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Case Details (Sorted by Age)

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VAERS ID:493886 (history)  Vaccinated:2013-05-24
Age:55.0  Onset:2013-05-25, Days after vaccination: 1
Gender:Male  Submitted:2013-06-11, Days after onset: 17
Location:California  Entered:2013-06-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole, Albuterol, Flovent, Antacids, Flunisolide
Current Illness: No illness at time of vaccination
Preexisting Conditions: NKDA, HX of Hep C, Asthma
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB244AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1947AA0SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Injection site pain, Injection site warmth, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Reaction was to Pneumo vaccine: Severe LUE pain, erythema and edema to much larger area than injection site, warm to touch. Patient was seen by MD and given Amoxicillin and Bactrim.

VAERS ID:494016 (history)  Vaccinated:2013-06-06
Age:55.0  Onset:2013-06-07, Days after vaccination: 1
Gender:Female  Submitted:2013-06-12, Days after onset: 5
Location:Maryland  Entered:2013-06-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to contrast
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4617AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Cellulitis, Erythema, Hypersensitivity, Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Left arm with edema, redness, pain, and warmth extending down to elbow. Seen for evaluation on 6/11/13 and treated for allergic reaction and cellulitis.

VAERS ID:494209 (history)  Vaccinated:2013-05-21
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-06-12
Location:Massachusetts  Entered:2013-06-13, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: CTA chest (-)
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H011898 SCUN
Administered by: Private     Purchased by: Unknown
Symptoms: Angiogram, Laboratory test normal, Pleurisy
SMQs:, Systemic lupus erythematosus (broad)
Write-up: Pleurisy, right 5/24/13.

VAERS ID:494223 (history)  Vaccinated:2013-06-10
Age:55.0  Onset:2013-06-12, Days after vaccination: 2
Gender:Female  Submitted:2013-06-14, Days after onset: 2
Location:Washington  Entered:2013-06-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Allergy to iodines
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB276AC IMRA
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURJ10271 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4612AA IMRA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000421 PO 
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH666AA0SCLA
Administered by: Other     Purchased by: Private
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: Large red non-tender bump where yellow fever was administered. Size of a silver dollar. Slightly warm to the touch.

VAERS ID:494328 (history)  Vaccinated:2013-06-03
Age:55.0  Onset:2013-06-05, Days after vaccination: 2
Gender:Female  Submitted:2013-06-17, Days after onset: 12
Location:Unknown  Entered:2013-06-17
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': WAES1306USA004102
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Oedema peripheral, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: This spontaneous report was received from a 55 year old female patient regarding herself. The patient had no pertinent medical history and no drug reactions or allergies. On 03-JUN-2013 (on Monday), the patient was vaccinated with a dose of ZOSTAVAX (lot number, expiry date, dose and route unspecified). There were no concomitant medications. On 05-JUN-2013 (on Wednesday), her arm started swelling. On 07-JUN-2013 (by Friday), it was red, raised, itchy and was about 3 inches in diameter. The patient did not seek any medical attention. No treatment was given and no lab tests were performed. The outcome of the events was unknown. The relatedness for the events was unknown for ZOSTAVAX. Additional information has been requested.

VAERS ID:494420 (history)  Vaccinated:2013-06-08
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-06-17
Location:Unknown  Entered:2013-06-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ESTRING; Vitamin D (unspecified)
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1306USA004620
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report was received from a pharmacist refers to a 55 year old female patient. No medical history was reported. On 08-JUN-2013, the patient was vaccinated with a dose of ZOSTAVAX (lot #, expiry, dose, route not reported). Concomitant therapies included ESTRING and vitamin d (unspecified). On an unknown date in June 2013, the patient had swelling and redness at the injection site. Pharmacist stated he was currently filling a prescription from the patient''s unspecified healthcare provider for a MEDROL dose pack. Patient sought medical attention- saw her unspecified primary care provider. The outcome of she had swelling and redness at the injection site was reported as not recovered. Additional information is not expected.

VAERS ID:494468 (history)  Vaccinated:2012-09-06
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-06-18
Location:Indiana  Entered:2013-06-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1204201 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H010515 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cellulitis, Erythema, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad)
Write-up: Pain, redness, fever, Dr DX cellulitis, RX of Keflex/ 10 days.

VAERS ID:494752 (history)  Vaccinated:2013-06-11
Age:55.0  Onset:2013-06-12, Days after vaccination: 1
Gender:Female  Submitted:2013-06-17, Days after onset: 5
Location:New Hampshire  Entered:2013-06-21, 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: Levothyroxine
Current Illness: Hypothyroidism
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0010100SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pruritus, Injection site reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Slight swelling, significant itching, large reddened area around injection site. Resolved after 2 days of BENADRYL.

VAERS ID:494833 (history)  Vaccinated:2013-06-19
Age:55.0  Onset:2013-06-19, Days after vaccination: 0
Gender:Male  Submitted:2013-06-21, Days after onset: 2
Location:Ohio  Entered:2013-06-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin; Glipizide; Blood pressure and chol med unknown.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Chills, Feeling hot, Paraesthesia, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad)
Write-up: Began with tingling sensation in fingers then arms felt bloated. Later that evening excruciating pain in body insides felt very hot. Got cold chills. 2 days later still having it.

VAERS ID:494953 (history)  Vaccinated:2013-06-10
Age:55.0  Onset:2013-06-11, Days after vaccination: 1
Gender:Female  Submitted:2013-06-12, Days after onset: 1
Location:Kansas  Entered:2013-06-24, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: CYMBALTA; Lisinopril; XANAX; ZETIA; ZYRTEC
Current Illness:
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0004430SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass, Malaise
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Day of vaccine did not feel well afterward. Next day - red lump at shot site. Following day - red bump the size of quarter and redness size of tennis ball.

VAERS ID:495063 (history)  Vaccinated:2013-02-26
Age:55.0  Onset:2013-02-26, Days after vaccination: 0
Gender:Female  Submitted:2013-06-25, Days after onset: 118
Location:Ohio  Entered:2013-06-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H015780 IMUN
TDAP: TDAP (ADACEL)SANOFI PASTEURC4347AA IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Erythema, Mass, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, swelling lasted 3 wks for lump to go away. After shot around evening time she noticed redness and swelling.

VAERS ID:495620 (history)  Vaccinated:2013-03-06
Age:55.0  Onset:2013-03-08, Days after vaccination: 2
Gender:Male  Submitted:2013-07-01, Days after onset: 114
Location:California  Entered:2013-07-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No medications at time of vaccinations. Case discussed with Dr. at facility on 1 July 2013.
Current Illness: Patient reports he was in his usual state of health and denies intercurrent illness.
Preexisting Conditions: No known allergies or pertinent medical conditions.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV3094IM 
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A1OTLA
Administered by: Military     Purchased by: Military
Symptoms: Blister, Pigmentation disorder, Pyrexia, Rash pustular, Robust take following exposure to vaccinia virus, Skin lesion
SMQs:, Severe cutaneous adverse reactions (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: 55 year old male with history rash following Smallpox vaccination and concern for adverse vaccine reaction presents for initial consultation. On 5 March of this year patient received Meningococcal conjugate and Typhoid killed injected vaccines. On 6 March he received Anthrax (dose #5) and ACAM2000 (re-vaccination; dose #2). Approximately 48 hours later he developed scattered vesicles (3-4) and pustules (2-3) over his forehead, chest, hip and back. Mild subjective fever. Denies arthralgias/myalgias and headache. Five days later he presented to Immunizations clinic where he was noted to have a major take at the vaccination site. His symptoms resolved over the course of the next 10-14 days without treatment; he feels that he has had continued recurrence of the lesions but admits that he has a history of chronic acneiform rash over his back. Denies residual scarring but notes some skin pigment changes at affected sites. He notes a linear “blister” over the right side of his waist that developed this weekend.

