3 (H). A2 Glob 1.1 (H).
CDC Split Type:
Vaccination
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS707390UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Alanine aminotransferase increased, Aldolase increased, Alpha 2 globulin abnormal, Arthralgia, Aspartate aminotransferase increased, Biopsy muscle abnormal, Blood creatine phosphokinase increased, Blood creatinine decreased, Bone density decreased, Bone pain, Decreased appetite, Electromyogram abnormal, Erythema, Fall, Fatigue, Gait disturbance, HIV antibody negative, Hepatitis A antibody negative, Hepatitis B test negative, Hepatitis C test negative, Joint range of motion decreased, Mood altered, Muscle atrophy, Muscle necrosis, Muscular weakness, Myalgia, Myopathy, Pain, Pain in extremity, Positron emission tomogram normal, Rash, Sleep disorder
SMQs:, Rhabdomyolysis/myopathy (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Osteoporosis/osteopenia (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: The day after the vaccine, my left arm hurt. Approximately two to three weeks later, I experienced extreme fatigue and muscle weakness. I seen three doctors before going to the clinic. My muscles wasted away in my shoulders and my left hip was in pain and I limped. I could not dress myself, tie my shoes, wash my hair and could barely drive my vehicle. I am unable to walk up stairs and walk a long distance. I fall alot and am not strong enough to pick myself up. My shoulder bones hurt and ache constantly. I was put on Prednisone in June of 2007 and underwent pt and ot therapy, to no avail. In December of 2007, I was also put on Lyrica and Boniva in February. I went back to the Clinic and they now put me on Methotrexate along with the prednisone, Lyrica and Boniva. I am still not functionable. 04/04/2008 MR received for several OVs between 4/19/2008 and 2/28/2008 with DX: necrotizing myopathy. Pt reports myalgias and upper extremity weakness beginning a few days after Flu shot 12/11/06 and worsening over the next months. Requiring assistance with ADL and work related activities. Significant functional impairment noted. PE(+) for Proximal upper limbs/shoulder girdle atrophy with significant weakness. Unable to fully abduct shoulders. Proximal weakness of lower limbs. Some improvement with prednisone, however has had several recent falls. Sleep is disturbed. Appetite poor. Depressed affect. Pt developed rash on chest 2/2008 as well as erythema over the knuckles. ? dematomyositis.

VAERS ID:307979 (history)  Vaccinated:2008-03-21
Age:39.0  Onset:2008-03-21, Days after vaccination: 0
Gender:Male  Submitted:2008-03-24, Days after onset: 3
Location:Wisconsin  Entered:2008-03-24
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: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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Dose
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1636SCUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA022122IMUN
Administered by: Military     Purchased by: Military
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: Pt received a 7th dose of Anthrax in error on 3/21/08 and a Typhoid dose on 3/21/08 when he had previously received a Typhoid dose on 1/12/08.

VAERS ID:308951 (history)  Vaccinated:2008-04-03
Age:39.0  Onset:2008-04-03, Days after vaccination: 0
Gender:Male  Submitted:2008-04-05, Days after onset: 2
Location:Washington  Entered:2008-04-05
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
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TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Insomnia, Nausea, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: I got a routine tetanus shot as part of general check-up. The first day after the shot I was fine, but by evening time and in the two days that followed, my arm has been in pretty extreme pain. It''s been getting worse. I can hardly lift my arm at all and can reach barely my mid chest. I am unable to sleep because every moment I make hurts. It''s swollen and very hard to feel. Last night I even had a nausea attack and almost vomited. I have not vomited in many many years. I''m waiting for the pain to subside.

VAERS ID:309066 (history)  Vaccinated:2008-03-31
Age:39.0  Onset:2008-04-01, Days after vaccination: 1
Gender:Female  Submitted:2008-04-07, Days after onset: 6
Location:North Carolina  Entered:2008-04-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol Inhaler (PRN)
Current Illness: None
Preexisting Conditions: Seasonal allergies; heart murmur.
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1482U1SCUN
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2287CA1IMUN
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Headache, Nausea, Oedema, Pain, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: The day after vaccination, experienced severe headache, nausea, edema of left upper arm and left axilla. Area of redness, slightly elevated approximately 2.5 inches x 1/2 - 1/4 inch in width noted in left upper arm below injection site. States also radiating pain in left shoulder/neck. Has applied moist heat to area and to arm. Ibuprofen for discomfort.

VAERS ID:309159 (history)  Vaccinated:2008-03-27
Age:39.0  Onset:2008-03-28, Days after vaccination: 1
Gender:Male  Submitted:2008-04-02, Days after onset: 5
Location:Texas  Entered:2008-04-08, 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: None reported
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS4380117C0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: Plasma donor reported by phone a rash that developed the morning after a rabies immunization was performed. The pt reported the rash was similar to "chicken pox" in its appearance and feel. Pt stated he had.

VAERS ID:309197 (history)  Vaccinated:2008-04-05
Age:39.0  Onset:2008-04-05, Days after vaccination: 0
Gender:Female  Submitted:2008-04-08, Days after onset: 3
Location:Pennsylvania  Entered:2008-04-09, 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: Laceration left index finger
Preexisting Conditions: Crohn''s disease; renal calculi; drug allergies iodine, codeine, PCN, Keflex
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2027AA IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt. received DT immunization (0.5 cc) for prophylaxis treatment s/p laceration on 04/05/08. Returned to ED c/o pain, swelling, redness right arm on 04/07/08. Treated and released.

VAERS ID:309210 (history)  Vaccinated:2008-03-18
Age:39.0  Onset:2008-03-18, Days after vaccination: 0
Gender:Female  Submitted:2008-04-09, Days after onset: 22
Location:California  Entered:2008-04-09
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: HTN, Dyslipidemia, Asthma, DM
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1132U IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Injection site erythema, Injection site pain
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: On follow up visit of 4/1/08 patient stated after vaccine experienced pain, redness at injection site and exacerbation of asthma symptoms with improved after using inhalers.

VAERS ID:309874 (history)  Vaccinated:2008-04-16
Age:39.0  Onset:2008-04-17, Days after vaccination: 1
Gender:Male  Submitted:2008-04-17, Days after onset: 0
Location:Florida  Entered:2008-04-17
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2563AA1IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA044622IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient was administered two vaccines, Typhim VI and Menactra on 04/16/2008 at 5:30PM. At 1:00AM on 4/17/2008 the patient awoke with pruritis and and a ill defined rash on his trunk, arms, and upper thighs. There were no respiratory or other symptoms noted. The patient presented to the Occupational Health Clinic at approximately 9:00AM on 4/17/2008 with the same complaint of itching. He reported that he had taken no medications for his symptoms, although at approximately 7:00PM on 4/16/2008 he had taken Mobic 7.5MG for an ankle injury. He reports that he just started taking this medication a "couple of days before" as prescribed by his orthopaedic physician. There were no signs of respiratory distress. After assessment the patient was given 50 MG of PO Benadryl. On follow up with the patient at 10:30AM on 4/17/2008 he was asymptomatic. The patient was told to follow up with his physician and to contact this provider if there were any further issues.

VAERS ID:310226 (history)  Vaccinated:2008-04-11
Age:39.0  Onset:2008-04-11, Days after vaccination: 0
Gender:Male  Submitted:2008-04-11, Days after onset: 0
Location:Wisconsin  Entered:2008-04-18, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU2019AB0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Donor became pale and lighthead 15 min after vaccination. Donor assisted to bed and placed supine. Diaphoretic. No LOC. Vitals taken. No nausea. Donor felt better after 27 min. and was released.

