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Case Details (Sorted by Age)

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VAERS ID:514049 (history)  Vaccinated:2013-11-15
Age:47.0  Onset:2013-11-15, Days after vaccination: 0
Gender:Female  Submitted:2013-11-20, Days after onset: 5
Location:New Jersey  Entered:2013-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Mycophenolate, hydroxychloroquine, warfarin
Current Illness: No
Preexisting Conditions: Sjogren''s syndrome patient. Previous allergy to docycycline.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 10  
Administered by: Unknown     Purchased by: Other
Symptoms: Burning sensation, Pain, Rash erythematous, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swelling, burning, deep red rash, burning, pain.

VAERS ID:514069 (history)  Vaccinated:2013-09-24
Age:47.0  Onset:2013-09-24, Days after vaccination: 0
Gender:Female  Submitted:2013-11-19, Days after onset: 56
Location:Florida  Entered:2013-11-20, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1308601 UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Neck pain, Pain, Pain in extremity
SMQs:, Arthritis (broad)
Write-up: Patient stated that since receiving vaccine in September she has experienced pain shooting down arm and wrist, over her collarbone and up her neck.

VAERS ID:514199 (history)  Vaccinated:2013-11-06
Age:47.0  Onset:2013-11-07, Days after vaccination: 1
Gender:Female  Submitted:2013-11-21, Days after onset: 14
Location:New Jersey  Entered:2013-11-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Flovent HFA; Famvir; Nexium; Valtrex; Sumatriptan Succinate; Nasonex; Astelin; Claritin; Xopenex HFA; Nabumetone; Valium
Current Illness: No acute distress. Prior fatigue and malaise.
Preexisting Conditions: Anxiety; headache; GERD; IBS; Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU4768AA IDLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0050067 IDLA
Administered by: Private     Purchased by: Private
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Fever.

VAERS ID:514282 (history)  Vaccinated:2013-11-20
Age:47.0  Onset:2013-11-21, Days after vaccination: 1
Gender:Female  Submitted:2013-11-21, Days after onset: 0
Location:New Jersey  Entered:2013-11-21
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
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSM4F840SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site swelling, Local swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Localized injection site redness and swelling (spreading up to neck).

VAERS ID:514449 (history)  Vaccinated:2013-10-30
Age:47.0  Onset:2013-10-30, Days after vaccination: 0
Gender:Female  Submitted:2013-11-23, Days after onset: 24
Location:California  Entered:2013-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: 11/20/2013 Dr. diagnosed bursitis in my left shoulder.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU478AA UNLA
Administered by: Unknown     Purchased by: Other
Symptoms: Bursitis, Hypersensitivity, Injection site joint movement impairment, Injection site pain, Musculoskeletal stiffness, Pain
SMQs:, Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Pain at time of injection, by 1 pm significant pain and stiffness when trying to move arm. As of 11/23/13 continued pain and limited range of motion in left shoulder/upper arm. Some hypersensitivity of skin around back of arm above bicep.

VAERS ID:514630 (history)  Vaccinated:2013-11-12
Age:47.0  Onset:2013-11-13, Days after vaccination: 1
Gender:Female  Submitted:2013-11-25, Days after onset: 12
Location:Nebraska  Entered:2013-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13098012IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Injection site pain, Injection site reaction, Joint range of motion decreased, Musculoskeletal stiffness
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: (Per injury report completed by patient). On Nov 19th 2013 I came up to employee health to get a flu shot, I received my flu shot in my right arm thinking its my dominate arm that is would be better in that one. I felt fine arm a little sore where shot was given normal. Wednesday morning I woke up and felt very stiff in my right shoulder and neck along with my arm still being sore from the shot. Thinking nothing of it thinking maybe I just slept wrong, and I proceeded with my day. As the day proceeded on, it got worse, I have put heat on the area and cold and ibuprofen, neither of any has helped with the situation. I had a friend massage that area, it gave a small amount of relief but it is still going on to the point at times its hard to breathe and turn my neck. It has become quite intolerable.

VAERS ID:514690 (history)  Vaccinated:2013-10-09
Age:47.0  Onset:2013-10-09, Days after vaccination: 0
Gender:Female  Submitted:2013-11-25, Days after onset: 47
Location:Unknown  Entered:2013-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitriptyline Hydrochloride; buspirone hydrochloride; IMITREX; Potassium (unspecified); CLARITIN; naproxen; ZOLOFT
Current Illness: Prophylaxis; Chronic obstructive pulmonary disease
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1310USA011674
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J004387 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dermatitis atopic, Injection site pruritus, Injection site rash, Injection site urticaria, Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Information was received from a L.P.N. regarding 47 year old female patient with COPD. On 09-OCT-2013, the patient was vaccinated with PNEUMOVAX23 (Lot # J004387, expiration 04-JAN-2015), 0.5 ml, intramuscular in the left arm. Concomitant therapies included amitriptyline hydrochloride, buspirone hydrochloride, IMITREX, potassium (unspecified), CLARITIN, naproxen and ZOLOFT. On 09-Oct-2013, the patient was also vaccinated with FLUZONE via right arm. The nurse reported that the patient experienced rash, hives and itching of both her arms and shoulders after receiving the PNEUMOVAX23 on 09-OCT-2011. On 11-OCT-2013, the patient was evaluated back in the office and was diagnosed with atopic dermatitis. Treatment included an unspecified skin moisturizer. At the time of this report the outcome of rash, atopic dermatitis, itching, and hives both arms was reported as recovered. Additional information has been requested.

VAERS ID:514769 (history)  Vaccinated:2013-11-20
Age:47.0  Onset:2013-11-21, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Rhode Island  Entered:2013-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH941AE UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4472AA SYRLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Localized redness, swelling and warm at site of Tdap injection (L deltoid) afebrile (98.6).

VAERS ID:514808 (history)  Vaccinated:2013-11-12
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2013-11-26
Location:New York  Entered:2013-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH908AA UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H021941 UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: Received TWINRIX, TDP, flu, pneumonia vaccine. KEFLEX.

VAERS ID:514811 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2013-11-26
Location:New York  Entered:2013-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH908AA UNLA
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSMF3X3 UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J005067 UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Joint range of motion decreased, Local swelling, Pain in extremity, 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), Arthritis (broad)
Write-up: 2 days T - up to 102.8. Pain could not lift arm. Local swelling with increasing margins. Rx TYLENOL, BENADRYL, day 3 - KEFLEX.

VAERS ID:515573 (history)  Vaccinated:2013-09-20
Age:47.0  Onset:2013-09-21, Days after vaccination: 1
Gender:Male  Submitted:2013-12-04, Days after onset: 74
Location:Pennsylvania  Entered:2013-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH905AA IM 
Administered by: Public     Purchased by: Private
Symptoms: Nausea, Tinnitus, Vertigo
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Vestibular disorders (narrow)
Write-up: 24 hours after receiving the flu vaccine, the patient developed nausea and vertigo. He has had lingering symptoms of tinnitus since that time.

VAERS ID:515717 (history)  Vaccinated:2013-10-22
Age:47.0  Onset:2013-10-22, Days after vaccination: 0
Gender:Female  Submitted:2013-12-05, Days after onset: 44
Location:Tennessee  Entered:2013-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole; Multivitamin
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Primary care physician stated possible tendonitis - prescribed oral steroids (Dexamethasone 3 times/day) for 5 days. Symptoms improved but did not disappear. Returned on cessation of medication. Symptoms worsened. Referred to specialist, orthopaedic and sports medicine. Dr. did x-rays and physical exam. Said shot was given too high up on arm, especially for a woman of my size (slender) and that it resulted in nerve damage to one or more nerves. Prescribed physical therapy 2 times per week for 3 weeks and possible Electromyogram (EMG/NCV) when 8 weeks post vaccination.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Drug administered at inappropriate site, Mobility decreased, Nerve injury, Pain, Pain in extremity
SMQs:, Parkinson-like events (broad), Accidents and injuries (narrow)
Write-up: Initial soreness of left arm, increased in severity overnight. Treated with ibuprofen - soreness was more severe than usually experienced with flu shot. Soreness got better but didn''t subside, getting worse over time and now very painful from shoulder to elbow, with painful and/or limited mobility.

VAERS ID:515806 (history)  Vaccinated:2013-09-26
Age:47.0  Onset:2013-10-03, Days after vaccination: 7
Gender:Male  Submitted:2013-12-04, Days after onset: 62
Location:Virginia  Entered:2013-12-06, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: High blood pressure; Elevated cholesterol; Cardiomyopathy
Diagnostic Lab Data: ECG, 03OCT2013, Abnormal; echocardiogram, Unknown
CDC Split Type: 2013SA123551
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEUR  IDUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Cardiac imaging procedure, Cardiomyopathy, Echocardiogram normal, Electrocardiogram abnormal
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (narrow)
Write-up: Note: Any requests for follow-up information on this case should be sent directly to the sponsor of this study, Sanofi Pasteur. This study case was received from the investigator in a trial on 26 November 2013. A 47 year-old male subject with past medical history of high blood pressure, elevated cholesterol and cardiomyopathy was found to have other primary cardiomyopathy 7 days after the subject had received the following vaccines on 26 September 2013: an injection of ACAM2000 (lot number, route and site of administration not reported), TYPHIM VI (lot number, route and site of administration not reported), FLUMIST (lot number not reported) and Anthrax vaccine (manufacturer, lot number, route and site of administration not reported). On 03 October 2013, the subject had an abnormal ECG. Echocardiogram results and MRI of the heart were not available. Troponin I, Lumbar puncture and MRI of the brain and spinal cord were not performed. Treatments were not reported. The subject''s outcome was not reported. Note: There is no reporter causality assessment as this is a safety surveillance (data mining, non-interventional) study. Documents held by sender: none.