VAERS ID:496331 (history)  Vaccinated:2013-07-05
Age:55.0  Onset:2013-07-06, Days after vaccination: 1
Gender:Male  Submitted:2013-07-10, Days after onset: 4
Location:Pennsylvania  Entered:2013-07-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H0190350SCLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pain, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 2" raised "welt", slight pain, no itch 2 days post injection, reddish in color, the 1 days later irregular rash 1-2 inches away from original, no pain, no itch, pt on 7-10-13 says both rashes are lessening.

VAERS ID:496384 (history)  Vaccinated:2013-06-07
Age:55.0  Onset:2013-06-18, Days after vaccination: 11
Gender:Male  Submitted:2013-07-09, Days after onset: 21
Location:Colorado  Entered:2013-07-10, 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: Possible exposure to Hep A
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB566AN0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash macular, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: 6/8 2013: Hives on both thighs 6/10 saw dr; Clobetasol prescribed 6/17 improving, mild discoloration 6/21 hives received to thighs and ABD - used clobetasol 6/26 improving, blotchy spots on ABD. 6/27 mild itching 7/3 increased itching, solid hive from knees to chest; BENADRYL and oatmeal baths 7/9 improving.

VAERS ID:496503 (history)  Vaccinated:2013-07-11
Age:55.0  Onset:2013-07-11, Days after vaccination: 0
Gender:Female  Submitted:2013-07-11, Days after onset: 0
Location:Florida  Entered:2013-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Nifedipine; Nexium; Zantac; Zocor; Vit C; Vit D; Florinal; Digex; ES Tylenol
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Epi given; Benadryl IV; Neb tx
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS739Y20IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0016970SCLA
Administered by: Military     Purchased by: Military
Symptoms: Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Left clinic immediately after receiving vaccines, instead of waiting per instructions. Drove about 3 miles from clinic and had the feeling of throat closing. Returned to clinic.

VAERS ID:496764 (history)  Vaccinated:0000-00-00
Age:55.0  Onset:0000-00-00
Gender:Male  Submitted:2013-07-11
Location:Unknown  Entered:2013-07-15, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Cyclosporine; Mycophenolic acid; IVIG
Current Illness:
Preexisting Conditions: The patient was a kidney transplant recipient.
Diagnostic Lab Data: Prior to vaccination, the subject had average aspartate aminotransferase (AST) values of 28 units/mL and alanine aminotransferase (ALT) levels of 27 units/mL. At 11 days post-vaccination, the patient did not report having a fever, but AST and ALT levels had increased to 60 and 53 units/mL, respectively. IVIG was administered on days 20, 21, and 22 postimmunization, with a daily dose of 500 mg/kg. AST and ALT levels had returned to normal by day 18 postvaccination, but total bilirubin was elevated (2.4 units/mL) at day 25 post-vaccination. Total bilirubin, AST, and ALT levels were within normal range when examined at day 47 post-vaccination. Follow-up with the patient at approximately 8 months post-vaccination indicated no long-term adverse
CDC 'Split Type': 201307500
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEUR  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, Blood bilirubin increased, CD4 lymphocytes decreased, CD8 lymphocytes decreased, Eczema, Flavivirus test positive, Immunoglobulin therapy, T-lymphocyte count decreased, Urticaria
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Haematopoietic leukopenia (narrow), Biliary system related investigations, signs and symptoms (narrow), Hypersensitivity (narrow)
Write-up: Initial report was retrieved from the scientific literature on 01 July 2013.The following was taken verbatim from the report: "We present a case study in which we measured the antiviral immune response of a kidney transplant recipient who received intravenous immunoglobulin (IVIG) as a precautionary step to reduce the risk of vaccine-associated viscerotropic disease after YFV vaccination. In 2007, a 55-year-old male kidney transplant (KTX) patient received live attenuated YFV-17D vaccine (Sanofi-Pasteur) in addition to concurrent immunization with an inactivated hepatitis A vaccine in preparation for a trip. The subject was 19 years post-deceased donor KTX and receiving maintenance immune suppression with cyclosporine (100 mg twice daily) and mycophenolic acid (360 mg twice daily). Shortly after immunization, the patient reviewed the vaccine contraindications and, realizing the risks associated with his vaccination, he contacted his nephrologist, who then contacted Transplant Infectious Disease for further consultation. Because viremia could not be monitored in real-time, liver enzymes were followed as a marker for yellow fever associated viscerotropic disease (YEL-AVD), a potentially life-threatening condition that results in virus dissemination and multiorgan failure. Prior to vaccination, the subject had average aspartate aminotransferase (AST) values of 28 units/mL and alanine aminotransferase (ALT) levels of 27 units/mL. At 11 days post-vaccination, the patient did not report having a fever, but AST and ALT levels had increased to 60 and 53 units/mL, respectively. IVIG was administered on days 20, 21, and 22 postimmunization, with a daily dose of 500 mg/kg. AST and ALT levels had returned to normal by day 18 postvaccination, but total bilirubin was elevated (2.4 units/mL) at day 25 post-vaccination. On day 26 (i.e., 4 days after final IVIG administration), the patient reported what may have been an urticarial or eczematous response on his face that resolved within 5 days. Total bilirubin, AST, and ALT levels were within normal range when examined at day 47 postvaccination. Follow-up with the patient at approximately 8 months post-vaccination indicated no long-term adverse events. Retrospective testing was performed on patient blood samples and on the IVIG lot administered to the KTX patient. The IVIG lot yielded a YFV-specific 50% plaque reduction neutralizing test (PRNT50) value of 320, demonstrating the presence of YFV-specific neutralizing antibodies similar to 10 other lots of IVIG samples across four vendors (geometric mean PRNT50, 226; range, 80Y320). Blood samples were drawn from the patient at 20, 47, and 246 days after vaccination and analyzed for YFV-specific neutralizing antibody as well as CD4+ and CD8+ T cell responses. For comparison, the immune response of eight healthy adults at 30 days after YFV-17D vaccination were examined. The patient seroconverted by 20 days postvaccination with antibody titers within the lower range of the controls. In contrast to neutralizing antibody levels, the patient''s virus specific CD4+ and CD8+ T-cell responses remained below detection (i.e., equivalent to naive controls) at all time points examined. Although it is unknown if IVIG prevented viral dissemination or viscerotropic disease, it did not appear to inhibit successful YFV vaccination as judged by seroconversion. These results suggest that IVIG could be administered as a precaution against potential YFV-AVD or other YFV vaccine associated adverse events." The patient''s outcome was recovered. Documents held by sender: none.

