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Found 554176 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:256288 (history)  Vaccinated:2005-05-01
Age:31.0  Onset:2005-06-01, Days after vaccination: 31
Gender:Male  Submitted:2006-05-12, Days after onset: 345
Location:Virginia  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: 06/2005: serum varicella zoster no seroconversion
CDC Split Type: WAES0506USA03838
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1  
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a RN concerning a 31 yr old male who in approx May 2005, was vaccinated with the second dose of varicella virus vaccine live. The RN reported that in June 2005, a titer did not show seroconversion. Unspecified medical attention was sought, and no symptoms were noted. At the time of this report, the outcome was unk. Additional information has been requested.

VAERS ID:256635 (history)  Vaccinated:2005-09-12
Age:31.0  Onset:2005-09-13, Days after vaccination: 1
Gender:Female  Submitted:2006-05-12, Days after onset: 241
Location:Maryland  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tubersol
Current Illness:
Preexisting Conditions: Palpitations. House dust allergy; House dust mite allergy; Mycotic allergy.
Diagnostic Lab Data: 09/15/05 body temp 97.8F
CDC Split Type: WAES0509USA02081
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.649442/0220R1  
Administered by: Private     Purchased by: Other
Symptoms: Choking, Dysphagia, Dyspnoea, Joint stiffness, Joint swelling, Malaise, Musculoskeletal stiffness, Productive cough, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (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), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Local Swelling; Dyspnea; Malaise; Choking Sensation; Dysphagia; Sputum Retention; Joint Swelling; Musculoskeletal Stiffness Information has been received from a health professional concerning a 34 year old white female with allergies to dust, mites, grass and mold, and a history of heart palpitations who was vaccinated with a first and second dose of varicella virus vaccine live (Oka/Merck) on 16-JUN-2005 and 12-SEP-2005 (lot #649442/0220R, administered SC at 16:00) Concomitant vaccination given at 16:00 on 12-SEP-2005 included an intradermal dose of tuberculin purified protein derivative (TUBERSOL). There was no illness at the time of vaccination. On 13-SEP-2005, the patient developed swelling in her neck and shoulders which was not visible. She did not feel well and could not swallow or breath normally. The patient was afebrile. Unspecified medical attention was sought. The nurse reported that she was going to give the patient diphenhydramine hydrochloride (Benadryl). No laboratory diagnostic tests were performed. There was no product quality complaint involved. Follow-up information from the registered nurse indicated that on 15-SEP-2005 at 14:00 the patient complained of feeling swollen on both sides of the neck, her throat felt sticky and she couldn''t breath properly, she had to take deep breathes to get air. The patient had a body temperature of 97.8. She had a stiff neck. The patient was treated with diphenhydramine hydrochloride (Benadryl). The patient felt like her throat was closing up. She was given methylprednisolone (MEDROL) dose pack. It was reported that the patient "had no problems" after her first dose of varicella virus vaccine live (Oka/Merck) At the time of the report the patient''s status was unknown. Additional information has been requested.

VAERS ID:257018 (history)  Vaccinated:2001-05-03
Age:31.0  Onset:2005-12-19, Days after vaccination: 1691
Gender:Female  Submitted:2006-05-12, Days after onset: 143
Location:Georgia  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pregnancy (LMP 9/26/05). Penicillin allergy.
Diagnostic Lab Data: Serum varicella zoster done 12/19/05 was susceptible to virus.
CDC Split Type: WAES0512USA02786
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from a physician concerning a 35-year-old female, who is 13 weeks pregnant with twins and allergic to penicillin, who on 03-MAY-2001 was vaccinated with a dose of varicella virus vaccine live and with a follow-up vaccination, "shortly after", with a dose of varicella virus vaccine live. There was no concomitant medication. Today, on 19-DEC-2005 the patient found out that the vaccine was not protecting her from the virus and that she was now susceptible to the virus. It was reported that the patient had not recovered. Unspecified medical attention was sought. No product quality complaint was involved. No other information was provided. Additional information has been requested.

VAERS ID:257042 (history)  Vaccinated:2005-09-28
Age:31.0  Onset:2005-12-14, Days after vaccination: 77
Gender:Female  Submitted:2006-05-12, Days after onset: 148
Location:Kansas  Entered:2006-05-17, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Drug hypersensitivity
Diagnostic Lab Data: Serum varicella zoster 12/14/05 8.7 eu/mL Negative is defined by lab as less than 15 eu/mL; no ELISA units were specified in measurement. Serum varicella zoster 08/09/05 1.2 eu/mL initial titer prior to therapy.
CDC Split Type: WAES0512USA03435
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 1SC 
Administered by: Public     Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Information has been received from an employee health nurse concerning a 31 yr old female certified nursing assistant with an allergy to levofloxacin (Levaquin), no history of chickenpox, and who had an initial titer on 09Aug05 which returned a result of 1.2 eu/ml, who on 24Aug05 was vaccinated SC with a 0.5mL first dose in the left arm of varicella virus vaccine live (lot9103907) and a second SC 0.5mL dose in the left arm of varicella virus vaccine live (lot 9103907) on 28Sep05. There was no concomitant medication. There was no illness at the time of vaccination. On 14Dec05 she had a titer drawn, which returned on 21Dec05 as negative. The nurse reported that negative is defined by the laboratory as less than 15 eu/mL and the employee was 8.7 eu/ml. No ELISA units were specified in the measurement. The employee is presently well and has been well. There was no product quality complaint reported. Unspecified medical attention was sought. Follow up information indicated that no additional information was available. Additional information is not expected.

VAERS ID:257878 (history)  Vaccinated:0000-00-00
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2006-05-19
Location:New York  Entered:2006-05-22, 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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: Titer did not show seroconversion to rubella.
CDC Split Type: WAES0505USA01102
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.    
Administered by: Other     Purchased by: Other
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Info has been received from a physician concerning a 31 year old female who several years ago, in approximately 2003, was vaccinated with a dose of MMRII. Subsequently, a "recent" titer did not show seroconversion to rubella. It was noted that the pt had no symptoms. Unspecified medical attention was sought. No product quality complaint was involved. Additional info has been requested.

VAERS ID:257905 (history)  Vaccinated:2005-07-11
Age:31.0  Onset:2005-07-11, Days after vaccination: 0
Gender:Female  Submitted:2006-05-19, Days after onset: 312
Location:Colorado  Entered:2006-05-22, 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: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Immunization
Diagnostic Lab Data: Diagnostic lab-no immunity to rubeola
CDC Split Type: WAES0507USA01401
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0778P IMLA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Injection site pain, Laboratory test abnormal
SMQs:, Lack of efficacy/effect (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Info has been received from an RN concerning a 31 year old white female with no known drug allergies and no illness at the time of vaccination, who at 11:15 on 7/11/05 was vaccinated, IM, in the left deltoid with a dose of MMRII (lot 649746/0778P). Concomitant therapy included hormonal contraceptives (unspecified) "until this past month". The nurse reported that the pt winced as the vaccine was administered so it was probably slightly painful. No other reaction was noted. It was reported that a recent titer showed no immunity to rubeola, but the pt stated she had received the vaccination as a child. Unspecified medical attention had been sought. On 7/13/05, at 09:00, ;the pt was vaccinated, IM, in the left deltoid with a 2nd dose of Hep-B (Engerix-B) (lot AHBV074AA). No additional info is expected.

VAERS ID:256723 (history)  Vaccinated:2006-05-12
Age:31.0  Onset:2006-05-15, Days after vaccination: 3
Gender:Female  Submitted:2006-05-23, Days after onset: 8
Location:Montana  Entered:2006-05-26, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type: WAES0605USA03550
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1008P IMUN
Administered by: Other     Purchased by: Other
Symptoms: Bacterial infection
SMQs:
Write-up: Information has been received from a health professional concerning a 30 year old female with asthma who on 5/12/2006 was vaccinated IM with a 0.5 ml dose of Pneumococcal 23v polysaccharide vaccine (lot 651320/1008P). On about 5/15/2006, the patient was seen in the office with an infected arm. She was admitted to the hospital that day for a possible staph infection. Laboratory diagnostic studies included blood and other test done in the hospital. At the time of this report, she was still in the hospital receiving intravenous antibiotics and had not recovered. It was noted that the patient received a dose of Pneumococcal 23v polysaccharide vaccine 5 years ago. No product quality complaint was involved. Infected arm was considered to be an other important medical event (OMIC). Additional information has been requested.

VAERS ID:258186 (history)  Vaccinated:2006-05-23
Age:31.0  Onset:2006-05-25, Days after vaccination: 2
Gender:Female  Submitted:2006-06-08, Days after onset: 14
Location:South Dakota  Entered:2006-06-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE KNOWN
Preexisting Conditions: Ancef, Morphine, Diamox, PCN, Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0790P0IMRA
TTOX: TETANUS TOXOID, ADSORBED (NO BRAND NAME)AVENTIS PASTEURU170319791IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Joint range of motion decreased, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 05/25/06 at 1310 pt went to the Emergency Room for eval of Right Arm (deloid) where tetanus and pneumovax given on 05/23/06. Patient complained of onset fever on 05/24/06 evening. Site appeared to be erythema, warm to the touch, but muscle tissue soft otherwise with limited ROM secondary to pain per ER report. Sensation intact, motor intact, no vascular compromise and tendon function normal per ER report. Patient clinical impression was 1)Soft tissue localized reaction 2nd to immunization. 2)fever 2nd to immunization. 05/26/2006 Contacted mother of patient, are not as red - possible bigger in size, but patient is moving more. Overall better. Fever in evening os 5/25 was 101.7 AX but goes down with medicine.

VAERS ID:258263 (history)  Vaccinated:2006-05-22
Age:31.0  Onset:2006-05-30, Days after vaccination: 8
Gender:Female  Submitted:2006-06-07, Days after onset: 8
Location:Texas  Entered:2006-06-12, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0029F1IMRA
Administered by: Private     Purchased by: Public
Symptoms: Chills, Dizziness, Dyspnoea, Fatigue, Hyperhidrosis, Nausea, Pyrexia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: She became ill, feeling dizzy, nauseated, has shortness of breath, fatigue, fever, chills and sweating. She fainted within a couple of minutes of the onset.

VAERS ID:258289 (history)  Vaccinated:2003-04-25
Age:31.0  Onset:2003-04-25, Days after vaccination: 0
Gender:Male  Submitted:2006-06-12, Days after onset: 1144
Location:Kentucky  Entered:2006-06-12
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None although I reported having a headache, but was told that was my neck injury causing it.
Preexisting Conditions: Cervical injury to C5-C6. I am not sure of the lot numbers and cannot remember where I was given the shots. I know it was in the arm, but cannot remember.
Diagnostic Lab Data: February- March 2004 Chronic fatigue. March 2005- Fibromyalgia (related to anthrax) Did lab work, about ten of my bodily fucntions are malfunctioning. Thyroid, insulin, testosterone to name a few. She has the list if needed. Lab tests 04/24/06 magnesium, homocysteine, insulin, cortisol, free. All other lab tests within normal limits. EMG of LUE on 01/04 normal. Per 60 day follow up: Recipient has residual symptoms of insomnia, fibromyalgia, bipolor (severe mood swings), anxiety, depression, epilepsy, hypthyrodism, unable to have children, pituitary malfuntion, inslulin malfuntion, unable to work, chronic fatigue, low testostorone, low killer cells. This patient is unable to work and having to constantly go to numerous doctors for this.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 2 RA
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Anxiety, Bipolar disorder, Blood cortisol, Blood homocysteine, Blood magnesium, Blood testosterone decreased, Convulsion, Depression, Difficulty in walking, Electromyogram, Electromyogram normal, Epilepsy, Epstein-Barr virus infection, Fatigue, Fibromyalgia, Headache, Hypoaesthesia, Hypothalamo-pituitary disorder, Hypothyroidism, Impaired work ability, Influenza like illness, Insomnia, Insulin resistance, Laboratory test abnormal, Mood swings, Neck pain, Pain, Thyroid function test abnormal, Tremor
SMQs:, Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Hypothyroidism (narrow), Hyperthyroidism (broad), Depression (excl suicide and self injury) (narrow), Lipodystrophy (broad), Generalised convulsive seizures following immunisation (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: I was given three Anthrax shots between March 03 and July 03. I did report a headache at the time, but was told that was in relation to a neck injury. When I came home in August, I still had headaches, and my body began to hurt all over, I could not sleep and as of today, still have problems. My short term memory was affected, and at times, I would get brain fog. As the months passed, I began to get worse. I finally saw a pain doctor who told me I had chronic fatigue. He gave me medications, but they didnt seem to help. Over the next few months, I saw other doctors who told me it was in my head, or that I had fibrolyalgia. I also developed tremors where my hands and legs shake. Finally, I had enough. I felt like I had been hit by a truck and dragged 100 miles. I felt like I had the flu constantly. It was hard for me to walk because of the pain, or at times, even get out of bed. I went to see another doctor. She did blood work on me, and found that at least 10 of my bodily functions were malfunctioning. My thyroid, insulin, testosterone and 7 more. I have to get infusions now, and also testosterone shots. I take oxcontin for the pain, requip now because I have this creppy crawling feeling on my legs at night and sometimes goes up my body. I take Xyrem to help me sleep. I take other meds alos and supplements. I am no longer able to work. She diagnosed me with Fibromyalgia and told me that the Anthrax shot did this to me. There is no other explanation. She said she had worked at the VA, and this was common to the anthrax vaccine. My life is hell now. Always feeling like I have the flu and everything else going wrong with me. Im 35, this shouldnt be happening. I do have blood reports to prove this and a doctor attesting to this. 07/03/06-36 pages of records received from patient. Anthrax vaccine received 03/38/03. On 06/17/03 patient submitted a formal statement to the U.S. Army stating that on 04/02/03 "while doing P.T. sit ups he felt neck pop/crack and immediately became in pain". Trouble sleeping unable to turn head to left at time with arm soreness upon awakening. Also indicated he had been advised he will be send back for a medical board and discharge. Notes also include H&P dated 06/03/04 indicate original injury in Fall of 2002 with "crunch" base of skull and left arm lasting 304 months. Pain in knees, elbows, buttocks, hips, hands, low back, neck. Oxycodone did not help. Past surgeries include ortho on L knee and R elbow in 1990. DX of cervical neck pain, insomnia, fatigue and anxiety. RX with Klonipin, Paxil and Ambien. Physical therapy treatments in 6/04. Per annual follow up no further information is available. Follow-up: Emergent BioSolutions has no further information on this report. In the event that additional relevant medical information is received, a follow up report will be submitted. 60 day Follow-up Information 06-NOV-2006: Anxiety, mood swings, low killer cells, low testosterone, pituatary, insulin resistence, Epstein Barr virus, headaches, fatigue, fibromyalgia, chronic fatigue, seiazures, hypothroidsin

VAERS ID:258598 (history)  Vaccinated:1991-01-20
Age:31.0  Onset:0000-00-00
Gender:Male  Submitted:2006-06-12
Location:Unknown  Entered:2006-06-20, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0  
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: BLANK

VAERS ID:258682 (history)  Vaccinated:2006-06-06
Age:31.0  Onset:2006-06-13, Days after vaccination: 7
Gender:Male  Submitted:2006-06-14, Days after onset: 1
Location:Maryland  Entered:2006-06-22, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH402075  LA
Administered by: Private     Purchased by: Private
Symptoms: Injection site abscess, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 4-5cm circumferential erythema, warm, painful to touch at vaccine site. Moderate drainage. Treat with Levaquin 750mg PO daily for 5 days.

VAERS ID:258694 (history)  Vaccinated:2006-06-09
Age:31.0  Onset:2006-06-16, Days after vaccination: 7
Gender:Male  Submitted:2006-06-22, Days after onset: 6
Location:Wisconsin  Entered:2006-06-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CBC-WBC 10.2, Lymphs 13, Monos 3.5, Granulocytes 83.5. Throat culture-Strept Gp A negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV1020SCRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB268AA1IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX08621IMRA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Ear pain, Erythema, Feeling hot, Hypertrophy, Pharyngolaryngeal pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient presented to Medical Treatment Facility on 20June06 with c/o bilateral ear pain, sore throat, chills times 4 days. Temp 101.2. TM''s not inflammed, slight tonsillar hypertrophy, white spot R tonsil, no lymphadenopathy. L shoulder with swelling, erythema, and warm. Open lesion 1cm diameter surrounded by 21/2 inches swelling/erythema. Smallpox vaccination on 09June06.

VAERS ID:258702 (history)  Vaccinated:2006-05-07
Age:31.0  Onset:2006-05-09, Days after vaccination: 2
Gender:Female  Submitted:2006-06-22, Days after onset: 44
Location:Texas  Entered:2006-06-22
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 known allergies
Diagnostic Lab Data: LP - non-diagnostic; CSF Culture: no growth Culture viral general, enterovirus, CMV, Herpes Simplex: no virus isolated. Blood cultures: negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Chills, Headache, Lymphadenopathy, Malaise, Myalgia, Nausea, Photophobia, Pyrexia, Rash, Somnolence
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: PAINFUL LT. AXILLARY ADENOPATHY ON 5/9/2006 THEN, PROGRESSIVE SMALL PUSTULAR LESIONS FROM LT. DELTOID AREA c/w VACCINIA. MYALGIAS, HA, MALAISE, NAUSEA, SUBJECTIVE FEVER & CHILLS, MILD TO MODERATE PHOTOPHOBIA, INCREASED DROWSINESS. RASH PROGRESSED TO BOTH UPPER ARMS, NECK AND UPPER BACK. PT EVALUATED BY ID PHYSICIAN IN ED. NOT ADMITTED. VIG NOT ADMINISTERED. SYMPTOMATIC THERAPY.

VAERS ID:258970 (history)  Vaccinated:2005-02-26
Age:31.0  Onset:2005-02-26, Days after vaccination: 0
Gender:Female  Submitted:2006-06-29, Days after onset: 487
Location:Maryland  Entered:2006-06-29
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 0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Acne, Headache
SMQs:
Write-up: I experienced headaches following each innoculation with Hep B. I also began having severe skin problems (acne and other facial/neck marks) following vaccination.

VAERS ID:259271 (history)  Vaccinated:2006-06-29
Age:31.0  Onset:2006-06-30, Days after vaccination: 1
Gender:Female  Submitted:2006-07-03, Days after onset: 3
Location:North Carolina  Entered:2006-07-07, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0211F SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Acute dizziness s/p MMR and was prescribed antivert by ER MD and told to follow-up with primary medical provider

VAERS ID:259285 (history)  Vaccinated:2006-06-22
Age:31.0  Onset:2006-06-22, Days after vaccination: 0
Gender:Male  Submitted:2006-06-26, Days after onset: 4
Location:Massachusetts  Entered:2006-07-07, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1040P0 LA
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD160  RA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, warmth, pain, swelling in left upper arm axillary area.

VAERS ID:259299 (history)  Vaccinated:2006-06-20
Age:31.0  Onset:2006-06-20, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Massachusetts  Entered:2006-07-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1040P0 RA
Administered by: Public     Purchased by: Unknown
Symptoms: Nonspecific reaction
SMQs:
Write-up: Left blank on form.

VAERS ID:259310 (history)  Vaccinated:2006-05-08
Age:31.0  Onset:2006-05-08, Days after vaccination: 0
Gender:Male  Submitted:2006-07-07, Days after onset: 60
Location:Texas  Entered:2006-07-07
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Elevated Homo- Systein levels High Cholesterol PMH: hyperlipidemia, electrical shock (requiring skin grafting), increased homocysteine level.
Diagnostic Lab Data: EKG, Cardiac labs, Stress test, Echo, Sonogram R/O DVT LABS: TEE confirmed presence of very small patent foramen ovale.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTH 0IMLA
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 5IMLA
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER 4SCLA
Administered by: Military     Purchased by: Military
Symptoms: Arrhythmia, Atrial septal defect, Convulsion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Congenital, familial and genetic disorders (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Heart arrythmia, Syncope, Seizure. Admitted through ED. Stress Test, 3 days telemetry monitoring, Echocardiogram, All normal. 12/12/06 Received medical records from hospital which reveal patient admitted 5/8/06-5/10/06 s/p syncopy & possible seizure following vax. Patient was incontinent of urine & had post ictal period. Found to be in atrial fib & was admitted to cardio to r/o MI which was ruled out by enzymes. Instructed not to receive further anthrax vax. Final Dx: Syncope.

VAERS ID:259334 (history)  Vaccinated:2006-07-03
Age:31.0  Onset:2006-07-04, Days after vaccination: 1
Gender:Female  Submitted:2006-07-06, Days after onset: 2
Location:California  Entered:2006-07-10, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lovastatin 20mg, Yasmin 3mg
Current Illness: Had cut her finger
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU18808A IMLA
Administered by: Public     Purchased by: Other
Symptoms: Feeling hot, Injection site erythema, Injection site mass, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Sl itching, induration 3" L deltoid with warmth. Had bites on that arm before, bug bites (mosquito) L deltoid upper arm of induration at 11 o'' clock and 6 o'' clock with redness.