VAERS ID:515833 (history)  Vaccinated:2013-10-18
Age:47.0  Onset:2013-10-18, Days after vaccination: 0
Gender:Female  Submitted:2013-12-06, Days after onset: 49
Location:Florida  Entered:2013-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cytomel; Hyzaar; Lexapro; Lysteda; Ritalin; Singulair; Symbicort; Synthroid; Vit B12
Current Illness: None reported
Preexisting Conditions: Allergies: fruits & vegatables, latex, adhesive, tape, Ibu, naproxyn, Ultram, Aleve, Vicodin
Diagnostic Lab Data: ANA screen, CMP, CBC, CRP, Sed rate
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR550080IMLA
Administered by: Private     Purchased by: Private
Symptoms: Antinuclear antibody, C-reactive protein, Full blood count, Headache, Hypoaesthesia, Metabolic function test, Paraesthesia, Red blood cell sedimentation rate, Sensation of heaviness, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad)
Write-up: Patient states h/a 45 minutes after injection, after nap h/a still constant but not throbbing, she then began to have numbness and tingling in her left arm and leg in which she describes as just a heaviness dullness of sensation in her left upper extremity.

VAERS ID:515846 (history)  Vaccinated:2013-12-03
Age:47.0  Onset:2013-12-05, Days after vaccination: 2
Gender:Female  Submitted:2013-12-06, Days after onset: 1
Location:Massachusetts  Entered:2013-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Etodolac Tablet Taking Albuterol Sulfate HFA 108 (90 Base) MCG/ACT Aerosol Solution Taking Flovent HFA 110 MCG/ACT Aerosol Taking PROzac 20 mg Capsule Taking Fenofibrate Micronized 134 MG Capsule Taking FLUoxetine HCl 10 MG
Current Illness: None
Preexisting Conditions: Diabetes Mellitus Type II, Hypertriglyceridemia, Obesity, chronic low back pain, depression
Diagnostic Lab Data: nNone. Prescribed pain medication, Benadryl for what appeared to be large local reaction. Rx for Keflex given to patient in rare chance there is cellulitis, though I suspect this is not the case.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4722AA1IDLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0040801SCLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Hyperhidrosis, Injection site erythema, Local reaction, Pyrexia, Vaccination site pain, Vaccination site warmth
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt developed fever, chills, sweats, headache, severe pain, redness and warmth at the vaccination site, posterior deltoid left arm administered subcutaneously. This worsened over 3 days.

VAERS ID:515981 (history)  Vaccinated:2013-11-21
Age:47.0  Onset:2013-11-23, Days after vaccination: 2
Gender:Female  Submitted:2013-12-06, Days after onset: 13
Location:North Carolina  Entered:2013-12-09, 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: SYNTHROID; COZAAR; LOESTRIN
Current Illness: None
Preexisting Conditions: Raw egg allergy; HTN; hypothyroid
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUR3: INFLUENZA (SEASONAL) (FLUBLOK)PROTEIN SCIENCES CORPORATION340503F0IMGM
Administered by: Public     Purchased by: Public
Symptoms: Lymph node pain, Lymphadenopathy
SMQs:
Write-up: Approximately 2 days post vaccine (given in (L) hip) the patient noticed a painful enlarged lymph node in her (L) groin 48 hrs later. Started KEFLEX 11/28 (500 QID) x 28 doses through 12/5. As of 12/6, lymph node is now normal size, non-tender, no further adenopathy.

VAERS ID:516255 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2013-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Chest discomfort, Dyspnoea, Muscle tightness, Nausea, Paralysis, Pyrexia, Visual impairment, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Chest wall tightness, difficult to take deep breaths, neck paralysis, nausea and vomiting, low grade fever, vision changes. Onset 4 hours after receiving vaccine, symptoms horrible for 3 days but lasted for 2-3 weeks. Problems with vision and neck tightness still present - pt can see.

VAERS ID:516291 (history)  Vaccinated:2013-12-02
Age:47.0  Onset:2013-12-02, Days after vaccination: 0
Gender:Male  Submitted:2013-12-09, Days after onset: 7
Location:Florida  Entered:2013-12-11, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13102010IMRA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Back pain, Dizziness, Injection site pain, Musculoskeletal pain, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Weakness/dizziness. Shoulder pain and back pain at injection site. Hives.

VAERS ID:516472 (history)  Vaccinated:2013-11-14
Age:47.0  Onset:2013-11-26, Days after vaccination: 12
Gender:Male  Submitted:2013-12-13, Days after onset: 17
Location:Massachusetts  Entered:2013-12-13
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: ASA; Vit D; Lisinopril; STRIBILD
Current Illness: None
Preexisting Conditions: HIV; HTN; PE
Diagnostic Lab Data: Varicella IgG Ab Neg 11/13/13; Varicella Zoster DFA 11/29/13
CDC Split Type:
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0065380SCLA
Administered by: Other     Purchased by: Public
Symptoms: Blood immunoglobulin G normal, Varicella post vaccine, Varicella virus test positive
SMQs:
Write-up: 11/7 - 11/10/13 Pt. may have been exposed to Varicella. His IgG titer was neg. Pt. developed varicella on 11/26/13. Was sent to hospital. Pt was treated for a mild case of varicella with Acyclovir and returned to jail on 12/3/13.

VAERS ID:516581 (history)  Vaccinated:2013-05-03
Age:47.0  Onset:2013-05-03, Days after vaccination: 0
Gender:Female  Submitted:2013-12-13, Days after onset: 224
Location:Virginia  Entered:2013-12-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen and Clartin
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Pt. states she had labs drawn at ER in October but she doesn''t recall which tests were ordered and what the results were.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH731AA0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B07CA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Anxiety, Laboratory test, Myositis, Nasopharyngitis, Paraesthesia, Vaccination site pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt. states her arm where the vaccines where admin. had severe pain and she had a "cold". She asked her friends for advice and they told her it was normal. The pain continued. Pt. went to ER in 10/2013 and was told her arm muscles were inflamed. She didn''t take the medication prescribed by MD. She called into the Health Dept, where the vaccines were admin, yesterday 12/12/13. She continues to feel pins and needles in her Left arm and has anxiety.

VAERS ID:516704 (history)  Vaccinated:2013-10-14
Age:47.0  Onset:2013-11-25, Days after vaccination: 42
Gender:Male  Submitted:2013-12-11, Days after onset: 16
Location:Pennsylvania  Entered:2013-12-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 17 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: HTN; Diabetes; Asthma; Chronic pain syndrome
Diagnostic Lab Data: Unknown
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH917AB2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Back pain, Fall, Paraesthesia, White blood cell count increased
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow)
Write-up: Unsure of signs and symptoms course of time, pt. only been in ER and hospital. Started 11/25/13 w/back pain, S/P fall and paresthesias, discharged 11/29/13 and readmitted 11/30/13 for increased WBC''s, w/? Guillain Barre and weakness, currently still in hospital on a rehab unit.

VAERS ID:516726 (history)  Vaccinated:2013-12-04
Age:47.0  Onset:2013-12-04, Days after vaccination: 0
Gender:Male  Submitted:2013-12-05, Days after onset: 1
Location:Illinois  Entered:2013-12-16, 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: None
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
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FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS010031A0IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS3T5490IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cough, Oropharyngeal pain, Swollen tongue, Tongue blistering
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Pt reported swollen tongue with blisters, sore throat, cough. Pt took Benadryl and symptoms resolved.

VAERS ID:517183 (history)  Vaccinated:2013-11-30
Age:47.0  Onset:2013-11-30, Days after vaccination: 0
Gender:Female  Submitted:2013-12-19, Days after onset: 19
Location:Virginia  Entered:2013-12-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 6SYRLA
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Immediate post-injection reaction, Injection site nerve damage, Injection site pain, Middle insomnia, Pain, Pain in extremity
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: Immediately had a soreness from shot (which is normal). Then that evening it was worse and the next day it was worse and the next day as well. I took ibuprofen but it really didn''t help. My arm was so painful that it woke me up at nights. I had sharp shooting pains when lifted a certain way. I lost strength in the arm. I have had the flu shot about 6 times now but it was the first time in my left arm. Normally I get it in the right arm. After about 3 weeks of it not getting better, I went to the doctor who said that the nurse probably hit a nerve. I am petite and have very lean arms. He prescribed vicodin, Gabapentin, and Nabumetone. I am now on my 2nd prescription of Nabumetone. I still have pain and it is almost 2 months after the flu shot. I am very healthy and exercise on a regular basis and have no physical problems. I know this reaction is from the flu shot because it immediately started bothering me and hasn''t stopped yet. I have lost strength in my arm and it continues to hurt. I hope it isn''t permanent but I am not sure.