VAERS ID:497389 (history)  Vaccinated:2013-07-08
Age:55.0  Onset:2013-07-08, Days after vaccination: 0
Gender:Male  Submitted:2013-07-22, Days after onset: 14
Location:Florida  Entered:2013-07-22
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: High Blood Pressure
Preexisting Conditions: Sinusitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Other
Symptoms: Blood pressure increased, Condition aggravated, Headache
SMQs:, Neuroleptic malignant syndrome (broad), Hypertension (narrow)
Write-up: Blood pressure would not come down 195/105. Severe headache.

VAERS ID:497952 (history)  Vaccinated:2013-07-19
Age:55.0  Onset:2013-07-19, Days after vaccination: 0
Gender:Female  Submitted:2013-07-29, Days after onset: 10
Location:Tennessee  Entered:2013-07-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Phyto Soya tablets
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: Laboratory General; Laboratory Chemistry; Lab Hematology (AST, ALT, Alkaline Phosphatase, Troponin I, among others); Lab Urology; EKG/ECG
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.J0007220IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Alanine aminotransferase, Aspartate aminotransferase, Asthenia, Blood alkaline phosphatase, Electrocardiogram, Fatigue, Haematology test, Headache, Hypertension, Syncope, Tachycardia, Troponin I, Urine analysis
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: High blood pressure (190/100 when highest); Tachycardia; Headache; Fatigue; Brief Fainting; Weakness.

VAERS ID:498249 (history)  Vaccinated:2013-07-01
Age:55.0  Onset:2013-07-01, Days after vaccination: 0
Gender:Female  Submitted:2013-08-01, Days after onset: 31
Location:Unknown  Entered:2013-08-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions: Codeine, Drug hypersensitivity; KEFLEX, Drug hypersensitivity; CELEBREX, Drug hypersensitivity; SULFA, Drug hypersensitivity; Erythromycin, Drug hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1307USA015275
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNAR
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a licensed practical nurse refers to a 55 year old female patient with allergies to erythromycin, sulfa, codeine, KEFLEX and CELEBREX and no pertinent medical history. Sometime within the last week (approximately between 15-JUL-2013 to 19-JUL-2013), the patient was vaccinated with a dose of ZOSTAVAX (dose, lot# and route were not reported) on the triceps area at a pharmacy. Same day of the vaccination, the patient developed redness, induration, and severe tenderness at the injection site. The patient sought medical attention by seeing her physician. No treatment was given. No lab diagnostic studies were performed. At the time of reporting, the patient was recovering. This is one of several reports from the same reporter. Additional information has been requested.

VAERS ID:498374 (history)  Vaccinated:2013-07-31
Age:55.0  Onset:2013-08-01, Days after vaccination: 1
Gender:Female  Submitted:2013-08-02, Days after onset: 1
Location:California  Entered:2013-08-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Savella 100mg, HCTZ 25mg.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0IDLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 8/1/13 4cmx3cm red raised, warm at injection site. 8/2/13 8cm x 4.5cm red raised, warm at injection site, with white ring or halo around. Very itchy.

VAERS ID:498793 (history)  Vaccinated:2013-08-05
Age:55.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Female  Submitted:2013-08-07, Days after onset: 2
Location:Florida  Entered:2013-08-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS355590UNLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Chills, Headache, Injection site pain, Injection site swelling, Pain, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pt reports shortly after " a few hours later" L deltoid became very swollen, tender, 1 day later developed headache, chills, shakes, joint pain, body ache. Treated - Tylenol/Aleve/Motrin, Ice pack.

VAERS ID:498815 (history)  Vaccinated:2013-08-05
Age:55.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Male  Submitted:2013-08-06, Days after onset: 1
Location:North Carolina  Entered:2013-08-08, 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: Lip swelling and itching
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0177590IMRA
Administered by: Public     Purchased by: Private
Symptoms: Lip swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient called later in the day, stating he had lip swelling and itching 1 hour after getting pneumonia shot. Started taking BENADRYL every 4-6 hrs. which seems to help symptoms.

VAERS ID:499042 (history)  Vaccinated:2013-08-05
Age:55.0  Onset:2013-08-07, Days after vaccination: 2
Gender:Female  Submitted:2013-08-11, Days after onset: 4
Location:North Carolina  Entered:2013-08-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pain, redness, swelling at injection site~Tetanus Diphtheria (no brand name)~UN~44.08~Patient
Other Medications: CellCept, Mestinon, multi vitamin, iron supplement, calcium and vit D supplement, magnesium supplement, baby aspirin
Current Illness: No
Preexisting Conditions: Myasthenia Gravis
Diagnostic Lab Data: I plan to call my doctor on Monday to report this, and if the pain continues, I will see a doctor for diagnosis and treatment. I am a personal trainer and I need to be able to use my arm and shoulder!
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Other
Symptoms: Mobility decreased, Musculoskeletal pain, Neck pain, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Arthritis (broad)
Write-up: I had no pain at time of injection on 8/5 or even the day after (8/6). I woke up on 8/7 with pain deep in my shoulder and it was painful to move my arm overhead. By the next day, the pain had worsened and since then I have been unable to move my arm behind my back. As of today (8/11), in addition to the shoulder pain, I now have pain radiating up my neck on the same side as the injection site.

VAERS ID:499195 (history)  Vaccinated:2013-08-09
Age:55.0  Onset:2013-08-10, Days after vaccination: 1
Gender:Female  Submitted:2013-08-13, Days after onset: 3
Location:Florida  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Valtrex 500mg
Current Illness: Current Genital Herpes flare up, had been taking Valtrex 500mg x3 days
Preexisting Conditions: HPV-genital warts
Diagnostic Lab Data: Patient with positive genital HPV and was currently undergoing treatment of flare up.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B110CA0SCRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0016931SCLA
Administered by: Military     Purchased by: Military
Symptoms: Condition aggravated, Human papilloma virus test positive, Injection site erythema, Injection site rash, Injection site swelling, Injection site vesicles, Oedema peripheral, Papilloma viral infection
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Patient woke up with whole left arm swollen and tiny raised bumps around injection site. Swelling subsided to just around bicep around by end of day. Sunday morning patient woke with large blisters in a circle around injection site and upper arm still swollen and red.

VAERS ID:499245 (history)  Vaccinated:2013-08-12
Age:55.0  Onset:2013-08-12, Days after vaccination: 0
Gender:Female  Submitted:2013-08-13, Days after onset: 1
Location:California  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER    
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Abdominal discomfort, Arthralgia, Chills, Dizziness, Headache, Hyperhidrosis, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Chills and take Tylenol which makes it followed by sweating, headache, achy arm where shots administered, dizziness, upset stomach, achy muscles and joints.