VAERS ID:259444 (history)  Vaccinated:2006-07-05
Age:31.0  Onset:2006-07-06, Days after vaccination: 1
Gender:Female  Submitted:2006-07-12, Days after onset: 6
Location:Pennsylvania  Entered:2006-07-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2491AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site redness, swelling, warm to touch, 55mm x 40mm induration and erythema. Also ache and chilled. Prescribed a Medrol dose pack.

VAERS ID:259643 (history)  Vaccinated:2006-07-07
Age:31.0  Onset:2006-07-07, Days after vaccination: 0
Gender:Female  Submitted:2006-07-17, Days after onset: 10
Location:North Carolina  Entered:2006-07-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Seasonal allergic rhinitis; Zyrtec
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 0IM 
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Injection site pain, Pruritus, Rash, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient developed a constellation of generalized itching, mild skin rash, injection site soreness, throat and chest tightness. Episodes 24 to 48 hours after a Td injection at her primary care clinic. Pruritus started 07/08/2006 and ended 07/13/2006, it was generalized and started about 24 hours after shot. Rash, focal, started 07/08/2006 and ended 07/13/2006, it was a few itchy papules on the forearm. Chest tightness started 07/09/2006 and ended 07/09/2006, episodes staring 48 hours after shot and resolved by the following day.

VAERS ID:259655 (history)  Vaccinated:2004-10-27
Age:31.0  Onset:0000-00-00
Gender:Male  Submitted:2006-07-09
Location:Massachusetts  Entered:2006-07-18, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0853  
Administered by: Military     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: Reaction not stated.

VAERS ID:259700 (history)  Vaccinated:2006-07-11
Age:31.0  Onset:2006-07-12, Days after vaccination: 1
Gender:Female  Submitted:2006-07-17, Days after onset: 5
Location:Arizona  Entered:2006-07-18, 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: Albuterol inhaler
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB248BA2IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 7/12/06 C/O soreness after injection and this AM noticed a raised area where injection was given. Which was to left deltoid. Obvious swelling to injection site no other bruising or discoloration.

VAERS ID:259810 (history)  Vaccinated:1999-05-25
Age:31.0  Onset:1999-05-27, Days after vaccination: 2
Gender:Male  Submitted:2006-07-20, Days after onset: 2611
Location:California  Entered:2006-07-20
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0433IDLA
Administered by: Military     Purchased by: Military
Symptoms: Amnesia, Arthralgia, Disturbance in attention, Dizziness, Fatigue
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Within a few days after receiving the fourth anthrax shot, patient experienced aching joints, episodes of being light headed, loss of concentration, memory loss, and moderate to severe fatigue. These symptoms lasted for appoximately two months. Other Anthrax shots administered 10/06/1998, 10/19/1998, 11/03/1998.

VAERS ID:260365 (history)  Vaccinated:2005-10-18
Age:31.0  Onset:2005-10-18, Days after vaccination: 0
Gender:Female  Submitted:2006-07-21, Days after onset: 276
Location:Virginia  Entered:2006-07-25, 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: Lipitor
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0510USA09113
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0791P IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site oedema, Pain, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Information has been received from a health professional concerning a 31 year old female who on 10/18/2005 was vaccianted with a 0.5ml dose IM in the left deltoid of Pneumococcal 23v polysaccharide vaccine, (lot 640453/0791P). Concomitant therapy included atorvastatin calcium Lipitor. That night, on 10/18/2005, the pt experienced a red and swollen left arm and she had pain in her shoulder blade and arm pit. The symptoms subsided on their own and she received no treatment. No medical attention was sought. The pt was considered recovered on 10/6/05. No further information was available. Additional information has been requested.

VAERS ID:260309 (history)  Vaccinated:2006-07-14
Age:31.0  Onset:2006-07-14, Days after vaccination: 0
Gender:Female  Submitted:2006-07-18, Days after onset: 4
Location:New Jersey  Entered:2006-07-26, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD145 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Disorientation, Fatigue, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Pt reported adverse reaction to DT vaccine on 7/18/06. Pt stated she felt very fatigued, nausea, feverish. Disoriented as if she had a hangover. These symptoms lasted for 3 days. Started approx 1 hr after vaccine was given on 07/14/06 and lasted until late in day 7/18/06. Pt states she now feels fine.

VAERS ID:260969 (history)  Vaccinated:2005-05-19
Age:31.0  Onset:2005-08-01, Days after vaccination: 74
Gender:Male  Submitted:2006-07-31, Days after onset: 364
Location:New Jersey  Entered:2006-08-02, Days after submission: 2
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: NONE
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Labs 10/25/05 GAD 65 AB 1.0 (<1.0), Islet cell AB, IFA w/reflex negative, A1C 9.4, Fructosamine 242, urine ketones negative, glucose 138. DX Tests: 9/3/05-CT pelvis with contrast: no active disease within the abdomen or pelvis. 01/23/06 MRI L Spine w/o contrast, degenerative changes, worst at L5-S1 on the left.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 3IMUN
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1083P1IMUN
HEPA: HEP A (VAQTA)MERCK & CO. INC.0917P1IMUN
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURX118921SCUN
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER40200720 UN
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU1354AA2IMUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURX085020IMUN
Administered by: Military     Purchased by: Military
Symptoms: Acidosis, Blood glucose increased, Diabetes mellitus, Fatigue, Laboratory test abnormal, Polydipsia, Polyuria, Weight decreased
SMQs:, Lactic acidosis (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Retroperitoneal fibrosis (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad)
Write-up: Diagnosed with Type 1 diabetes in Sept 2004, classic symptoms of polyuria, polydipsia, acidosis, fatigue and weight loss. Brief hospitalization for IVF''s and insulin initiation. Family history of diabetes. 8/3/06-medical records included with VAERS report. Chief Complaint on visit of 6/20-06: " I was told you were doing research on people who got diabetes after getting the vaccines." HX Present illness: Patient interested in filing a VAERS report regarding the onset of his Type 1 diabetes following receipt of multiple vaccines. After vaccines of MMR, IPV, TD, Hep A and Hep B on 5/2/05 complained of "feeling sick" (body aches, fatigue) within 2-3 day period. No local reactions to Typhoid and Influenza vaccines on 5/19/05. Smallpox on 6/13/05 and denies any significantly increased redness, streaking or swollen axillary lymph nodes. C/O pruritus at small pox vaccine site. In August 2005 began to experience increase in drinking water and frequency of urination, weight loss of 5 pounds. Increase intake "lots of sugar in his diet to regain weight." Constipation for 2 weeks, back pain, numbness and tingling in legs, felt like "feet wouldn''t move." Fatigue, continued weight loss, breath "fruity", seen in ER blood glucose $g300, admitted for ketoacidosis, hospitalized for 7 days. Family HX: type 1 diabetes and type 2 diabetes. Consulting MD: no fevers or chills, positive for weight loss and anorexia. No blurry vision, no nausea, vomiting or abdominal pain. Positive for polydipsia and polyuria. Positive for nocturia, no dysuria. Positive for musculoskeletal pain in his legs and back. All other pertinent review of systems are negative. DX: Diabetes Mellitus Type I with symptom onset approximately 3-4 months following multiple vaccinations. No additional records requested. krk

VAERS ID:260988 (history)  Vaccinated:2006-05-12
Age:31.0  Onset:2006-05-12, Days after vaccination: 0
Gender:Female  Submitted:2006-07-28, Days after onset: 77
Location:North Carolina  Entered:2006-08-02, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Claritin D, Lexapro
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Possible rash from MMR inj
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0950R0SC 
Administered by: Private     Purchased by: Other
Symptoms: Rash, Rash erythematous, Skin ulcer
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Arms and left thigh nummular, circumscribed, different size lesions that are erythematous in nature, slight raised without vesicles. They blanche on evaluation. No target appearance to them. They are 1/2cm to a full cm in size.

VAERS ID:261101 (history)  Vaccinated:2006-06-30
Age:31.0  Onset:2006-06-30, Days after vaccination: 0
Gender:Female  Submitted:2006-08-04, Days after onset: 35
Location:Minnesota  Entered:2006-08-04
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: 6 weeks postpartum
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)AVENTIS PASTEUR 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Joint range of motion decreased, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Extreme arm/muscle pain from shoulder to wrist beginning a few hours after the injection. Not typical injection site pain. The extreme arm pain lasted at least 2 weeks resulting in a decrease in range of motion of the arm. As of today (more than a month after injection given), pain and soreness still present limiting full arm mobility. Ultrasound treatments recommended but did not result in improvement.

VAERS ID:261130 (history)  Vaccinated:2003-03-20
Age:31.0  Onset:2003-12-12, Days after vaccination: 267
Gender:Male  Submitted:2006-07-31, Days after onset: 961
Location:North Carolina  Entered:2006-08-07, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: cyst, ear infection, scalp on hand
Preexisting Conditions: NONE
Diagnostic Lab Data: Normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 3UNUN
Administered by: Military     Purchased by: Military
Symptoms: Abdominal discomfort, Cyst, Fungal infection, Headache, Infection, Migraine, Tendon disorder
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (narrow)
Write-up: Abdomen: burning sensation, tendon disorder, cyst, headache, migraine. Infection, fungal, infection ear and sinus, skin pustule sores on scalp.

VAERS ID:261188 (history)  Vaccinated:2006-07-25
Age:31.0  Onset:2006-07-31, Days after vaccination: 6
Gender:Male  Submitted:2006-08-07, Days after onset: 7
Location:Wisconsin  Entered:2006-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.AHBVB289BA0IMRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Diarrhoea, Gastroenteritis, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Presented to the Clinic on 8/3/06 with c/o Nausea and Vomiting x 3 days. Diarrhea and extreme headaches for 3 days. Diagnosed with smallpox vaccine reaction and gastroenteritis. Phenergan 25mg ordered. Quarters x 24 hours and follow up at clinic in am.

VAERS ID:261640 (history)  Vaccinated:2006-08-03
Age:31.0  Onset:2006-08-04, Days after vaccination: 1
Gender:Female  Submitted:2006-08-16, Days after onset: 12
Location:Indiana  Entered:2006-08-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Takes Prozac
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2556AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Feeling hot, Injection site swelling, Lymphadenopathy, Pyrexia, Rhinorrhoea, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Area of injection started size of 50 cent piece as day progressed nose running, lymph nodes in neck swelled, area on left deltoid grew to 9 centimeters, hot to touch, core area 6cm, hard, looked pus like, low grade temp 99.6-99.8, chills, in bed shaking. Called in sick for work on Saturday (NICU nurse). Symptoms gone by Tuesday.

VAERS ID:261682 (history)  Vaccinated:2006-08-07
Age:31.0  Onset:2006-08-08, Days after vaccination: 1
Gender:Male  Submitted:2006-08-11, Days after onset: 3
Location:Nebraska  Entered:2006-08-17, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2556AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Reddened swollen left deltoid 4" diameter. (Patient thinks he might have had tetanus immunization 6 years ago, has no documentation.

VAERS ID:261782 (history)  Vaccinated:2006-08-02
Age:31.0  Onset:2006-08-12, Days after vaccination: 10
Gender:Female  Submitted:2006-08-13, Days after onset: 1
Location:South Carolina  Entered:2006-08-18, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH  IMUN
Administered by: Military     Purchased by: Military
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash

VAERS ID:262026 (history)  Vaccinated:2006-08-16
Age:31.0  Onset:2006-08-17, Days after vaccination: 1
Gender:Male  Submitted:2006-08-23, Days after onset: 6
Location:Massachusetts  Entered:2006-08-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Morbid obesity
Diagnostic Lab Data: None performed yet
CDC Split Type:
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TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD 1606IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Hyperhidrosis, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Fever (unmeasured), sweats, chills, malaise

VAERS ID:262355 (history)  Vaccinated:2006-08-21
Age:31.0  Onset:2006-08-22, Days after vaccination: 1
Gender:Male  Submitted:2006-08-29, Days after onset: 7
Location:Missouri  Entered:2006-08-30, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asprin
Diagnostic Lab Data: None
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1026SCLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ06631IMRA
Administered by: Military     Purchased by: Military
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling left upper arm into left shoulder and down to elbow.

VAERS ID:262676 (history)  Vaccinated:2006-08-17
Age:31.0  Onset:2006-08-18, Days after vaccination: 1
Gender:Male  Submitted:2006-08-29, Days after onset: 11
Location:Delaware  Entered:2006-09-07, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720  
Administered by: Military     Purchased by: Military
Symptoms: Chills, Fatigue, Injection site erythema, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Significant redness surrounding site of vaccine administration. (pt also experiencing persistent fever/chills/fatigue x 2 wks).

VAERS ID:262714 (history)  Vaccinated:2006-08-21
Age:31.0  Onset:2006-08-24, Days after vaccination: 3
Gender:Female  Submitted:2006-08-30, Days after onset: 6
Location:Kentucky  Entered:2006-09-07, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB289BA1IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0617F SCLA
Administered by: Other     Purchased by: Private
Symptoms: Parotitis, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal infections (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 8/29/06 stated swelling behind right ear and right cheek area 3 days after MMR was given. She stated it got worse, no fever V/S stable. 8/29/06 was seen by Dr. Diagnosis possible parotitis. Pt instructed to apply warm compresses, NSAIDS as needed.

VAERS ID:262920 (history)  Vaccinated:2006-08-15
Age:31.0  Onset:2006-08-16, Days after vaccination: 1
Gender:Female  Submitted:2006-08-18, Days after onset: 2
Location:California  Entered:2006-09-12, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: allergic to bees and ants
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Military     Purchased by: Military
Symptoms: Injection site swelling, Oedema, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 15 Aug 06 at 1030 received Anthrax left arm. Signs and symptoms started approximately 0600 16 Aug 06, she noticed swelling at the site, 1800, 16 Aug 06 by mouth started BENADRYL/TYLENOL/warm compress. 18 Aug 06, 1900 190mm diameter of edema. 99.2 temperature

VAERS ID:263000 (history)  Vaccinated:2006-08-29
Age:31.0  Onset:2006-08-29, Days after vaccination: 0
Gender:Female  Submitted:2006-09-01, Days after onset: 3
Location:Arizona  Entered:2006-09-13, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: BCP Yasmin
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Not available here
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0499F1SCLA
Administered by: Private     Purchased by: Private
Symptoms: Eye disorder, Facial palsy, Headache, Hypoaesthesia, Tongue oedema, Vision blurred
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Glaucoma (broad), Lens disorders (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: MMR vaccine given 8/29/06 about 1400, that evening noted numbness of right mouth and tongue swollen, 8/30 am, right eye unable to close and less movement. Right side of face, also headache back of head, blurred vision, 8/31 ER 1400 CT scan, lab tests, RX prednisone and referred to PCP and neurologist with diagnosis of Bells palsy.

VAERS ID:263416 (history)  Vaccinated:2006-08-25
Age:31.0  Onset:2006-08-28, Days after vaccination: 3
Gender:Male  Submitted:2006-09-21, Days after onset: 24
Location:North Carolina  Entered:2006-09-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Cell Count, BF Site/Specimen 28 Aug 2006 2350 Color CEREBROSPINAL FLUID COLORLESS Clarity CEREBROSPINAL FLUID HAZY Tube Number CEREBROSPINAL FLUID TUBE #3 Volume CEREBROSPINAL FLUID 1.0 WBC CEREBROSPINAL FLUID 2039 (H) RBC CEREBROSPINAL FLUID 5 PMN Cells/100 WBCs CEREBROSPINAL FLUID NPP Lymphocytes CEREBROSPINAL FLUID 81 Mono/Macrophage CEREBROSPINAL FLUID 9 Eosinophils CEREBROSPINAL FLUID NPP Basophils CEREBROSPINAL FLUID NPP CSF Mesothelial CEREBROSPINAL FLUID NPP Synovial Cells CEREBROSPINAL FLUID NPP Number Cells Diffed CEREBROSPINAL FLUID 100 Path Review CEREBROSPINAL FLUID CONCUR WITH FINDINGS
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSUNKNOWN5SCUN
Administered by: Military     Purchased by: Military
Symptoms: Meningitis
SMQs:, Noninfectious meningitis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was diagnosed with aseptic meningitis approx 3days after vaccination with anthrax #6.

VAERS ID:263886 (history)  Vaccinated:2006-09-22
Age:31.0  Onset:2006-09-23, Days after vaccination: 1
Gender:Female  Submitted:2006-09-25, Days after onset: 2
Location:Washington  Entered:2006-10-03, 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: Routine labs were done at the hospital and were normal.
CDC Split Type:
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TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD300100301PO 
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Hyperhidrosis, Hypotension
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypoglycaemia (broad)
Write-up: Pt took the second dose of oral typhoid vaccine and 5 hours later she had severe stomach cramps. An hour or so later she became diaphoretic and she went to ER. Her blood pressure in the ER was 75/49. She was given IV fluids, observed for 3 hours and released after her vital signs were normal.

VAERS ID:263965 (history)  Vaccinated:2006-08-28
Age:31.0  Onset:2006-08-31, Days after vaccination: 3
Gender:Female  Submitted:2006-09-28, Days after onset: 28
Location:North Carolina  Entered:2006-10-03, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1676DA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Right upper arm with 2 by 5 cm area of erythema surrounding injection site. PREDNISONE 9pak) 10 mg 6-D pak was given.

VAERS ID:263995 (history)  Vaccinated:2006-09-19
Age:31.0  Onset:2006-09-30, Days after vaccination: 11
Gender:Male  Submitted:2006-10-04, Days after onset: 4
Location:Wisconsin  Entered:2006-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC Split Type:
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Injection site erythema, Injection site induration, Injection site pain, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Presented to ER on 9/30/06 with c/o redness and tenderness surrounding his smallpox vaccination site. Received his smallpox vaccination on 9/19/06 and had area checked on 9/28/06 and it looked fine. The redness and tenderness developed on the 30th. He had been involved in training on the 29th and 30th. L upper arm smallpox vaccination site with 6 by 10cm area of warmth, redness and erythema surrounding the area of his previous vaccination. Some break down and maceration of the central area was noted. The area was indurated and warm, consistent with cellulitis. He was given Ancef 2 grams IV piggy-back and was started on Clindamycin 150mg 2 tablets four times a day for 10 day. Warm compresses ordered for four times a day, keep area dressed and clean. SM followed up on 10/2/06. Was to continue on Clyndamycin, RTC to clinic 3 days or prn. Light duty x 3 days.

VAERS ID:264269 (history)  Vaccinated:2006-10-10
Age:31.0  Onset:2006-10-10, Days after vaccination: 0
Gender:Female  Submitted:2006-10-10, Days after onset: 0
Location:Virginia  Entered:2006-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hypothyroidism
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500429P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Palpitations, Somnolence, Tongue disorder
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)
Write-up: Administered Flumist vaccine at 1245-1300. Pt felt sleepy, tongue heavy and palpitations within 1 hour of administration.

VAERS ID:264400 (history)  Vaccinated:2006-10-06
Age:31.0  Onset:2006-10-06, Days after vaccination: 0
Gender:Female  Submitted:2006-10-11, Days after onset: 5
Location:Georgia  Entered:2006-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depakote ER 500mg 1 daily. Daily Vitamins and Calcium Depo Provera 150mg q 3 mo.
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2275AA0IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1053R1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Convulsion
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Reported on 10/10/06 that she had seizure (absence of reality) approximately one hour after having had vaccines of MMR and Fluzone. States she has had "controlled seizure disorder" on Depakote and has only had one other "seizure" episode. She has had MMR and Td previously on the same day without problems. She stated she took Benadryl and then slept. She stated the following morning she awoke feeling much better. Has scheduled appt. with neurologist on 10/12/06 for regular annual visit.

VAERS ID:264449 (history)  Vaccinated:1999-05-21
Age:31.0  Onset:2002-03-01, Days after vaccination: 1015
Gender:Male  Submitted:2006-10-12, Days after onset: 1685
Location:Unknown  Entered:2006-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: denied
Preexisting Conditions: denies prior to 2002
Diagnostic Lab Data: pending- none available
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 3  
Administered by: Military     Purchased by: Military
Symptoms: Aggression, Anxiety, Arthralgia, Arthritis, Asthenia, Chest pain, Fatigue, Flushing, Gastrointestinal disorder, Hypoaesthesia, Lymphadenopathy, Malaise, Mental impairment, Myalgia, Nausea, Neoplasm, Nightmare, Pain, Paranoia, Peripheral coldness, Rash, Sexual dysfunction, Synovitis, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Tumours of unspecified malignancy (narrow), Hypersensitivity (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Since receiving AVA vaccinations in 1999 I''ve developed problems with mental changes (1999), tumors in my left leg (2002), chronic pain, lymphadenopathy, joint pain, GI problems, rashes, blurry vision, and paranoia. He reported on return from overseas in 1999, he advised medical of problems with his left leg and right shoulder. He stated he could no longer run due to joint/muscular pain. In March 2002 his left leg "gave out" and was advised he needed surgery for "bone cancer". In July 2002 he began to complain of nausea, vomiting following normal PT and thought he''d pulled a muscle. Two days later his left leg/foot was numb and cold. An MRI/angiogram revealed a "massive tumor" from his knee to ankle which was surgically removed 2 weeks later. He was hospitalized for 8-9 days with a diagnosis of Diffuse Pigmented Villonodular Synovitis (DPVMS). Following his first Anthrax vaccination, his arm was sore and it hurt to move. His chest hurt, he felt flushed, fatigued, generalized weakness/malaise, feeling both physical and mentally "bad" with increased aggressive behaviors. He also developed a nodule to the vaccine site which lasted for 1-2 weeks. All these symptoms began to resolve prior to receipt of the next vaccine and worsened with each sequential vaccination As of 9/2006 he continues to experience severe joint/muscular pain, persistent left leg swelling, lymphadenopathy, neurogic pain, GI problems, arthritis in neck/back/spine, blurry vision, sexual dysfunction, and long term memory concerns (anxiety, nightmares, obsessive compulsive disorder). 10/26/06 Received Clinical Summary from WRAMC-VHC which reveal patient evaluated by phone from WRAMC-VHC 9/2006 with complaints of mental changes, left leg tumors, chronic pain, lymphadenopathy, joint pain, GI problems, rashes, blurry visiion & paranoia since receiving anthrax vax in 1999 as noted on VAERS report. Patient was medically retired from military in 2004 w/40% DOD disability & 80% VA disability. Patient stated current symptoms include severe joint/muscular pain, persistent left leg swelling, lymphadenopathy, neurologic pain, GI problems, arthritis in neck/back/spine, blurry vision, sexual dysfunction & lung term memory concerns (anxiety, nightmares, OCD). DX: Diffuse pigmented villonodular synovitis, 2002; depression, 2005; neuropathic pain disorder, 2005, s/p dpvms; & DDD neck/spine, 2004. No current dx was offered at that time.