VAERS ID:310933 (history)  Vaccinated:2007-03-28
Age:39.0  Onset:2007-04-05, Days after vaccination: 8
Gender:Male  Submitted:2008-04-25, Days after onset: 386
Location:Virginia  Entered:2008-04-25
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: Had chills for four days.
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Pain, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: I felt like I got the flu. Had a running nose, felt aches and joint pains along with a fever. It lasted seven days.

VAERS ID:311404 (history)  Vaccinated:2008-03-25
Age:39.0  Onset:2008-03-27, Days after vaccination: 2
Gender:Female  Submitted:2008-05-01, Days after onset: 35
Location:Indiana  Entered:2008-05-01
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: MD called department stating may be swollen lymph node. Will continue to follow up with patient.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2152CA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Induration, Injection site pain, Neck pain, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Two days later she stopped by office to show at the base of her neck, on the right side, patient has about 3x3 slightly swollen area, 1" area in the middle very firm. Entire area "very tender". Patient states has been moving right arm "quite a bit" since receiving TD vaccine on 3/25/08. Pain began "last night". Pain runs from R deltoid, across shoulder, and up side of neck, no other c/o. Instructed to call family MD.

VAERS ID:311872 (history)  Vaccinated:2003-05-01
Age:39.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:Puerto Rico  Entered:2008-05-08
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
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Balance disorder, Dizziness, Headache, Hypertension, Nausea, Pain, Vertigo
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (narrow), Arthritis (broad)
Write-up: Headache frequently, nausea, dizziness & vertigo. Pain in the joints all the body, body aching, losing balance, high blood pressure.

VAERS ID:311963 (history)  Vaccinated:2008-04-29
Age:39.0  Onset:2008-05-05, Days after vaccination: 6
Gender:Female  Submitted:2008-05-06, Days after onset: 1
Location:Kentucky  Entered:2008-05-09, 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: KFlex
Current Illness: none
Preexisting Conditions: DM
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2067AA UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Back pain, Neck pain, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Arthritis (broad)
Write-up: Complained of soreness in back, hips, arms and neck.

VAERS ID:312117 (history)  Vaccinated:2008-05-01
Age:39.0  Onset:2008-05-01, Days after vaccination: 0
Gender:Female  Submitted:2008-05-05, Days after onset: 4
Location:South Carolina  Entered:2008-05-12, 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: Allergy serum .50cc SQ every week
Current Illness:
Preexisting Conditions: Allergic to tetracycline, cats, dust mites
Diagnostic Lab Data:
CDC Split Type: SC0805
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB526AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Body temperature increased
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: Temp 99.5-100.5 from 5/1/08 through 5/5/08

VAERS ID:312466 (history)  Vaccinated:2008-05-15
Age:39.0  Onset:0000-00-00
Gender:Unknown  Submitted:2008-05-16
Location:North Carolina  Entered:2008-05-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1659U1SCLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUF316AA0SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient developed hives on his face and neck

VAERS ID:313013 (history)  Vaccinated:2007-05-22
Age:39.0  Onset:2007-05-22, Days after vaccination: 0
Gender:Male  Submitted:2008-05-22, Days after onset: 366
Location:Virginia  Entered:2008-05-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: na
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2308AA6UNLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Erythema, Fatigue, Immediate post-injection reaction, Injection site pain, Injection site pruritus, Oedema peripheral, Pain
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Influenza vaccination left upper arm 22May 2007. Pt had immediate pain (5/10) at the injection site which lasted 30 sec. About 6 hours later the pt noted redness and swelling from his shoulder to his elbow. He also had an achy pain (3/10) and itching around the injection site. He also felt tired and weak. He denied decrease ROM, strength, numbness/tingling in his left shoulder, arm or hand. He denied fever, N, V, diarrhea, rash, SOB, chest pain. Instructed to take Motrin and Benadryl which he did about 2 hours later. Pt slept all nite. Redness, swelling and pain were 50% better in the am. Itching had resolved. Pt took one more dose of Motrin and Benadryl that am. All sx resolved in 3-4 days.

VAERS ID:313146 (history)  Vaccinated:2008-05-06
Age:39.0  Onset:2008-05-08, Days after vaccination: 2
Gender:Male  Submitted:2008-05-22, Days after onset: 14
Location:Unknown  Entered:2008-05-23, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Hospitalisation; Hepatitis C; Alcohol withdrawal syndrome; Hypertension
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0805USA02888
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0248X SCUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Oedema peripheral, Pruritus
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: Initial and follow-up information has been received from a pharmacist concerning a 39 year old male, who on 06-MAY-2008 (previously reported as 12-MAY-2008) was vaccinated SQ with a dose of PNEUMOVAX 23 (Lot# 661039/0248X). It was reported that at the time of the injection the patient was hospitalized (05-MAY-2008) for alcohol withdrawal, hypertension, and hepatitis C. On 08-MAY-2008 the patient complained of pain at the elbow in the arm where the vaccination was received. The patient was treated with ANCEF, 1 gram intravenously and ice was applied to the affected area. The affected area was 2 inches below the elbow to the mid upper arm. Later in the day on 08-MAY-2008 the patient was examined by the physician and it was reported that the patient''s arm was reddened with edema. It was also reported that on 12-MAY-2008 the patient developed severe redness, hotness, and swelling at the injection site. The patient also experienced itching. The patient was treated with vancomycin, 1 gram intravenously. On 12-MAY-2008 the patient was discharged. The patient''s discharge diagnoses were vaccine reaction, alcohol withdrawal, hypertension, and hepatitis C. The patient recovered from the PNEUMOVAX 23 reaction on an unspecified date. The events prolonged hospitalization. Additional information has been requested.

VAERS ID:314356 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: diagnostic laboratory - negative titers
CDC Split Type: WAES0711USA04460
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative
SMQs:
Write-up: Information has been received from a registered nurse concerning a 39-year-old female who in 1995 (12 years ago) was vaccinated with 2 doses of varicella virus vaccine live (Oka/Merck) and now has negative titers. The patient sought medical attention via a phone call with the physician. A product quality complaint was not involved. Additional information has been requested.

VAERS ID:315735 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-16
Location:Unknown  Entered:2008-05-23, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA00573
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Secondary transmission
SMQs:
Write-up: Information has been received from a female pharmacist who developed shingles on 11 FEB 2007, two weeks after her daughter was vaccinated, on 30 JAN 2007, with varicella virus vaccine live (Oka/Merck). On 14 FEB 2007, the patient was seen medically for a mild episode. On an unspecified date the event resolved without complications. The patient sought unspecified medical attention from her physician. There was no product quality complaint. There were no lab diagnostic studies performed. Additional information has been requested.

VAERS ID:314547 (history)  Vaccinated:2008-05-28
Age:39.0  Onset:2008-05-29, Days after vaccination: 1
Gender:Female  Submitted:2008-06-02, Days after onset: 4
Location:Virginia  Entered:2008-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Routine immunization
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MU: MUMPS (MUMPSVAX II)MERCK & CO. INC.0449X SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2927AA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Neck pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Fever of 101 degrees 24 hrs after mumps + Tdap vaccines then soreness in neck 48 hrs after. Fever lasted 24 hrs. Soreness is present currently.

VAERS ID:315713 (history)  Vaccinated:2008-05-22
Age:39.0  Onset:2008-05-22, Days after vaccination: 0
Gender:Female  Submitted:2008-06-05, Days after onset: 14
Location:Washington  Entered:2008-06-09, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: multi-vitamin
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None-Nl exam
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2965AA UNLA
Administered by: Private     Purchased by: Private
Symptoms: Immediate post-injection reaction, Pain in extremity
SMQs:, Hypersensitivity (narrow)
Write-up: L deltoid pain immediately after vaccine & persisting for $g2wk. Required (per pt) urgent care visit.