VAERS ID:499300 (history)  Vaccinated:2013-08-02
Age:55.0  Onset:2013-08-04, Days after vaccination: 2
Gender:Female  Submitted:2013-08-13, Days after onset: 9
Location:Oklahoma  Entered:2013-08-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Simvastatin
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0016920SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Site of injection swelled and became red. It was warm to the touch and burned but didn''t hurt.

VAERS ID:499317 (history)  Vaccinated:2013-08-07
Age:55.0  Onset:2013-08-12, Days after vaccination: 5
Gender:Female  Submitted:2013-08-13, Days after onset: 1
Location:Florida  Entered:2013-08-13
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: Hyperlipidemia; Hypertension; (NKDA)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4646AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated

VAERS ID:499413 (history)  Vaccinated:2013-08-12
Age:55.0  Onset:2013-08-13, Days after vaccination: 1
Gender:Female  Submitted:2013-08-14, Days after onset: 1
Location:Arizona  Entered:2013-08-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine .100mg qday, Omeprazole 20mg qday, Sevella 50mg qday
Current Illness: None
Preexisting Conditions: Medications Allergies: Morphine, Contrast Iodine, NSAIDs, Augmentin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC4250AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Oedema, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Edema and Rash - Both mostly resolved. No SOB.

VAERS ID:499609 (history)  Vaccinated:2013-08-13
Age:55.0  Onset:2013-08-13, Days after vaccination: 0
Gender:Female  Submitted:2013-08-15, Days after onset: 2
Location:Unknown  Entered:2013-08-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA006140
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event, Wrong drug administered
SMQs:
Write-up: This spontaneous report as received from registered nurse (R.N.) refers to a 55 year old female patient. On 13-AUG-2013 the patient was suppose to receive VARIVAX (Merck), but was inadvertently given the ZOSTAVAX (Lot #, 0.66ml, subcutaneous route). Concomitant therapy was not reported. No adverse effect reported. Additional information has been requested.

VAERS ID:499703 (history)  Vaccinated:2013-08-14
Age:55.0  Onset:2013-08-15, Days after vaccination: 1
Gender:Female  Submitted:2013-08-18, Days after onset: 3
Location:Alabama  Entered:2013-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Paxil, Wellbutrin, Vagifem, Tylenol, rotator cuff surgery in July No pain meds other than Tylenol
Current Illness: None
Preexisting Conditions: Depression
Diagnostic Lab Data: None Will notify physician in am
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Diarrhoea, Faeces discoloured, Frequent bowel movements, Gastrointestinal sounds abnormal
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Severe aching of joints, extreme gastrointestinal sounds, frequent green bowel movements with some occuring as loose stools. This persisted 2 1/2 days with no other obvious signs of illness and no fever. 25 years ago I had such severe aching and pain after the injections I omitted the 3rd dose in the series even though I was told this was unrelated to the vaccine. 25 years ago I do not recall having green bowel movements however (no I have not eaten any thing that would generate a green color to bowel movements).

VAERS ID:499844 (history)  Vaccinated:2013-08-05
Age:55.0  Onset:2013-08-05, Days after vaccination: 0
Gender:Female  Submitted:2013-08-14, Days after onset: 9
Location:North Carolina  Entered:2013-08-19, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0016980SCLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Injection site warmth, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Patient developed a red, itchy, warm welt at the site of injection. Patient called MD who advised patient to use cold compresses and acetaminophen.

VAERS ID:499953 (history)  Vaccinated:2013-08-13
Age:55.0  Onset:2013-08-14, Days after vaccination: 1
Gender:Female  Submitted:2013-08-16, Days after onset: 2
Location:New York  Entered:2013-08-20, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No allergies
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVC220BA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0135810IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4418AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Injection site oedema, Local swelling, 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: Pt. returned to clinic 8/16/13 c/o left arm mild edema (R), fever since 8/14/13 and mild reddened 2cm x 2cm on (L) arm. No drainage. KEFLEX 500g PO every 8 hr for a week. Pt. was seen on 8/19/13 for f/up and improve swollen/edema on arm. Pt. still reports fever and pain decreased, redness resolved.

VAERS ID:499980 (history)  Vaccinated:2013-08-14
Age:55.0  Onset:2013-08-15, Days after vaccination: 1
Gender:Female  Submitted:2013-08-20, Days after onset: 5
Location:Michigan  Entered:2013-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0162830IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: High fever - 102.0 F, HA, nausea.

VAERS ID:500003 (history)  Vaccinated:2013-08-13
Age:55.0  Onset:2013-08-15, Days after vaccination: 2
Gender:Female  Submitted:2013-08-20, Days after onset: 5
Location:Unknown  Entered:2013-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA007938
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J001002 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Abdominal discomfort, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 55 year old female patient with no drug reactions/allergies. Patients pertinent medical history was none. On 13-AUG-2013, the patient was vaccinated with ZOSTAVAX (lot # J001002, expiry date 25-APR-2014, route and dose were not reported). Concomitant therapies included simvastatin. On 15-AUG-2013, the patient developed fever as high as 101.7F and experienced gastrointestinal upset. The patient sought medical attention (contacted pharmacist). The event fever was treated with MOTRIN. The outcome of gastrointestinal upset and fever was reported as not recovered/not resolved. Additional information has been requested.

VAERS ID:500335 (history)  Vaccinated:2013-08-14
Age:55.0  Onset:2013-08-15, Days after vaccination: 1
Gender:Female  Submitted:2013-08-16, Days after onset: 1
Location:Nebraska  Entered:2013-08-23, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4646AA1UNRA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Injection site erythema, Injection site warmth, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Rt deltoid red warm, fatigue achiness in arm starting evening after received vaccine and still present 8/16/2013.

VAERS ID:500533 (history)  Vaccinated:2013-08-05
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-08-25
Location:Unknown  Entered:2013-08-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA005435
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H021292 SCUN
Administered by: Other     Purchased by: Other
Symptoms: 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 was received from a pharmacist refers to a 55 years old female patient. On 05-AUG-2013 the patient was vaccinated with a 0.65ml dose of ZOSTAVAX (lot# H021292, expiration date: 23-FEB-2014), subcutaneous at unspecified location. Concomitant therapies included with CYMBALTA, SINGULAIR, hydrochlorothiazide, XANAX, prednisone, PEPCID, NEURONTIN, trazodone hydrochloride, albuterol, DUONEB, PERCOCET and metoprolol. The pharmacist reported that patient received ZOSTAVAX and had an injection site reaction that was swollen and "half dollar size" that was also "hot to the touch" on an unspecified date. The patient had sought medical attention via pharmacy visit. None lab diagnostics studies was performed. No treatment was given. At the time of report, the outcome was not recovered. Additional information has been requested.