VAERS ID:264901 (history)  Vaccinated:2006-10-05
Age:31.0  Onset:2006-10-13, Days after vaccination: 8
Gender:Male  Submitted:2006-10-18, Days after onset: 5
Location:Unknown  Entered:2006-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Previous severe anxiety reactions with chest pain reported by patient. No allergies noted.
Diagnostic Lab Data: ECG within normal limits. CK-MB 1.2, Troponin was less than 0.05. CXR normal per MD. BMP and CBC normal LABS: labs, EKG & CXR were all read as WNL./ss
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH  IDLA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Lymphadenopathy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Arrived at our installation on 10/16/06 and reported c/o chest pain within 2 hours of arrival. He was taken to theER and evaluated. Apparently had received his smallpox vaccination on 05Oct06, approximately 8 days later he developed fever, aching and tender lymph nodes. 2 days following this he noted some pain in his left chest between the axilla and middle chest, symptoms did not increase in inhalation/exhalation. He has had past medical history of severe anxiety episodes with chest pain per patient. Soldier reported pain level at a 2 to 3 out of ten during ER visit. Lab testing done. Diagnosed as Chest pain, possibly associated with a smallpox vaccination but without any signs of any specific pericarditis or myocarditis. Patient was seen on follow up on 10/18/06 and soldier reported that he was feeling well. Released without limitations. 10/30/06 Received hospital ER medical records which reveal patient had received vax 10/5 & developed fever, achiness & axillary lymph node tenderness 8 days later. Two days prior to ER, had left chest pain between axilla & mid chest. PMH: severe anxiety episodes with chest pain. Dx: chest pain, possible associated with smallpox vax but w/o any signs of pericarditis or myocarditis. Was to rest in ER over night & f/u with Troop medical clinic in AM. No treatment rendered./ss

VAERS ID:265037 (history)  Vaccinated:2006-10-17
Age:31.0  Onset:2006-10-19, Days after vaccination: 2
Gender:Female  Submitted:2006-10-20, Days after onset: 1
Location:Maryland  Entered:2006-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No illness until the vaccination. Then became progressively ill. My three young children and husband are perfectly healthy. My
Preexisting Conditions: None
Diagnostic Lab Data:
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC 0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Headache, Hyperhidrosis, Malaise, Nasal congestion, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: I recieved the flu mist vaccination on 10/17 at 9:30 AM. Within a few hours, I developed a headache and nasal congestion. Over the next two days, these symptoms continued and worsened. By the evening of 10/19, I was feeling terrible. Throughout the night, I progressed to having extreme chills, fever, sweats, body aches, a pounding headache and nasal congestion/running nose. Today is 10/20, and these synptoms are still present. I feel terrible and very ill.

VAERS ID:265063 (history)  Vaccinated:2006-10-21
Age:31.0  Onset:2006-10-21, Days after vaccination: 0
Gender:Female  Submitted:2006-10-22, Days after onset: 1
Location:California  Entered:2006-10-22
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: Allergy to aspirin, chronic asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR21213A172IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Pyrexia, Restlessness, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Six hours after receiving vaccination, I developed a low grade fever, muscle aches, restlessness and vomiting. Symptoms lasted 18 hours and within 24 hours of vaccination completely dissipated.

VAERS ID:265228 (history)  Vaccinated:2006-10-09
Age:31.0  Onset:2006-10-09, Days after vaccination: 0
Gender:Female  Submitted:2006-10-11, Days after onset: 2
Location:California  Entered:2006-10-24, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins, B12, Calcium, Vit C, Glucosamine, Cranberry, Prevacid, Effexor.
Current Illness: NONE
Preexisting Conditions: Sulphanomide
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2240AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Arm was hurting one hour after shot was given, pt developed hives and itching 6 hours later. Pt saw PCP next day at 4pm and received Decadron shot, prednisone and Atarax.

VAERS ID:265321 (history)  Vaccinated:2006-10-25
Age:31.0  Onset:2006-10-25, Days after vaccination: 0
Gender:Male  Submitted:2006-10-25, Days after onset: 0
Location:Ohio  Entered:2006-10-25
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: n/a
Preexisting Conditions: n/a
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR2217AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient passed out for around 30 seconds. This was about 20 minutes after the shot was administered.

VAERS ID:265481 (history)  Vaccinated:2006-10-17
Age:31.0  Onset:2006-10-17, Days after vaccination: 0
Gender:Female  Submitted:2006-10-26, Days after onset: 9
Location:New Jersey  Entered:2006-10-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Asthma as child years and last environmental seasonal.
Diagnostic Lab Data: Chest X ray, Labs CBC LABS: CXR neg. WBC 8.4, neut 84.7, lymph 11.7. Strep screen neg.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2165EA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cough, Myalgia, Pharyngolaryngeal pain, Pyrexia, Vaccination complication, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: At approx 2-3 hours after receiving the vaccine began to have a dry cough, sore throat , Wheezing, temp went to 103. Took Benadryl, went to ED had IV, Tylenol, chest X ray and Labs. 1/29/07 Received medical records from hospital which reveal patient seen in ER on 10/17/06 with cough w/wheeze, fever of 103, myalgias & sore throat. Tx w/IVF, antipyretics & neb tx. Improved & d/c to home to f/u w/PCP if no improvement. FINAL DX: febrile illness s/p flu shot.

VAERS ID:265705 (history)  Vaccinated:2006-10-17
Age:31.0  Onset:2006-10-19, Days after vaccination: 2
Gender:Female  Submitted:2006-10-31, Days after onset: 12
Location:Minnesota  Entered:2006-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho Evra
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: 10/24/2006 CBC done 10/24/2006 Normal enhanced head CT 10/24/2006 Lumbar puncture - neg for meningitis and RBCs 10/26/06 Normal CBC
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE, INC./WYETH LABORATORIES, INC500434P0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Neck pain, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Sore throat on 10/19 in the AM - no treatment. Headache and neck pain starting on 10/21. Severe headache, neck pain, and fever on 10/22. Went to doctor on 10/22. Doctor sent patient to ER. CT scan, blood work, and lumbar puncture done in ER. Given MS 6 mg, Zofran 4 mg X 2, Phenergan 25 mg, 2 gm Rocephin; all IV. Headache and neck pain continued for next 3 days. CBC done on 10/26. Patient returned to ER because of severe head ache. Blood patch to lumbar puncture site was done on 10/26 to correct leaking spinal fluid from lumbar puncture. Patient''s headache was still present but pain was much less. Patient said symptoms subsided completely on 10/29.

VAERS ID:265784 (history)  Vaccinated:2006-10-21
Age:31.0  Onset:2006-10-21, Days after vaccination: 0
Gender:Female  Submitted:2006-10-21, Days after onset: 0
Location:New Mexico  Entered:2006-11-01, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2240AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Dizziness, Dyspnoea, Hypoaesthesia, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient experienced dizziness and felt as though she was going to faint. Numbness in arm injection was given in left. Difficulty breathing when trying to speak, very pale. 911 called - patient started to recover on her own. 911 assessed and patient was able to go home with family. Asked by 911 to follow up with primary physician.

VAERS ID:266178 (history)  Vaccinated:2005-06-10
Age:31.0  Onset:2005-06-11, Days after vaccination: 1
Gender:Female  Submitted:2005-06-13, Days after onset: 2
Location:Georgia  Entered:2006-11-07, Days after submission: 512
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: GA06032
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD-1177IMLA
Administered by: Public     Purchased by: Public
Symptoms: Feeling hot, Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 06/13/05 Client RTC with complaints of pain and redness at site of Td-LDT. Says it started 6/11/05. redness noted 12 cm X 12 cm, warm to touch. 7.5 cm x 7 cm indurated area. No fever. Client to take Benadryl and ibuprofen and put cold compresses alternating with warm compresses. To see PMD if does not resolve. 6/15/05 Client reports redness and pain subsided.

VAERS ID:266334 (history)  Vaccinated:2006-08-29
Age:31.0  Onset:2006-09-14, Days after vaccination: 16
Gender:Female  Submitted:2006-11-08, Days after onset: 55
Location:New Jersey  Entered:2006-11-08
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: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0907R0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Varicella rash post vaccine on 9/14/06 seen in office visit.

VAERS ID:266368 (history)  Vaccinated:2006-10-24
Age:31.0  Onset:2006-10-24, Days after vaccination: 0
Gender:Female  Submitted:2006-11-06, Days after onset: 13
Location:Unknown  Entered:2006-11-09, 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:
Current Illness:
Preexisting Conditions: Asthma chronic, Latex allergy.
Diagnostic Lab Data:
CDC Split Type: WAES0610USA13946
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1006P IMUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Dyspnoea, Injection site erythema, Injection site induration
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)
Write-up: Information has been received from a 31 year old female nurse practitioner with chronic asthma and latex allergy who on 10/24/06 was vaccinated with a dose of Pneumococcal 23v polysaccharide vaccine (lot 651318/1006P) (0.5ml), IM. Concomitant therapy that day included influenza virus vaccine (unspecified), at a different site. Subsequently, about two hours post vaccination, the pt developed local reactions at the injection site. The reactions included erythema, induration and cellulitis. She stated that she was also short of breath and required additional asthma medication. At the time of the report, the pt was recovering. The reporter considered her experience to be an other medical event (OMIC). Additional information has been requested.

VAERS ID:266411 (history)  Vaccinated:2006-08-31
Age:31.0  Onset:2006-08-31, Days after vaccination: 0
Gender:Male  Submitted:2006-11-09, Days after onset: 70
Location:Ohio  Entered:2006-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: ALT=70; MRI pending Normal electrolytes, CBC (except for a monocytosis), TSH negative HIV, monospot, EBV, and CMV
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUE623AA0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Chest pain, Fatigue, Headache, Vertigo
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (narrow)
Write-up: Vertigo 90 minutes after vaccination and still present; also has headache, fatigue, and chest pain; slight transaminitis; no fever, mental status changes, abdominal pain.

VAERS ID:266609 (history)  Vaccinated:2006-11-06
Age:31.0  Onset:2006-11-06, Days after vaccination: 0
Gender:Female  Submitted:2006-11-07, Days after onset: 1
Location:Texas  Entered:2006-11-13, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICSU2245AA UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site hypersensitivity, Injection site oedema, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness and swelling at site, itching to area.

VAERS ID:267001 (history)  Vaccinated:2006-10-25
Age:31.0  Onset:2000-10-27, Days after vaccination: -2189
Gender:Female  Submitted:2006-11-07, Days after onset: 2202
Location:Massachusetts  Entered:2006-11-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl, Advair,
Current Illness: NONE
Preexisting Conditions: asthma, hypothyroidism, anxiety, depression.
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0577R0SCLA
Administered by: Private     Purchased by: Public
Symptoms: Cellulitis, Chills, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: NL/YG cellulitis on left upper arm with fever, chills. Resolved with ibuprofen, ice and rest over next 48-72 hours.

VAERS ID:267027 (history)  Vaccinated:2006-11-14
Age:31.0  Onset:2006-11-14, Days after vaccination: 0
Gender:Female  Submitted:2006-11-16, Days after onset: 2
Location:Michigan  Entered:2006-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Lupus
Preexisting Conditions: lupus
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2271AA2IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1004Y0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Injection site erythema, Injection site warmth, Rash, Rash macular
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately 4 to 5 hours later, patient developed pain in joints throughout body; upper arm where vaccines were administered was red, warm (looked like blotchy rash).

VAERS ID:267372 (history)  Vaccinated:2006-11-15
Age:31.0  Onset:2006-11-15, Days after vaccination: 0
Gender:Female  Submitted:2006-11-20, Days after onset: 5
Location:Pennsylvania  Entered:2006-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: DENIES
Preexisting Conditions: NKA
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1786AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Hypersensitivity, Joint range of motion decreased
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: PER PATIENT: REC''D TETANUS SHOT ON 11/15/06. MY ARM THAT EVENING WAS REDDENED AND WARM TO TOUCH FROM MY WRIST TO MY SHOULDER. IT WAS ALSO HARD AND I WAS UNABLE TO MOVE IT. WENT TO CLINIC ON FRIDAY AND REC''D CARE FROM PHYSICIAN. PER TX CLINIC: LT SHOULDER CELLULITIS/ALLERGIC RX STARTED ON ANTIBIOTIC, MEDROL DOSE PACK, AND ANALGESIC RTW 11/20/06 WITHOUT COMPLICATIONS.

VAERS ID:267395 (history)  Vaccinated:2006-11-16
Age:31.0  Onset:2006-11-17, Days after vaccination: 1
Gender:Male  Submitted:2006-11-20, Days after onset: 3
Location:Colorado  Entered:2006-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2250AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives break out on Fri, Monday 24 hours later.

VAERS ID:267498 (history)  Vaccinated:2006-04-27
Age:31.0  Onset:2006-08-29, Days after vaccination: 124
Gender:Female  Submitted:2006-11-14, Days after onset: 77
Location:Florida  Entered:2006-11-21, 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: NONE
Current Illness:
Preexisting Conditions: Hepatitis C
Diagnostic Lab Data: Hepatic enzyme 8/06 elevated.
CDC Split Type: A0618823A
Vaccination
Manufacturer
Lot
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Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB055AA0 UN
Administered by: Other     Purchased by: Other
Symptoms: Hepatic enzyme increased
SMQs:, Liver related investigations, signs and symptoms (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of elevated liver enzymes in a 31 year old female subject who was vaccinated with Twinrix for prophylaxis. The subjects medical history included Hep C. There were no concurrent medications. On 4/27/06, the subject received 1st dose of Twinrix. On 8/29/06 4 months after vaccination with Twinrix, it was noted that the subject had developed elevated liver enzymes. As a result of this event, the immunization series with Twinrix was discontinued. This case was assessed as medically serious by manufacturer (OMIC). At the time of reporting the event was unresolved.

VAERS ID:267504 (history)  Vaccinated:2006-11-08
Age:31.0  Onset:2006-11-13, Days after vaccination: 5
Gender:Male  Submitted:2006-11-15, Days after onset: 2
Location:Oregon  Entered:2006-11-21, 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: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Labs WNL, CBC, ESR, Monospot, Strep throat culture.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2286AA IMUN
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Headache, Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed headache, fatigue and bilateral generalized lymphadenopathy, (cervical, axillary, and inguinal), that continues even 1 week after vaccination.

VAERS ID:267756 (history)  Vaccinated:2006-11-03
Age:31.0  Onset:2006-11-06, Days after vaccination: 3
Gender:Female  Submitted:2006-11-21, Days after onset: 15
Location:Maine  Entered:2006-11-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Blood test
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU22018A IMLA
Administered by: Public     Purchased by: Other
Symptoms: Headache, Musculoskeletal stiffness, Nausea, Neck pain, Vomiting
SMQs:, Acute pancreatitis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: 4 days after Flu shot developed neck stiffness, nausea, vomiting, headache neck pain. Treated by PCP IV pain meds IV fluids.

VAERS ID:267886 (history)  Vaccinated:2006-11-07
Age:31.0  Onset:2006-11-07, Days after vaccination: 0
Gender:Female  Submitted:2006-11-07, Days after onset: 0
Location:North Carolina  Entered:2006-11-28, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: no known drug allergies or food allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2286AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient complained of itching-9:06am 11/7/06; 11/7/06 9:28am client complained of shortness of breath to co-workers. First alert team notified and responded. At 9:06am given by mouth Benadryl 25mg given. At 9:28am Benadryl 50mg IM left arm: Epi 0.5cc SQ Right arm given. Transported via stretcher to ER.

VAERS ID:267888 (history)  Vaccinated:2006-10-30
Age:31.0  Onset:2006-10-31, Days after vaccination: 1
Gender:Female  Submitted:2006-11-22, Days after onset: 22
Location:Washington  Entered:2006-11-28, 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: No know drug allergies, positive PPD, negative CXR 1/21/03
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA206AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approx 25 hours after flu shot was received, developed itchy rash over all body. As time went on, it worsened to bumps and redness (11/1/06 about 2am). Went to ER at 0230am 11/1/06. Treated with meds with symptoms resolved almost immediately.

VAERS ID:268038 (history)  Vaccinated:2006-11-14
Age:31.0  Onset:2006-11-15, Days after vaccination: 1
Gender:Female  Submitted:2006-11-30, Days after onset: 15
Location:New York  Entered:2006-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: erythromycin allergy
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB058AA1IMRA
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1880DA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling and pain of injection site within 24 hours of vaccine of left deltoid after receiving Td. Last TD given over 10 years ago. 3 days after vaccine, site had mild erythema swelling and tenderness. No induration.

VAERS ID:268133 (history)  Vaccinated:2006-11-28
Age:31.0  Onset:2006-11-28, Days after vaccination: 0
Gender:Female  Submitted:2006-12-01, Days after onset: 3
Location:Michigan  Entered:2006-12-01
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2307AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness, swelling. Cellulitis. Treated with Keflex, Motrin.

VAERS ID:268352 (history)  Vaccinated:2006-11-27
Age:31.0  Onset:2006-11-27, Days after vaccination: 0
Gender:Female  Submitted:2006-11-29, Days after onset: 2
Location:Georgia  Entered:2006-12-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEP: HEP B (FOREIGN)MERCK & CO. INC.0601F0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Feeling hot, Myalgia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient said about 8:00pm her arm started swelling and was sore. Today at 12:10 patient arm is swollen, slightly tight feeling and warm to touch. Instructed patient to apply cold compresses to site.

VAERS ID:268378 (history)  Vaccinated:2006-11-30
Age:31.0  Onset:2006-11-30, Days after vaccination: 0
Gender:Female  Submitted:2006-12-05, Days after onset: 5
Location:Washington  Entered:2006-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo-Provera also given at same visit.
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2251AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash, Rash macular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: pt returned to clinic about 2hrs after vaccination with complaint of pruritis and rash on face, trunk & arms. Pt devloped erethematous macular rash & discrete wheals on face, chest, back, abdomen and upper extremeties & wheals on lower extremities. Pt received 50mg Diphenhydramine IM and was sent home with diphenhydramine 25-50mg po q6h prn.

VAERS ID:268384 (history)  Vaccinated:2006-11-16
Age:31.0  Onset:2006-11-30, Days after vaccination: 14
Gender:Male  Submitted:2006-12-05, Days after onset: 5
Location:Texas  Entered:2006-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: T = 98.1F
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2242AA0IMRA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2559AA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0794F0SCRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Pyrexia, Rash maculo-papular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever and fatigue 2 weeks post vaccination, noticed maculopapular lesions on trunk, face and arms over several days.

VAERS ID:268458 (history)  Vaccinated:0000-00-00
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2006-12-06
Location:Maryland  Entered:2006-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone only oral contraceptive
Current Illness: none
Preexisting Conditions: Stable asthma/rxed with Advair
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2260AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 4 days after receiving Fluogen employee starting getting fine erythemic rash on anterior and lateral aspects of thighs and lower back/c/o itchiness but no other sx.

VAERS ID:269665 (history)  Vaccinated:1991-04-05
Age:31.0  Onset:0000-00-00
Gender:Male  Submitted:2006-12-12
Location:Puerto Rico  Entered:2006-12-27, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? Yes
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
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UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Unknown
Symptoms: Arthralgia, Asthma, Back pain, Bronchitis chronic, Gastrooesophageal reflux disease, Headache, Hyperlipidaemia, Hypersensitivity, Knee operation, Migraine, Rash, Rhinitis allergic, Sinusitis, Sleep apnoea syndrome, Tinnitus, Visual disturbance
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific dysfunction (narrow), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hearing impairment (narrow), Lipodystrophy (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Low back pain, and asthma problems, tinnitus, sinusitis, migraine, headache, allergic, joint pain, skin rash etc, vision. 02/06/07-records received and reviewed DX: Asthmas bronchial mixed hyperlipidemia allergic rhinitis DDD-Lumbo sacral spine Chronic back pain GERD sleep problems chronic bronchitis nos abnormal glucose tolerance test hyperlipidemia chronic sinusitis asthmas, unspecified chronic back pain arthralgia surgical history left knee meniscus repair 2001 obstructive sleep apnea.