VAERS ID:315866 (history)  Vaccinated:2008-05-20
Age:39.0  Onset:2008-05-29, Days after vaccination: 9
Gender:Male  Submitted:2008-05-30, Days after onset: 1
Location:Unknown  Entered:2008-06-10, 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: unk
Preexisting Conditions: nka
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER  OTLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Injection site erythema, Injection site streaking, Lymphadenopathy
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Started having L axillary adenopathy, L deltoid erythema/streaking adjacent to scab vaccine/inoculation site which appears okay. Adenopathy reaction to vaccine that is typical; questionable cellulitis secondarily & will prescribe short course of KEFLEX 500 QID x7 day; take ibuprofen or Q6 hours PRN; f/u with provider next week; NKDA.

VAERS ID:317826 (history)  Vaccinated:2005-07-26
Age:39.0  Onset:2005-07-26, Days after vaccination: 0
Gender:Female  Submitted:2005-12-01, Days after onset: 128
Location:Indiana  Entered:2008-06-17, Days after submission: 928
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: No illness or medical conditions at time of vaccination. No other medications.
Diagnostic Lab Data: None
CDC Split Type: 200501812
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (DECAVAC)SANOFI PASTEURU1215AA UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Pain in extremity, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Case received from a healthcare professional on 13 and 14-Sep-05 (MIS/VIS reference numbers # 05-0447 and 05-0450). A 39-year-old female patient, with no relevant medical history, had received and injection an injection of DECAVAC (lot # U1215AA, on left deltoid) on 26 Jul 05 and later on the same day, she complained of headache, arm edema, sore arm, rash on arm (no description) and low grade fever. It was reported that the vaccine was given with a 5/8" needle. She required a doctor visit. The patient did not received any corrective treatment. The patient recovered on 29-Jul-05. Follow up information received on 17/Nov/2005. As per responsible physician there is no further information for this case.

VAERS ID:317832 (history)  Vaccinated:2005-08-23
Age:39.0  Onset:2005-08-23, Days after vaccination: 0
Gender:Male  Submitted:2005-09-23, Days after onset: 31
Location:New Jersey  Entered:2008-06-17, Days after submission: 998
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 his last dose of Td in 1995.
Diagnostic Lab Data:
CDC Split Type: 200501670
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (DECAVAC)SANOFI PASTEUR  UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Hypokinesia, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Muscular weakness, Oedema peripheral, Pain in extremity, Paraesthesia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: Initial report received from a physician on 26-August-2005. A male patient, who is also a physician (age not reported), experienced severe pain in the arm where the vaccine was administered and slight fever (exact temperature not reported) 12-24 hours after he received DECAVAC (lot number not reported) on 23-August-2005. The patient stated possibly lymph node involvement. The symptoms persisted and the patient was unable to life his arm. At the time of report, the patient had not received. Follow-up information received on 31-August-2005. The patient is a 39 year old male physician. On 23-August-2005, the eve of vaccination, the patient experienced pain at the injection site, subjective fever, chills and "felt warm to touch". 48 hours later, the patient developed axillary lymph node swelling, severe pain and arm weakness. On the seventh day post injection, the patient had a 10 x 6 cm area of redness, warmth and swelling at the injection site that covered 70% of the upper arm. The patient was treated for infection. Follow-up information received on 06-September-2005. The patient stated that the swelling of the deltoid had decreased however he still had significant swelling in the axillary area. He complained that when his arm was not elevated, he experienced tingling, pain and swelling in the arm.

VAERS ID:317357 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2008-05-30
Location:Unknown  Entered:2008-06-18, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: serum mumps IgG antibody - negat
CDC Split Type: WAES0708USA00651
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Mumps antibody test negative
SMQs:
Write-up: Information has been received from a family nurse practitioner concerning a 39 year old female who on an undisclosed date was vaccinated with a first dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3). A recent titer was negative for mumps. On 12-JUL-2007 the patient was vaccinated with a second dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3). There was no concomitant medication. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.

VAERS ID:317545 (history)  Vaccinated:2007-12-20
Age:39.0  Onset:2007-12-20, Days after vaccination: 0
Gender:Female  Submitted:2009-05-29, Days after onset: 525
Location:Iowa  Entered:2008-06-18, Days after submission: 345
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypersensitivity reaction; Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0801USA02733
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0865U4SCUN
Administered by: Public     Purchased by: Other
Symptoms: Cellulitis, 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: Information has been received from a 39 year old female nurse with previous "reactions to multiple vaccines" who on 18-DEC-2007 was vaccinated with a fifth dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3). The patient reported that after receiving her fifth dose of measles virus vaccine live (enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) because she did not have a titer, she experienced redness at the injection site and her right upper deltoid was swollen the size of a baseball. The experience occurred within 24 hours of vaccination. Unspecified medical attention was sought. The patient was given antibiotics and BENADRYL. The patient reported that she had an "allergic reaction with previous injections." The outcome was reported as improved but not total resolved, recovering. No lot number was provided. There was no product quality complaint. In follow-up information from a physician, it was reported that the 39 year old patient with a penicillin allergy experienced severe cellulitis, which required an emergency room/doctor visit. The patient subsequently recovered. There was no illness at the time of vaccination. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/30/2008. Information has been received from a 39 year old female nurse with previous "reaction to multiple vaccines" who on 20-DEC-2007 at 12:30 PM (also reported as 18-DEC-2007) was vaccinated SC with a fifth (also reported as second) dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus live (Wistar RA 27/3) (rHA) (Lot # 657138/0865U). There was no illness at the time of vaccination. The patient reported that after receiving her fifth dose of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar PA 27/3) because she did not have a titer, she experienced redness at the injection site and her right upper deltoid was swollen the size of a baseball. The experienced occurred within 24 hours of vaccination. Unspecified medical attention was sought. The patient was given antibiotics and BENADRYL. The patient reported that she had an "allergic reaction with previous injections". The outcome was reported as improved but not totally resolved, recovering. No lot number was provided. There was no product quality complaint. In follow-up information from a physician. It was reported that the 39 year old white patient with a penicillin allergy experienced severe cellulitits, which required an emergency room/doctor visit. The patient subsequently recovered. There was no illness at the time of vaccination. Follow up information indicated that on 20-DEC-2008, the patient experienced swelling and tenderness at the injection site. Severe cellulitis was noted. ROCEPHEN was adminstered IM to treat, along with CEPHALEXIN oral. The patient recovered. No additional information is expected.

VAERS ID:316723 (history)  Vaccinated:2008-04-18
Age:39.0  Onset:2008-04-22, Days after vaccination: 4
Gender:Male  Submitted:2008-06-20, Days after onset: 59
Location:Arkansas  Entered:2008-06-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURERFAV1631SC 
Administered by: Military     Purchased by: Unknown
Symptoms: Rash maculo-papular, Vaccine positive rechallenge
SMQs:, Hypersensitivity (narrow)
Write-up: Pt with maculopapular rash developing 3-4 days after receiving anthrax immunization. Pt did not tell techician had a rash and was rechallenged on may 2nd 2008. Rash improved but still persisting 4weeks after that injection. Rash has cleared substantially with only residual rash left on legs and arms. Was present entire body excluding face, hands and feet. No systemic sx''s.

VAERS ID:318344 (history)  Vaccinated:2008-06-27
Age:39.0  Onset:2008-06-28, Days after vaccination: 1
Gender:Female  Submitted:2008-07-01, Days after onset: 3
Location:Illinois  Entered:2008-07-07, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to sunlight and seasonal (Spring; Summer)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB107AC0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Received Hepatitis A vaccination on Fri 6/29 am. Began around 3pm Sat. with rash on ankles and extending up legs. Had hives on right ankle and left upper thigh

VAERS ID:318441 (history)  Vaccinated:2008-06-04
Age:39.0  Onset:2008-06-04, Days after vaccination: 0
Gender:Female  Submitted:2008-06-27, Days after onset: 23
Location:New York  Entered:2008-07-08, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Leeapro
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2938AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Fevers to 102, erythema, pain at site within 24 hours. Treated with Benadryl and Motrin.