VAERS ID:500504 (history)  Vaccinated:2013-08-23
Age:55.0  Onset:2013-08-23, Days after vaccination: 0
Gender:Female  Submitted:2013-08-26, Days after onset: 3
Location:Florida  Entered:2013-08-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: PER RN AT TIME OF VISIT CLIENT DENIED.
Current Illness: PER RN AT TIME OF VACCINATION CLIENT DENIED
Preexisting Conditions: PER RN AT TIME OF VACCINATION CLIENT DENIED; PER RN AT TIME OF VACCINATION; NKDA
Diagnostic Lab Data: PENDING
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ12010IMLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Chills, Fatigue, Headache, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: CLINIC HDC/CHD RECEIVED CALL FROM CLIENT @ 11:30 AM ON 8/26/2013 REPORTING THE FOLLOWING SYMPTOMS: CHILLS, HEADACHE, WEAKNESS, NAUSEA (NO VOMITING), FATIGUE AND PAIN AT INJECTION SITE (LD)/ARM. CLIENT REPORTED THAT THESE SYMPTOMS PRESENTED ON THE EVENING OF 8/23/13. CLIENT STATED THAT SHE HAD NOT BEEN EVALUATED BY MEDICAL PERSONNEL OR HER PHYSICIAN FOR THESE SYMPTOMS AT THIS TIME. CLIENT URGED TO SEEK MEDICAL EVALUATION OF SYMPTOMS WITH PHYSICIAN OR ER. CLIENT SPOKE WITH CLINIC SPV RN WHO ALSO URGED CLIENT TO SEEK MEDICAL EVALUATION OF SYMPTOMS. RN REPORTED CLIENT TO REPORT A MD APPT THIS AFTERNOON FOR EVALUATION.

VAERS ID:500680 (history)  Vaccinated:2013-08-16
Age:55.0  Onset:2013-08-17, Days after vaccination: 1
Gender:Male  Submitted:2013-08-18, Days after onset: 1
Location:Massachusetts  Entered:2013-08-27, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR523061IMAR
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt called 2 days after vaccine. 24 hours after vaccine, 4 fingers on arm that received vaccine went numb and are still numb. Advised pt to call PCP.

VAERS ID:500802 (history)  Vaccinated:2013-08-22
Age:55.0  Onset:2013-08-24, Days after vaccination: 2
Gender:Female  Submitted:2013-08-28, Days after onset: 4
Location:Unknown  Entered:2013-08-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA012261
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: This spontaneous report was received from a pharmacist referring to a 55 year old female patient who on 22-AUG-2013, was vaccinated with a dose of PNEUMOVAX23, (lot # not reported) intramuscular in the left deltoid. Concomitant therapies included unspecified steroid inhaler. Pharmacist reported that on 24-AUG-2013, the patient returned to the pharmacy with a red, warm area under her left armpit. No treatment was given for the events and none lab diagnostics test were performed. The outcome of red, warm area under her left armpit was reported as not recovered/not resolved. Additional information has been requested.

VAERS ID:500977 (history)  Vaccinated:2013-08-27
Age:55.0  Onset:2013-08-27, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2013-08-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxine
Current Illness: Not aware
Preexisting Conditions: Not aware
Diagnostic Lab Data: Blood pressure
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH909AA0SYRLA
Administered by: Other     Purchased by: Unknown
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Pt was feeling nauseated and dizzy several minutes after the shot. Pt laid down and was monitored by checking blood pressure.

VAERS ID:501029 (history)  Vaccinated:2013-08-11
Age:55.0  Onset:2013-08-12, Days after vaccination: 1
Gender:Male  Submitted:2013-08-30, Days after onset: 18
Location:New York  Entered:2013-08-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Public     Purchased by: Other
Symptoms: Cyanosis, Erythema, Pain, Skin discolouration
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Since the vaccine was given, pain, redness continued for 1-2 week. Gradually redness gone, but still intermittent pain - it''s been 20 days and still have slight black and blue and period pain feeling.

VAERS ID:501311 (history)  Vaccinated:2013-09-01
Age:55.0  Onset:2013-09-02, Days after vaccination: 1
Gender:Female  Submitted:2013-09-03, Days after onset: 1
Location:California  Entered:2013-09-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: HTN; Hypothyroid
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08349211A0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0047470IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Injection site pain, Injection site pruritus, Injection site swelling, Paraesthesia
SMQs:, Anaphylactic reaction (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: Patient reported over phone redness spreading down arm pain injection site to elbow, swelling and itching, second night tingling in hand but not afterwards. Pt recommended antihistamine OTC and MD visit.

VAERS ID:501606 (history)  Vaccinated:0000-00-00
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-09-05
Location:Maryland  Entered:2013-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1309USA001779
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Polyarthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)
Write-up: This spontaneous report was received from a 55 year old female patient regarding herself. Approximately on an unknown date in 1993 (reported as 20 years ago), the patient was vaccinated with a dose of RECOMBIVAX HB, (lot number, expiry date and route was not reported). On an unknown date in 1993 (reported as 20 years ago), the patient experienced generalized arthritis symptoms especially in her legs. The symptoms lasted about 3 weeks and then subsided. The outcome of generalized arthritis symptoms especially in her legs was recovered (reported as subsided). It was unknown if patient sought medical attention. Additional information is not expected.

VAERS ID:501632 (history)  Vaccinated:2013-08-27
Age:55.0  Onset:2013-08-29, Days after vaccination: 2
Gender:Male  Submitted:2013-09-05, Days after onset: 7
Location:Unknown  Entered:2013-09-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1309USA000415
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J001697 SCLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Rash macular
SMQs:, Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a Doctor of Pharmacy refers to a 55 year old male patient. No medical history or drug reactions/allergies were reported. On 27-AUG-2013, the patient was vaccinated with ZOSTAVAX (lot # J001697; exp. date: 06-MAY-2014), 0.65 ml, subcutaneous in the left arm for shingles prevention. On 29-AUG-2013, the patient experienced a red blotch over the injection site. The patient did not seek medical attention. At the time of the report, the outcome of red blotch over the injection site was unknown. Additional information has been requested.

VAERS ID:501758 (history)  Vaccinated:2013-09-01
Age:55.0  Onset:2013-09-02, Days after vaccination: 1
Gender:Female  Submitted:2013-09-06, Days after onset: 4
Location:Ohio  Entered:2013-09-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH904AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0138470IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Dizziness, Headache, Injection site pain, Lethargy, Nasopharyngitis, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Day after site - painful; pt felt lethargic, HA (severe), cold/chills, dizzy, nausea 2nd day after pt felt HA using new to APAP.

VAERS ID:501815 (history)  Vaccinated:2013-08-25
Age:55.0  Onset:2013-08-27, Days after vaccination: 2
Gender:Female  Submitted:2013-09-06, Days after onset: 10
Location:Unknown  Entered:2013-09-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1308USA014329
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNAR
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J003360 SCAR
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site warmth, Lymph node pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a Registered Pharmacist refers to a 55 year old female patient with no known pertinent medical history or drug reactions/allergies. On 25-AUG-2013, the patient was vaccinated with ZOSTAVAX (Lot # J003360; exp. date: 21-JUN-2014) 0.65 ml, subcutaneous. Concomitant therapies included influenza virus vaccine (manufacturer unknown). On 27-AUG-2013, the patient developed tenderness, redness and warmth at the site were ZOSTAVAX was injected. The patient also reported "pain in her lymph nodes". The patient sought medical attention, she went to see the pharmacist. No laboratory tests were performed. As treatment for the events, the patient was instructed to use ibuprofen (manufacturer unknown) and apply a cold compress to the injection site. The pharmacist reported that no rash and no fever was present. At the time of the report, the outcome of the events was not recovered. Additional information has been requested.