VAERS ID:269721 (history)  Vaccinated:2003-02-23
Age:31.0  Onset:0000-00-00
Gender:Male  Submitted:2006-12-20
Location:Puerto Rico  Entered:2006-12-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS  IMRA
DT: DT ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER    
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH   UN
Administered by: Military     Purchased by: Military
Symptoms: Arrhythmia, Arthralgia, Back pain, Bone pain, Dry mouth, Headache, Nausea, Pain, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Ache: bones, joints, arrhythmia (AF), dry mouth, nausea, headaches, pain: lower back, bones and joints, right shoulder, hips and leg.

VAERS ID:269916 (history)  Vaccinated:2006-12-18
Age:31.0  Onset:2006-12-18, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New York  Entered:2007-01-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Drug hypersensitivity
Preexisting Conditions: Allergic to depacote, Lortab, nuerontin, valicum,
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.1161F0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Pruritus generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt called 12/20/06 and reported that on the evening of 12/18/06 she developed generalized itching and hives, no other symptoms. She was instructed to take 25mg Benadryl Q 6H when needed. No further vaccinations will be administered per Dr.p report has been received from a registered nurse concernng a 31 year old female with drug allergies to DEPAKOTE, LORTAS, NEURONTIN, VALIUM and FIORICET. On 18-DEC-2006 (also reported as 18-DEC-1976) the patient was vaccinated with her first dose of GARDASIL (Lot number 65450/1161F) intramuscularly in the left deltoid. On 18-DEC-2006 in the eveneing, the patient experienced generalized itching and hives. The patient was instructed to take BENADRYL 25 mg every 6-8 hours until the itching subsided. The patient was informed that she will not be receiving the additional 2 vaccinations. Additional informationis not expected.

VAERS ID:270142 (history)  Vaccinated:2006-12-01
Age:31.0  Onset:2006-12-01, Days after vaccination: 0
Gender:Male  Submitted:2006-12-04, Days after onset: 3
Location:Pennsylvania  Entered:2007-01-08, Days after submission: 35
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: Allergy to Penicillin (as a child), hypertension (stopped meds self 2 years ago)
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2195AA0IM 
Administered by: Public     Purchased by: Other
Symptoms: Cold sweat, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)
Write-up: Client received Fluzone ''06-07'' influenza vaccine at 2:20 pm. At 2:40 pm employee health notified he was cold, clammy, diaphoretic. He was transported to the Emergency Care Center per wheel chair. Placed on chart, vitals were stable. No other treatment. Discharge from hospital 20 minutes after arrival.

VAERS ID:270435 (history)  Vaccinated:2006-11-08
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2006-12-05
Location:Michigan  Entered:2007-01-12, Days after submission: 38
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)EVANS VACCINESAFLUA236BA1IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0674F0IM 
Administered by: Other     Purchased by: Unknown
Symptoms: Chills, Influenza like illness, Injection site erythema, Injection site oedema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left arm was very sore, slightly red and swollen. I also had flu type symptoms like, fever, chills. Lasted for 2-3 days.

VAERS ID:270630 (history)  Vaccinated:2007-01-09
Age:31.0  Onset:2007-01-11, Days after vaccination: 2
Gender:Male  Submitted:2007-01-17, Days after onset: 6
Location:California  Entered:2007-01-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: Hx of stomach ulcers in 2006 - resolved before vaccination. Chronic hx of heat rash in extremities however patient states current rashing is different from previous heat rashes.
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.0216F0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Blister, Gastric ulcer, Heat rash, Pruritus, Rash
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Gastrointestinal ulceration (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Beginning 2 days after vaccination, minimal bilateral forearm pruritic blistering occurred. Over following 2-5 days, patient stratched blistered causing them to open and now rash appears to be resolving. No rashing on chest or face. No associated brusing, bleeding (epistasis or gingival), GI distress, fever or chills.

VAERS ID:271075 (history)  Vaccinated:2007-01-20
Age:31.0  Onset:2007-01-20, Days after vaccination: 0
Gender:Male  Submitted:2007-01-24, Days after onset: 4
Location:North Carolina  Entered:2007-01-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None.
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER   RA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Erythema, Headache, Localised oedema, Mass, Pain, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Headache, weakness, local redness/edema/mass/pain and rhinorrhea.

VAERS ID:271550 (history)  Vaccinated:2007-01-26
Age:31.0  Onset:2007-01-26, Days after vaccination: 0
Gender:Female  Submitted:2007-01-31, Days after onset: 5
Location:Kentucky  Entered:2007-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Blood Pressure medication
Current Illness:
Preexisting Conditions: Hx of tachycardia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2279AA0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt presented with HIVES and itching after Flu Vaccine given about 20 minutes after vaccine.Pt given 50 mg IM of Benadryl. Pt monitored for 30 minutes after reaction. Pt ambulated to vehicle, husband drove home, no further problems. Counseled on S/SX to watch for and when to present to ER.

VAERS ID:271778 (history)  Vaccinated:2006-07-14
Age:31.0  Onset:2006-07-15, Days after vaccination: 1
Gender:Female  Submitted:2006-07-20, Days after onset: 5
Location:Pennsylvania  Entered:2007-02-05, Days after submission: 200
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Effexor, Trazadona
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: AE0613
Vaccination
Manufacturer
Lot
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Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD157 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Injection site erythema, Injection site swelling, Muscle tightness, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient received Td injection and next day developed redness, swelling at injection site, generalized muscle pain, muscle tightness, nausea and chills. Patient visited Urgent Care Center to report an adverse event. At the time of the visit patient''s reaction was subsiding. Patient still had some generalized muscle pain and was given Benadryl and Ibuprofen.

VAERS ID:271994 (history)  Vaccinated:2006-07-11
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2007-02-06
Location:Louisiana  Entered:2007-02-09, 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: Prenatal vitamins, Iron, Zyrtec
Current Illness:
Preexisting Conditions: Allergy to Penicillin. The patient received an injury to her toe that resulted to vacc with Adacel on 11 Jul 2006. Follow up rec''d on 06 Nov 2006. Significant medical conditions DM II. Date of LMP was 04 Dec 2005. 3 previous preg, 2 resulted in live births, with no congenital anomalies, 1 resulted in spontaneous abortion prior to 20 weeks gestation. Current preg history consisted o
Diagnostic Lab Data: Alpha feto protein at 34 weeks with normal results, fetal stress tests every week for 32 weeks with normal results, 3 ultrasounds the last one at 20 weeks, all with normal results.
CDC Split Type: 200601744
Vaccination
Manufacturer
Lot
Dose
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Site
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2340AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Alpha 1 foetoprotein amniotic fluid normal, Foetal non-stress test, Gestational diabetes, Normal delivery, Pregnancy, Ultrasound scan normal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Initial report received on 11/Jul/2006 from a health care professional. A 31 year old female patient with a past medical history that includes the current pregnancy, allergy to Penicillin, and two previous pregnancies that resulted in the delivery of one normal/viable infant per pregnancy had received a 0.5ml intra muscular dose of Adacel, lot number C2340AA, in the left deltoid, on 11/Jul/2006. The patient had been vaccinated with Adacel for an injury she received to her toe. Her last menstrual period was on 14/Dec/2005. Her expected date of delivery was not provided. Per the reporter, the subject has not experienced any adverse events since the vaccination with Adacel on 11/Jul/2006. Follow up information received on 06 November 2006. The completed Pregnancy report form was received. The patient had the following significant medical conditions. Diabetes Mellitus II, Ovarian cancer and obesity. The date of her last menstrual period was 04 Dec 2005 and her estimated date of delivery was 26 Sept 2006. She had 3 previous pregnancies, 2 of which resulted in live births, with no congenital anomalies and 1 of which resulted in a spontaneous abortion prior to 20 weeks gestation. The patient also exposed to the following drugs. Prenatal vitamins with Iron for an intrauterine pregnancy indication-taken per os at the start of the pregnancy and Zyrtec for an allergy indication taken per os at 20 weeks of the pregnancy. Her current pregnancy history consisted of Group B strep and gestational diabetes mellitus at 34 weeks with normal results. The patient gave birth vaginally on 18 Sept 2006, at 39 gestational weeks, to one female, live child with no congenital anomaly. The child''s weight was 5 lbs, 10.8 oz and her length was 18 1/2 inches. Her apgar scores were 8 at 1 minute and 9 at 5 minutes. Follow up information received on 05 January 2007. The baby continues to do well. Follow up information received on 29 January 2007. After internal review, case upgraded to serious status. The patient had 3 ultrasounds and they were a

VAERS ID:273177 (history)  Vaccinated:2006-12-12
Age:31.0  Onset:2006-12-12, Days after vaccination: 0
Gender:Female  Submitted:2007-02-27, Days after onset: 77
Location:Unknown  Entered:2007-02-28, 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: GLUCOPHAGE
Current Illness: Type II diabetes mellitus, Sulfonamide allergy, Drug hypersensitivity, Penicillin allergy
Preexisting Conditions: Gastric bypass, gastric stapling reversal, asthma
Diagnostic Lab Data:
CDC Split Type: WAES0702USA03479
Vaccination
Manufacturer
Lot
Dose
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Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0955F0IM 
Administered by: Other     Purchased by: Other
Symptoms: Amnesia, Convulsion, Dyspnoea, Headache, Incoherent, Influenza like illness, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Acute central respiratory depression (broad), Psychosis and psychotic disorders (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from a licensed practical nurse concerning a 31 year old female with type II diabetes mellitus, sulfa, morphine, DEMEROL and penicillin allergy and a history of gastric bypass (1994), reverse gastric bypass (1996) and mild asthma who on 12-DEC-2006 was vaccinated with her first dose of Gardasil (lot #653978/0955F), 0.5 ml, IM. Concomitant therapy included metformin HCL (GLUCOPHAGE). On 12-DEC-2006 less than one hour after receiving her first dose of Gardasil, the patient developed "Flu-Like" symptoms. The patient stated that she had a headache and nausea but was not sure if she had a fever. About ten hours after the initial vaccine was administered the patient had a convulsive seizure. The seizure lasted about 2 minutes. The patient was not coherent and was breathing heavy. After the seizure, the patient continued to fell ill and had no memory of the seizure. The patient did not go to the hospital. The patient''s husband was an EMT, so he attended to her but did not given her any medication. The patient had no prior history of seizures. The next day the patient felt better. Upon internal review, convulsive seizure was considered to be an other important medical event. Additional information has been requested.

VAERS ID:274152 (history)  Vaccinated:2007-03-08
Age:31.0  Onset:2007-03-09, Days after vaccination: 1
Gender:Female  Submitted:2007-03-16, Days after onset: 6
Location:California  Entered:2007-03-16
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: blood test
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DT: DT ADSORBED (NO BRAND NAME)BSI    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Blood test, Chills, Dizziness, Fatigue, Hypoaesthesia, Injection site pain, Myalgia, Neck pain, Pain in extremity, Pyrexia, Reaction to preservatives
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: I was admited to the above mentioned Hospital emergency room on 03/08/2007, at 05:29 pm. for minor injury to the eye. The nurse insisted on me getting the DIPHTHERIA/TETANUS VACCINE. I was not given the vaccine information or informed of the risks prior to vaccination. NP asssured me that vaccine is very safe. Vaccine was adminestered to me, and related printed information was given to me during the discharge on 06:23:35 pm of the same day. I went home and on the same night and woke up 4-6 hours later with sevire paine in the site of injection, in the upper right arm , which progressed in to complete numness of the same arm, followed by the severe fatigue and muscle pain of the back, arms and legs. Six hours later joint inflammation and muscle pain was so severe that it was painful for me to move at all, I started having chills and fever of 100,3 F, dizziness, fatigue and severe pains to the back of the neck in addition to al the above mentioned simptoms. My husband became very concerned, he gave me Ibprofen and took me to Emergency Room on 03/09/2007,at 09:30 pm. I was seen by doctor. I had to be wheeled in the wheel chair, because it was very painful for me to walk and I had a severe fatigue and dizziness. I explained all the above mentioned symptoms, but the doctor keep denying that my illness is vaccination related and I have a case of flu. He recomended plenty of fluids and rest and discharge me. I know he didn''t fill out the adverse react. report or contact the first emergency room I was admitted to, because he denies it''s vaccine related. Then we came home my husband gave me another dose of Ibprofen and I had to sleep in the recliner, in sitting position, because it was to painfull for me to lay down. I had severe muscle and joint pains for the next 3 days. The numbness in my right arm started to decrease after 3 days, I start slowly using that arm after 5 days. It is been 8 days since reaction to vaccination and I am having arthritis like pains in my joints, especially in my wrists, but NEVER develop any

VAERS ID:274406 (history)  Vaccinated:2007-03-17
Age:31.0  Onset:2007-03-17, Days after vaccination: 0
Gender:Female  Submitted:2007-03-19, Days after onset: 2
Location:South Carolina  Entered:2007-03-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB403BA1IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Palpitations, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Received hepatitis B vaccine Saturday evening 3-17-07 at approximately 6:30pm. Between 9:00 and 9:30p started having heart palpitation Sunday morning at approximately 7:00 am blurred vision, fainted. Transported to medical center - lab work, chest x-ray and EKG obtained - some PVCS noted (did not admit). Syncope episode around 1:30pm 3-19-07.

VAERS ID:274513 (history)  Vaccinated:2006-07-20
Age:31.0  Onset:2006-07-20, Days after vaccination: 0
Gender:Female  Submitted:2007-03-21, Days after onset: 244
Location:Massachusetts  Entered:2007-03-22, 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: UNK
Current Illness:
Preexisting Conditions: Pregnancy NOS (LMP=6/22/2006)
Diagnostic Lab Data: Beta-Human Chorionic 07/20/06, positive
CDC Split Type: WAES0607USA04154
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0031R  UN
Administered by: Other     Purchased by: Other
Symptoms: Abortion induced, Drug exposure during pregnancy, Foetal chromosome abnormality, Pregnancy test positive
SMQs:, Congenital, familial and genetic disorders (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Information has been received from a nurse practitioner concerning a 31-year-old female patient who on 20-JUL-2006 (previously reported as 12-JUL-2006) was vaccinated with a dose of MMR II (lot #649240/0031R). Her LMP was on 22-JUN-2006 and her estimated date of delivery was 29-MAR-2007. The nurse reported that the patient became pregnant on approximately 03-JUL-2006. The patient was vaccinated about four and a half weeks after her LMP. It was noted that the nurse did not know the patient was pregnant as she had told the doctor that she was going to try to get pregnant in the fall of 2006. The patient was seen in the am of 20-JUL-2006 and was told that her pregnancy test was positive. Additional information has been received from the nurse practitioner. Medications taken during her pregnancy included prenatal vitamins and a folic acid supplement. Her obstetrical history was unknown but she was follow by an OB/GYN. The patient had an elective termination 20 weeks from her LMP, on approximately 10-NOV-2006. The fetus had a congenital anomaly described as Jacosen syndrome (11q23 deletion). Upon internal review, induced abortion was considered to be an other important medical event. Additional information has been requested.

VAERS ID:274540 (history)  Vaccinated:2006-04-04
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2006-04-17
Location:D.C.  Entered:2007-03-22, Days after submission: 339
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: BERNA20060059
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD  PO 
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
Administered by: Other     Purchased by: Other
Symptoms: Lymphadenopathy
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This 31-year old female was vaccinated with Vivotif (Batch no.: unknown) on 04-Apr.2006. She also received yellow fever and tetanus-diphtheria vaccine on the same day. She had developed ADENOPTAHY IN THE NECK AND AXILLAE. Her doctor is planning to biopsy one of her nodes. Further information is expected. The case was reported to be non-serious.

VAERS ID:275261 (history)  Vaccinated:0000-00-00
Age:31.0  Onset:0000-00-00
Gender:Male  Submitted:2007-03-07
Location:Georgia  Entered:2007-03-26, Days after submission: 18
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: spinal tap ?/?/01 Mild elevation in protein; pulmonary function test ?/?/01 results unspecified
CDC Split Type: WAES0602USA01341
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1749K1  
Administered by: Other     Purchased by: Other
Symptoms: CSF protein increased, Guillain-Barre syndrome, Lumbar puncture, Muscular weakness, Pain in extremity, Pulmonary function test
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Information has been received from a medical assistant concerning a 31-year-old male with no pertinent medical history, who was vaccinated with a second dose of hepatitis B (lot # 637982/1749K) (date, route and dose unspecified). There was no concomitant medication. In 2001 the patient complained of weakness in both hands, soreness in the biceps and forearms bilaterally; unspecified medical attention was sought. The patient was subsequently diagnosed with a mild case of Guillain-Barre Syndrome and was hospitalized. Pulmonary function tests were performed (results unspecified) and a spinal tap revealed mild elevation in protein. The time frame between the dose of hepatitis B and the onset of the symptoms is unknown. It was reported that the patient recovered. Medication taken by the patient as of 06-FEB-2006 included "baby aspirin" and multivitamins. No product quality complaint was involved. The reporter considered the patient''s adverse experience to be life threatening. Additional information has been requested.

VAERS ID:275272 (history)  Vaccinated:2006-03-20
Age:31.0  Onset:2006-03-20, Days after vaccination: 0
Gender:Female  Submitted:2007-03-07, Days after onset: 352
Location:Maine  Entered:2007-03-26, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0604USA00538
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 0 UN
Administered by: Other     Purchased by: Other
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Information has been received from a physician concerning a female in her early 30s with a family history of multiple sclerosis who in the "week of 20-MAR-2006" was vaccinated with a first 1.0ml dose of Recombivax HB. The "week of 20 Mar 2006", within 24 hours of vaccination, the patient experienced myalgia in her lower extremities. She described it as her legs felt like she was walking in water. It was noted that symptoms lasted 1 day. It was also noted that she recovered on 04-APR-2006. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested.

VAERS ID:275323 (history)  Vaccinated:2004-02-25
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2007-03-07
Location:Unknown  Entered:2007-03-26, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: atenolol, hydrochlorothiazide
Current Illness:
Preexisting Conditions: Drug hypersensitivity; Hypertension
Diagnostic Lab Data: Serum hepatitis B, 08/07/06, negative
CDC Split Type: WAES0608USA01944
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.646999/0999N1IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hepatitis B e antigen negative, Hepatitis B surface antigen negative, Inappropriate schedule of drug administration, Thyroidectomy
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Hypothyroidism (broad), Hyperthyroidism (broad), Medication errors (narrow)
Write-up: Information has been received from a physician''s assistant concerning a 31 year old female with an allergy to codeine and hypertension who was vaccinated IM with a first, second and third dose of hepatitis B virus vaccine rHBsAg (yeast) on 20, Jan 2004 (Lot # 643221/0386M) 25, Feb 2004 (Lot # 646999/0999N), and 13, Feb 2006 (Lot # 649259/0833R) respectively. Concomitant therapy included atenolol and hydrochlorothiazide. On 07, Aug 2006 the patient had a hepatitis B titer that was negative. Unspecified medical attention was sought. There was no product quality complaint involved. Information received on 09, Aug 2006 contained the following adverse experiences: partial thyroidectomy (December 2005)

VAERS ID:274961 (history)  Vaccinated:2007-03-13
Age:31.0  Onset:2007-03-14, Days after vaccination: 1
Gender:Male  Submitted:2007-03-22, Days after onset: 8
Location:Connecticut  Entered:2007-03-27, 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
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)AVENTIS PASTEUR02632AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Abdominal pain, Chills, Headache, Muscle spasms, Nausea, Pain, Pain in extremity, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever 101F, aching arms and legs, cramping, chills, traphorisis. Abdomen pain, mild nausea, headache. Treated with Ibuprofen, increase fluids

VAERS ID:275407 (history)  Vaccinated:1991-03-01
Age:31.0  Onset:1991-03-01, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Puerto Rico  Entered:2007-04-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Rash, pain joints
Preexisting Conditions: To the present body aches
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Unknown
Symptoms: Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Body aches, feverish c/o nausea, no vomiting the day. Vaccine administered.

VAERS ID:275418 (history)  Vaccinated:2007-03-24
Age:31.0  Onset:2007-03-24, Days after vaccination: 0
Gender:Female  Submitted:2007-03-31, Days after onset: 7
Location:Arizona  Entered:2007-04-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)AVENTIS PASTEURZ090510IMRA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Body temperature increased, Food allergy, Influenza like illness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approx 8 pm 3-24-07 felt nausea, joint pain entire body, emesis x 2, temp 100.8 flu like s/s - con''t Tue 3-25-07 morn Went to her PCP. Given PO Benadryl s/s resolved 3-25-07 by evening. PCP DX allergy to chicken protein.