VAERS ID:517939 (history)  Vaccinated:2013-08-20
Age:47.0  Onset:2013-08-22, Days after vaccination: 2
Gender:Female  Submitted:2013-12-19, Days after onset: 119
Location:Wisconsin  Entered:2013-12-30, 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: Albuterol HFA; ALLEGRA; ADVAIR HFA; NORCO; ATROVENT; PATADAY; Triamcinolone acetonide
Current Illness: No
Preexisting Conditions: Chronic allergic conjunctivitis; Glaucoma suspect; Dry eye syndrome; Allergic rhinitis, nostril sore; Asthma; Female stress incontinence; Plantar fasciitis; Compartment syndrome; Cervicalgia; Low back pain; Rosacea; Head pain; Stress; Serum total bilirubin elevated; Preventative health care; Family history of glaucoma; Laryngopharyngeal reflux/hoarseness; Aches; Nonspecific abnormal electrocardiogram (ECG) (EKG); Infrequent menses
Diagnostic Lab Data: See attached letter
CDC Split Type:
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.H0173040IMLA
Administered by: Private     Purchased by: Other
Symptoms: Arthropathy, Musculoskeletal pain, Rotator cuff syndrome, Tendon disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (broad)
Write-up: Rotator cuff tear, rotator tendinopathy, shoulder impingement, biceps tendinopathy (unlikely), labral tear, AC and SC joint problems, chronic tears (no other hx although has repetitive use), something caused by the hep b injections (seems chronologically related). Chronologically related to hep b injections: No further hep B injections (#3).

VAERS ID:518027 (history)  Vaccinated:2013-12-19
Age:47.0  Onset:2013-12-30, Days after vaccination: 11
Gender:Female  Submitted:2013-12-31, Days after onset: 1
Location:Massachusetts  Entered:2013-12-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Continued, ongoing pain in upper deltoid, left arm, at injection site.

VAERS ID:518086 (history)  Vaccinated:2013-12-17
Age:47.0  Onset:2013-12-17, Days after vaccination: 0
Gender:Female  Submitted:2013-12-31, Days after onset: 14
Location:North Carolina  Entered:2013-12-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J011651 SCLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALST25E6 IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J011338 SCLA
Administered by: Public     Purchased by: Private
Symptoms: Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Pain in arm (had Dr''s order to receive vaccination); achy; fever.

VAERS ID:518340 (history)  Vaccinated:2013-12-02
Age:47.0  Onset:2013-12-04, Days after vaccination: 2
Gender:Female  Submitted:2014-01-03, Days after onset: 30
Location:Arkansas  Entered:2014-01-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSK94NR1IMRA
Administered by: Private     Purchased by: Private
Symptoms: Local swelling, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Raised rash on legs. Swollen feet and hands. Achy body. Doctor advised not to take any further doses.

VAERS ID:518413 (history)  Vaccinated:2014-01-02
Age:47.0  Onset:2014-01-03, Days after vaccination: 1
Gender:Female  Submitted:2014-01-05, Days after onset: 2
Location:North Carolina  Entered:2014-01-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: No lab data or diagnostic tests available at this time - I will see my primary care doctor tomorrow b/c I think I need antibiotics
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13493P0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Nipple pain
SMQs:
Write-up: Severe pain behind nipple of left breast.

VAERS ID:518803 (history)  Vaccinated:2013-11-04
Age:47.0  Onset:2013-11-19, Days after vaccination: 15
Gender:Male  Submitted:2014-01-09, Days after onset: 51
Location:Florida  Entered:2014-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxcarbamazepine, venlafaxine, loperamide, sertraline, trazodone, clonazepam
Current Illness: A rash on face appeared two weeks after vaccination. A raised red rash on right side of face from ear lobe across cheeks, to 1/3 outer aspect of uppe eyelid. One vesicle on lower cheek. Checked negative for shingles.
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH907AB IMLA
Administered by: Military     Purchased by: Private
Symptoms: Blister, Rash, Rash erythematous
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Raised red rash across face with one vesicle. Started on Valtrex but came back negative for shingles.

VAERS ID:518833 (history)  Vaccinated:2014-01-02
Age:47.0  Onset:2014-01-05, Days after vaccination: 3
Gender:Female  Submitted:2014-01-09, Days after onset: 4
Location:North Carolina  Entered:2014-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS010021A0IMUN
Administered by: Other     Purchased by: Private
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Pt states has severe itching all over body. Started a few days after immunization. Pt states no new meds since vaccine. States has used BENADRYL to help with itching but has had itching for 3 days now.

VAERS ID:518838 (history)  Vaccinated:2014-01-09
Age:47.0  Onset:2014-01-09, Days after vaccination: 0
Gender:Female  Submitted:2014-01-09, Days after onset: 0
Location:Georgia  Entered:2014-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: VIIBRYD
Current Illness: Anx and depression - severe
Preexisting Conditions: Cortisone
Diagnostic Lab Data:
CDC Split Type:
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS4G7P20UNLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J0061370SCUN
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS2RY590UNRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ16290UNRA
Administered by: Other     Purchased by: Private
Symptoms: Loss of consciousness, Malaise, Presyncope
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), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Gave immunizations Typhoid, Tdap, Hep A and MMR. After MMR she said she didn''t feel well. She passed out in chair and had what appeared to be a vagal response. In 30-45 sec. she came too. She was assisted to couch where she rested with cool cloth. After 20-30 min.

VAERS ID:518852 (history)  Vaccinated:2013-11-21
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2014-01-09
Location:Minnesota  Entered:2014-01-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT4721BA UNRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.H021243 UNRA
Administered by: Private     Purchased by: Other
Symptoms: Hypoaesthesia, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Numbness hand/arm, pain upper arm, triceps weakness.

VAERS ID:519011 (history)  Vaccinated:2014-01-11
Age:47.0  Onset:2014-01-11, Days after vaccination: 0
Gender:Female  Submitted:2014-01-12, Days after onset: 1
Location:Texas  Entered:2014-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Felt dizzy
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALST39590UNRA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Patient felt faint, then proceeded to faint. I caught patient and sat her down. Called 911. She came to about 5 -10 sec. later. 911 cleared patient.

VAERS ID:519611 (history)  Vaccinated:2013-11-07
Age:47.0  Onset:2013-11-07, Days after vaccination: 0
Gender:Female  Submitted:2014-01-16, Days after onset: 70
Location:Washington  Entered:2014-01-16
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: Musculoskeletal Ultrasound 12/21/2013
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AGRIFLU)NOVARTIS VACCINES AND DIAGNOSTICS13381P9IMLA
Administered by: Private     Purchased by: Private
Symptoms: Bursitis, Skeletal survey abnormal
SMQs:
Write-up: Patient developed gradual onset of subacromial bursitis in the shoulder.

VAERS ID:519977 (history)  Vaccinated:2009-12-24
Age:47.0  Onset:2009-12-27, Days after vaccination: 3
Gender:Female  Submitted:2014-01-21, Days after onset: 1486
Location:Florida  Entered:2014-01-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multi vitamin
Current Illness: No
Preexisting Conditions: Allergy to nickel & thimerosol
Diagnostic Lab Data: None
CDC Split Type:
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Oral discomfort
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Burning of the corner of the mouth, extending to upper lip. No rash, very mild redness. This occurred every few days, then every week, then every few weeks, then every few months until by the end of the year the symptoms stopped completely.

VAERS ID:520081 (history)  Vaccinated:2014-01-20
Age:47.0  Onset:2014-01-20, Days after vaccination: 0
Gender:Male  Submitted:2014-01-21, Days after onset: 1
Location:Tennessee  Entered:2014-01-21
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: Have not seen my Dr yet.
CDC Split Type:
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ADEN_4_7: ADENOVIRUS TYPES 4 & 7, LIVE, ORAL (NO BRAND NAME)TEVA PHARMACEUTICALS    
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Dizziness, Dysgeusia, Headache, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Nausea, dizzy, headache, body ache, metal taste in mouth, feel like I have diarrhea. No treatment yet. Called family dr to report symptoms.

VAERS ID:520443 (history)  Vaccinated:2014-01-07
Age:47.0  Onset:2014-01-07, Days after vaccination: 0
Gender:Female  Submitted:2014-01-23, Days after onset: 16
Location:Texas  Entered:2014-01-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions: Verbalized mild egg allergy; Verbalized allergic to insulin with egg component; Diabetic
Diagnostic Lab Data: None
CDC Split Type:
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FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS775ZX IMRA
Administered by: Public     Purchased by: Public
Symptoms: Condition aggravated, Dehydration, Influenza, Malaise, Pyrexia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: State night of 1/7/14, had high-grade fever, malaise. After several days went to ER was dehydrated and diagnosed with "flu" not covered by flu shot. Told ER received flu shot same day as "got sick". Received IV antibiotics in hospital. States hospital informed D/T egg allergy - should not have received and to let this nurse know of adverse event. Denies hives, chest tightness, throat swelling. States last "a couple of weeks".