VAERS ID:502270 (history)  Vaccinated:2013-09-03
Age:55.0  Onset:2013-09-04, Days after vaccination: 1
Gender:Female  Submitted:2013-09-12, Days after onset: 8
Location:Kentucky  Entered:2013-09-12
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 DIAGNOSTICS1307601 IMLA
Administered by: Other     Purchased by: Public
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad)
Write-up: Patient called on 9/12/13 complaining of "sore arm" and inability to raise arm. Vaccine was given on 9/3/13. Patient said issue started morning of 9/4/13. Recommended patient seek medical treatment if she was in severe pain and unable to lift arm.

VAERS ID:502403 (history)  Vaccinated:2013-09-06
Age:55.0  Onset:2013-09-06, Days after vaccination: 0
Gender:Female  Submitted:2013-09-06, Days after onset: 0
Location:New York  Entered:2013-09-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Mild hives on (L) cheek
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS2T4JT0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed hives on (L) side of face 2 hours after receiving flu vaccine.

VAERS ID:502663 (history)  Vaccinated:2013-09-12
Age:55.0  Onset:2013-09-12, Days after vaccination: 0
Gender:Female  Submitted:2013-09-16, Days after onset: 4
Location:Texas  Entered:2013-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MINOCYCLINE CAP 100MG; EPIDUO TOPICAL GEL
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 DIAGNOSTICS1308001 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad)
Write-up: SORENESS, ACHY, CAN NOT LIFT UP LEFT ARM, EXTREME PAIN.

VAERS ID:503077 (history)  Vaccinated:2013-09-18
Age:55.0  Onset:2013-09-18, Days after vaccination: 0
Gender:Female  Submitted:2013-09-19, Days after onset: 1
Location:Texas  Entered:2013-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH891AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt stated immediate pain at injection site. Localized significant swelling without erythema at site of injection. (left deltoid)

VAERS ID:503079 (history)  Vaccinated:2013-09-18
Age:55.0  Onset:2013-09-18, Days after vaccination: 0
Gender:Female  Submitted:2013-09-19, Days after onset: 1
Location:New York  Entered:2013-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Enalapril 10 mg po qd, HCTZ 25 mg po qd, Prilosec 20 mg po qd, Proair HFA inhaler 2 puffs po q 4-6 hours prn, Flonase nasal spray 2 sprays q nostril daily.
Current Illness: No acute illnesses.
Preexisting Conditions: Allergic: Iodine, ASA, Sulfa, shellfish; soy, wheat. PMH: hypertension, exercise-induced asthma, environmental allergies, left rotator cuff tear.
Diagnostic Lab Data: CXR and EKG WNL.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR54507 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chest X-ray normal, Dyspnoea, Electrocardiogram normal, Pain, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: On return home after work, patient felt shortness of breath, generalized body aches, and as if torso "was in a vise". Previous flu vaccines w/o difficulties. Patient went to Urgent Care. She was told her symptoms "were probably a reaction to the flu shot", and prescribed ibuprofen 600 mg po tid prn. A chest x-ray and EKG were done and were WNL per patient.

VAERS ID:503463 (history)  Vaccinated:2013-09-16
Age:55.0  Onset:2013-09-16, Days after vaccination: 0
Gender:Female  Submitted:2013-09-20, Days after onset: 4
Location:New York  Entered:2013-09-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No known drug allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13373P0SYRLA
Administered by: Other     Purchased by: Unknown
Symptoms: Incorrect route of drug administration, Injection site anaesthesia, Injection site pain, Injection site warmth, Musculoskeletal stiffness, Skin warm
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: R.N. was unable to locate deltoid properly - flu vaccine erroneously given in left shoulder joint. Within 1/2 hr. patient developed warmth, numbness and pain at injection site and warmth, stiffness in left face and axillary area.

VAERS ID:503667 (history)  Vaccinated:2013-09-18
Age:55.0  Onset:2013-09-18, Days after vaccination: 0
Gender:Male  Submitted:2013-09-18, Days after onset: 0
Location:Idaho  Entered:2013-09-23, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: COPD; HTN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13081010UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSN43520UNRA
Administered by: Private     Purchased by: Private
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: Patient called office after leaving and headed home with complaints of a terrible metallic taste. Metallic taste increased as patient returned home. Drank Sunny Delight and metallic taste was resolved. Patient was given FLUVIRIN Tdap vaccines. No treatment given to patient.

VAERS ID:503834 (history)  Vaccinated:0000-00-00
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-09-24
Location:Unknown  Entered:2013-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0923567A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Anti-neutrophil cytoplasmic antibody positive vasculitis, Antineutrophil cytoplasmic antibody positive, Lung disorder, Microscopic polyangiitis, Plasmapheresis, Renal disorder
SMQs:, Vasculitis (narrow), Hypersensitivity (narrow)
Write-up: This case was reported in a literature article and described the occurrence of anti-neutrophil cytoplasmic antibody positive vasculitis in a 55-year-old female subject who was vaccinated with Influenza vaccine (unspecified), manufacturer unspecified). On an unspecified date, the subject received unspecified dose of Influenza vaccine (unspecified) (unknown route, site of injection and batch number). Three weeks after vaccination with Influenza vaccine (unspecified), the subject experienced anti-neutrophil cytoplasmic antibody positive vasculitis (perinuclear/myeloperoxidase) and microscopic polyangiitis. The kidney and the lung were the organs which were implicated. This case was assessed as medically serious by GSK. The subject was treated with cyclophosphamide, prednisone and plasma exchange. At the time of reporting, the subject was in remission and dialysis independent. This case is linked to 7 cases coming from the same publication.

VAERS ID:503853 (history)  Vaccinated:2013-08-29
Age:55.0  Onset:2013-09-01, Days after vaccination: 3
Gender:Female  Submitted:2013-09-17, Days after onset: 16
Location:Tennessee  Entered:2013-09-24, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH896AA UNRA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Cough, Headache, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Chills, cough, low grade fever, soreness, headache like the worst case of the flu I have ever had.

VAERS ID:503866 (history)  Vaccinated:2013-09-18
Age:55.0  Onset:2013-09-18, Days after vaccination: 0
Gender:Male  Submitted:2013-09-24, Days after onset: 6
Location:Georga  Entered:2013-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Platelets 1.25 WBC 3.0
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH672AA SCRA
Administered by: Other     Purchased by: Other
Symptoms: Computerised tomogram normal, Headache, Platelet count decreased, White blood cell count decreased
SMQs:, Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Systemic lupus erythematosus (broad)
Write-up: Developed headache at the base of the skull, nape of neck, right side. Subsided as day progressed. Awoke to headache the next morning and has not subsided. Aspirin and acetaminophen have no affect. Ibuprofen does provide relief. Sunday morning, went to ED. CT scan showed no abnormalities, with exception of an area on that side which they said was a normal abmormality subarachonoid granulation. Determined to be musculoskeletal although no injury. Also, we also found in blood work that platelets and WBC''s were abmormally low. Following up on 9/24 with visit to PCP.