VAERS ID:275619 (history)  Vaccinated:2007-02-02
Age:31.0  Onset:2007-02-27, Days after vaccination: 25
Gender:Female  Submitted:2007-04-04, Days after onset: 35
Location:New Mexico  Entered:2007-04-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Trilevelen; Ranitidine; Zoloft; Hctz; Metaformin; Loperamide; Actacand
Current Illness: NONE
Preexisting Conditions: Polycystic Ovary Syndrome; HTN; IBS; Depression
Diagnostic Lab Data: Vaccinia Virus Isolation Culture-sent to hospital virology/epidemiology lab on 3/7/07-reported as negative to doctor
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200750 LA
Administered by: Other     Purchased by: Other
Symptoms: Culture negative, Rash papular, Rash vesicular, Skin lesion, Urticaria, Vaccinia, Wound drainage
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient reported skin lesions on leg on 2/27/07-pink/red and scaly papules covering area of 3 cm x 3 cm of right lower leg and small papule on right lateral knee. No fever, no chills-no systemic signs and symptoms; On 3/5/07 evaluated by doctor-vesicular rash on right lower leg with drainage, right lateral knee lesion with drainage; Pt evaluated by doctor (3/6/07) and doctor (10) on 3/7/07. Vaccinia culture sent-(hives); supportive cane and off work for 7 days; dings to all lesions. Last flu date 3/20/07 lesion-no further vesicles. doctor contacted by doctor.

VAERS ID:275796 (history)  Vaccinated:2007-04-02
Age:31.0  Onset:2007-04-07, Days after vaccination: 5
Gender:Male  Submitted:2007-04-09, Days after onset: 2
Location:California  Entered:2007-04-09
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: pt taking Motrin for shin splints x 1wk
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDRA
Administered by: Military     Purchased by: Military
Symptoms: Axillary pain, Dizziness, Fatigue, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: Pt developed fatigue, lightheadedness, and painful swelling in R axilla 4-5 days after vaccine administration in R upper arm. Pt seen today in clinic w/ same complaints. Says symptoms have been stable over last 2-3 days. Denies LOC, HA, f/c, SOB, chest pain, n/v.

VAERS ID:275808 (history)  Vaccinated:2007-02-06
Age:31.0  Onset:2007-02-07, Days after vaccination: 1
Gender:Male  Submitted:2007-04-10, Days after onset: 61
Location:Maryland  Entered:2007-04-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETHUNK0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Joint stiffness, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: SHOULDER PAIN AND STIFFNESS SINCE VACCINATION, 2 MONTHS.

VAERS ID:275913 (history)  Vaccinated:2006-08-04
Age:31.0  Onset:0000-00-00
Gender:Male  Submitted:2007-04-05
Location:California  Entered:2007-04-10, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: Vaccina PCR testing - Negative Bcx - negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200710 LA
Administered by: Military     Purchased by: Military
Symptoms: Blood culture negative, Injection site induration, Injection site reaction, Polymerase chain reaction, Skin ulcer
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received vaccine Aug 06 site crusted over x 4 months then fell off to expose a 1cm ulcer that persisted ever since our first visit Mar 07. I changed the dressing for bandaid with Teffa and over course of 2 weeks it worsened/ progressed to entire upper arm and small area over face.

VAERS ID:275922 (history)  Vaccinated:2007-04-02
Age:31.0  Onset:2007-04-03, Days after vaccination: 1
Gender:Male  Submitted:2007-04-10, Days after onset: 7
Location:Texas  Entered:2007-04-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSUNKNOWN1SCLA
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN5IMLA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURERUNKNOWN1IMRA
Administered by: Military     Purchased by: Other
Symptoms: Erythema, Induration
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt with 8x6cm of erythema, 5x5cm of induration. NOT ALL INFORMATION IS AVAILABLE.

VAERS ID:276848 (history)  Vaccinated:0000-00-00
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2007-04-13
Location:New Jersey  Entered:2007-04-16, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0703USA03994
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IJUN
Administered by: Private     Purchased by: Other
Symptoms: Incorrect route of drug administration, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 31 year old female who was vaccinated with Gardasil. Subsequently the patient developed a severe rash. The patient was vaccinated in the biceps and possibly subcutaneouusly. The patient was not given a second dose to the previous rash. As of 20-MAR-2007, the patient was recovering from the severe rash. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007.

VAERS ID:276984 (history)  Vaccinated:2007-04-10
Age:31.0  Onset:2007-04-11, Days after vaccination: 1
Gender:Female  Submitted:2007-04-19, Days after onset: 8
Location:New York  Entered:2007-04-19
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: History of recurrent URI
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1035F0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: One day following vaccination patient developed pain, bruising and a 4 cm area of erythema at the site of injection. Patient also describe generalized achiness and muscle pain. MD prescribed Cipro.

VAERS ID:277193 (history)  Vaccinated:2006-09-26
Age:31.0  Onset:2006-09-28, Days after vaccination: 2
Gender:Female  Submitted:2006-09-28, Days after onset: 0
Location:Georgia  Entered:2007-04-23, Days after submission: 207
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2556AA0 RA
Administered by: Public     Purchased by: Private
Symptoms: Oedema peripheral, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Rt arm slightly swollen, warm to touch, Advised client to take Tylenol and apply cold compress to area.

VAERS ID:277466 (history)  Vaccinated:2007-04-24
Age:31.0  Onset:2007-04-27, Days after vaccination: 3
Gender:Male  Submitted:2007-04-26, Days after onset: 1
Location:California  Entered:2007-04-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1056SC 
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: L triceps swelling, redness through elbow measurement: L 11.5 R 10.5, 12.5 R 11, L 12.3/4 R 11 3/4. treatment cold compress Keflex 500 mg PO BID x 10 days.

VAERS ID:277695 (history)  Vaccinated:2007-04-18
Age:31.0  Onset:2007-04-19, Days after vaccination: 1
Gender:Female  Submitted:2007-04-24, Days after onset: 5
Location:North Carolina  Entered:2007-05-01, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: NC07034
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU1878AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Fatigue, Injection site erythema, Injection site swelling, Myalgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Left arm was sore 4/18 after injection and extremely sore 4/19 AM. On 4/20 75mm x 75mm redness and swelling about 70mm below the injection site. Also felt tired and myaleia on 4/20. Ok by 4/23.

VAERS ID:277777 (history)  Vaccinated:2007-04-30
Age:31.0  Onset:2007-04-30, Days after vaccination: 0
Gender:Female  Submitted:2007-05-02, Days after onset: 2
Location:Kansas  Entered:2007-05-02
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: Type 1 diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Oedema peripheral, Skin warm, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient''s left arm became red, warm and swollen beginning the day of injection in the afternoon. One the second day she felt like the flu. Today she still has an area of erythema and tenderness of about 4cm by 5 cm distal the injection site without swelling, erythema or warmth.

VAERS ID:277846 (history)  Vaccinated:2007-04-24
Age:31.0  Onset:2007-04-26, Days after vaccination: 2
Gender:Female  Submitted:2007-04-27, Days after onset: 1
Location:South Carolina  Entered:2007-05-03, 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: PPD skin test
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.1010F IMLA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEUR41927DA IMRA
Administered by: Private     Purchased by: Private
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), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swollen (R) deltoid with local erythema within 24 hours without progression, and fever.

VAERS ID:277952 (history)  Vaccinated:2004-02-23
Age:31.0  Onset:2005-03-20, Days after vaccination: 391
Gender:Unknown  Submitted:2007-05-04, Days after onset: 774
Location:Texas  Entered:2007-05-04
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: BLOOD TEST, X RAYS, EKG
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV0811IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amnesia, Arthralgia, Back pain, Blood test, Dry mouth, Dyspepsia, Electrocardiogram, Headache, Lip dry, Sinus disorder, Sleep disorder, X-ray
SMQs:, Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific dysfunction (narrow), Arthritis (broad)
Write-up: SINUS,LOWER BACK PAIN,HEADACHES,LOSS OF MEMORY,JOINT PAIN,HEART BURN,DRY MOUTH AND LIPS,SLEEPING DISORDER.

VAERS ID:277957 (history)  Vaccinated:1991-02-22
Age:31.0  Onset:1991-12-01, Days after vaccination: 282
Gender:Unknown  Submitted:2007-05-04, Days after onset: 5632
Location:Puerto Rico  Entered:2007-05-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSUNK0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Alopecia, Amnesia, Arthralgia, Arthropathy, Dizziness, Headache
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalopathy/delirium (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: HEADACHES, DISINESS, MEMORY LOSS, PAIN IN JOINTS, TRICK JOINTS, HAIR LOSS

VAERS ID:277978 (history)  Vaccinated:2007-05-05
Age:31.0  Onset:2007-05-05, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2007-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2720AA0IMRA
Administered by: Military     Purchased by: Military
Symptoms: Body temperature increased, Chills, Migraine, Pain, Photophobia
SMQs:, Neuroleptic malignant syndrome (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Increased temperature of 102 at times. Migraine, light sensitivity, body aches, chills. temperature lasting only few hours, migraine headache lasting approx 12 hours and patient continues to have migraine headache at time of reporting. Patient seen by military provider no tx at this time. Pt instructed rescue primary PCP if symptoms persist or worsen.

VAERS ID:278120 (history)  Vaccinated:2004-03-16
Age:31.0  Onset:2004-03-16, Days after vaccination: 0
Gender:Male  Submitted:2006-09-05, Days after onset: 902
Location:California  Entered:2007-05-07, Days after submission: 244
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: 200602315
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEURW14190  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Adverse event, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)
Write-up: Initial information received on 31/Aug/2006 from a company representative. This information was reported in the context of a litigation case and the initial information was reported by a health care professional. A 31 year old male patient received an initial dose of Imovax Rabies lot number W1419-3 on 16/Mar/2004, as part of post-exposure prophylaxis following a bat bite on the patient''s left middle finger. It was not reported whether the bat was tested for rabies. On 14/Apr/2004, the patient reported that he had been experiencing "shakes" and the patient was administered the subsequent dose. It was not reported whether the patient recovered from the event. This patient experienced a subsequent adverse event of "jaw chattering" following the administration of the second dose of Imovax Rabies, which is reported in case 2006-02337.

VAERS ID:278121 (history)  Vaccinated:2004-04-14
Age:31.0  Onset:2004-04-14, Days after vaccination: 0
Gender:Male  Submitted:2006-09-05, Days after onset: 874
Location:California  Entered:2007-05-07, Days after submission: 244
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: shakiness~Rabies (no brand name)~1~31~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: The patient previously experienced "shakes" following administration of a first dose of Imovax Rabies on 16/Mar/2004.
Diagnostic Lab Data:
CDC Split Type: 200602337
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEURW12751  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Trismus
SMQs:, Dystonia (narrow)
Write-up: Initial information received on 31/Aug/2006 from a company representative. This information was reported in the context of a litigation case, and the initial information was reported by a health care professional. A 31 year old male patient received a second dose of Imovax Rabies, lot number W1275 (invalid lot number) on 14/Apr/2004, as part of post-exposure prophylaxis following a bat bite on the patient''s left middle finger. It was not reported whether the bat was tested for rabies. On 19/Apr/2004, the patient reported that he had been experiencing "jaw chattering" since receiving the dose on 14/Apr/2006. There was no mention of the patient being treated for the symptoms. It was not reported whether the patient continued with the rabies series or whether he recovered from the event. This patient experienced a previous adverse event of "shakes" following the administration of the first dose of Imovax Rabies which is reported in case 2006-02315.

VAERS ID:278254 (history)  Vaccinated:2007-03-26
Age:31.0  Onset:2007-03-26, Days after vaccination: 0
Gender:Female  Submitted:2007-04-05, Days after onset: 10
Location:Idaho  Entered:2007-05-09, Days after submission: 34
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Factor V
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
MMR: MEASLES + MUMPS + RUBELLA (VIRIVAC)MERCK & CO. INC.0700F2SCLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Flushing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Shot was given around 12:15 pm. Around 2:00 pm I began to feel dizzy and flushed. (I had patients tell me that I was white)

VAERS ID:278445 (history)  Vaccinated:2007-05-03
Age:31.0  Onset:2007-05-04, Days after vaccination: 1
Gender:Female  Submitted:2007-05-11, Days after onset: 7
Location:Tennessee  Entered:2007-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Nausea and vomiting~Tetanus Diphtheria (no brand name)~4~21~In Patient
Other Medications: Camila, OTC multivitamin
Current Illness: None
Preexisting Conditions: Reactive hypoglycemia, seasonal allergic rhinitis, migraine headaches, rosacea
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2569AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Abscess, Cellulitis, Chills, Erythema, Haematoma, Headache, Injection site discolouration, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Nausea, Oedema peripheral, Pyrexia, Rash macular, Tenderness, Tremor, Vomiting
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Patient received Tdap 5/3/07 PM in left deltoid. 5/4/07 she was awakened by nausea with vomiting, "horrible" headache, shaking chills, and fever to 102. She slept all day 5/4/07, and by 5/5/07 the fever was gone, but the left arm at injection site had "ballooned",and the entire arm was swollen such that she removed her rings for fear of not being able to get them off her swollen fingers. Patient took Tylenol, Aleve and Beadryl. She felt better by 5/6/07 and the swelling appeared to be receding. Then 5/8/07 evening the injection site got redder and more painful, extending from the top of the left deltoid to the distal one third of the upper arm laterally and posteriorly. Patient saw a surgeon friend who opined that she had either an abscess or a hematoma, and gave her doxycycline 100mg BID which she started 5/9/07. During this time, patient continued to take Aleve (?)4 tablets a day and Tylenol (?)twice a day. On my examination, 5/10/07, there was greenish blue discoloration at injection site, mild induration, but no fluctuance. Faint macular erythema extended over posterolateral deltoid to just below the deltoid tendon. Tenderness spread from the puncture site to encompass most of the lateral aspect of the deltoid. There was no cervical or axillary adenopathy. No fever. Findings did not really look like cellulitis resolving after only two doses of doxycycline, but patient was told to finish at least 7 days of doxycycline and cont Aleve and Tylenol as needed for pain.

VAERS ID:279139 (history)  Vaccinated:2007-05-08
Age:31.0  Onset:2007-05-10, Days after vaccination: 2
Gender:Female  Submitted:2007-05-11, Days after onset: 1
Location:Virginia  Entered:2007-05-21, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: recurrent PVCs, stable
Diagnostic Lab Data: chest x-ray negative, EKG negative (unchanged from previous)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
MEN: MENINGOCOCCAL (MENOMUNE)CONNAUGHT LABORATORIESUE489A10SCRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC14B027AA0 LA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ06632 LA
Administered by: Military     Purchased by: Military
Symptoms: Chest X-ray normal, Chest pain, Electrocardiogram normal, Injection site pain, Pericarditis, Pleurisy, Pleuritic pain
SMQs:, Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left pleuritic chest pain starting 48 hours after immunizations with peak pain approx 60-72 hours after immunizations. EKG normal. CXR normal. Suspected pericorditis vs pleurisy. Treatment w/NSAIDS. Also significant muscle pain at injection site left deltoid 2-60 minutes after injection. No fever. No muscle swelling.

VAERS ID:280365 (history)  Vaccinated:1995-04-01
Age:31.0  Onset:2006-04-27, Days after vaccination: 4044
Gender:Female  Submitted:2007-05-16, Days after onset: 384
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data: serum varicella zoster, 4/27/2006, not immune
CDC Split Type: WAES0604USA04332
Vaccination
Manufacturer
Lot
Dose
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Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative
SMQs:
Write-up: Information has been received from a 31 year old female in her second trimester of pregnancy with no medical history or allergies who in April 1995, was vaccinated SC with a dose of Varivax. There was no concomitant therapy. The patient reported that on 27 APR 2006, blood work revealed that she was "not immune to chickenpox anymore." Unspecified medical attention was sought. At the time of this report, the patient had not recovered. No further information is available.

VAERS ID:280613 (history)  Vaccinated:2006-04-27
Age:31.0  Onset:2006-05-09, Days after vaccination: 12
Gender:Female  Submitted:2007-05-16, Days after onset: 372
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type: WAES0605USA01844
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1024R SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a health professional concerning a 31 year old female with no pertinent medical history and no drug reactions/allergies who on 27 Apr 2006 was vaccinated SC with a 0.5 mL dose of Varivax (Lot# 652557/1024R). On 09 May 2006 the patient experienced swelling at the injection site and generalized itching of her body. No pox were noted. The outcome was reported as not recovered. There were no lab diagnostic studies performed. Unspecified medical attention was sought. There was no product quality complaint. No further information was available at that time. Additional information has been requested.

VAERS ID:280964 (history)  Vaccinated:0000-00-00
Age:31.0  Onset:2006-06-27
Gender:Male  Submitted:2007-05-16, Days after onset: 323
Location:Unknown  Entered:2007-05-24, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Serum varicella zoster 06/27/06 - subtheraputic
CDC Split Type: WAES0607USA00831
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative
SMQs:
Write-up: Information has been received from a physician''s assistant concerning a 31 year old male who in 2003 was vaccianted with a dose of varicella virus vaccine live. On 27-JUN-2006 the patient''s titer result was subtheraputic. Unspecified medical attention was sought. There was no product quality complaint involved. Additional information has been requested.

VAERS ID:279844 (history)  Vaccinated:2007-05-14
Age:31.0  Onset:2007-05-15, Days after vaccination: 1
Gender:Female  Submitted:2007-05-25, Days after onset: 10
Location:Michigan  Entered:2007-05-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flexeril x 1, Ortho Tricyclen
Current Illness: none
Preexisting Conditions: Fibromyalgia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD 1PO 
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Palpitations, Similar reaction on previous exposure to drug
SMQs:, Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Patient started (o) typhoid-Vivotif at approx 24 hr after 1st capsules, Felt "heart racing (+) increased dizziness" Attempted to reach Pt to tell her to hold further but she took 2nd dose with similar response. Then d/c''d-symptoms stopped-no other c/o. Didn''t follow up P.C.P

VAERS ID:279907 (history)  Vaccinated:2007-05-10
Age:31.0  Onset:2007-05-18, Days after vaccination: 8
Gender:Male  Submitted:2007-05-29, Days after onset: 11
Location:Maryland  Entered:2007-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Head CT- normal
CDC Split Type:
Vaccination
Manufacturer
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1061UNUN
Administered by: Military     Purchased by: Military
Symptoms: Anorexia, Computerised tomogram normal, Dizziness, Fatigue, Feeling hot and cold, Headache, Hyperhidrosis, Nausea, Photophobia, Sinusitis, Tension headache, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Pt woke up on May 18th with severe headache. No improvement with Motrin. Also had nausea. Had lightheadedness when standing. Had photophobia. Headache described as squeezing on top of head/band around head. No blurry vision. Lasted for 4 days. Went to the ER around 3AM the day after it started. Diagnosed with tension headache and sinusitis. Had negative Head CT. Was given a Z-pak and some "headache medicine" which sounded like vicodin or other narcotic. The meds helped but he required the pain med for the 4 days. He had anorexia. The smell of food made him vomit. Pain worse with sitting up. Was essentially incapacitated for 4 days. Had some hot and cold spells and sweats. Never got temperature reading. No diarrhea. No sore throat, no myalgias or arthralgias. Had fatigue. Feels totally fine now (5/29/07).

VAERS ID:280119 (history)  Vaccinated:2007-03-29
Age:31.0  Onset:2007-04-02, Days after vaccination: 4
Gender:Male  Submitted:2007-05-31, Days after onset: 59
Location:Nevada  Entered:2007-05-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Military     Purchased by: Military
Symptoms: Decreased appetite, Fatigue, Headache, Irritability, Lymph node pain, Lymphadenopathy, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Symptoms: Still experiencing swollen and tender lymph nodes on/around neck/collar bone area after two months, either side or both at a time. Mild fever, sore throat, loss of appetite, fatigue, irritability, and headaches.

VAERS ID:280204 (history)  Vaccinated:2007-05-17
Age:31.0  Onset:2007-05-26, Days after vaccination: 9
Gender:Male  Submitted:2007-06-01, Days after onset: 6
Location:Indiana  Entered:2007-06-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Prescreening revealed no contraindications. No known illness at time of vaccination.
Preexisting Conditions: History of asthma. PMH: MVA. NKDA.
Diagnostic Lab Data: Hospital: Comprehensive Metabolic Panel revealed elevated CK, SGOT, MASS CKMB, and Troponin. Transferred hospital: Elevated CPK and troponin detected. Cardiac catheterization revealed nonspecific ST abnormality and abnormal ECG. According to notes from state Department of Health, EKG, Echo, and LV testing were much improved on 5/30/07; however there were still some issues with lung function. Labs and Diagnostics: EKG showed ST elevation. Troponin 3.8. Coronary angiography showed mild luminal irregularities in the mid circumflex artery and the L anterior descending artery. EF of 25%. Findings c/w Myopericarditis. CXR Borderline cardiomegaly and pulmonary vascular prominence. Mixed interstitial and alveolar opacities bilat. 2D Echo
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0 RA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4020072 IDLA
Administered by: Military     Purchased by: Unknown
Symptoms: Angina pectoris, Aspartate aminotransferase increased, Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, Blood glucose increased, C-reactive protein increased, Cardiac stress test abnormal, Cardiomegaly, Catheterisation cardiac abnormal, Chest X-ray abnormal, Chest pain, Echocardiogram, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Immunisation reaction, Metabolic function test abnormal, Myopericarditis, Oxygen supplementation, Pain, Red blood cell sedimentation rate increased, Troponin increased
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (narrow), Other ischaemic heart disease (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Myopericarditis following smallpox vaccination. Body aches began ~5/26, but were attributed to body armor - took 1000mg Tylenol evening of 5/27; woke up with CP on morning of 5/28. Pt presented at hospital with body aches and chest pain (sharp pain upon inspiration) on morning of 5/28. Transferred morning of 5/28 by Rural/Metro Ambulance to another Hospital. Treated in route w/ IV, 324 mg baby aspirin and oxygen administered by nasal canula. Presented at hospital with angina. Hospitalized 5/28-5/30. 06/04/2007 MR received for hospitalization 5/28-30/2007 for initial onset of body aches x 2 days preceding an episode of chest pain on 5/28/2007. Chest pain was worst lying down and improved upon sitting or standing. Initially seen at another facility where he was noted to have an ST elevation on EKG and elevated troponin. Transfered to current facility for eval and tx. DX: Likely small-pox vaccination associated Myopericarditis. 08/03/2007 F/U records received from military. DX: probable vaccinia related myopericarditis.