VAERS ID:319711 (history)  Vaccinated:2008-07-02
Age:39.0  Onset:2008-07-14, Days after vaccination: 12
Gender:Female  Submitted:2008-07-18, Days after onset: 4
Location:Washington  Entered:2008-07-18
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
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1217F SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Cough, Ear discomfort, Feeling hot, Nasopharyngitis, Nausea, Neck pain, Rash generalised
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Received MMR vaccine 07/02/2008. Employee phoned our clinic 07/16/2008 complaining of joint aches and aches in the back of the neck of a couple days duration. Rash (red bumps) beginning 07/16/2008 on face and neck, and also having nausea. By 07/18/2008 rash also on chest, back, legs and arms. Joint pain and pain in neck nearly resolved by 07/18, and is no longer complaining of nausea. Today (07/18) has stuffy ears bilaterally, and feels like she is getting a cold. Has a non-productive cough, but thinks that is from "nerves". Has felt feverish, but temp today in our clinic is 97.7 degrees F. Treatment for these symptoms has been: ibuprofen prn, rest, reassurance that these symptoms are not uncommon following an MMR vaccine. I have collaborated with ARNP and MD regarding the care of this employee. Have also discussed the case with a Public Health Specialist at the CDC.

VAERS ID:319898 (history)  Vaccinated:2008-07-10
Age:39.0  Onset:2008-07-15, Days after vaccination: 5
Gender:Female  Submitted:2008-07-16, Days after onset: 1
Location:Nebraska  Entered:2008-07-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER1884U0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Fatigue, Headache, Nausea, Oedema peripheral, Skin nodule, Vomiting
SMQs:, Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Onset of symptoms 7/15/08 of severe intense headache, N/V, fatigue, lump in Lt axilla-tender to touch and swollen afebrile. Treated with IBUPROFEN and ice pack to site.

VAERS ID:320452 (history)  Vaccinated:2008-07-15
Age:39.0  Onset:2008-07-18, Days after vaccination: 3
Gender:Female  Submitted:2008-07-21, Days after onset: 3
Location:Pennsylvania  Entered:2008-07-25, 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: PPD; albuterol MDI; MVI qd; ZOLOFT 50 mg
Current Illness: 5 wks post TAH BSO
Preexisting Conditions: Tyl#3, MS04, ASA, NSAIDS. PMH: Gastric Bypass. TAH/BSO
Diagnostic Lab Data: Labs and Diagnostics: CBC with Hct 11.4, Hgb 33.8, MCV 74.7, MCH 25.3, RDW 15.8. Blood glucose 161. BUN 5. EKG in SR with slight non-specific ST T wave changes.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2370AA0  
TDAP: TDAP (ADACEL)SANOFI PASTEURC2938AA0  
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Blood glucose increased, Blood urea decreased, Diarrhoea, Electrocardiogram ST segment abnormal, Electrocardiogram abnormal, Fatigue, Gait disturbance, Haematocrit decreased, Haemoglobin decreased, Hyperglycaemia, Hypoaesthesia, Mean cell haemoglobin decreased, Mean cell volume decreased, Muscle fatigue, Muscular weakness, Pain, Pain in extremity, Paraesthesia, Red cell distribution width increased, Sensory loss
SMQs:, Rhabdomyolysis/myopathy (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Myocardial infarction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: Muscle weakness, pain, numbness and tingling hands, feet, legs and arms. 10/7/2008 Office records received from PCP for 7/21/08. Pt presented with c/o arm and leg pain, extreme muscle fatigue and diarrhea since 7/18/08. PE (+) for wide based gait, decreased muscle strength in lower (3/5) & upper 4/5) extremities as well as decreased sensation to sharp and dull. Normal reflexes. Sent to ER (above) with concern for GBS. 10/06/2008 ER record received for DOS 7/21/2008 with DX: Hyperglycemia. Pt presented to ER from PCP''s office with c/o new onset weakness, aching and paresthesias of the extremities. PE WNL. D/C home. 10/10/08 Spoke with reporter who recently saw patient. Still having some muscle tingling and weakness as well as easy fatigability. No definite dx.

VAERS ID:321843 (history)  Vaccinated:2007-07-17
Age:39.0  Onset:2007-07-17, Days after vaccination: 0
Gender:Female  Submitted:2008-07-30, Days after onset: 379
Location:Florida  Entered:2008-08-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA04971
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0698U SCRA
Administered by: Private     Purchased by: Other
Symptoms: Axillary pain, Erythema, Injection site erythema, Injection site pain, Injection site warmth, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Information has been received from a medical assistant (MA), concerning a 39 year old female patient who on 17-JUL-2007 was vaccinated, SC in the right arm, with a dose of PNEUMOVAX 23 (Lot #657039/0698U). Subsequently the patient developed redness, pain and warmth at the site of the injection that radiated into the right axilla. At the time of this report, the patient had recovered from the events (duration not specified). The patient sought unspecified medical attention. The MA reported that of the 6 vaccinations with PNEUMOVAX 23 administered from Lot #657039/0698U, (3 male and 3 female patients with an age range from 28-61 years), 3 additional patients experienced symptoms similar to the events described above (WAES 0709USA03054, male; WAES #0707USA04634, male), and 1 additional patient experienced a "minimal reaction" (WAES 0708USA00702). The records of testing prior to release of the lot in question, have been rechecked and found to be satisfactory. The lot complies with the standards of the center, and was released. Additional information is not expected.

VAERS ID:322364 (history)  Vaccinated:2007-10-10
Age:39.0  Onset:2007-10-12, Days after vaccination: 2
Gender:Female  Submitted:2008-07-30, Days after onset: 292
Location:Washington  Entered:2008-08-06, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0710USA03035
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2453AA IMUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0859U IMUN
Administered by: Other     Purchased by: Private
Symptoms: Injection site cellulitis, Injection site swelling, Lethargy
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Initial and follow-up information has been received from a pharmacist concerning a 39 (also reported as 35) year old female patient, who on 10-OCT-2007 (also reported as 12-OCT-2007), was vaccinated intramuscularly with a dose of PNEUMOVAX 23 (Lot# 657040/0859U). Concomitant therapy given in the same deltoid, about 2 to 3 inches from the first site, included a dose of influenza virus split virion 3v vaccine inactivated (Lot# "U2453AA"), administered intramuscularly. There were no illness at the time of the vaccinations. On 12-OCT-2007, the patient developed swelling up to 4 times the baseline at the injection site within 24 hours from the time of vaccination. It was reported that the patient felt lethargic and "like she was about to die." The patient went to the hospital and was diagnosed with cellulitis at the site of the PNEUMOVAX 23, which spread to the rest of her body. The emergency room doctor stated that the cellulitis was due to the vaccination with PNEUMOVAX 23. She was put on Cephalexin and sent home. On 14-OCT-2007, the patient was reported to be feeling much better. On 15-OCT-2007, it was reported that the patient was going to see a physician at a Hospital. The reporter is requesting a lot check for PNEUMOVAX 23 (Lot# 657040/0859U). A standard lot check investigation was performed. All in-process quality checks for the lot number in question were satisfactory. The lot met the requirements of the Center for Biologics Evaluation and Research and was released. Additional information has been requested.