VAERS ID:504136 (history)  Vaccinated:2013-09-20
Age:55.0  Onset:2013-09-20, Days after vaccination: 0
Gender:Male  Submitted:2013-09-25, Days after onset: 5
Location:D.C.  Entered:2013-09-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: Unknown - patient sent to doctor for evaluation.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH899AA4IMLA
Administered by: Other     Purchased by: Other
Symptoms: Grip strength decreased, Hypoaesthesia, Injection site pain
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: States left arm deltoid region extremely painful. Started day of injection and continues on - now 5 days post injection. Patient states numbness in hand. Has decreased grip in left hand.

VAERS ID:504251 (history)  Vaccinated:2013-09-10
Age:55.0  Onset:2013-09-11, Days after vaccination: 1
Gender:Male  Submitted:2013-09-13, Days after onset: 2
Location:Ohio  Entered:2013-09-26, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13076010IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0040800IMLA
Administered by: Other     Purchased by: Private
Symptoms: Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: After receiving pneumonia vaccination, the patient had a severe reaction. She was admitted to hospital. She is being treated with antibiotics and pain medication. Patient experienced extreme swelling.

VAERS ID:504267 (history)  Vaccinated:2013-09-25
Age:55.0  Onset:2013-09-25, Days after vaccination: 0
Gender:Female  Submitted:2013-09-26, Days after onset: 1
Location:Colorado  Entered:2013-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Sulfa drugs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Cough, Headache, Pharyngeal oedema, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Throat swelling, coughing for 4 hours, followed by high fever (102) and headache beginning at 5:00 PM. Went straight to bed. Took 2 aspirin. Still have some headache this morning. Fever is down.

VAERS ID:504300 (history)  Vaccinated:2013-09-26
Age:55.0  Onset:2013-09-26, Days after vaccination: 0
Gender:Male  Submitted:2013-09-26, Days after onset: 0
Location:Ohio  Entered:2013-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Emphysema
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13392P IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H022280 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Dysgeusia
SMQs:, Taste and smell disorders (narrow)
Write-up: After patient was given vaccination, he reported a funny taste in his mouth, asked if it was metallic, he said no just a funny taste.

VAERS ID:504329 (history)  Vaccinated:2013-09-18
Age:55.0  Onset:2013-09-19, Days after vaccination: 1
Gender:Female  Submitted:2013-09-23, Days after onset: 4
Location:New York  Entered:2013-09-26, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN - hives
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS75E5S0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Inflammation, Local swelling, Malaise, 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: Fever, malaise. Large-red-swollen painful-inflamed area upper arm 10cm x 10cm. Treatment: ice, BENADRYL, ADVIL.

VAERS ID:504504 (history)  Vaccinated:2013-09-24
Age:55.0  Onset:2013-09-24, Days after vaccination: 0
Gender:Female  Submitted:2013-09-27, Days after onset: 3
Location:Arizona  Entered:2013-09-27
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: Only allergy is hay fever and metrodiozol (Flagyl)
Diagnostic Lab Data: Patient will recover....4 days after shot will have pain, weakness and dizziness.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 2  
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Asthenia, Dizziness, Fatigue, Headache, Myalgia, Paraesthesia, Thirst
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: Began with prickly feeling in upper body that went to scalp, progressed to headache, muscle and joint pain, dizziness, thirst, extreme fatigue and weakness.

VAERS ID:504505 (history)  Vaccinated:2013-09-25
Age:55.0  Onset:2013-09-27, Days after vaccination: 2
Gender:Female  Submitted:2013-09-27, Days after onset: 0
Location:Pennsylvania  Entered:2013-09-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSL4CP925IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling, Seroma
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left shoulder superclavicular swelling 3.5 x 2.5 inches. Tender to touch. No redness. Seen by physician who believes patient has a "seroma from the way the vaccine is administered". Instructed to apply heat and call if it becomes worse.

VAERS ID:504686 (history)  Vaccinated:2013-09-26
Age:55.0  Onset:2013-09-27, Days after vaccination: 1
Gender:Female  Submitted:2013-09-30, Days after onset: 3
Location:Florida  Entered:2013-09-30
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH906AB SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt presented 48 hrs post vaccination with erythema extending in a 3" diameter around injection site. Pt monitoring.

VAERS ID:504692 (history)  Vaccinated:2013-09-11
Age:55.0  Onset:2013-09-12, Days after vaccination: 1
Gender:Male  Submitted:2013-09-30, Days after onset: 18
Location:Unknown  Entered:2013-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1309USA007717
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J003806 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Pain, Pruritus, Rash, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a pharmacist refers to a 55 year old male patient. The patient had no pertinent medical history or drug reactions or allergies. On 11-SEP-2013, the patient was vaccinated with a dose of ZOSTAVAX (lot # J003806, expiry date 03-JUL-2014, subcutaneous). Concomitant therapies included testosterone injection. On 12-SEP-2013, the patient experienced large rash, approximately four inches in height and two inches in width with extreme pain, burning, itching and hot to touch after received ZOSTAVAX. The physician stated that hte patient should have been four fingers below shoulder, the patient was seen in the pharmacy on 14-SEP-2013 and there ws improvement demonstrated by decrease in size of reaction. The patient was treated with KEFLEX and triamcinolone. There was no lab tests performed. The outcom eof the events were reported as recovering, the patient sought medical attention. Additional information has been requested.

VAERS ID:504694 (history)  Vaccinated:2013-09-18
Age:55.0  Onset:2013-09-18, Days after vaccination: 0
Gender:Female  Submitted:2013-09-23, Days after onset: 5
Location:Indiana  Entered:2013-09-30, 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: Not ill when vaccinated
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0033600SCLA
Administered by: Other     Purchased by: Public
Symptoms: Pharyngeal oedema, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Hives; Swelling in throat; Treated in ER for 4-5 hours then released; Given Benadryl and Solumedrol in ER, released with Medrol Dose Pak.

VAERS ID:504695 (history)  Vaccinated:2013-09-26
Age:55.0  Onset:2013-09-27, Days after vaccination: 1
Gender:Female  Submitted:2013-09-30, Days after onset: 3
Location:Florida  Entered:2013-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J00494 SCLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Vaccine given on 9/26/13. ON 9/30/13 patient showed me the injection site. Red, hard, not/warm to touch, itchy and site of injection was very visible.

VAERS ID:504788 (history)  Vaccinated:2013-09-03
Age:55.0  Onset:2013-09-04, Days after vaccination: 1
Gender:Female  Submitted:2013-09-30, Days after onset: 26
Location:Illinois  Entered:2013-09-30
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 DIAGNOSTICS13079010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Musculoskeletal pain, Tendon calcification, Tendonitis, X-ray limb abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Osteonecrosis (broad)
Write-up: After receiving the flu shot, patient experienced pain in the shoulder lasting a few days. Patient then had an X-ray of the shoulder and her physician said she had calcification tendonitis.