VAERS ID:283478 (history)  Vaccinated:2006-10-11
Age:31.0  Onset:2006-10-11, Days after vaccination: 0
Gender:Male  Submitted:2007-05-30, Days after onset: 231
Location:Maryland  Entered:2007-06-04, 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: IMURAN; [composition unspecified]
Current Illness: Crohn''s disease
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0610USA09286
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0490R SCUN
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Information has been received from a pharmacist concerning a 31-year-old white male with no drug reactions/allergies and with Crohn''s disease who on 11-OCT-2006 was vaccinated SC in the left arm with MMR (Lot # 649810/0490R). Concomitant therapy included a Td booster, "Pertasa" 4 cups TID, and IMURAN 125mg daily. On 11-OCT-2006 the patient experienced lightheadedness and felt sick in the stomach for 12 hours after vaccination. There were no lab diagnostic studies performed. The outcome was recovered on 12-OCT-2006 in the PM. Unspecified medical attention was sought. There was no product quality complaint. Follow up information indicated that on 12-OCT-2006 at 1:00AM the patient simply "did not feel good", and was nauseous and achy. No additional information is expected.

VAERS ID:283490 (history)  Vaccinated:0000-00-00
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-30
Location:Unknown  Entered:2007-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Diagnostic laboratory test, MMR II titer negative
CDC Split Type: WAES0611USA05916
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Laboratory test
SMQs:
Write-up: Information has been received from a 31 year old female Doctor of Pharmacy who "years ago" was vaccinated with MMR II. Subsequently, when a titer was drawn not "too long ago" the patient failed to seroconvert. The patient sought unspecified medical attention and received a booster dose. There was no PQC complaint. Additional information has been requested.

VAERS ID:283727 (history)  Vaccinated:0000-00-00
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2007-05-30
Location:Unknown  Entered:2007-06-04, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0704USA00001
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative
SMQs:
Write-up: Information has been received from a 31 year old female Doctor Of Pharmacy who in approximately 2000 or 2001 was vaccinated with RECOMBIVAX series (unsure of which vaccine/manufacturer not reported) and failed to seroconvert. The patient sought medical attention and a booster was given. A PQC was not reported. Additional information has been requested.

VAERS ID:280879 (history)  Vaccinated:2007-06-04
Age:31.0  Onset:2007-06-06, Days after vaccination: 2
Gender:Female  Submitted:2007-06-07, Days after onset: 1
Location:Pennsylvania  Entered:2007-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depoprovera
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2734AA IM 
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness, warmth around injection site size of tennis ball. No treatment necessary, just Advil prn and ice to right shoulder

VAERS ID:281436 (history)  Vaccinated:2007-06-11
Age:31.0  Onset:2007-06-11, Days after vaccination: 0
Gender:Female  Submitted:2007-06-12, Days after onset: 1
Location:Oregon  Entered:2007-06-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2631AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Flushing, Lip swelling, Malaise, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: About 50 min after vaccine patient complained of flushing and itching on face-one hive. She was advised to take Benadryl 50 mg by mouth. She left for lunch then with husband. Patient returned at 1:20 pm-had taken Benadryl but complained of lips swelling, feeling worse. Dr. ordered Epinephrine 0.1mL and Dauadion 4 mg IM. Patient felt well enough to go home after 45 minutes.

VAERS ID:283765 (history)  Vaccinated:2007-03-16
Age:31.0  Onset:2007-03-16, Days after vaccination: 0
Gender:Female  Submitted:2007-06-14, Days after onset: 90
Location:Unknown  Entered:2007-06-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0705USA01060
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0187U0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Information has been received from a medical assistant concerning a 31 year old female who on 16-MAR-2007 was vaccinated with Gardasil (Lot #656049/0187U), intramuscular, in the left deltoid. On 16-MAR-2007 the patient experienced shortness of breath beginning 2 hours after the vaccination. It lasted a couple hours and then resolved without treatment. Additional information has been requested.

VAERS ID:282283 (history)  Vaccinated:2007-06-08
Age:31.0  Onset:2007-06-09, Days after vaccination: 1
Gender:Female  Submitted:2007-06-19, Days after onset: 10
Location:Louisiana  Entered:2007-06-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: hashimoto thyroiditis, polycystic ovarian syndrome records received 7/11/07- PMH: hypothyroidism, polycystic ovarian syndrome
Diagnostic Lab Data: records received 7/11/07-WBC 17.36.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Chest pain, Chills, Cough, Decreased appetite, Dizziness, Dry mouth, Eye pruritus, Eye swelling, Fatigue, Headache, Hypersensitivity, Injection site pain, Injection site swelling, Injection site warmth, Myalgia, Nausea, Ocular hyperaemia, Pain, Pyrexia, Rash generalised, Sensory disturbance, Throat tightness, Urticaria, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: injection site pain, swollen, muscle pain, warmth. Swelling/pain/sensitive throughout body, chest pains, fever over 104, hives/rash throughout body, nausea/vomitting, cellulitis, headache, chills, fatique, decreased appetite, dizziness, cough, throat tightnes, dry mouth, eye itching/red/swollen. 7/11/07-records received for DOS 6/7 and 6/9/07-DC DX: Allergic reaction to Pneumovax vaccination. Secondary DX: Headache, hypothyroidism. HX of Palpitations. C/O fever and rash on left arm. Fever to 104. Rash at injection site gradually spread. Muscle tightening makes arm movement difficult.

VAERS ID:282631 (history)  Vaccinated:2000-05-30
Age:31.0  Onset:0000-00-00
Gender:Male  Submitted:2007-06-19
Location:Unknown  Entered:2007-06-21, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Refer to attached clinical summary
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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Dose
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Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV008   
Administered by: Military     Purchased by: Military
Symptoms: Blister, Dry skin, Skin disorder, Skin exfoliation, Skin lesion
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Referred for evaluation of recurrent lesions on fingers and feet following receipt of anthrax vaccines. First appearance of skin changes was after his initial 3 anthrax vaccines over a period of 5 weeks. To the best of his recollection, the lesions appeared within 1-2 weeks after his 3rd anthrax vaccine. They usually start as a few spots ''like a blister'' on his fingertips and later on his toes. At their worst, in addition to his fingertips and toes, his feet and palms were affected too. There was no relationship to which arm he received the vaccines in - the lesions appeared bilaterally. The skin would later become dry (so dry it would sometimes crack) and flake and then it would peel. He described this pattern as ''cyclical; and usually lasts about 3-4 months. The cycle seemed to stop between anthrax vaccinations and the within 1 week of receiving his next anthrax vaccine, the spots would re-appear. Between 2000 and 2003 9period when no anthrax vaccine were received), the service member dose not recall having problems with skin changes. He had seen a dermatologist when the lesions were cyclical. He was treated with numerous topical, but nothing seemed to help. He has never been patch tested. He is not able to identify any other possible triggers (chemicals, cleaners, etc) Service member denies noted a temporal association to other vaccines. He denies any unusual or prolonged local reactions or other systemic symptoms following any of his 9 anthrax vaccines.

VAERS ID:283096 (history)  Vaccinated:2007-06-21
Age:31.0  Onset:2007-06-27, Days after vaccination: 6
Gender:Male  Submitted:2007-06-28, Days after onset: 1
Location:Ohio  Entered:2007-06-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: denies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU1704DA  LA
Administered by: Public     Purchased by: Other
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Pt called office today, described pain in LT arm sore can''t raised arm at this time - denies redness - swelling - fever at this time - Pain just developed on 6/27/07 in AM

VAERS ID:283644 (history)  Vaccinated:2007-05-10
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2007-07-02
Location:Unknown  Entered:2007-07-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pregnancy NOS (LMP = 3/26/2007)
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0705USA02762
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0389U1IM 
Administered by: Other     Purchased by: Other
Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Inappropriate schedule of drug administration
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow), Medication errors (narrow)
Write-up: Initial and follow up information has been received through the Merck pregnancy registry, from a 31 year old female healthcare professional, who on 10-MAY-2007 (previously reported as 30-APR-2007), was vaccinated intramuscularly with the second dose of Gardasil (Lot #657736/0389U), and recently found out she was pregnant. The date of the LMP was reported as 26-MAR-2007, with an estimated delivery date on 31-DEC-2007. Unspecified medical attention was sought. It was not known if the patient had been seen by OB/GYN. Follow up information from the healthcare professional, stated that she "had a miscarriage." No further information or details were provided. Upon internal review, "had a miscarriage" was considered to be serious as an other significant medical event. Additional information has been requested.

VAERS ID:284030 (history)  Vaccinated:2007-06-07
Age:31.0  Onset:2007-06-08, Days after vaccination: 1
Gender:Female  Submitted:2007-07-06, Days after onset: 28
Location:California  Entered:2007-07-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: No
Preexisting Conditions: Allergies to erythromycin-developed confusion. Allergy Toradol-developed bleeding during surgery.
Diagnostic Lab Data: Referred to a clinic that manages occupational injuries & was seen two times-1st visit 7/2/07 on the day symptoms were reported. Given 600 mg naprosyn, heat. Discharged on 2nd visit on 7/6/07 and advised by the treating MD not to take the
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1003F0SCRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Received MMR vaccine at pre-employment physical on 6/7/07. Called employee health on 7/2/07 and stated she was having redness at the site of her MMR vaccine; noted R arm soreness immediately after the vaccine and redness starting about 2 weeks after the initial vaccine. Reported that the injection site became more red and indurated with a hard lump; tried ice without much benefit. Further stated the induration is about the "size of a quarter with erythema around it approximately the size of the opening of a paper cup".

VAERS ID:284060 (history)  Vaccinated:2007-06-07
Age:31.0  Onset:2007-06-08, Days after vaccination: 1
Gender:Female  Submitted:2007-07-02, Days after onset: 24
Location:Michigan  Entered:2007-07-06, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1323F1IMLA
Administered by: Military     Purchased by: Private
Symptoms: Headache, Local swelling, Pyrexia
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever and headache and localized swelling.

VAERS ID:284113 (history)  Vaccinated:2007-07-03
Age:31.0  Onset:2007-07-04, Days after vaccination: 1
Gender:Female  Submitted:2007-07-09, Days after onset: 5
Location:Maryland  Entered:2007-07-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aviane - birth control; allegra-d
Current Illness: none
Preexisting Conditions: allergies - trees, grasses
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal pain upper, Decreased appetite, Insomnia, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 7/4/07 - 12:30 pm after lunch experienced stomach knots/cramps; 5 pm after dinner stomach knots again and nuasea, very hot; 8 pm vomit, nuasea, fever of 100.0-100.9, stomach knots, body aches; tried to sleep, limited food/ liquid intake until 7/6 when I felt more normal; advil as needed

VAERS ID:285340 (history)  Vaccinated:2007-02-20
Age:31.0  Onset:2007-03-10, Days after vaccination: 18
Gender:Female  Submitted:2007-07-19, Days after onset: 130
Location:Tennessee  Entered:2007-07-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
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Manufacturer
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0347F UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Malaise, Pyrexia, Vaccination failure, Varicella
SMQs:, Lack of efficacy/effect (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Varicella outbreak all over, fever, malaise

VAERS ID:286224 (history)  Vaccinated:2007-07-11
Age:31.0  Onset:2007-07-13, Days after vaccination: 2
Gender:Female  Submitted:2007-07-20, Days after onset: 7
Location:Pennsylvania  Entered:2007-07-30, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Buprophenine
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB377AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Was given vaccine on 7/11/07. Developed hive like rash on 7/13/05. Started on Prednisone on 7/16/07 and Claritin on 7/18/07

VAERS ID:286387 (history)  Vaccinated:2007-07-27
Age:31.0  Onset:2007-07-29, Days after vaccination: 2
Gender:Male  Submitted:2007-07-31, Days after onset: 2
Location:Florida  Entered:2007-07-31
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2730AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site anaesthesia, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, rednees, numb at the site, but also sore to the touch. Injection site is hot to the touch. Was prescriped Naproxin (anti-inflamitory medication). Also warm compresses to the site.

VAERS ID:286398 (history)  Vaccinated:2006-10-27
Age:31.0  Onset:2006-10-27, Days after vaccination: 0
Gender:Female  Submitted:2007-07-31, Days after onset: 277
Location:Texas  Entered:2007-07-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Hives~Tetanus Diphtheria (no brand name)~5~14~In Patient
Other Medications: Diflucan, Ortho Tricyclen, MTZ
Current Illness: None
Preexisting Conditions: Sulf drugs, penicillin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURERU1596BA4IMRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site swelling, Oedema peripheral, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: TD vaccine given 10/27/06. Hives in the mouth, feet had swelling on same day and swelling at the site. went to ER at Hospital 10/30/06. Was given steriods, IV, Benadryl IV, and sent home with a Z-Pack and steriods.

VAERS ID:286441 (history)  Vaccinated:2007-07-13
Age:31.0  Onset:2007-07-14, Days after vaccination: 1
Gender:Female  Submitted:2007-08-01, Days after onset: 18
Location:Colorado  Entered:2007-08-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Atavan 0.5 mg, 1-2 tablets TID, ordered after 7/17/07 due to syx reported here.
Diagnostic Lab Data: West Nile blood test on day 6 of symptoms negative.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1468F2SCLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Arthropod bite, Body temperature increased, Diarrhoea, Headache, Heart rate increased, Nasopharyngitis, Nausea, Neck pain, Pain, Weight decreased
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 7/14/07 awakened with severe abdominal cramping, nausea,diarrhea, general body aches, headache, rapid heart rate. Went to Urgent Care and was "dismissed as having a virus". Later in the evening with the symptoms "getting worse" went to ER and was again dismissed as "having flu". 7/17/07 headache and neck pain increased and she felt "like my heart was going to pound our of her chest" went to her family physician practice(Family Medicine). She was seen by 3 different physicians over the next several days. Had mosquito bites. One doctor told she "probably had viral meningitis" since it was a possible reaction from MMR.Referred to cardiologist due heart rate(117 bpm) & arrythmias. Started wearing a heart monitor 7/31/07 to continue for 30 days with daily multiple electronic monitoring by MD. Lost 14 pounds since onset of syx. Given Atavan .5mg (1-2 tabs TID)for anxiety started in the last week. Symptoms improving since then, heart rate still at 117. Beginning to eat, continued diarrhea. Took Imodium AD twice, diarrhea abatted,then recurred. No local reaction at inject site. Cold syx started 8 days into "reaction" , temp highest 99 degrees F.

VAERS ID:287071 (history)  Vaccinated:2006-11-02
Age:31.0  Onset:2006-11-04, Days after vaccination: 2
Gender:Male  Submitted:2007-07-30, Days after onset: 267
Location:Unknown  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: Unknown
Current Illness:
Preexisting Conditions: Pneumonia; Bacterial infection
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0611USA01950
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0619F UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site swelling, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Information has been received from a pharmacist concerning a 31 year old male with a history of pneumonia and bacterial infection who on 02-NOV-2006 was vaccinated with Pneumovax 23 (Lot # 651401/0619F). On 04-NOV-2006 the patient experienced nausea, vomiting, swelling at injection site that went up his arm. The patient was seen in the Emergency Room (ER) and given antibiotics, but was not admitted. At the time of the report, it was not reported if the patient recovered. A lot check of concern has been requested. The records of testing prior to release of the lot in question have been rechecked and found to be satisfactory. The lot met the requirements of Center for Biologics Evaluation and Research and was released. Additional information has been requested.

VAERS ID:286908 (history)  Vaccinated:2007-07-07
Age:31.0  Onset:2007-07-09, Days after vaccination: 2
Gender:Female  Submitted:2007-07-17, Days after onset: 8
Location:Colorado  Entered:2007-08-06, Days after submission: 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: Seasonal Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1055SCLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB367AA2IMRA
Administered by: Military     Purchased by: Military
Symptoms: Chest discomfort, Chest pain, Influenza like illness, Pain
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Shot given approx 1130 hrs 7 Jul 07. Illness (flu-like symptoms) at 24 hr mark. Soreness at injection site (left del.) on 9 July - "chest pain/tightness - with general achy all over body." 10 July, seen doctor about issues of past three days. Meds given - Atarax 10mg, PO/Piroxicam 10mg caps. Pleased on 24 hr quarters.

VAERS ID:288306 (history)  Vaccinated:2007-08-13
Age:31.0  Onset:2007-08-13, Days after vaccination: 0
Gender:Male  Submitted:2007-08-17, Days after onset: 4
Location:Washington  Entered:2007-08-17
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: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUE818AA1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Adverse event, Flushing, Hypersensitivity
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 20 minutes post yellow fever vaccination developed flushing with no other sx to indicate it was an allergic reation but an adverse reaction. Pt treated with Benadryl 25mg.

VAERS ID:289271 (history)  Vaccinated:2006-12-26
Age:31.0  Onset:2007-02-12, Days after vaccination: 48
Gender:Female  Submitted:2007-08-24, Days after onset: 192
Location:California  Entered:2007-08-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had exposure to alcohol, caffeine, passive smoke and mold during her pregnancy. The patient experienced cough from 12 February until 18 February 2007 and had received antibiotic therapy for a respiratory infection (bronchitis, cold, and fever) from 06 March 2007 until 04 May 2007, all prior to the birth of her baby. The patient also had a history of Meningitis occurring on three separate occasions during the following years: 1996, 1998, and 2000.
Diagnostic Lab Data: 06/Jan/2007 and 30/Jan/2007 - ultrasound (normal); 16/Feb/2007 - Glucose tolerance test (0 - normal); 02/May/2007 - ultrasound (abnormal, low amniotic fluid); 08/May/2007 - Non-stress Test - (normal)
CDC Split Type: 200702829
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Bronchitis, Caesarean section, Cardiac stress test, Cough, Drug exposure during pregnancy, Foetal disorder, Glucose tolerance test normal, Nasopharyngitis, Oligohydramnios, Ultrasound abdomen abnormal
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Foetal disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial report received 14 August 2007 from a health care professional. A 31-year-old female patient had received a prophylactic injection of Fluzone on 26 December 2006 during her second trimester of pregnancy. The patient''s date of conception had been reported as 25 August 2006 with an estimated delivery date of 18 May 2007. Exposures reported during pregnancy included alcohol, passive smoke, caffeine, and mold "in office". During her third trimester, beginning on 12 February 2007, she experienced a cough which lasted seven days, ending on 18 February 2007. Then, beginning 08 March 2007, she experienced a temperature of 100 degrees Fahrenheit, and "bronchitis/cold" symptoms. Her temperature returned to normal the following day but her bronchitis/cold symptoms persisted until 04 May 2007. She had been prescribed "antibiotics NCS" from 01 April 2007 until 30 April 2007 and Z-PAKs from 15 April 2007 to 04 May 2007. An ultrasound performed 02 May 2007 revealed "low amniotic fluid" and a non-stress test performed on 08 May 2007 had normal results. The patient had a c-section after diagnosis of oligohydramnics on 18 May 2007, her AFI was 2. The baby had cyanosis at birth which resolved within 2 hours. Shortly after birth the baby started having difficulties breathing and was diagnosed with pulmonary hypertension and intubated for 24 hours and the pulmonary hypertension resolved. Oxygen was administered another 24 hours and on 20 May 2007, the baby was breathing normally. The baby had been prescribed antibiotics for one week and all laboratory results were normal, negative for infection. The baby had been monitored for five additional days and had been released on 26 May 2007. This case was originally reported as non-serious, however, it was upgraded to serious by manufacturer. This case is linked to the baby''s case 2007-02795 (pulmonary hypertension, jaundice).