VAERS ID:520877 (history)  Vaccinated:2014-01-21
Age:47.0  Onset:2014-01-21, Days after vaccination: 0
Gender:Female  Submitted:2014-01-27, Days after onset: 6
Location:New Mexico  Entered:2014-01-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS7734Y IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, induration around injection site.

VAERS ID:521314 (history)  Vaccinated:2014-01-27
Age:47.0  Onset:2014-01-28, Days after vaccination: 1
Gender:Female  Submitted:2014-01-30, Days after onset: 2
Location:Michigan  Entered:2014-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.U4789AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Local swelling, Musculoskeletal stiffness, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: Swollen arm down to elbow. Sore red stiff.

VAERS ID:521928 (history)  Vaccinated:2014-01-13
Age:47.0  Onset:2014-01-13, Days after vaccination: 0
Gender:Female  Submitted:2014-02-05, Days after onset: 23
Location:California  Entered:2014-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Estradiol .5 mg daily
Current Illness: No
Preexisting Conditions: Allergies: Latex, cinnamon, annatto, erythromycin
Diagnostic Lab Data: 8 hrs in ER, Dr said test were negative for all tests... have an entire folder of all activity. Had to leave hospital still in pain w/ no answers. Just told to follow up w/Dr.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4728BA0IDLA
Administered by: Public     Purchased by: Private
Symptoms: Back pain, Chest pain, Dyspnoea, Dysstasia, Eye irritation, Flatulence, Laboratory test normal, Musculoskeletal chest pain, Restlessness
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Akathisia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Corneal disorders (broad)
Write-up: Eyes were burning, felt unsettled, then sharp pains in top right rib area under breast, shortness of breath followed by severe pain under breast & back area. Chest was hurting- Continued for 15-20 min, walked, tried to use restroom, continued to hold hand on rib area. Called neighbor (nurse) to come help me. I couldn''t sit, lay down, trouble getting on/off toilet. felt like bad gas - daughter took me to ER.

VAERS ID:522194 (history)  Vaccinated:2014-01-06
Age:47.0  Onset:2014-01-06, Days after vaccination: 0
Gender:Female  Submitted:2014-02-08, Days after onset: 33
Location:Pennsylvania  Entered:2014-02-08
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: CMP, CBC, TSH, CHEST X-RAY
CDC Split Type:
Vaccination
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FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS12049011IMLL
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Blood thyroid stimulating hormone, Body temperature increased, Chest X-ray, Feeling cold, Full blood count, Hypoaesthesia, Metabolic function test, Paraesthesia, Rhinorrhoea, Sneezing
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Paresthesia: numbness, coldness, weakness, tingling sensation, sneezing runny nose low grade temp.

VAERS ID:523162 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2014-02-20
Location:North Carolina  Entered:2014-02-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
RAB: RABIES (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
YF: YELLOW FEVER (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Blood pressure fluctuation, Lung disorder, Myalgia, Pulse abnormal, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow)
Write-up: Episodes of vertigo, myalgias, vacillating BP and pulse occur 5-20 times per day, lasting for 5 minutes to a few hours. Symptoms began after receiving immunizations in 2002. His trainee immunizations were repeated at the same time because his immunization record was lost. Upon arriving, he was hospitalized for 12 days for a lung condition. Since then multiple specialists and workups have not yielded a diagnosis. He is under care. He was to provide a record of his immunizations, but has not as yet.

VAERS ID:523331 (history)  Vaccinated:2013-11-02
Age:47.0  Onset:2013-11-03, Days after vaccination: 1
Gender:Male  Submitted:2014-02-21, Days after onset: 110
Location:Washington  Entered:2014-02-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol
Current Illness: None
Preexisting Conditions: Hypertension
Diagnostic Lab Data: Visit to Clinic 02/08/2014, interview and evaluation only.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13412P5IMLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Chronic, sharp pain on left arm where shot was administered, pain remains in arm from day after shot to present.

VAERS ID:523385 (history)  Vaccinated:2013-11-13
Age:47.0  Onset:2013-11-14, Days after vaccination: 1
Gender:Female  Submitted:2014-02-22, Days after onset: 100
Location:Missouri  Entered:2014-02-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13097010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Musculoskeletal disorder, Pain in extremity, Pruritus
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Arm was itchy and sore after immunization, soreness moved down the arm into the forearm and elbow area, pt could not pick up or support weight with arm that shot was administered in. Pt has not seen MD about ruling out other diagnosis.

VAERS ID:523796 (history)  Vaccinated:2013-10-13
Age:47.0  Onset:2013-10-13, Days after vaccination: 0
Gender:Female  Submitted:2013-10-14, Days after onset: 1
Location:Texas  Entered:2014-02-24, Days after submission: 133
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2013SE75838
Vaccination
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FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug administration error, Syringe issue
SMQs:
Write-up: A report has been received from a pharmacist concerning a 47 year old, female subject, who had been receiving FLUMIST (Intranasal). FLUMIST (Intranasal) started on 13-Oct-2013. It was reported that the clip was messed up on the FLUMIST syringe he used so he thought the entire dose went into one nostril which started on 18-oct-2013. The outcome of the event of the clip was messed up on the FLUMIST syringe I used so I think the entire dose went into one nostril is unknown. The report was considered to be non-serious.

VAERS ID:523836 (history)  Vaccinated:2013-11-11
Age:47.0  Onset:2013-11-11, Days after vaccination: 0
Gender:Female  Submitted:2013-11-25, Days after onset: 14
Location:California  Entered:2014-02-24, Days after submission: 91
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: 2013SE86868
Vaccination
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Dose
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FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Underdose
SMQs:
Write-up: A report has been received from a Pharmacist concerning a 47 year old, Female subject, who had been receiving FLUMIST quadrivalent (intranasal). FLUMIST quadrivalent (intranasal) started on 11-Nov-2013. The patient experienced administration of only a half dose of FLUMIST in one nostril which started on 11-Nov-2013. The outcome of the event of administration of only a half dose of FLUMIST in one nostril is unknown. The report was considered to be non-serious.

VAERS ID:523847 (history)  Vaccinated:2014-02-19
Age:47.0  Onset:2014-02-20, Days after vaccination: 1
Gender:Female  Submitted:2014-02-25, Days after onset: 5
Location:Pennsylvania  Entered:2014-02-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine 40 mg per day. Vitamin D and probiotics. I have not had any vaccines since I was a child and am a very healthy person.
Current Illness: No, healthy
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Activities of daily living impaired, Arthralgia, Diarrhoea, Dizziness, Fatigue, Impaired work ability, Injection site pain, Local swelling, Mobility decreased, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Arm swollen, unable to lift arm above shoulder, pain in injection sight, 2 days later...muscle and joint aches and pains, intense fatigue, 3 days later....intense fatigue, muscle and joint aches and pains, nauseous, diarrhea, dizziness, fever. I was unable to get out of bed or eat or drink anything for 36 hours, except to get up for severe diarrhea. Was unable to work.

VAERS ID:524427 (history)  Vaccinated:2014-02-25
Age:47.0  Onset:2014-02-26, Days after vaccination: 1
Gender:Female  Submitted:2014-03-03, Days after onset: 5
Location:Ohio  Entered:2014-03-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SALICYLIC ACID 17 % EX LIQD
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS7K9N7 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth, Myalgia, Nausea, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Fevers, chills, myalgias, nausea, vomiting, swelling around the area of injection 5X10 cm, redness and indurated, tender and warm.

VAERS ID:524536 (history)  Vaccinated:2013-10-14
Age:47.0  Onset:2013-10-14, Days after vaccination: 0
Gender:Female  Submitted:2014-03-04, Days after onset: 141
Location:Kansas  Entered:2014-03-04
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: An allergy to eggs in last year, allergist gave her the flu vaccine 2012-2013, no reaction. Previously had flu vaccine for last 10 years, every year with no reaction.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH910AC10IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort
SMQs:, Anaphylactic reaction (broad)
Write-up: Symptoms of tightness of chest began about 1 to 1 1/2 hours after vaccination given.Went to ED, O2Sat 80, received epi, solumedral and benydral.