VAERS ID:323378 (history)  Vaccinated:2007-11-07
Age:39.0  Onset:2007-11-07, Days after vaccination: 0
Gender:Male  Submitted:2009-07-30, Days after onset: 630
Location:California  Entered:2008-08-06, Days after submission: 358
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Irritable bowel syndrome; Anxiety; Arthritis, General symptom
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0711USA03328
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0963U0UNUN
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Erythema, Headache, Hypokinesia, Pain in extremity, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Information has been received from a health professional concerning a 39 year old male with irritable bowel syndrome, anxiety, arthritis, and no known drug allergies who on 07-NOV-2007 was vaccinated in the deltoid with a 0.5mL dose of pneumococcal 23v polysaccharide vaccine (Lot# 658451/0963U). Concomitant suspect therapy included finasteride, tablet. Other concomitant therapy included EFFEXOR and PROTONIX. On 07-NOV-2007, the patient experienced a fever, difficulty breathing, soreness of the arm, and difficulty moving the arm. On 12-NOV-2007, the patient was seen in the office and has another appointment to be seen again. No laboratory diagnostics were performed. At the time of the report, the outcome of the patient was unknown. No product quality was involved. Additional information is not expected. This is in follow-up to report (s) previously submitted on 7/10/2008. Follow-up information received from a medical assistant indicated that he was a 39 year old male patient, weighing 175.8 pounds and 69 inches in height, who in the afternoon of 07-NOV-2007, was vaccinated with the first dose of PNEUMOVAX (Lot # 658451/0963U), 0.5 mL in the left deltoid. There was an unspecified physical symptom at the time of vaccination. On 08-NOV-2007 at 2:30 AM, the patient experience fever, soreness to left deltoid, decrease PPT 63%, redness to left deltoid, headache. Treatment given to the patient was : TORADOL 60 mg, NAPROXEN 300 mg, VENTOLIN HFA and PREDNISONE.

VAERS ID:321639 (history)  Vaccinated:2008-07-31
Age:39.0  Onset:2008-07-31, Days after vaccination: 0
Gender:Female  Submitted:2008-08-01, Days after onset: 1
Location:New Jersey  Entered:2008-08-08, 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: Migraines
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0503X SCUN
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Within 5 to 10 minutes after administering MMR, left upper deltoid became warm to touch, with erythema. BENADRYL 50mg P.O. given.

VAERS ID:322234 (history)  Vaccinated:2008-08-12
Age:39.0  Onset:2008-08-12, Days after vaccination: 0
Gender:Female  Submitted:2008-08-14, Days after onset: 2
Location:Alabama  Entered:2008-08-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TST Mantoux, Tubersel Sanofi Pasteur, C2806AA, intradermal LFA, annually
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: To see MD today.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2688AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Fatigue, Neck pain, Pain, Skin nodule
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Tdap given IM Lt deltoid on 8-12-08. That night she noticed dime size sore knot to Lt neck, below skull (lymph node?), also c/o joint pain, tiredness, aches. Today, 8-14-08, continues to c/o sore, dime size knot to Lt neck. Referred to MD for evaluation.

VAERS ID:322342 (history)  Vaccinated:2007-09-17
Age:39.0  Onset:2007-09-18, Days after vaccination: 1
Gender:Female  Submitted:2008-08-13, Days after onset: 330
Location:California  Entered:2008-08-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICSRNCHI412011A12IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site pain, Musculoskeletal stiffness, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Intense pain at injection site and entire left arm which became stiff and painful to move. Exercise exacerbated symptoms, which last on and off six months. Symptoms would onset suddenly and last a few hours. Patient never sought treatment.

VAERS ID:324433 (history)  Vaccinated:2006-09-28
Age:39.0  Onset:2006-09-28, Days after vaccination: 0
Gender:Female  Submitted:2007-06-27, Days after onset: 272
Location:California  Entered:2008-08-15, Days after submission: 415
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: MEDI0004973
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Private     Purchased by: Other
Symptoms: Anxiety, Caesarean section, Drug exposure during pregnancy, Fatigue, Headache, Pharyngolaryngeal pain
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: MEDI-0004973 is a Not Serious Spontaneous case from a Consumer involving VACCINE EXPOSURE DURING PREGNANCY: (Unlabelled). The reporter causality is Possible to FluMist. A 39-year-old female who is 14-weeks pregnant (obtained via ultrasound) received FluMist on 28-Sep-2006 from her child''s pediatrician. A few hours after receiving the vaccine, the patient developed mild sore throat, mild headache and mild fatigue. There were no changes in symptom intensity and the symptoms dissipated on their own without any medical interventions. Sore throat was fully resolved on 30 Sep-2006. Headache and fatigue completed dissipated on 02-Oct-2006. After receiving the vaccine, the patient was told by her obstetrician that a "pregnant woman should not be receiving FluMist* vaccine. After hearing this statement and "reading up on FluMist," patient became "quite concerned and became very anxious." Patient attributed developing anxiety to "worrying about the possible effect FluMist may have on my (unborn) baby." This patient was G4P2 with a history of one elective abortion in April, 2006 for Down Syndrome. Her last menstrual period was 21-Jun-2006 and her estimated date of delivery was 30-Mar-2007. The patient denied having any history of medical problems. She denied taking any medications (prescribed and over the counter) during her pregnancy. The patient stated her anxiety persisted throughout her pregnancy. Her anxiety resolved after she delivered a healthy baby boy via scheduled caesarian-section on 21-Mar-2007. She stated that there were no complications during her pregnancy or during the birth of her baby. The baby "is doing well." The reporter causality is possible to FluMist. 27-Jun-2007: Follow up information obtained and incorporated in above narrative: information regarding clinical outcome.

VAERS ID:322895 (history)  Vaccinated:2008-08-15
Age:39.0  Onset:2008-08-19, Days after vaccination: 4
Gender:Female  Submitted:2008-08-21, Days after onset: 2
Location:California  Entered:2008-08-21
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.0504X SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2774AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: SEVERE PAIN ON LEFT ARM FOR 2 DAYS AND DIZZINES.PATIENT IS A REFUGE AND WE REFERED TO CHATOLIC CHARITIS TO BE SEEN BY A PHYSICIAN.WE HAVE DIFICULTY COMUNICATING WITH PATIENT BECAUSE OF LANGUAGE BARRIOR.

VAERS ID:323048 (history)  Vaccinated:2008-08-14
Age:39.0  Onset:2008-08-15, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:2008-08-22
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: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR90715C UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 8x11cm area erythema, warmth and tenderness developed distal to injection site day after injection.

VAERS ID:323214 (history)  Vaccinated:2008-06-10
Age:39.0  Onset:2008-06-15, Days after vaccination: 5
Gender:Male  Submitted:2008-08-25, Days after onset: 71
Location:Oregon  Entered:2008-08-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None at the time of vaccination. Usually none.
Current Illness: Ear infection
Preexisting Conditions: Ear Infection - hadn''t started antibiotics yet.
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU1991CA20IMLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Exercise tolerance decreased, Muscle atrophy, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: Initial symptoms were muscle aches that didn''t resolve. Since has had continued muscle aching,wasting of the upper arms. Overall decrease in strength and endurance. Started taking herbal antitoxins around Aug 11, 2008, this seems to have prevented continued decline but there has been no improvement. He felt he was in the best shape in his life prior to vaccination. Walking at least 3 miles a day and weight lifting. However he did have an ear infection that he had not treated with antibiotics until about a week after receivint the vaccination.

VAERS ID:323527 (history)  Vaccinated:2008-08-25
Age:39.0  Onset:2008-08-26, Days after vaccination: 1
Gender:Female  Submitted:2008-08-27, Days after onset: 1
Location:Texas  Entered:2008-08-27
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: tobacco use
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Other
Symptoms: Induration, Mass, Pain in extremity, Rash, Red blood cell abnormality
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: The patient developed a hard, red, painful lump on upper right arm and a rash. Patient given 3 shots on same day, 2 in right deltoid, 1 in left deltoid. Patient does not know which vaccines went into her right arm and no notation was made on her immunization record. This form mailed to health department after being faxed to VAERS.