VAERS ID:289971 (history)  Vaccinated:2007-08-11
Age:31.0  Onset:2007-08-17, Days after vaccination: 6
Gender:Female  Submitted:2007-08-27, Days after onset: 10
Location:Indiana  Entered:2007-09-06, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1053SCRA
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Headache, Lymphadenopathy, Malaise, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: fever, nausea, vomiting, headaches, muscle aches, lymphadenopathy, coughing, malaise fluids, rest, ibuprofen, Ultracet

VAERS ID:290357 (history)  Vaccinated:2007-09-04
Age:31.0  Onset:2007-09-04, Days after vaccination: 0
Gender:Female  Submitted:2007-09-12, Days after onset: 8
Location:California  Entered:2007-09-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: MRI - negative for nec fasciitis; CK normal. WBC 21,000, ASO pending
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTOX: DIPHTHERIA TOXOIDS (NO BRAND NAME)UNKNOWN MANUFACTURER 3 LA
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1 LA
Administered by: Military     Purchased by: Military
Symptoms: Blood creatine phosphokinase normal, Cellulitis, Chills, Erythema, Nuclear magnetic resonance imaging, Streptococcus identification test, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt developed cellulitis and subsequently admitted to exclude necrotizing fasciitis. Pt vaccinated 4 Sept 07 and had onset of chills and erythema same day. She was admitted 7 sept 07. Unfortunately, all 3 vacines were given in same deltoid - provider counselled.

VAERS ID:290740 (history)  Vaccinated:2007-05-11
Age:31.0  Onset:2007-05-12, Days after vaccination: 1
Gender:Female  Submitted:2007-08-13, Days after onset: 93
Location:Michigan  Entered:2007-09-17, Days after submission: 35
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: states allergic to yeast but in small quantities is ok
Diagnostic Lab Data: Unknown
CDC Split Type: M12007020
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB287BA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Rhinorrhoea, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Client received HBV #2 5/11/07. Started within a few hours developed runny nose the next day had hives on face and legs and swollen face. Called her physician was gave a "steroid shot and steroid dose pack. Before completion of dose pack hives returned requiring another steroid dose pack hives then resolved. No rxn to HBV #1 given at health department states had reaction to dose #2 and did not think it would be a problem to receive HBV despite "slight yeast allergy"

VAERS ID:291467 (history)  Vaccinated:2007-07-13
Age:31.0  Onset:2007-07-14, Days after vaccination: 1
Gender:Female  Submitted:2007-08-09, Days after onset: 26
Location:Michigan  Entered:2007-09-20, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: no illness at vaccination time.
Diagnostic Lab Data: CBC was done on an unspecified date-results were unknown.
CDC Split Type: 200702587
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2759A0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Back pain, Chills, Full blood count, Headache, Injection site induration, Injection site pain, Musculoskeletal stiffness, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A 31 year old female patient, no illness at vaccination time, received on 13 July 2007 first dose of Adacel (lot# C2759AA), intramuscular, into the right arm. The next day, on 14 July 2007, she experienced fever of 102 F, stiff neck, neck of neck and head ache, lower back pain, chill and nausea. She had a 7 cm indurated and painful area around vaccine site. Symptoms lasted 3 days before recovering. CBC was done on an unspecified date results were unknown.

VAERS ID:293246 (history)  Vaccinated:2007-03-07
Age:31.0  Onset:2007-03-07, Days after vaccination: 0
Gender:Female  Submitted:2007-09-17, Days after onset: 193
Location:New York  Entered:2007-09-20, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown 11/7/07-records received- PMH: low back injury April 2007.
Diagnostic Lab Data: 11/7/07-records received-EEG normal. MRI brain minimal left mastoid air sinus fluid representing a nonspecific finding.CT brain no acute intracranial hemorrhage. Neutrophils 59.5. Vit B12 166.
CDC Split Type: WAES0708USA03747
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0211U0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Computerised tomogram normal, Electroencephalogram normal, Facial palsy, Hypoaesthesia, Inappropriate schedule of drug administration, Myalgia, Neutrophil count increased, Nuclear magnetic resonance imaging brain normal, Pain in extremity, Paraesthesia, Swelling, Swelling face, Thinking abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hearing impairment (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician concerning a 32 year old female who on 07-MAR-2007 was vaccinated with a first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot #0211U) and a second dose on 30-MAY-2007. On 18-AUG-2007 the patient began to experience neurological disturbances, generalized swelling of the body, drooping of her face, numbness of her hands, pain in her fingers, pain in her joints and abnormal thought processes. The patient called the doctor. As of 20-AUG-2007 the patient had not yet recovered. Additional information has been requested. 10/29/07-rcords received for DOS 3/7-10/11/07-Seen for routine exam and on 3/29 and 4/4/07- for breast biopsy. 8/20/07-seeing neurologist for C/O swollen face, drooping, numbness of fingers. Myalgias, arthralgias. 9/5/07-continues with neuro symptoms. Guillain-Barre has been rulled out. DX possible autoimmune syndrome with selective malabsorption. 11/7/07-neuro consult records received for DOS 8/16/07-Impression: Symptoms of paresthesia all over, unsure of etiology. Sensory-type seizure is possible.Complex partial seizures may also be possible explanation for transient episode of confusion. Neurological examination is nonfocal.

VAERS ID:291095 (history)  Vaccinated:2007-09-19
Age:31.0  Onset:2007-09-19, Days after vaccination: 0
Gender:Male  Submitted:2007-09-23, Days after onset: 4
Location:Washington  Entered:2007-09-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: typhoid serum, erythomycin. PMH: Right wrist pain. allergic to erythromycin and Typhoid vaccine.
Diagnostic Lab Data: LP, CT scan. Labs and Diagnostics: CBC, BMP, LP. CT all unremarkable, however haed CT did show an incidentally noted hypodensity.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB367AA2IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2731AA0IMLA
Administered by: Military     Purchased by: Other
Symptoms: Arthralgia, Chest pain, Chills, Computerised tomogram, Dyskinesia, Dyspnoea, Full blood count, Headache, Hypoaesthesia, Immunisation reaction, Laboratory test, Lumbar puncture, Lumbar puncture normal, Meningitis aseptic, Myalgia, Nausea, Pain, Photophobia, Pyrexia, Reaction to previous exposure to any vaccine, Scan brain, Tachycardia, Urinary incontinence
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dyskinesia (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Sudden onset of fever (~102), chills, nausea, body aches, head aches, chest pain. 10/09/2007 MR received for DOS 9/20-24/2007 with D/C Dx of Immunization Reaction, Post LP headache. Pt presented to ER with H/A, diffuse arthralgias, CP, SOB, shaking chills and fever which began within 15 minutes after receiving TDaP vax. Had similar rxn after Typhoid vax in the past. PE significant for being ill appearing, shaking chills, tachycardia, pain with ROM, myalgias. Admitted with assessment: adverse reaction to TDaP immunization. Clinical presentation of aseptic meningitis. Had episodes of jerky movements and one episode of urianry incontinance. (+) nausea and photophobia. Some numbness from the waist down. Pt received blood patch for post LP H/A. Symptoms resolving by hospital day 4.

VAERS ID:291216 (history)  Vaccinated:2007-07-20
Age:31.0  Onset:2007-07-28, Days after vaccination: 8
Gender:Female  Submitted:2007-09-15, Days after onset: 49
Location:Missouri  Entered:2007-09-24, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Military     Purchased by: Military
Symptoms: Joint swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hives began on hand moved to face - all the way to feet. July 28 (8th day of vaccine) was first day. I also had swelling of the knees and ankles - uncomfortable. About 5 days later with Benadryl ceased.

VAERS ID:291255 (history)  Vaccinated:2007-08-30
Age:31.0  Onset:2007-09-02, Days after vaccination: 3
Gender:Female  Submitted:2007-09-14, Days after onset: 12
Location:Missouri  Entered:2007-09-24, 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: ZYRTEC, JUNEL (birth control)
Current Illness: None
Preexisting Conditions: Numerous allergies/seasonal, animal and plant among them
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)SANOFI PASTEUREJN230B0 RA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Mass, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Quarter sized reddened area with hardened spot in the center of same. Itching (like a mosquito bite) at times more severe than others. Symptoms lasted 48 hours. Patient takes Zyrtec daily for allergies.

VAERS ID:291321 (history)  Vaccinated:2007-08-03
Age:31.0  Onset:2007-08-03, Days after vaccination: 0
Gender:Female  Submitted:2007-09-13, Days after onset: 41
Location:Texas  Entered:2007-09-25, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0108U IMLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.0228U0SCLA
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU1953DA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Induration, Skin warm, Swelling, Wrong drug administered
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)
Write-up: Swelling on the side of left tricep, felt hard and warm 20mm x 28mm.

VAERS ID:291360 (history)  Vaccinated:2007-08-09
Age:31.0  Onset:2007-08-09, Days after vaccination: 0
Gender:Female  Submitted:2007-08-09, Days after onset: 0
Location:Texas  Entered:2007-09-25, Days after submission: 47
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
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB294BA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Flushing
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Patient reports dizzy feeling with some flushing almost immediately after injection. Symptoms prescribed for approximately 45 minutes. Patient appeared to have diminishing symptoms upon exit.

VAERS ID:291426 (history)  Vaccinated:2007-09-24
Age:31.0  Onset:2007-09-25, Days after vaccination: 1
Gender:Female  Submitted:2007-09-26, Days after onset: 1
Location:Montana  Entered:2007-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: NA~ ()~NULL~~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: blood count. Physical Exam
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Unknown
Symptoms: Asthenia, Blood count, Chills, Dyspnoea, Headache, Inappropriate schedule of drug administration, Nausea, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Severe Chills and Body aches. Fever. Headache. Nausea. Overall weakness. Difficulty breathing.

VAERS ID:291864 (history)  Vaccinated:2007-09-27
Age:31.0  Onset:2007-09-28, Days after vaccination: 1
Gender:Male  Submitted:2007-10-02, Days after onset: 4
Location:North Carolina  Entered:2007-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2383BA2SCLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Induration, Injection site cellulitis, Lymphadenopathy, Pyrexia, Tenderness
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Cellulitis (erythema, induration, tenderness, lymphadenopathy, and fever) in arm around injection site. Appeared 18 hours after vaccination. Responded to clindamycin.

VAERS ID:292533 (history)  Vaccinated:2007-07-26
Age:31.0  Onset:2007-07-26, Days after vaccination: 0
Gender:Female  Submitted:2007-10-09, Days after onset: 75
Location:Unknown  Entered:2007-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denied
Preexisting Conditions: denied
Diagnostic Lab Data: unknown
CDC Split Type:
Vaccination
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MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 2IM 
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Chest discomfort, Dizziness, Dyspnoea, Headache, Myalgia, Nausea, Oxygen supplementation, Reaction to previous exposure to any vaccine
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad)
Write-up: The Meningococcal vaccination came due 26 Feb 2007 while stationed aboard the USS Bataan. Within 5 minutes post vaccination she experienced similar symptoms of dizziness and wooziness felt with TD/typhoid vaccines in 2004. She returned to medical with increasing dizziness, headaches, nausea w/o vomiting, weakness and "out of body sensation", difficulty breathing with "squeezing lower lungs", and difficulty inhaling. She was placed on oxygen, administered a inhalation treatment without relief. She c/o her chest squeezing and "caving in". She was treated with 2 shots of Epinephrine with slow resolution of symptoms. After several hours observation she was released to her bunk (on ship). She was treated with oral steroids, albuterol inhaler x 3 days for tightness in chest and shortness of breath. Within 48 hours she reported being "back to normal" and by 72 hours only c/o sore thigh muscles with activity (climbing ladders). She reported no residual effects.

VAERS ID:292569 (history)  Vaccinated:2007-09-26
Age:31.0  Onset:2007-09-26, Days after vaccination: 0
Gender:Female  Submitted:2007-10-03, Days after onset: 7
Location:Georgia  Entered:2007-10-10, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Sulfa drugs
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2559AA UNLA
Administered by: Public     Purchased by: Other
Symptoms: Muscle spasms, Pain in extremity
SMQs:, Dystonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Tdap vaccine administered approx 10 AM. Employee c/o (L) lower leg cramping around 5 pm. Employee c/o pain in (L) lower leg also.

VAERS ID:292596 (history)  Vaccinated:2007-09-20
Age:31.0  Onset:2007-10-01, Days after vaccination: 11
Gender:Male  Submitted:2007-10-04, Days after onset: 3
Location:Unknown  Entered:2007-10-10, 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: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760IDLA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Lymphangitis, Night sweats, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Lymphangitis, fevers, night sweats, headache x 3 days.

VAERS ID:292913 (history)  Vaccinated:2007-10-10
Age:31.0  Onset:2007-10-10, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Virginia  Entered:2007-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500488P1IN 
Administered by: Military     Purchased by: Military
Symptoms: Eye discharge, Eye pain, Eye swelling, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Painful conjucta, eye swollen, red, and + discharge.

VAERS ID:292970 (history)  Vaccinated:2007-06-24
Age:31.0  Onset:2007-06-25, Days after vaccination: 1
Gender:Female  Submitted:2007-10-14, Days after onset: 111
Location:New Hampshire  Entered:2007-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Thrombocytopenia with absent radius
Diagnostic Lab Data: L forearm xray- negative, pt ultimately had hardware (pins/ screws/ plate) removed from left forearm 9/10/07.
CDC Split Type:
Vaccination
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TDAP: TDAP (ADACEL)SANOFI PASTEURUNKNOWN0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site swelling, Pain, X-ray normal
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: The morning after injection pt developed swelling at site that progressed for several days. The pain also continued to progress until severe. Pt seen in the office 7/3/07), evaluated and treated with analgesics. xrays done at the visit were unremarkable.

VAERS ID:293115 (history)  Vaccinated:2007-10-12
Age:31.0  Onset:2007-10-13, Days after vaccination: 1
Gender:Male  Submitted:2007-10-15, Days after onset: 2
Location:Pennsylvania  Entered:2007-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA 316BA2IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received flu vaccine on 10/12/07 around 1:45pm. On 10/13/07 around 4 pm noticed back itching. The next morning 10/14/07 noticed "hives" under arms, on chest and uppr abdomen and itching of entire torso and groin. He went to the emergency room around 4pm because of intensity of symptoms and received a shot of prednisone and a prescription for oral prednisone.

VAERS ID:293178 (history)  Vaccinated:2007-08-10
Age:31.0  Onset:2007-08-11, Days after vaccination: 1
Gender:Male  Submitted:2007-08-13, Days after onset: 2
Location:Unknown  Entered:2007-10-15, Days after submission: 63
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1095SCLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pain in extremity, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 31 yo male presents with swelling, redness, pain, and itching to R upper arm x 2 days. 3 days ago received 6th Anthrax vaccination. Sx external from mild upper arm to proximal forearm measuring 29x21 cm.

VAERS ID:293497 (history)  Vaccinated:2007-09-25
Age:31.0  Onset:2007-10-06, Days after vaccination: 11
Gender:Male  Submitted:2007-10-06, Days after onset: 0
Location:Unknown  Entered:2007-10-17, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200720IDLA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis
SMQs:
Write-up: Cellulitis

VAERS ID:294011 (history)  Vaccinated:2007-10-18
Age:31.0  Onset:2007-10-18, Days after vaccination: 0
Gender:Female  Submitted:2007-10-22, Days after onset: 4
Location:Georgia  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: fluoxetine Birth control
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA303BA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Convulsion, Immediate post-injection reaction, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Patient lost conciousness 5 minutes after vaccine was administered. She came around after 1 minute. She may have had a seizure. She rested, recovered and went home.

VAERS ID:294836 (history)  Vaccinated:2007-10-17
Age:31.0  Onset:2007-10-17, Days after vaccination: 0
Gender:Female  Submitted:2007-10-26, Days after onset: 9
Location:Unknown  Entered:2007-10-30, 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: None
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2462AA0UNUN
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB432AA1UNUN
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHBVB432AA1UNUN
Administered by: Private     Purchased by: Private
Symptoms: Eye swelling, Hypoaesthesia, Influenza like illness, Lip swelling, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Flu-like symptoms for 24 hours after vaccination; swollen lips, numbness; red puffy eyes

VAERS ID:295019 (history)  Vaccinated:2007-10-26
Age:31.0  Onset:2007-10-28, Days after vaccination: 2
Gender:Female  Submitted:2007-10-31, Days after onset: 3
Location:Maryland  Entered:2007-10-31
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: Pt also received Polio and Typhoid on same date (right deltoid). In addition, pt requested MMR titers during this time. After titers drawn - pt became lightheaded and c/o N, however, no loss of consciousness. Pt remained in clinic additi
CDC Split Type:
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IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA01080IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2824AA0IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ05670IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Erythema, Injection site pruritus, Injection site swelling, Malaise, Nasopharyngitis, Nausea, Oedema peripheral, Skin warm, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left arm w/swelling and redness - approx 5 1/2" x 3 1/2", additional sx''s include: N, lightheadedness, area warm to touch, pt states "just don''t feel good"; Denies any respiratory difficulty, fever, numbness or tingling at site. Pt seen at urgent care facility 2 days after vaccine 10/28/07. TX - ABX (Cephalexin 500mg PO qid x7 d) along w/Benadryl for itching at site. Pt advised to f/u w/urgent care facility after ABX complete. HD received TC from pt 10/30. Pt states redness has decreased, however, swelling remains at site. Advised pt to f/u w/HD if any additional changes.

VAERS ID:295057 (history)  Vaccinated:2007-10-22
Age:31.0  Onset:2007-10-22, Days after vaccination: 0
Gender:Female  Submitted:2007-10-24, Days after onset: 2
Location:Maryland  Entered:2007-10-31, 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: Ibuprofen-200 mg
Current Illness: no illness
Preexisting Conditions: Amoxicillin, Codeine, PCN/Sulfa meds
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2490AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Cough, Headache, Injection site erythema, Injection site induration, Injection site pain, Pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema (L) arm, c/o pain (L) arm tender. *Indurated has gotten sick with vaccine before achey coughing c/o headaches. Total body pain.

VAERS ID:295194 (history)  Vaccinated:2007-10-22
Age:31.0  Onset:2007-10-24, Days after vaccination: 2
Gender:Female  Submitted:2007-10-31, Days after onset: 7
Location:Mississippi  Entered:2007-11-01, 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: None reoprted
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MS07029
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2523AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site swelling, Local swelling, Pain in extremity, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: reorted on 10/29 that she received a flu shot 10/22 @ employee flu clinic. Had soreness and swelling that afternoon. Next day shes said she had swelling @ site; on 10/24 noticed swelling in L neck area. Had some soreness in that area, but not a present. Still has minior swelling in that area. To make appointment with PMD. No fever after flu shot or at present.

VAERS ID:295862 (history)  Vaccinated:2007-11-06
Age:31.0  Onset:2007-11-06, Days after vaccination: 0
Gender:Female  Submitted:2007-11-07, Days after onset: 1
Location:Massachusetts  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: none
Current Illness: none
Preexisting Conditions: seasonal asthma; sulfa allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERUNK IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Chest discomfort, Cough, Erythema, Eye irritation, Ocular hyperaemia, Pharyngolaryngeal pain, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Glaucoma (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: wheezing and tightness in chest, coughing (asthma-like symptoms) ~4 hours post-vax lasting 6 hours before sleep- no symptoms next AM; sore throat ~10hrs post-vax - no symptoms next AM; redness and irritation in both eyes ~6 hours post-vax lasting ~24hrs. No treatment sought.

VAERS ID:296106 (history)  Vaccinated:2007-11-05
Age:31.0  Onset:2007-11-05, Days after vaccination: 0
Gender:Female  Submitted:2007-11-08, Days after onset: 3
Location:Missouri  Entered:2007-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest pain, Chills, Injection site pain, Neck pain, Pain in extremity, Pharyngolaryngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: sore throat. chills, fever, pain in entire arm where injection was given, pain in neck and chest area.

VAERS ID:296200 (history)  Vaccinated:2007-11-05
Age:31.0  Onset:2007-11-05, Days after vaccination: 0
Gender:Female  Submitted:2007-11-09, Days after onset: 4
Location:North Carolina  Entered:2007-11-09
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: The subject has previously received flu shots.
Diagnostic Lab Data: UNK
CDC Split Type: A0693639A
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA298BA UNLA
Administered by: Other     Purchased by: Private
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: This case was reported by a pharmacist and described the occurrence of arm numbness in a 31-year-old female subject who was vaccinated with Fluarix for prophylaxis. On 5 November 2007 at 12:30 the subject received unspecified dose of Fluarix at 0.5 ml in the left arm. On 5 November 2007, 1 hour after vaccination with Fluarix, the subject experienced arm numbness. The pharmacist considered the event was clinically significant (or requiring intervention). At the time of reporting the event was unresolved.