VAERS ID:524745 (history)  Vaccinated:2014-03-05
Age:47.0  Onset:2014-03-05, Days after vaccination: 0
Gender:Female  Submitted:2014-03-05, Days after onset: 0
Location:New York  Entered:2014-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitex, multivitamin, iron, B complex vitamin
Current Illness: No
Preexisting Conditions: Latex, shellfish, sensitivity to eggs
Diagnostic Lab Data: Doctor recommended Benadryl, I willingly took...started feeling better in a couple hours. I refused emergency room.
CDC Split Type:
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FLUR3: INFLUENZA (SEASONAL) (FLUBLOK)PROTEIN SCIENCES CORPORATION 0IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Blood glucose normal, Blood pressure increased, Dizziness, Feeling abnormal, Hypoaesthesia oral, Nausea, Rash macular
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Suddenly felt nauseous, lips were numb, head felt dizzy, just felt miserable, nurse assisted me...fellow coworkers took blood pressure 138/90 (norm is 100/60), blood sugar 135 (had eaten bologna sandwich and half a bagel with peach tea) this happened at work, I''m new, an RN. They saw red botched on my skin.

VAERS ID:526158 (history)  Vaccinated:2014-03-14
Age:47.0  Onset:2014-03-15, Days after vaccination: 1
Gender:Female  Submitted:2014-03-17, Days after onset: 2
Location:New York  Entered:2014-03-19, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinusitis
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0133440IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, 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: Left deltoid redness, swelling, hot to touch, painful - localized. Cellulitis.

VAERS ID:526353 (history)  Vaccinated:2013-11-22
Age:47.0  Onset:2013-11-22, Days after vaccination: 0
Gender:Female  Submitted:2014-03-18, Days after onset: 115
Location:Massachusetts  Entered:2014-03-21, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 1998~Influenza (Seasonal) (no brand name)~UN~0.00~Patient
Other Medications: Metformin
Current Illness: None
Preexisting Conditions: Multiple environmenal allergies; Egg allergy; Peanuts; Gluten; Clams; Scallops; Peppers
Diagnostic Lab Data: Has been to OT. Seen by Orthopedist shoulder x-rays due to pain in affected shoulder (C6-7 degenerative disc disease) Will see Neurologist ?EMG
CDC Split Type:
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FLUR3: INFLUENZA (SEASONAL) (FLUBLOK)PROTEIN SCIENCES CORPORATION340503F0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Headache, Injection site pain, Intervertebral disc degeneration, Local swelling, Paraesthesia, Pruritus, Upper respiratory tract congestion, X-ray limb
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Received egg free flu (FLU-BLOK) and almost immediately had burning and itching of the affected arm. Progressed to head congestion and headache and needed use of albuterol MDI. Arm was swollen, itchy, pain over injection site. Developed tingling distally. Saw PCP and given 6 day taper of steroids.

VAERS ID:526535 (history)  Vaccinated:2014-03-21
Age:47.0  Onset:2014-03-21, Days after vaccination: 0
Gender:Female  Submitted:2014-03-24, Days after onset: 3
Location:New Hampshire  Entered:2014-03-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0043340IMRA
Administered by: Private     Purchased by: Private
Symptoms: Myalgia, Pain, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Deltoid soreness, slight swelling, increase soreness w/movement.

VAERS ID:526620 (history)  Vaccinated:2014-03-17
Age:47.0  Onset:2014-03-23, Days after vaccination: 6
Gender:Male  Submitted:2014-03-25, Days after onset: 2
Location:Iowa  Entered:2014-03-25
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: Still have symptoms today 3-25-14. Left lower leg, outer calf/ankle area with pink, dry skin noted with itching. Overall dry skin.
CDC Split Type:
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TDAP: TDAP (ADACEL)SANOFI PASTEURU4700BA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dry skin, Erythema, Pruritus generalised, Skin irritation
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: "Red, irritated, itchy skin all over". Clarified as "arms and legs". Took Benadryl OTC 1 tablet/allergy... No vaccine reactions prior to this.

VAERS ID:526674 (history)  Vaccinated:2014-03-17
Age:47.0  Onset:2014-03-21, Days after vaccination: 4
Gender:Female  Submitted:2014-03-25, Days after onset: 4
Location:Arizona  Entered:2014-03-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Montelukaust, Symbicort, Proair, Xopenex, pravastatin, levalbuterol.
Current Illness: N/A
Preexisting Conditions: Avelox
Diagnostic Lab Data:
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J011042 IMRA
Administered by: Private     Purchased by: Other
Symptoms: Contusion, Erythema
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (broad)
Write-up: Bruising, and red streak from elbow to bicep.

VAERS ID:526779 (history)  Vaccinated:2014-03-25
Age:47.0  Onset:2014-03-25, Days after vaccination: 0
Gender:Male  Submitted:2014-03-26, Days after onset: 1
Location:Virginia  Entered:2014-03-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Irritable x 5 hrs.~Hep B (no brand name)~1~47.00~Patient
Other Medications: ALEVE
Current Illness: None
Preexisting Conditions: High cholesterol; MVA 7/13 with HNP of cervical spine last steroid inj on 1/14
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS99B321IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Feeling of body temperature change, Generalised erythema, Headache
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: After getting Hep B vaccine #2 at 1100, pt reports he developed headache, feeling hot/cold and redness of face, neck, arms, hands at 1300 with 2 episodes of mild lightheadedness. When seen at Employee Health at 1510, his symptoms of redness were fading, his headache was 4/10 with ALEVE at 1330 and he was not experiencing other symptoms; email from pt next AM states he recovered.

VAERS ID:526958 (history)  Vaccinated:2014-03-25
Age:47.0  Onset:2014-03-25, Days after vaccination: 0
Gender:Unknown  Submitted:2014-03-28, Days after onset: 3
Location:Unknown  Entered:2014-03-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1403USA013024
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H014196 SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a nurse refers to a 47 years old patient (gender unknown). On 25-MAR-2014 the patient was vaccinated with PNEUMOVAX 23, injection, lot # H014196, expiry date 19-MAR-2014, dose (unknown), frequency (unknown), route of administration (unknown). No concomitants were reported. On 25-MAR-2014, the patient received an expired dose of PNEUMOVAX 23. No adverse effect has been observed or reported. Action taken with respect to PNEUMOVAX 23 was not applicable. No product quality complaint was involved. Outcome of events was unknown. Additional information has been requested.

VAERS ID:527240 (history)  Vaccinated:2009-10-01
Age:47.0  Onset:2009-10-01, Days after vaccination: 0
Gender:Female  Submitted:2014-03-31, Days after onset: 1642
Location:Unknown  Entered:2014-03-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Type 1 diabetes mellitus
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1403USA009400
Vaccination
Manufacturer
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Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  SYRUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Influenza like illness, Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: This spontaneous report as received from a consumer refers to herself who was a 47 year old female patient, as part of marketing research program. Patient''s relevant medical history included type 1 diabetes. On an unspecified date in October 2009 the patient was vaccinated with PNEUMOVAX23 (strength, formulation, lot#, dose, route and duration were unspecified). Concomitant therapy might included flu shot received at the same time. On an unspecified date in October 2009, after receiving shot, the patient experienced tennis-ball sac swelling on elbow and flu-like symptoms. Patient was treated with BENADRYL. The outcome of events was reported as recovered/resolved in 2009, "about 3 days after onset". Action taken was reported as "none". Reporter considered the events as non-serious and considered the events as related to the suspect therapy. Additional information has been requested.

VAERS ID:527380 (history)  Vaccinated:2014-04-02
Age:47.0  Onset:2014-04-02, Days after vaccination: 0
Gender:Female  Submitted:2014-04-02, Days after onset: 0
Location:Tennessee  Entered:2014-04-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, Albuterol Inhaler, Vit B-12, Calcium, Vit C, Vit E, Vit B-6, Echinacea and goldenseal, MVI and Herbal tea
Current Illness: No
Preexisting Conditions: HTN, Depression, Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J000201 SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dysphonia, Headache, Throat irritation
SMQs:, Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Pt c/o "feeling allergies in throat", feeling hoarse, and headache.

VAERS ID:527651 (history)  Vaccinated:2014-01-13
Age:47.0  Onset:2014-01-28, Days after vaccination: 15
Gender:Female  Submitted:2014-04-05, Days after onset: 66
Location:Florida  Entered:2014-04-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Only multi v, fish oil, chew C
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Still undergoing multiple tests. Including blood testing, MRI, had CT scan, chest X-ray, EKG all neg but symptoms PERSIST!
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH889AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Blood test normal, Chest X-ray normal, Computerised tomogram normal, Dizziness, Electrocardiogram normal, Hypoaesthesia, Nuclear magnetic resonance imaging normal, Paraesthesia, Vision blurred
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: Numbness tingling started in left forearm then left foot progressed into left leg and eventually into right arm and legs and both feet. Prickly sensations, blurred vision, dizziness.

VAERS ID:527661 (history)  Vaccinated:2013-12-09
Age:47.0  Onset:2013-12-09, Days after vaccination: 0
Gender:Male  Submitted:2014-04-01, Days after onset: 112
Location:Illinois  Entered:2014-04-07, 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: WELLBUTRIN XL; Cholecalciferol; ZOLOFT; Multivitamin; Flax seed
Current Illness: None
Preexisting Conditions: Benign familial hypocalciuric hypercalcemia
Diagnostic Lab Data: MRI shoulder - Edematous enlargement of shoulder joint synovium displacing biceps tendon.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS35GY311IMLA
Administered by: Private     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injected limb mobility decreased, Injection site pain, Nuclear magnetic resonance imaging abnormal, Periarthritis, Surgery
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Arthritis (narrow)
Write-up: Immediate pain at injection site and unable to move left (ipsilateral) shoulder by next day. Frozen shoulder requiring surgical manipulation under anesthesia 4 months later.