VAERS ID:323926 (history)  Vaccinated:2004-01-01
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-08-25
Location:Unknown  Entered:2008-09-02, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Records at hospital and clinic.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER    
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER    
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Anxiety, Arthritis, Asthenia, Back pain, Balance disorder, Blood cholesterol increased, Depression, Disturbance in attention, Dyspepsia, Erectile dysfunction, Insomnia, Irritability, Memory impairment, Pain, Phonophobia, Tinnitus, Visual disturbance
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Hostility/aggression (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Depression (excl suicide and self injury) (narrow), Hearing impairment (narrow), Vestibular disorders (broad), Lipodystrophy (broad), Arthritis (narrow)
Write-up: Anxiety, arthritis, balance problems, high cholesterol, difficulty loss and trouble concentrating, depression, digestive problems, energy loss, hearing (ringing and low tolerance to noise), impotence, insomnia, memory difficult/loss, depression irritable, low back pain, pain throughout the body, joint, muscle, neck, back. Sleep problems, unable to sleep flat, tinnitus, vision problems.

VAERS ID:324459 (history)  Vaccinated:2008-08-25
Age:39.0  Onset:2008-08-30, Days after vaccination: 5
Gender:Female  Submitted:2008-09-02, Days after onset: 3
Location:Georgia  Entered:2008-09-08, 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: None
Current Illness: Patient fainted at time of vaccine 8/25/08.
Preexisting Conditions: PCN; none; Fibromyalgia
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB224CA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3027AA0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA05220IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypoaesthesia, Oedema peripheral, Pain, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient had HEP A, TDAP & TYPHOID vaccines on 8/25/08. She reports minimal soreness only on 8/26 & 8/27 then pain went away. Patient reports falling asleep in a recliner in the am of 8/30/08 and waking up with right arm swollen and warm to the touch in right deltoid area with whole arm feeling numb. States she was sleeping on right arm.

VAERS ID:324859 (history)  Vaccinated:2008-07-18
Age:39.0  Onset:2008-07-20, Days after vaccination: 2
Gender:Male  Submitted:2008-09-11, Days after onset: 53
Location:Unknown  Entered:2008-09-11
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: None
Diagnostic Lab Data: ECG, Labwork: ESR, CRP, TSH, Troponin, RF, ANA
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB521BA3IMLA
Administered by: Military     Purchased by: Military
Symptoms: Antinuclear antibody, Blood thyroid stimulating hormone, C-reactive protein, Chest discomfort, Cough, Dyspnoea, Effusion, Electrocardiogram, Laboratory test, Pericarditis, Red blood cell sedimentation rate, Rheumatoid factor, Troponin
SMQs:, Anaphylactic reaction (broad), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad)
Write-up: Pt recieved smallpox on 22 Mar 2006. Noticed symptoms a month later. Tightness in chest and difficulty taking deep breaths lasted a week. "Pt has recurrent pericarditis, 5 epsiodes by history in the last two years. Initial trigger may have been viral. Occurred 2-3 months after smallpox vaccination, so not likely to be from that but cannot rule it out. He has ongoing dry cough and ongoing effusion, but symptoms of chest pain have passed. No evidence for tamponade."- 08 Aug 08 doctor visit explanation.

VAERS ID:325097 (history)  Vaccinated:2008-08-08
Age:39.0  Onset:2008-08-08, Days after vaccination: 0
Gender:Male  Submitted:2008-09-10, Days after onset: 33
Location:Oregon  Entered:2008-09-15, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0398X2UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Lymphadenopathy, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Left shoulder upper arm soreness and swelling with axillary lymph node 1 cm, skin redness/pinkness in 6x4 cm area of axilla.

VAERS ID:325184 (history)  Vaccinated:2008-08-25
Age:39.0  Onset:2008-08-27, Days after vaccination: 2
Gender:Male  Submitted:2008-09-06, Days after onset: 10
Location:Georgia  Entered:2008-09-16, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 3IMLA
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER 2 RA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site nodule, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient developed a large, painful nodule in his left upper arm (65 x 80mm) within a few days on Anthrax vaccination. Typhoid vaccine also given in L UE. This was patient''s 4th Anthrax shot - previous 3 were in Feb-March 2000.

VAERS ID:325235 (history)  Vaccinated:2008-09-13
Age:39.0  Onset:2008-09-13, Days after vaccination: 0
Gender:Female  Submitted:2008-09-16, Days after onset: 3
Location:Michigan  Entered:2008-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: NKDA, No Birth defects, No medical conditions
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURC2965BA0IMLA
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500551P1IN 
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pain, Tenderness, Wrong drug administered
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt has area of 9.5X4 cm on left deltoid that is reddened and tender to the touch. Pain extends toward left subclavicular area. No numbness or radiation down affected arm reported. Symptoms started within 3 hours of vaccination.

VAERS ID:325766 (history)  Vaccinated:2008-08-27
Age:39.0  Onset:2008-08-28, Days after vaccination: 1
Gender:Male  Submitted:2008-08-29, Days after onset: 1
Location:Unknown  Entered:2008-09-22, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1551UNRA
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURW04003A0 LA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Induration, Oedema peripheral, Pruritus, Swelling
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: 17 cm x 16 cm area of redness, swelling to elbow. Indurated, itches, swelling.

VAERS ID:326010 (history)  Vaccinated:2008-09-19
Age:39.0  Onset:2008-09-22, Days after vaccination: 3
Gender:Female  Submitted:2008-09-24, Days after onset: 2
Location:California  Entered:2008-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, sudafed, allegra
Current Illness: none
Preexisting Conditions: depression, allergic rhinitis
Diagnostic Lab Data: none yet
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500546P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Headache, Myalgia, Sinus headache
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Three days after the vaccine, onset of dizziness, headache and light headed with muscle aches. Sinus pain.

VAERS ID:326180 (history)  Vaccinated:2008-09-24
Age:39.0  Onset:2008-09-24, Days after vaccination: 0
Gender:Female  Submitted:2008-09-25, Days after onset: 1
Location:Georgia  Entered:2008-09-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CIPRO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA349CD IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Feeling hot, Pruritus generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Approx one hour after receiving the flu vaccine, she noticed body itching, hot feeling. light headed. After two hours, developed hives on left arm which was the arm of vaccination. Saw Dr. who recommended antihistamine. Pt took Benadryl. Felt better. Next day, still improving.

VAERS ID:326542 (history)  Vaccinated:2008-09-23
Age:39.0  Onset:2008-09-23, Days after vaccination: 0
Gender:Female  Submitted:2008-09-24, Days after onset: 1
Location:Wisconsin  Entered:2008-09-30, 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: MAXALT
Current Illness: None
Preexisting Conditions: Fresh fruit- allergy, migraines
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3027BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Body aches, fever, vomiting -12 hrs after shot

VAERS ID:327200 (history)  Vaccinated:2008-10-04
Age:39.0  Onset:2008-10-04, Days after vaccination: 0
Gender:Male  Submitted:2008-10-07, Days after onset: 3
Location:Nevada  Entered:2008-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lamotrigine, Clonazepam, Effexor, Kadian, Lovastain, Abilify, Ibuprofen 800
Current Illness: None
Preexisting Conditions: Depression, Anxiety, Arthritis/joint pain
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEUR 3IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0988F0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Injection site erythema, Injection site swelling, Injection site vesicles, Injection site warmth, Muscle fatigue, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Fever, chills, severe body ache/muscle fatigue, extreme redness, swelling, blistering and heat at injection site and an approx. 3 inch diameter surrounding site.