VAERS ID:296826 (history)  Vaccinated:2007-06-30
Age:31.0  Onset:2007-06-30, Days after vaccination: 0
Gender:Female  Submitted:2007-11-14, Days after onset: 137
Location:Unknown  Entered:2007-11-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Renal disorder
Preexisting Conditions:
Diagnostic Lab Data: biopsy 07/01?/07 - "pocket of vaccine at the shoulder joint within the bone"; magnetic resonance 07/01?/07 - Cyst; complete blood cell 07/01?/07 - Results not reported; blood chemistry 07/01?/07 - Results not reported; glomerular filtration
CDC Split Type: WAES0711USA02002
Vaccination
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Biopsy, Cyst, Full blood count, Glomerular filtration rate, Hypoaesthesia, Immediate post-injection reaction, Incorrect route of drug administration, Injected limb mobility decreased, Injection site calcification, Injection site cyst, Laboratory test, Mobility decreased, Nuclear magnetic resonance imaging abnormal, Pain
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Medication errors (narrow)
Write-up: Information has been received from a registered nurse concerning her a 31 year old niece with "one kidney from kidney disease" and no allergies who in June end or early July 2007 was vaccinated into shoulder bone with a 0.5 ml dose of Recombivax HB. Immediately after vaccination, the patient experienced extreme pain that was described as "like hot lead". The patient had minimal movement from the arm that was vaccinated and was under worker''s comp. It was reported that at times the arm went numb. The patient was taking "massive" doses of ibuprofen (MOTRIN), doing physical therapy, and using hot/cold therapy to relieve the pain. An MRI from the area showed a cyst, which when biopsied was "a pocket of the vaccine at the shoulder joint within the bone". Calcification was found at and around the area of injection. A complete blood test, blood chemistry test and effective infiltration rate and was undertaken. At the time of report the patient had not recovered. The patient''s experiences were considered to be disabling by the reporter. Additional information has been requested.

VAERS ID:296921 (history)  Vaccinated:2007-10-31
Age:31.0  Onset:2007-11-01, Days after vaccination: 1
Gender:Female  Submitted:2007-11-08, Days after onset: 7
Location:Michigan  Entered:2007-11-15, 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
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2862AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Telephone call with c/o within 20 hour of receiving Tdap total body ache, unable to work. In Bed, felt better after 36 hours. No fever. alternated motrin and Tyenol x24 hours; Last Td 12/8/04

VAERS ID:296949 (history)  Vaccinated:2007-11-08
Age:31.0  Onset:2007-11-08, Days after vaccination: 0
Gender:Female  Submitted:2007-11-12, Days after onset: 4
Location:Minnesota  Entered:2007-11-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500480P0IN 
Administered by: Other     Purchased by: Private
Symptoms: Burning sensation, Erythema, Feeling hot, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Employee developed a hot, burning sensation and an area of erythema on left jaw line and neck, measuring 2 1/2 " x 4" within one hour of having FluMist administered. Complained of itch. No breathing difficulties. Used Benadryl Cream and cool compress. Erythema resolving after 24 hours. Had Flumist in 2006, without problems.

VAERS ID:297181 (history)  Vaccinated:2007-10-16
Age:31.0  Onset:2007-10-18, Days after vaccination: 2
Gender:Female  Submitted:2007-11-19, Days after onset: 32
Location:Colorado  Entered:2007-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: NKDA, no medical conditions
Diagnostic Lab Data: none
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA280DA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Lethargy, Malaise, Pain
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad)
Write-up: 10-16-07: Received vaccination. 10-18-2007: Woke up and felt aches in legs, arms, and back. Experienced general malaise and lethargy. Symptoms were more pronounced upon awakening. No fever or chills. Took intermittent ibuprofen 400 mg once to twice daily. 10-27-07: Symptoms resolved.

VAERS ID:297697 (history)  Vaccinated:2006-10-21
Age:31.0  Onset:2006-11-15, Days after vaccination: 25
Gender:Female  Submitted:2007-11-24, Days after onset: 374
Location:Utah  Entered:2007-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Hypothryoidism
Diagnostic Lab Data: Brain MRI, every blood test possible, full body CT scan, colonoscopy, and spinal tap.
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Blood test, Colonoscopy, Computerised tomogram, Convulsion, Dizziness, Fatigue, Fibromyalgia, Hypoaesthesia, Insomnia, Lumbar puncture, Multiple sclerosis, Nausea, Nuclear magnetic resonance imaging brain, Pain, Serum sickness
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Demyelination (narrow), Vestibular disorders (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Arthritis (broad), Hypoglycaemia (broad)
Write-up: For several months I was going to the Doctor for cronic pain, numbness in my arms and constant nausea and dizziness. Doctors tried to diagnose me with MS, Fibromyalgia and Cronic Fatige after months of blood tests and other testing. None of these illness'' fit my problems exactly and were all ruled out. The illness began to spread into my nerves and I felt like I was having seizures, could not sleep at all - even with large dose sleeping pills and did not feel like myself. After months of testing and nothing to help, I felt like I was dying a slow death. The symptoms started to spread through my entire body. At first only one side of my body was numb and had pains, it then spread to the other side. I now have pains in every joint in my body. I feel like I am 80 years old suffering from RA. When I was very sick, I felt like I was being slowly poisioned. I had the flu shot in October of 2006. I was finally directed to a Doctor in the beginning of April who I feel saved my life. He told me I had a form of Syrum sickness from the flu shot and immediately had me take Prednisone. It took eight weeks of being on Prednisone before I began to feel like myself again. The mini seizures have stopped now. I have taken Prednisone for eight months now just to treat the symptoms and function in daily life. I was not able to perform nomal tasks without this medication. I am slowly weaning from the medication by reducing dosage 1mg a month. I have been told to expect at least two years before symptoms to reduce. At this point, I do not know what the long term permanent damage will be. My 5 yr old son who also received a flue shot on the same day as me is also suffering similar aches and pains and problems that I encountered. I have not felt his symptoms have been bad enough to justify the dangers of taking prednisone. I hope more than anything his problems will correct themselves on their own. I cannot stress enough that this has been the most miserable experience of my life. I may never be the same again (o

VAERS ID:297793 (history)  Vaccinated:2007-11-06
Age:31.0  Onset:2007-11-09, Days after vaccination: 3
Gender:Female  Submitted:2007-11-21, Days after onset: 12
Location:Louisiana  Entered:2007-11-26, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC, Lytes Plus
CDC Split Type:
Vaccination
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Lot
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2775AA UNRA
Administered by: Private     Purchased by: Private
Symptoms: Blood electrolytes, Full blood count, Lymphadenopathy, Musculoskeletal stiffness, Oedema peripheral, Swelling face, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed tenderness, swelling and stiffness to (R) arm within 24 hrs. Progression went up neck/ clavicle and shoulder. Unable to move neck. swelling also to (R) side of face. Cover 4 days. steroids. f/u visit had decreased WBC and also had lymph node involvement. Symptoms began to resolve on 7th day. missed 5 days of work. Had 2 f/u visits with internal med physician after initial ER visit.

VAERS ID:298071 (history)  Vaccinated:2007-11-19
Age:31.0  Onset:2007-11-19, Days after vaccination: 0
Gender:Female  Submitted:2007-11-21, Days after onset: 2
Location:Montana  Entered:2007-11-26, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Unknown
Symptoms: Infection
SMQs:
Write-up: Received infection from shot.

VAERS ID:298037 (history)  Vaccinated:2007-10-11
Age:31.0  Onset:2007-10-14, Days after vaccination: 3
Gender:Female  Submitted:2007-11-13, Days after onset: 30
Location:Massachusetts  Entered:2007-11-28, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None PMH: sinusitis
Diagnostic Lab Data: 11/09/07: WBC = 1.2; Platelets 108; ANC = 500; AST = 265; ALT = 106; Bone marrow: no leukemia; CT abd/pelusslonist WNL LABS: CT of abdomen/chest & sinuses were WNL. CXR WNL. Bone marrow biopsy WNL. ESR 70 (H). Rheumatoid factor 27.9 (H)
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Antinuclear antibody positive, Arthralgia, Aspartate aminotransferase increased, Autoimmune disorder, Biopsy bone marrow normal, Chest X-ray normal, Chills, Collagen-vascular disease, Computerised tomogram normal, Cough, Echocardiogram normal, Fatigue, Haematocrit decreased, Haemoglobin decreased, Headache, Hyperhidrosis, Lymphadenopathy, Malaise, Neutropenia, Neutrophil count decreased, Pancytopenia, Pharyngolaryngeal pain, Platelet count decreased, Pyrexia, Red blood cell sedimentation rate increased, Rheumatoid factor increased, Sinus congestion, Vaccination complication, Viral infection, White blood cell count decreased
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Agranulocytosis (narrow), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Arthritis (broad), Myelodysplastic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: Fever, chills, rigors, T $g 102 developed 2 days after vaccination, then neutropenia down to WBC = 1.3 and absolute neutrophil count 500 by 11/08/07, AST = 265; ALT = 106. 12/11/07 Reviewed hospital medical records which reveal patient experienced fever of unknown origin intermittently x 3 weeks of 102-103 with sweats & chills, HA, sinus congestion, sore throat, semi-productive cough, malaise, swollen tender submandibular lymph glands, fatigue & arthralgia when febrile. Seen by pcp multiple times & had ID & hematology outpatient consults prior to admission. Admitted 11/8-11/13/2007 for antibiotic & further eval . ID, heme & rheumatology consults obtained while hospitalized. Tx w/IV antibiotics. Fever gradually resolved. FINAL DX: pancytopenia, possibly related to underlying viral illness or autoimmune disorder; Fever of unknown origin, possibly related to viral syndrome, collagen vascular disease or reaction to flu vaccine.

VAERS ID:298520 (history)  Vaccinated:2007-12-03
Age:31.0  Onset:2007-12-03, Days after vaccination: 0
Gender:Female  Submitted:2007-12-03, Days after onset: 0
Location:Texas  Entered:2007-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED00149111A IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash papular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 5:00 PM C/O ITCHING TO LEFT UPPER EXTREMITY AND TORSO, SCANT RAISED PAPULES TO LEFT FOREARM AND WRIST 5:15 VS B/P 132/76,P 93,RR 20 BENEDRYL 25MG PO GIVEN FOR ITCHING. MONITORED IN MEDICAL OFFICE.5:45 PM CONTINUE TO C/O ITCHING WITH INCREASED IRRITATION SPREADING T/O TORSO, DR NOTIFIED, RECEIVED ORDERS TO REPEAT BENEDRYL AND GIVE UP 100MG PO PRN, GAVE 25MG MORE AT THIS TIME, CONTINUE TO MONITOR IN MEDICAL OFFICE. 6:20PM VS B/P 108/82, P 82, RR20 PATIENT STATES TO HAVE DECREASED IRRITATION AND LESS ITCHING AT THIS TIME, NOTABLE FOR DECREASED RAISED RASH TO LEFT FOREARM AND WRIST AREAS.

VAERS ID:300354 (history)  Vaccinated:2006-09-20
Age:31.0  Onset:2006-09-24, Days after vaccination: 4
Gender:Male  Submitted:2007-11-14, Days after onset: 416
Location:Texas  Entered:2007-12-04, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: headache and flu like symptoms~Vaccine not specified (no brand name)~~0~In Patient
Other Medications: no concurrent medication
Current Illness: unknown
Preexisting Conditions:
Diagnostic Lab Data: unspecified bloodwork results were "good".
CDC Split Type: A0623126A
Vaccination
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 2  
Administered by: Unknown     Purchased by: Military
Symptoms: Arthralgia, Blood test, Fatigue, Headache, Influenza like illness, Joint swelling, Oral pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by a consumer and described the occurrence of joint paint in a 31 year old male subject who was vaccinated with Twinrix for prophylaxis. A physician or other health care professional has not verified this report. There were no concurrent medications. The subject reported he had experienced headache and flu-like symptoms in the past with other vaccines. The subject received 1st dose of Twinrix in the summer of 2004. On 20 September 2006, the subject received 2nd dose of Twinrix (right arm). On 24 or 25 September 2006, 4-5 days after vaccination with Twinrix, the subject reported that his ankles, wrists, and elbows began to hurt and were swollen. He reported no visible bruises, however, his ankles and wrists felt as if they were bruised. He also reported his ankles, wrists, and the bottoms of his feet hurt when they were touched. The subject described the pain as a "nagging pain". On an unspecified date in September2006, after receiving Twinrix, the subject experienced fatigue, headache, flu-like symptoms, and his gums hurt. He described the fatigue as "extreme" and stated that "he felt as if he were 100 years old". The subject reported that when he ran for approximately 30 minutes on 09 October 2006, "the pain faded after running approximately 1/2 miles, however, it returned twice as bad after he showered and dressed". he stated he is usually pretty active but for the last few weeks, he has not been able to do much more than what he absolutely has to do to make it through the day. He reported walking has become easier. The subject was treated with Motrin twice a day. He reported "the bloodwork results were good". He is schedule to see his physician for a follow-up visit on 11 October 2006. At the time of reported, the flu-like symptoms, gums hurt and headache had resolved, but joint pain, swelling of joints, fatigue, and sensations of bruising were unresolved.

VAERS ID:298919 (history)  Vaccinated:2007-12-05
Age:31.0  Onset:2007-12-06, Days after vaccination: 1
Gender:Female  Submitted:2007-12-06, Days after onset: 0
Location:Unknown  Entered:2007-12-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: Physical Examination
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1733SCRA
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA049AA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Fatigue, Incorrect route of drug administration, Influenza like illness, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was given her 4th Anthrax vaccine one month early and was incorrectly administered distal to the deltoid. Also pt recieved the FLU vaccine on the same day. As a result on the following day, the patient c/o of flu like symptoms with fever, bodyaches, fatigue, abnormal swelling and redness in L arm from Anthrax vaccination.

VAERS ID:299363 (history)  Vaccinated:2007-11-28
Age:31.0  Onset:2007-12-04, Days after vaccination: 6
Gender:Female  Submitted:2007-12-12, Days after onset: 8
Location:Georgia  Entered:2007-12-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: weight loss meds: phentermine, lasix, potassium;
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA316BA1IMRA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: tokk flus shot (Fluarix, GSK lot#AFLUA316BA) on 11-28-07; developed macular rash 5 days later on 12-2-07; presented to clinic on 12-4-07 treated with loratadine, hydrocortisone cream; rechecked on 12-6-07: still has pruritus and mild rash but improved from previous visit; given Inj. Dexamethasone 4 mg IM; phone conversation with patient on 12-12-07 showed she had improved;

VAERS ID:299813 (history)  Vaccinated:2007-12-12
Age:31.0  Onset:2007-12-13, Days after vaccination: 1
Gender:Female  Submitted:2007-12-14, Days after onset: 1
Location:California  Entered:2007-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2506AA5IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt was given the Inactivated Influenza Vaccine IM in the Left Deltoid Muscle. She received this injection on 12/12/2007. The area was red, bruised, swollen, warm to the touch, painful to the touch, and was approximately 3 inches in diameter around the injection site.

VAERS ID:300338 (history)  Vaccinated:2007-12-06
Age:31.0  Onset:0000-00-00
Gender:Female  Submitted:2007-12-19
Location:Georgia  Entered:2007-12-19
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: None
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS806823IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0806F1SCRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2172AA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEUR2759AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: Adm vaccine on 12/06/2007 and client inform us of pregnancy 12/14/2007

VAERS ID:301395 (history)  Vaccinated:2007-11-07
Age:31.0  Onset:2007-11-07, Days after vaccination: 0
Gender:Female  Submitted:2007-12-14, Days after onset: 37
Location:Indiana  Entered:2007-12-21, 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: Unknown; no concurrent illnesses
Preexisting Conditions: No relevant medical history, or allergies. No concurrent medications. No alcohol or tobacco use.
Diagnostic Lab Data: UNK; MRI scan indicated administration likely occurred into the infraspinatus tendon/bursa and local inflammation of tendon along with partial tear likely at injection site
CDC Split Type: A0696102A
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA315CA UNUN
Administered by: Other     Purchased by: Private
Symptoms: Bursa injury, Incorrect route of drug administration, Inflammation, Lymphadenopathy, Nuclear magnetic resonance imaging abnormal, Rotator cuff syndrome
SMQs:, Accidents and injuries (narrow), Tendinopathies and ligament disorders (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a pharmacist and described the occurrence of bursa injury in a 31-year-old female subject who was vaccinated with Fluarix (GlaxoSmithKline) for prophylaxis. On the morning of 7 November 2007 the subject received unspecified dose of Fluarix (.5 ml, unknown) that was mistakenly administered into the bursa and in the top of the shoulder rather than intramuscularly. On 7 November 2007, at an unspecified time after vaccination with Fluarix, the subject experienced bursa injury and intramuscular formulation administered by other route. The subject required medical attention at the doctors office and was treated with a Medrol dose pack (Medrol Pak) and ibuprofen. At the time of reporting the events were unresolved. The pharmacist considered the events were possibly related to vaccination with Fluarix. Follow-up received on 25 January 2008 via the pharmacist. He reported that on 08 November 2007, the subject experienced a partial tear and inflammation of the rotator cuff tendon from the misplacement of the injection and secondary axillary lymphadenopathy. He also confirmed that on 08 November 2007, the subject experienced a bursa injury and intramuscular formulation administered by another route. He noted that the MRI indicated administration likely occurred into the infraspinatus tendon/bursa and local inflammation of tendon along with partial tear likely at injection site. The subject was treated with a MEDROL 4 mg dosepack and referred to physical therapy. He noted that the partial tear and inflammation of the rotation cuff tendon and bursa injury improved and he considered that these events were not related to the use of FLUARIX. He reported that the secondary axillary lymphadenopathy resolved on 07 January 2008 and he considered that it was possibly related on the use of FLUARIX. He considered that the events were not serious. The reporter indicated that the events could have been associated with the erroneous administration based on the result of the MRI.

VAERS ID:302070 (history)  Vaccinated:2006-11-06
Age:31.0  Onset:2006-11-06, Days after vaccination: 0
Gender:Female  Submitted:2007-12-21, Days after onset: 410
Location:New York  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:
Current Illness:
Preexisting Conditions: Poliomyelitis; Cardiac pacemaker insertion
Diagnostic Lab Data: None
CDC Split Type: WAES0710USA00392
Vaccination
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Constipation, Herpes zoster, Hypertension, Inappropriate schedule of drug administration, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Medication errors (narrow), Hypoglycaemia (broad)
Write-up: Information has been received from a 76-year-old female with no drug allergies, a pacemaker and a history of polio in 1943 who on 06-NOV-2006 was vaccinated with a 0.65 milliliter dose of Zostavax (Oka/Merck). Concomitant therapy included warfarin sodium (COUMADIN), verapamil and alendronate sodium (MSD). On approximately 31-MAR-2007 the patient experienced shingles. After she had the shingles, she had two episodes of syncope. She fainted once within one week after getting the shingles and then she fainted again on 18-JUN-2007. She reported that for the past year and a half, when she turns her head to the left or right, she will sometimes have "mini-blackouts". They do not involve a total loss of consciousness, such as the two incidents she had since the shingles. She also reported that she had been experiencing high blood pressure and constipation. The outcome was reported as recovering. No product quality complaint was involved. Follow up information received indicates the current physician''s group did not administer the vaccination. No other information was available. Follow-up information was received from the consumer who wanted to clarify that this was not a complaint about Zostavax (Oka/Merck). While she did get shingles post vaccination she believes that the vaccine made a great impace because she felt no pain. She believes that the case of shingles that she developed was common and related to her age. Additional information is not expected.

VAERS ID:301268 (history)  Vaccinated:2007-11-14
Age:31.0  Onset:2007-11-28, Days after vaccination: 14
Gender:Male  Submitted:2008-01-01, Days after onset: 34
Location:Hawaii  Entered:2008-01-01
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
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH40200760OTLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema multiforme
SMQs:, Severe cutaneous adverse reactions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient presented with mild symptoms of Erythema Multiforme distributing from vaccination site 14 days post vaccination. Patient required no treatment and spontaneously resolved within 3 days.

VAERS ID:301498 (history)  Vaccinated:2007-11-07
Age:31.0  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 BIOSOLUTIONSFAV1106SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered, No adverse reaction
SMQs:, Medication errors (narrow)
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:301501 (history)  Vaccinated:2007-11-07
Age:31.0  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: SAR, PPD converter
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1106SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered, No adverse reaction
SMQs:, Medication errors (narrow)
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:301510 (history)  Vaccinated:2007-11-07
Age:31.0  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: Allergy: Motrin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1106SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:, Medication errors (narrow)
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:301538 (history)  Vaccinated:2007-11-07
Age:31.0  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 BIOSOLUTIONSFAV1105SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered, No adverse reaction
SMQs:, Medication errors (narrow)
Write-up: Anthrax Lot # FAV110 administered after expired date due to administrative oversight. No adverse reaction at this time. Report submitted per agency direction.

VAERS ID:301556 (history)  Vaccinated:2007-11-07
Age:31.0  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: Hyperlipidemia
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1105SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:, Medication errors (narrow)
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:301566 (history)  Vaccinated:2007-11-07
Age:31.0  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:, Medication errors (narrow)
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:301568 (history)  Vaccinated:2007-11-15
Age:31.0  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 BIOSOLUTIONSFAV1104SCUN
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:, Medication errors (narrow)
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:301593 (history)  Vaccinated:2007-12-19
Age:31.0  Onset:2007-12-20, Days after vaccination: 1
Gender:Male  Submitted:2008-01-03, Days after onset: 14
Location:Michigan  Entered:2008-01-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: multi vitamin
Current Illness: none
Preexisting Conditions: pcn allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURZ211022IMLA
Administered by: Military     Purchased by: Military
Symptoms: Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient noticed diffuse red patches on trunk of body primarily on chest and stomach. Symptoms noticed approx 24 hours following vaccination. Patient took otc Benadryl with no improvement of symptoms.