VAERS ID:527701 (history)  Vaccinated:2014-01-21
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2014-04-07
Location:Unknown  Entered:2014-04-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 2014: titer drawn: borderline immunity; 26-MAR-2014: titer drawn: value less than 0.9, considered negative
CDC Split Type: WAES1404USA002339
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0082291SCUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative, Viral titre decreased
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 47 year old female patient. On 22-NOV-2013 the patient received the first dose of VARIVAX (lot # J008229, expiry date: 15-MAR-2015 dose 0.5 ml, subcutaneously) for "school requirement". On 21-JAN-2014 the patient received the 2nd dose of VARIVAX (lot# J008229, expiry date: 12-JULY-2015, dose 0.5ml subcutaneously). The patient was seen in the office on 26-MAR-2014 and stated that, on unspecified date in 2014, had titers drawn at her community college which showed her to have borderline immunity. The titers were re-drawn on 26-MAR-2014 and results received on 28-MAR-2014 showed a value of less than 0.9 which was considered negative. The outcome of the events was unknown. The relationship of the events to VARIVAX was unknown. Additional information has been requested.

VAERS ID:527835 (history)  Vaccinated:2014-04-02
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2014-04-02
Location:Virginia  Entered:2014-04-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Hep B vaccination
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Military     Purchased by: Military
Symptoms: Unevaluable event
SMQs:
Write-up: None.

VAERS ID:527868 (history)  Vaccinated:2014-01-09
Age:47.0  Onset:2014-01-09, Days after vaccination: 0
Gender:Male  Submitted:2014-03-25, Days after onset: 74
Location:Florida  Entered:2014-04-08, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH922AB IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4385AA0IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain over the left shoulder and deltoid muscle since he received the Tdap vaccine per patient.

VAERS ID:527944 (history)  Vaccinated:2013-11-20
Age:47.0  Onset:2013-11-20, Days after vaccination: 0
Gender:Female  Submitted:2014-04-09, Days after onset: 139
Location:Indiana  Entered:2014-04-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrocodone, ibuprofen, Imitrex
Current Illness: NO
Preexisting Conditions: Arthritis Lumbar & thoracic region, Mild Psoriasis on knees & elbows, Migraine Headaches
Diagnostic Lab Data: No tests
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pain in extremity
SMQs:
Write-up: Left arm hurt severely more than typical flu shot I''ve had in past.

VAERS ID:528085 (history)  Vaccinated:2014-03-31
Age:47.0  Onset:2014-04-04, Days after vaccination: 4
Gender:Female  Submitted:2014-04-10, Days after onset: 6
Location:California  Entered:2014-04-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No. In good health
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNLA
Administered by: Private     Purchased by: Other
Symptoms: Dizziness, Fatigue, Headache, Joint swelling, Local swelling, Lymphadenopathy
SMQs:, Angioedema (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: Fatigue, swollen glands, swollen joints, swollen fingers, headache, dizziness, light headidness

VAERS ID:528399 (history)  Vaccinated:2014-03-21
Age:47.0  Onset:2014-03-22, Days after vaccination: 1
Gender:Female  Submitted:2014-04-10, Days after onset: 19
Location:Virginia  Entered:2014-04-14, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TB skin test
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS2R459 IMRA
Administered by: Private     Purchased by: Other
Symptoms: Injection site swelling, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: (R) upper arm swelling, lymph node enlargement (R) axillary region, reported 3-24-14, 4-7-14 symptoms minimal.

VAERS ID:528535 (history)  Vaccinated:0000-00-00
Age:47.0  Onset:0000-00-00
Gender:Male  Submitted:2014-04-15
Location:Unknown  Entered:2014-04-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: HIV test positive
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1404USA007126
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report was received from a healthcare worker refers to a 47 or 48 year old male patient. The patient current conditions included HIV positive. The reporter stated that on an unknown date, the patient who was 47 or 48 years old was vaccinated with ZOSTAVAX (dose, route and frequency were not reported). No adverse events were reported. No further information was provided. Additional information has been requested.

VAERS ID:529225 (history)  Vaccinated:2014-04-21
Age:47.0  Onset:2014-04-21, Days after vaccination: 0
Gender:Female  Submitted:2014-04-23, Days after onset: 2
Location:North Carolina  Entered:2014-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0189450SCRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSN435Z0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0099890SCRA
Administered by: Public     Purchased by: Private
Symptoms: Disturbance in attention, Dyspnoea, Headache, Immediate post-injection reaction, Injection site erythema, Local reaction, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: C/o headache and attention problems immediately after vaccine. Later that evening, experienced fever (unknown degree), nausea, and difficulty breathing. No medication and did not seek medical attention. Noticed local reaction (redness, golf-ball size) at site).

VAERS ID:529342 (history)  Vaccinated:2013-12-09
Age:47.0  Onset:2013-12-09, Days after vaccination: 0
Gender:Female  Submitted:2014-04-24, Days after onset: 135
Location:Minnesota  Entered:2014-04-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDRS28070IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Mobility decreased, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: PT REPORTED SEVERE PAIN AT INJECTION SITE AND LINGERING MUSCLE STIFFNESS IN SHOULDER AND UPPER ARM. SHE STILL HAS LIMITED MOTION AND STIFFNESS IN THAT UPPER ARM.

VAERS ID:529413 (history)  Vaccinated:2014-04-25
Age:47.0  Onset:2014-04-25, Days after vaccination: 0
Gender:Female  Submitted:2014-04-25, Days after onset: 0
Location:Ohio  Entered:2014-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None noted
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS3F2741UNLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Feeling hot, Rash, Respiration abnormal, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: 1050 AM - Pt called in states had felt warm when leaving after vaccine given - presently feeling dizzy, breathing fast and funny. BP 140/95- states previous vaccine she noted a rash on arms. Husband is Dr. - advised to seek medical care per nurse.

VAERS ID:529737 (history)  Vaccinated:2013-11-01
Age:47.0  Onset:2013-11-01, Days after vaccination: 0
Gender:Female  Submitted:2014-04-29, Days after onset: 179
Location:Indiana  Entered:2014-04-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1404USA014896
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.J006868 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant refers to a 47 year old female patient. In November 2013, the patient was vaccinated with a 0.5 ml dose of PROQUAD (Merck) (Lot # reported as J006868, expiration date 14-DEC-2014) subcutaneously. No adverse effects were reported. Additional information has been requested.

VAERS ID:529814 (history)  Vaccinated:2014-02-04
Age:47.0  Onset:2014-02-05, Days after vaccination: 1
Gender:Female  Submitted:2014-04-30, Days after onset: 83
Location:Texas  Entered:2014-04-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ambien, amitriptyline, Celebrex, Fentanyl, folic acid, Humira, Neurontin, Opana, Plaquenil, Soma, Xanax
Current Illness: No
Preexisting Conditions: Rheumatoid arthritis, fibromyalgia, had taken a course of prednisone 1/14/14, had course of cortisone injections 1/26/14, had Humira injection 2/2/14
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH951AC15IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Drooling, Dysgeusia, Feeling abnormal, Hypoaesthesia oral, Hypotonia, Lacrimation increased, Nausea, Neck pain, Speech disorder, VIIth nerve paralysis, Vision blurred
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Lacrimal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Arthritis (broad)
Write-up: Woke up in night with right side neck pain and nausea and felt bad. Over course of time the following symptoms occurred - front tooth numbness, drooling, strange tastes in mouth, watery eyes, blurred vision, unable to speak clearly, right sided facial flaccid. Was diagnosed with Bells palsy.

VAERS ID:530315 (history)  Vaccinated:2014-03-04
Age:47.0  Onset:2014-03-04, Days after vaccination: 0
Gender:Unknown  Submitted:2014-05-07, Days after onset: 63
Location:Unknown  Entered:2014-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1404USA014297
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0480AE UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug
SMQs:
Write-up: This spontaneous report was received from a register nurse concerning a 47 year old patient of an unknown gender. Medical history and concurrent conditions were not reported. On 04-MAR-2014, the patient was vaccinated with M-M-R II (route was not reported) lot # 0480AE, expiration date 29-AUG-2015 (also reported as 20-SEP-2014), batch number H017436, albumin status rHA (recombinant human albumin. On 09-APR-2014, patient was vaccinated with M-M-R II (route was not reported) lot # J006954, expiration date 07-JUN-2015. Co-suspect and concomitant therapies were not reported. The register nurse reported that M-M-R II went through a unsupported temperature excursion; however 10 doses of M-M-R II were overlooked because they were stored in the fridge. These doses were administered to 10 patients. The clinic has contacted the patients and 3 out of 10 patients had received an additional dose of M-M-R II. This case is linked to 1404USA001099, 1404USA001100, 1404USA001101, 1404USA001102, 1403USA010165, 1404USA014293, 1404USA014294, 1404USA014295, 1404USA014296, 1404USA014298, 1404USA014299, 1404USA01430 and 1404USA014301. Additional information has been requested.