VAERS ID:327556 (history)  Vaccinated:2008-10-07
Age:39.0  Onset:2008-10-07, Days after vaccination: 0
Gender:Female  Submitted:2008-10-08, Days after onset: 1
Location:California  Entered:2008-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Ulcerative Colitis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB569AA IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1746U SCRA
Administered by: Public     Purchased by: Private
Symptoms: Feeling abnormal, Immediate post-injection reaction, Pruritus, Rash papular
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Hypersensitivity (narrow)
Write-up: Patient c/o feeling "funny" immediately after vaccine administration. 15 minutes after vaccine adminstration, c/o left sided itching on forearm, upper arm, neck, scalp and foot. Scattered papular rash observed left forearm. Sent to ER- received PO prednisone & benadryl with good relief.

VAERS ID:327568 (history)  Vaccinated:2008-10-02
Age:39.0  Onset:2008-10-03, Days after vaccination: 1
Gender:Female  Submitted:2008-10-08, Days after onset: 5
Location:Oregon  Entered:2008-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Xanax, Divan
Current Illness: none
Preexisting Conditions: lisopril, vicodin
Diagnostic Lab Data: n/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2752AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0519X IMLA
Administered by: Private     Purchased by: Private
Symptoms: Contusion, Headache, Musculoskeletal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Accidents and injuries (narrow)
Write-up: Patient c/o headache, fever up to 102.7 and left shoulder pain. Small bruise at center of left shoulder. Patient received both flu shot and Pneumovax at 9 a.m. 10/2/08 in the left deltoid. Patient reported that several hours later she started developing symptoms (HA, fever, shoulder pain). She presented to the immediate care the following day. Beyond ANSAIDS and ice/heat, the MD ordered her to follow up in 2-3 days unless completely better. There has been no follow up from patient.

VAERS ID:327748 (history)  Vaccinated:2008-06-16
Age:39.0  Onset:2008-06-16, Days after vaccination: 0
Gender:Female  Submitted:2008-09-24, Days after onset: 100
Location:Texas  Entered:2008-10-08, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0806USA03837
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0298X SCUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a registered pharmacist, concerning a patient, with no previous medical history reported who was vaccinated with a dose of ZOSTAVAX (Oka/Merck) (Lot # 659406/0298X) subcutaneously on 16-Jun-2008. On 16-JUN-2008, in the evening her arm became red and swollen to the "size of a softball" at the injection site. The pharmacist suggested that the patient see her physician. Sought medical attention: spoke with pharmacist. At the time at the report, the patient had not recovered. There was no product quality complaint. Additional information has been requested.

VAERS ID:327855 (history)  Vaccinated:2008-10-07
Age:39.0  Onset:2008-10-07, Days after vaccination: 0
Gender:Female  Submitted:2008-10-09, Days after onset: 2
Location:Georgia  Entered:2008-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA375AA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: INFECTION SITE--RED SWOLLEN

VAERS ID:328368 (history)  Vaccinated:2008-10-07
Age:39.0  Onset:2008-10-09, Days after vaccination: 2
Gender:Female  Submitted:2008-10-13, Days after onset: 4
Location:Ohio  Entered:2008-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALBUTEROL
Current Illness: No
Preexisting Conditions: PCN, DARVOCET, Caffeine, Asthma
Diagnostic Lab Data: Urine
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURV2807AA0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Diarrhoea, Injection site infection, Pyrexia, Swelling, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: Swelling, fever, chills, vomiting, diarrhea 2 days-3days post. site infected per ER MD- got antibiotics

VAERS ID:328592 (history)  Vaccinated:2008-10-14
Age:39.0  Onset:2008-10-14, Days after vaccination: 0
Gender:Female  Submitted:2008-10-15, Days after onset: 1
Location:Ohio  Entered:2008-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glucotrol, magnesium, synthroid, premarin,januvia, amiloride, b12 injections.
Current Illness: None
Preexisting Conditions: Diabetic, hypothroidism, hypomagnesium, b12 anemia
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Chills, Cold sweat, Cough, Eye discharge, Myalgia, Nasal congestion, Ocular hyperaemia, Oropharyngeal pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad)
Write-up: Recieved Flu Vaccine at around 2:00 pm, by 5:00 pm of the same day I had a high fever 101.6, muscle aches, cough, stuffed up nose (so severe everytime I swalled my tongue was sucked up to the back of my throat), red blood shot eyes with yellowish discharge, sore/scrathcy throat, chills/ cold sweat. When I got up the next morning both eyes were matted shut with a yellowish discharge. By 12:30 pm the next day I still have a fever, aches, red blood shot eyes, with a yellow discharge and cold chills.

VAERS ID:328798 (history)  Vaccinated:2008-09-30
Age:39.0  Onset:2008-10-13, Days after vaccination: 13
Gender:Female  Submitted:2008-10-16, Days after onset: 3
Location:Illinois  Entered:2008-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Phenobarbital;
Current Illness: None.
Preexisting Conditions: Seizure disorder.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.19240 SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3027BA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Rash generalised
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Diffuse lenticular rash noticed approximately 16 days following administration; local induration at site of MMR noticed approximately 12 days following administration.

VAERS ID:328818 (history)  Vaccinated:2008-10-07
Age:39.0  Onset:2008-10-07, Days after vaccination: 0
Gender:Female  Submitted:2008-10-08, Days after onset: 1
Location:Minnesota  Entered:2008-10-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA; Family Hx Breast malignancy, Overactive bladder
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2997AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Body temperature increased, Chills, Fatigue, Frequent bowel movements, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Vomiting, frequent bowel movements, abdominal cramping, headache, chills, fatigue, and temperature of 99.6 degrees F.

VAERS ID:328923 (history)  Vaccinated:2008-10-16
Age:39.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-10-17, Days after onset: 1
Location:Pennsylvania  Entered:2008-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fall environmental allergy
Preexisting Conditions: Erythromycin - GI intolerance
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUF455BA IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU2754AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dysphagia, Dyspnoea, Sensation of foreign body, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Had immunization at 10 AM. At 2 PM, school nurse called reporting symptoms of wheezing, and feeling lump in throat. Advised to go to ER. ER report, said mild difficulty breathing and swallowing. Pt received SOLU-MEDROL and BENADRYL and PEPCID. Observed 3 hrs. Discharged on Prednisone and BENADRYL.

VAERS ID:329068 (history)  Vaccinated:2008-10-16
Age:39.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:South Carolina  Entered:2008-10-17
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: Allergy Sulfa / Hx of MS
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA032AA1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: Use of expired influenza vaccine. No c/o illness, symptoms.

VAERS ID:329077 (history)  Vaccinated:2008-10-15
Age:39.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Florida  Entered:2008-10-17
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) (FLUZONE)SANOFI PASTEURU2755AA0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia, Throat irritation, Throat tightness, 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), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad)
Write-up: Patient received injection at about 3 pm and between 5-6 pm started getting fever, scratchy throat. Between 6-7 pm sx of throat closing and vomiting. Patient seen and treated.