VAERS ID:530343 (history)  Vaccinated:2014-01-31
Age:47.0  Onset:2014-02-01, Days after vaccination: 1
Gender:Female  Submitted:2014-05-07, Days after onset: 94
Location:New York  Entered:2014-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lopressor
Current Illness: None
Preexisting Conditions: Hypertension controlled with Medication Lopressor, Thyroid Nodules, Hashimoto Dz, Benign Pituitary Tumor, Hx of Kidney Stones and Uterine Artery Ablation.
Diagnostic Lab Data: None known at this time.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0068070SCLA
Administered by: Unknown     Purchased by: Private
Symptoms: Palpitations, Vaccination complication
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)
Write-up: Patient states had racing heart and was unable to do anything. Concerned that she was having reaction to vaccine and went to Emergency Department for Treatment. Given Benadryl and discharged.

VAERS ID:530451 (history)  Vaccinated:2014-04-24
Age:47.0  Onset:2014-05-03, Days after vaccination: 9
Gender:Female  Submitted:2014-05-08, Days after onset: 5
Location:Pennsylvania  Entered:2014-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS925P20IMRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J0037900SCRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS932Z90IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0084400SCLA
Administered by: Public     Purchased by: Public
Symptoms: Rash generalised, Rash vesicular, Vaccination site reaction
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Vesiculated rash that started at vaccine site (left arm) and has spread to neck, abdomen, legs, face and scalp.

VAERS ID:530651 (history)  Vaccinated:2014-05-06
Age:47.0  Onset:2014-05-06, Days after vaccination: 0
Gender:Female  Submitted:2014-05-13, Days after onset: 7
Location:Ohio  Entered:2014-05-13
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
TDAP: TDAP (ADACEL)SANOFI PASTEURU4869AA SYRLA
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal discomfort, Coordination abnormal, Disorientation, Fatigue, Heart rate increased, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Rapid heart rate, extreme fatigue, muscle weakness, problems with coordination, disorientation, gastrointestinal upset lasting one week. I am still experiencing some fatigue and gastro issues.

VAERS ID:532528 (history)  Vaccinated:2014-05-19
Age:47.0  Onset:0000-00-00
Gender:Unknown  Submitted:2014-05-30
Location:Unknown  Entered:2014-05-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1405USA015280
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H013847 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report was received from a physician refers to a 47 year old patient of unknown gender. On 19-MAY-2014 the patient was vaccinated with PNEUMOVAX lot # H013847; exp date 15-MAR-2014, 0.5 ml (milliliters), intramuscular injection. On 19-MAY-2014 the patient had a medication error for expired dose of vaccine administered and no adverse effect was reported. There was no product quality complaint (PWC) involved. Patient sought no medical attention. The outcome of expired dose of vaccine administered and no adverse effect was reported is unknown. Additional information has been requested.

VAERS ID:532644 (history)  Vaccinated:2014-05-20
Age:47.0  Onset:2014-05-23, Days after vaccination: 3
Gender:Female  Submitted:2014-05-23, Days after onset: 0
Location:California  Entered:2014-05-30, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Tetracycline allergy
Diagnostic Lab Data: Clinical f/u - Rxed wtih BACTRIM DS empirically - unclear of inflammation or infection reaction
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSTA3ZZ0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Local swelling, Pruritus, Pyrexia, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Fever at 102 degrees. Local erythema/swelling/tenderness with itching no abscess.

VAERS ID:533214 (history)  Vaccinated:2014-06-03
Age:47.0  Onset:2014-06-03, Days after vaccination: 0
Gender:Female  Submitted:2014-06-06, Days after onset: 3
Location:Pennsylvania  Entered:2014-06-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PAXIL; ALTACE
Current Illness:
Preexisting Conditions: Penicillin; Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.K0035950SCLA
Administered by: Other     Purchased by: Private
Symptoms: Cellulitis, Erythema, Local swelling, Lymphadenopathy, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swelling, redness - entire upper arm lymph node swelling, fever, pain diagnosed by MD - cellulitis.

VAERS ID:533647 (history)  Vaccinated:2014-06-10
Age:47.0  Onset:2014-06-10, Days after vaccination: 0
Gender:Female  Submitted:2014-06-11, Days after onset: 1
Location:Indiana  Entered:2014-06-12, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4804AA IMUN
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site warmth, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Itching began 20 min after injection itching in arm, back, neck, hair and face red. Inj site warm/red. Took 25 mg BENADRYL. Symp resolved.

VAERS ID:533775 (history)  Vaccinated:2014-05-13
Age:47.0  Onset:2014-05-14, Days after vaccination: 1
Gender:Female  Submitted:2014-06-12, Days after onset: 29
Location:Pennsylvania  Entered:2014-06-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CELEXA; XYZAL; Albuterol sulfate; Ranitidine; FLOVENT
Current Illness: Drug hypersensitivity; Spinal column stenosis; Hypersensitivity; Asthma
Preexisting Conditions: Anxiety; Tramadol hydrochloride, Drug hypersensitivity; Vicodin, Drug hypersensitivity; Codeine, Drug hypersensitivity; SULFA, Drug hypersensitivity
Diagnostic Lab Data:
CDC Split Type: WAES1405USA013999
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMRA
Administered by: Other     Purchased by: Other
Symptoms: 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: This spontaneous report as received from a nurse refers to a 47 year old female patient with asthma, spinal stenosis, environmental allergies, allergy to sulfa drugs, codeine, acetaminophen, VICODIN, Tramadol and history of anxiety. On 13-MAY-2014, the patient was vaccinated with a dose of PNEUMOVAX 23 0.5 ml, intramuscularly injection in the right deltoid (lot#, expiry date unspecified). Concomitant therapies included CELEXA 20 mg, XYZAL 5 mg, albuterol (manufacturer unknown) as needed, ranitidine 150 mg twice daily and FLOVENT two puffs twice daily. On 14-MAY-2014, the patient developed swelling, warmness, pain at the injection site of right deltoid. The patient sought medical attention, came into office and was treated with DEXAMETHASONE injection in the deltoid area, ALEVE, and cold compress as needed. No diagnostic test were provided. The outcome of events was unknown. The relatedness between events and PNEUMOVAX 23 was not reported. Additional information is not expected.

VAERS ID:533928 (history)  Vaccinated:2014-05-16
Age:47.0  Onset:2014-05-16, Days after vaccination: 0
Gender:Female  Submitted:2014-06-13, Days after onset: 28
Location:North Carolina  Entered:2014-06-13
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; NKA
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS99B320UNRA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0189480SCUN
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0070220SCUN
Administered by: Public     Purchased by: Unknown
Symptoms: Limb discomfort, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Rt arm -felt heavy and soreness - still feels heavy and sore after 28 days. Had slight fever/aching 2-3 after vaccine administered. Educated pt re: live virus vaccine. Pt advised f/u with PMD for evaluation.

VAERS ID:534708 (history)  Vaccinated:2014-06-18
Age:47.0  Onset:2014-06-19, Days after vaccination: 1
Gender:Male  Submitted:2014-06-23, Days after onset: 4
Location:New Jersey  Entered:2014-06-23
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
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS52DM50IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Local swelling, Pain in extremity, Pyrexia, Tenderness
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient said next day his arm was swollen, tender and painful and he went to his physician and examined him, he is in so much pain, patient is receiving pain relievers, also he reported fever.

VAERS ID:534944 (history)  Vaccinated:2012-11-01
Age:47.0  Onset:0000-00-00
Gender:Female  Submitted:2014-06-25
Location:Unknown  Entered:2014-06-25
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC Split Type: A1077738A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS  IMRA
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Depression, Influenza like illness, Injected limb mobility decreased, Insomnia, Pain, Pain in extremity, Periarthritis, Stress, Tenderness
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (narrow), Arthritis (narrow)
Write-up: This case was reported by a healthcare professional (the subject) and described the occurrence of flu-like symptoms in a 47-year-old female subject who was vaccinated with Influenza vaccine unspecified (GlaxoSmithKline). No pertinent medical history. In November 2012, the subject received an unspecified dose of Influenza vaccine unspecified (intramuscular, right deltoid). Within 1 week after vaccination with Influenza vaccine unspecified, the subject experienced flu-like symptoms. After 2 weeks, the events were resolved. From January 2013, the subject developed severe right frozen shoulder that lasted until January 2014. In May 2013, she went to physical therapy and it made the pain worse, she couldn''t support the therapy. In August 2013, she was treated with steroid but it was not effective. She continued the physical therapy until April 2014. Her shoulder was still not normal and it caused her great stress because she''s right handed and had limited range of motion. She stated that her arm hurt so much that she could not move it and she couldn''t even button her bra. The pain and tenderness was so severe that she could not sleep at night. Psychologically, the pain has been difficult and depressing. The healthcare professional considered the events were disabling. At the time of reporting, the events were unresolved. The subject considered the events were almost certainly related to vaccination with Influenza vaccine unspecified. As no additional information could be obtained, the case has been closed.

VAERS ID:536045 (history)  Vaccinated:2014-06-16
Age:47.0  Onset:2014-06-16, Days after vaccination: 0
Gender:Male  Submitted:2014-07-07, Days after onset: 21
Location:Unknown  Entered:2014-07-08, 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: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1406USA008583
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect drug dosage form administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 47 year old male patient. On 16-JUN-2014, the patient inadvertently received 0.5ml, intramuscularly, a dose of GARDASIL (strength and lot # not reported). The nurse stated that that was related to staff error and not product confusion. No adverse effect reported. Additional information has been requested.

VAERS ID:536118 (history)  Vaccinated:2014-06-18
Age:47.0  Onset:2014-06-18, Days after vaccination: 0
Gender:Male  Submitted:2014-06-24, Days after onset: 6
Location:Rhode Island  Entered:2014-07-08, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSA54AL UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Headache, Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: -72 hrs of fever, HA, myalgias and nausea. -Improved with NSAIDs.

VAERS ID:536288 (history)  Vaccinated:2014-06-30
Age:47.0  Onset:2014-06-30, Days after vaccination: 0
Gender:Female  Submitted:2014-07-09, Days after onset: 9
Location:Ohio  Entered:2014-07-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; CYMBALTA; CYTOMEL
Current Illness: None
Preexisting Conditions: NKDA; Thyroid Disease; Headaches
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H013042 SCLA
Administered by: Private     Purchased by: Unknown
Symptoms: Rash generalised, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: General body rash began approximately 9 hrs after MMR immunization given. Went to PCP for evaluation; told reaction to medication. Rash never blistered. Resolving 7-9-14.

VAERS ID:536534 (history)  Vaccinated:2014-07-08
Age:47.0  Onset:2014-07-08, Days after vaccination: 0
Gender:Female  Submitted:2014-07-11, Days after onset: 3
Location:Michigan  Entered:2014-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4837AB IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Diarrhoea, Dizziness, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: 7/8/14 after vaccine - fever, hives, joint pain, dizziness.

VAERS ID:536672 (history)  Vaccinated:2014-06-21
Age:47.0  Onset:2014-06-26, Days after vaccination: 5
Gender:Female  Submitted:2014-06-30, Days after onset: 4
Location:Arizona  Entered:2014-07-14, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR4655AA0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient telephone 5 days after injection stating she has pain, and swelling at the site. Improved with ice. Follow up phone call on 6/28/14: Adverse effect resolved.

VAERS ID:536849 (history)  Vaccinated:2012-06-24
Age:47.0  Onset:2012-07-10, Days after vaccination: 16
Gender:Male  Submitted:2014-07-16, Days after onset: 736
Location:Mississippi  Entered:2014-07-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prylosec or Nexium, Pravastatin
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Herpes virus infection, Pruritus, Rash pustular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Military mobilization received small pox vaccine for overseas deployment. Pustules below the belt line and just above genitals and on buttocks with itching and sensitivity appeared a few weeks later. Went on sick call a few weeks after symptoms and diagnosis was unknown but given Ketoconazole topical solution to relieve symptoms. Reappears every 2-3 months, saw my healthcare provider at home around July 2013 and he diagnosed as herpes and prescribed Valacyclovir HCL1.

VAERS ID:537031 (history)  Vaccinated:2014-07-16
Age:47.0  Onset:2014-07-20, Days after vaccination: 4
Gender:Female  Submitted:2014-07-20, Days after onset: 0
Location:Florida  Entered:2014-07-20
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advil, Levothyroxine 75mg,
Current Illness: just fell that was the purpose of going to urgent care, cut open wounds on left hand/fingers
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Hypoaesthesia, Limb discomfort, Limb injury, Pain, Rash, Skin warm, Tenderness, Tension
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Hypersensitivity (narrow)
Write-up: Had Tetanus shot due to hand injury (couldn''t remember when I had a shot ever, so yes I ok''d the shot) Had symptoms that accompany the vaccine normally, was told to take advil and cold compress, but the painfulness and tenderness was extreme. Then 7/20 when I woke up my arm was tense, and a hot rash was there, and sort of numb feeling around the red area. I know that needed attending to, so called the facility and they had me come in. 07/20/14

VAERS ID:537335 (history)  Vaccinated:2014-07-15
Age:47.0  Onset:2014-07-16, Days after vaccination: 1
Gender:Female  Submitted:2014-07-19, Days after onset: 3
Location:California  Entered:2014-07-22, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MAXZIDE; Lisinopril
Current Illness: None
Preexisting Conditions: Hypertension
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4432AB0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Injection site cellulitis, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left deltoid erythema, warmth, tenderness. Treated for non-purulent cellulitis with KEFLEX and BACTRIM.

VAERS ID:537699 (history)  Vaccinated:2014-07-16
Age:47.0  Onset:2014-07-16, Days after vaccination: 0
Gender:Unknown  Submitted:2014-07-25, Days after onset: 9
Location:Unknown  Entered:2014-07-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1407USA011619
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H017759 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a nurse refers to a 47 year old patient of unknown gender. The patient's drug allergies and pertinent medical history was not reported. On 16-JUL-2014 the patient was vaccinated with expired PNEUMOVAX23 (lot# H017759, expiration date: 04-JUL-2014). Concomitant medications were not reported. No adverse effects were reported. No product quality complaint (PQC) was reported for PNEUMOVAX23. Additional information is not expected because the reporter does not want to be contacted regarding the report.

VAERS ID:538716 (history)  Vaccinated:2014-07-25
Age:47.0  Onset:2014-08-01, Days after vaccination: 7
Gender:Female  Submitted:2014-08-04, Days after onset: 3
Location:North Carolina  Entered:2014-08-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ambien, Belviq, Claritin, Nasonex, Synthroid.
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4902BA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Induration, redness, swelling, warmth at injection site. Treated with Bactrim.

VAERS ID:538739 (history)  Vaccinated:2014-07-07
Age:47.0  Onset:2014-07-07, Days after vaccination: 0
Gender:Female  Submitted:2014-08-04, Days after onset: 28
Location:California  Entered:2014-08-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Primidone twice daily for tremors
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0141520SCRA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: On 7/7/14 HCW reported redness to injection site. On 7-8-14 the redness and firmness measured 5ins by 5 ins and was painful. Evaluated by MD on site.

VAERS ID:539335 (history)  Vaccinated:2014-08-06
Age:47.0  Onset:2014-08-06, Days after vaccination: 0
Gender:Male  Submitted:2014-08-08, Days after onset: 2
Location:Texas  Entered:2014-08-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin 20mg; patanol 0.1% eye drops
Current Illness: Poor weight gain
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSN59M3 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Chills, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Insomnia, Night sweats, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Walk-in patient reports left upper arm pain that stated late in the evening on 8/6/14 and have continued to get worse each day. He reports he was unable to sleep last night due to the pain, shivering & night sweats. He received a Tdap vaccine on 8/6/14. Currently the pain is in the arm & radiates throughout the left arm into his upper chest & antecubital area. Left upper arm is red, firm to palpation & slightly swollen. Explained to patient that to treat with ibuprofen & ice, but also the option of ER precaution is available for treatment to help with symptoms. Records provided to patient if he desires to go to ER. Patient verbalized understanding.

VAERS ID:539563 (history)  Vaccinated:2014-07-23
Age:47.0  Onset:2014-07-23, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Idaho  Entered:2014-08-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS011011A IMLA
Administered by: Other     Purchased by: Private
Symptoms: Mobility decreased, Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad)
Write-up: Patient arm was sore and continued to get worse and go down arm and up over shoulder. Had a few days where couldn''t move arm, recovering and doing physical therapy.

VAERS ID:539683 (history)  Vaccinated:2014-08-11
Age:47.0  Onset:2014-08-12, Days after vaccination: 1
Gender:Female  Submitted:2014-08-13, Days after onset: 1
Location:Texas  Entered:2014-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa; Benadryl; Microgestin
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR64837AB UNUN
Administered by: Unknown     Purchased by: Other
Symptoms: Fatigue, Irritability, Muscular weakness, Myalgia, Upper respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Eosinophilic pneumonia (broad)
Write-up: Fatigue, achy muscles throughout whole body, weakness in legs, upper respiratory congestion, irritable.

VAERS ID:540057 (history)  Vaccinated:2014-08-13
Age:47.0  Onset:2014-08-14, Days after vaccination: 1
Gender:Female  Submitted:2014-08-15, Days after onset: 1
Location:Massachusetts  Entered:2014-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril; methadone
Current Illness: No
Preexisting Conditions: Allergy-penicillin, bee stings
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H017433 SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4456AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema-redness and warmth at injection site upper left outside arm. Reports pain at site. Approx 1.5inches wide and 2.5 inches long.

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