VAERS ID:329035 (history)  Vaccinated:2008-10-18
Age:39.0  Onset:2008-10-18, Days after vaccination: 0
Gender:Female  Submitted:2008-10-18, Days after onset: 0
Location:Pennsylvania  Entered:2008-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: adderall xr, synthroid, claritin, singulair, adderall, xyrem, zyrtec
Current Illness: none
Preexisting Conditions: seasonal allergies, sulfa allergy, sensitivity to latex adhesive, sensitivity to preservatives such as MSG, IBS, Fibromyalgia, Hashimoto''s Thyroiditis, and Narcolepsy.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR89882 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Dysgeusia, Eye irritation, Feeling abnormal, Flushing, Injection site pain, Lacrimation increased, Muscle tightness, Ocular hyperaemia, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad), Corneal disorders (broad), Lacrimal disorders (narrow), Hypersensitivity (broad)
Write-up: I woke up this morning feeling just fine, and I have not been sick, nor did I feel like I was getting sick. I went to get a flu vaccine this morning around 11:30 am. at my local store. Following the vaccine, I felt normal tenderness in the location of the vaccine. I finished my errands and went home around 1:30 pm, at which time I noticed a few very obvious adverse reactions. My face is flushed and hot to the touch and temp is 99.7. My eyes feel watery, red and irritated. My brain somehow feels like it has expanded, making my upper jaw feel very strange and enlarged. My nose feels strange as well...and my head overall feels like there is a vise grip on it. It is a strange tightening feeling, and it extends down the back of my neck. I have a metallic taste in my mouth. I called my family doctor''s answering service and spoke to the doctor on call around 2:45. She told me to take ibuprofen, and drink fluids, and said it is probably not due to the vaccine...but that if other symptoms should develop, I could call her back or go to the ER for evaluation. I do not feel that the symptoms I am having are a normal reaction to the vaccine, and I am concerned. On my receipt,it says that the manufacturer of this vaccine is "fluzine"--which was not a choice in your list below, which is why I didn''t choose a manufacturer.

VAERS ID:329187 (history)  Vaccinated:2008-10-09
Age:39.0  Onset:2008-10-10, Days after vaccination: 1
Gender:Male  Submitted:2008-10-13, Days after onset: 3
Location:Wisconsin  Entered:2008-10-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1071U SCRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Injection site erythema, Injection site swelling, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Received Varicella vaccine 10/9/08 AM in MD''s office. 10/10/08 - Arm very sore and tender. Mild redness and swelling at injection site. Had a headache and chills. 10/11/08 Noticed swelling more significant with tenderness and increased redness. 10/12 Seen in clinic and prescribed antibiotic.

VAERS ID:329495 (history)  Vaccinated:2008-10-14
Age:39.0  Onset:2008-10-14, Days after vaccination: 0
Gender:Female  Submitted:2008-10-21, Days after onset: 7
Location:Ohio  Entered:2008-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2767AA UNRA
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Cough, Disorientation, Flushing, Headache, Hypersensitivity, Influenza like illness, Insomnia, Malaise, Muscle twitching, Oropharyngeal pain, Pain, Pallor, Respiratory tract congestion, Somnolence, Throat tightness, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: A Patient that received an on-site flu shot on 10/14/08 between 9am and 10am at the Clinic called 10/20/08 to report an adverse reaction to the flu vaccine that was administered that morning by Clinic Nurse. Patient reported that she received her flu shot at approximately 9:15am that morning. Two hours post vaccination she started with a dry cough, tightness in her chest and throat, headache, malaise and general flu like symptoms. At that time she took at ALAVERT tablet. She ate her lunch which she brought from home despite feeling ill. She states that she continued to experience tightness in her throat, became flushed and pale and vomited. At that time, she was taken to the hospital by squad. At the hospital she was treated for an allergic reaction and given STEROIDS, BENADRYL, PHENERGAN and IV fluids. Labs were drawn. The patient ha no lab results to report. She then stated that she was feeling achy and was administered TORADOL. She was discharged to home at 5:30pm at which time she was extremely groggy. At home she was unable to sleep and experienced twitching in her lower limbs. She took ADVIL PM and states that she fell asleep between 3 and 4am. She complained of feeling congested and disorinte and had a sore throat the following day. She remained off work on Wednesday 10/15 and 10/16 and returned to work on Friday 10/17. She reported that she is feeling much better today, 10/20/08. Flu vaccine - Sanofi Aventis Lot #U2767AA

VAERS ID:329737 (history)  Vaccinated:2008-10-15
Age:39.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-21, Days after onset: 6
Location:California  Entered:2008-10-23, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had a cough for one week prior to the vaccination. ''None reported'' was indicated for the following: additional pre-existing allergies/medical conditions; additional vaccinations within four weeks of 15 October 2008; concomitant medications prior to vaccine; adverse events following prior vaccinations.
Diagnostic Lab Data: Not reported
CDC Split Type: 200803244
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2745A IMLA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Initial report received from a healthcare professional on 17 October 2008. A 39-year-old female patient had received a left deltoid intramuscular injection of FLUZONE SV 2008-2009 (lot number U2745AA) on 15 October 2008 at 11:30 AM and that evening, she experienced fever (temperature unknown), chills, aches and vomiting. The patient had a history of cough for one week prior to the vaccination. She was hospitalized on 16 October 2008. At the time of the report, outcome was ''not recovered'' and the patient remained hospitalized. No additional details were provided. Documents held by sender: None.

VAERS ID:329806 (history)  Vaccinated:2008-10-20
Age:39.0  Onset:2008-10-20, Days after vaccination: 0
Gender:Female  Submitted:2008-10-23, Days after onset: 3
Location:Virginia  Entered:2008-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinioprl 10 mg daily began 10/6/08; Wellbutrin SR 150 mg 2 x daily
Current Illness:
Preexisting Conditions: Allergies cat, Keflex,sulfa Hypertension, Smoking cessation
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2789BA5IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Aura, Headache, Injection site erythema, Injection site induration, Injection site irritation, Injection site pruritus, Injection site swelling, Injection site warmth, Migraine, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Convulsions (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: C/O more intense burning at injection site at time of vaccine administration. No bleeding observed, inj site re wiped with alcohol swab and Bandaide applied. HA began 4 hrs after inj. R-sided migraine type with a little blurred vision and color aura (which is normal for this person when a migraine occurs). Took 600 mg Ifuprofen at 4 pm.which is what she normally takes for HA. Had slight injection site irritation and swelling that evening. Removed bandaid and applied ice at 6 pm. No further c/o or action taken that evening. Tues 10/21/08 upon arising noted itching, redness, heat, swelling at the inj site. HA continued. Took Ifuprofen 600 mg at 6 am and 12 noon without relief for HA. Purchased generic extra stringth "Excedrin Migraine" took two tablets at 5:30 pm. Arm continued with burning, itching, redness and localized pain. HA continued but was resolved by AM 10/22/08. Arm symptoms continued 10/22 but no action taken. 10/23/08 contacted individual who administered immunization to report current symptoms of reddness, and itching. Seen by RN. Noted 2.5" x 4.5" area of induration, warmth and firmness. Skin color not changed. Rec ice or heat for comfort, OTC cream/lotion for itching if needed. See PMD if symptons worsen. CDC/VEARS report completed.

VAERS ID:329833 (history)  Vaccinated:2008-10-20
Age:39.0  Onset:2008-10-20, Days after vaccination: 0
Gender:Female  Submitted:2008-10-23, Days after onset: 3
Location:Oregon  Entered:2008-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diamox, aspirin
Current Illness:
Preexisting Conditions: Hyperkalemic periodic paralysis
Diagnostic Lab Data: CBC, CHem panel, ordered and pending
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN UNUN
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Full blood count, Laboratory test, Lethargy, Pain, Pain in extremity
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Patient had Pneumovax and Flu shots at another facility on 10/20. She had shooting pains in her legs and arms and weakness and lethargy later that evening and continuing through today.

VAERS ID:329941 (history)  Vaccinated:2008-10-03
Age:39.0  Onset:2008-10-03, Days after vaccination: 0
Gender:Female  Submitted:2008-10-24, Days after onset: 21
Location:Michigan  Entered:2008-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: arm swells~Td Adsorbed (no brand name)~UN~~In Patient
Other Medications:
Current Illness: no
Preexisting Conditions: keflex, iodine, tetanus, CT dye
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2744AA2IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chest pain, Dysphagia, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)