VAERS ID:504830 (history)  Vaccinated:2013-09-26
Age:55.0  Onset:2013-09-26, Days after vaccination: 0
Gender:Male  Submitted:2013-09-30, Days after onset: 4
Location:California  Entered:2013-09-30
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: Tetanus and bee allergies. On 20mg Butrans patch for carpal tunnel
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Abdominal distension, Abdominal pain upper, Chills, Diarrhoea, Headache, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: It started that evening after dinner, extreme bloating with stomach ache, threw up all night every 20 min until mid next day with continued extreme stomach pain. Also had chills and headache. After throwing up stopped, finished off day with diarrhea. Next day all symptoms gone, except headache. What I ate all day was the same as my friend, so don''t think food poisoning. Also threw up brown bile.

VAERS ID:504840 (history)  Vaccinated:2013-09-26
Age:55.0  Onset:2013-09-27, Days after vaccination: 1
Gender:Female  Submitted:2013-09-30, Days after onset: 3
Location:North Carolina  Entered:2013-09-30
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: SEPTRA; NAPROSYN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Musculoskeletal pain, Pain in extremity, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Welt - red in middle now arm hurts to shoulder.

VAERS ID:504930 (history)  Vaccinated:0000-00-00
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-10-01
Location:Unknown  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1309USA011547
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Injection site swelling
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This spontaneous report as received from a 55 year old female patient regarding herself. Patient's relevant medical history was unknown. On an unknown date in 2012, the patient was vaccinated with a dose of ZOSTAVAX (Lot number, expiry date, route and dose were not reported). Concomitant medication was unknown. On an unknown date in 2012, the patient experienced swelling at injection site, missed work for several days and returned to the doctor. Diagnostic tests carried out were unknown. The outcome of swelling at injection site, missed work for several days was reported as recovering/resolving (also reported as resolved). The reporter considered the event to be related to ZOSTAVAX. Additional information is not expected.

VAERS ID:505078 (history)  Vaccinated:2013-09-24
Age:55.0  Onset:2013-09-24, Days after vaccination: 0
Gender:Female  Submitted:2013-10-01, Days after onset: 7
Location:Washington  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to grass
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH890AA2IMLA
Administered by: Military     Purchased by: Military
Symptoms: Headache, Irritability, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad)
Write-up: Stabbing pain and irritability. Took full dose of Allegra and Aleve. Partially made it better. The next day, had nausea and extreme headache lasting two days.

VAERS ID:505096 (history)  Vaccinated:2013-10-01
Age:55.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Male  Submitted:2013-10-01, Days after onset: 0
Location:Alabama  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy: Prozac
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13375P0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dyspnoea, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: AE: Red itching rash visible on arms, "woozy feeling", shortness of breath. Treatment: Auvi-q.

VAERS ID:505191 (history)  Vaccinated:2013-09-25
Age:55.0  Onset:2013-09-26, Days after vaccination: 1
Gender:Female  Submitted:2013-10-01, Days after onset: 5
Location:Missouri  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR546070IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site discharge, Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient had tenderness and oozing at injection site the morning after vaccine was given (9/26/13). The patient reported this to the pharmacy on 10-1-13. The area was red and still tender, but not oozing. Pt was instructed to apply NEOSPORIN to area and use cool/warm compresses alternating.

VAERS ID:505196 (history)  Vaccinated:2013-09-20
Age:55.0  Onset:2013-09-25, Days after vaccination: 5
Gender:Male  Submitted:2013-09-26, Days after onset: 1
Location:Washington  Entered:2013-10-01, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH89AD IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site bruising, Injection site rash
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: Bruise noted at injection site, approx 1 1/2" x 1". No swelling or redness, no fever. Rash like area below inj site, about 1" x 1". Not itchy or painful. Improved in 24 hours with cortisone cr to area.

VAERS ID:505185 (history)  Vaccinated:2004-10-19
Age:55.0  Onset:2004-10-19, Days after vaccination: 0
Gender:Female  Submitted:2013-09-30, Days after onset: 3268
Location:Ohio  Entered:2013-10-02, Days after submission: 2
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  UNAR
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNAR
Administered by: Private     Purchased by: Private
Symptoms: Anaphylactic reaction, Dysphagia, Feeling cold, Hypersensitivity, Local swelling, Poor peripheral circulation, Rash
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Acute allergic reaction/anaphylaxis. Rash within 10 min. of injection tried to get back in to see Dr, but was told he was busy. Left office. Arm began to swell. By early evening arm had nearly doubled in size and circulation in arm was being cut off. Could not swallow water and was ice cold. Went to ER where they diagnosed an acute vaccine allergic reaction and IV''d steroids and histamine blockers for several hours. Was on prednisone for 2 weeks. Arm swollen for those 2 weeks!!

VAERS ID:505208 (history)  Vaccinated:2013-09-26
Age:55.0  Onset:2013-09-26, Days after vaccination: 0
Gender:Female  Submitted:2013-10-02, Days after onset: 6
Location:Massachusetts  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Idiopathic Urticaria, Allergic Rhinitis, Food Allergy, Essential HTN, Small Airway Disease, History of TIA.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1308501 UNRA
Administered by: Other     Purchased by: Other
Symptoms: Dysgeusia, Erythema, Flushing, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Taste and smell disorders (narrow), Hypersensitivity (narrow)
Write-up: Patient was flushed and red within the first 5- 10 minutes with a metallic like taste in her mouth, returned to nurse. When patient returned to nurse she was itchy and had hives on her chest and going up her neck onto her face. No breathing difficulty or throat tightening at that time noted. Patient took Benadryl and reported to feel better in 15 minutes.

VAERS ID:505373 (history)  Vaccinated:2013-09-25
Age:55.0  Onset:2013-10-01, Days after vaccination: 6
Gender:Female  Submitted:2013-10-02, Days after onset: 1
Location:Mississippi  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN allergy; Raynaud''s
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSYJ4751SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Hyperhidrosis, Injection site erythema, Injection site nodule, Injection site swelling, Injection site warmth
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling, knot at site and warm to touch. Patient said has headache and sweating. 1 week after injection. Applied CORTIZONE to site and warm compress.

VAERS ID:505587 (history)  Vaccinated:2013-09-26
Age:55.0  Onset:2013-09-29, Days after vaccination: 3
Gender:Male  Submitted:2013-10-01, Days after onset: 2
Location:Tennessee  Entered:2013-10-02, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: HTN; High cholesterol; Asthma; Seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS45BL33SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site vesicles
SMQs:
Write-up: 4mm blister at injection site. Received vaccination on Thurs. 9/26 and noticed blister on Sunday 9/29. Use antibiotic ointment on Monday 9/30. No pain with blister.

VAERS ID:505646 (history)  Vaccinated:2013-05-09
Age:55.0  Onset:2013-05-10, Days after vaccination: 1
Gender:Female  Submitted:2013-09-18, Days after onset: 131
Location:Arizona  Entered:2013-10-02, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to DURAGESIC; Codeine allergy; Sulfa allergy
Preexisting Conditions: No concomitant vaccinations. No adverse events following previous vaccinations.
Diagnostic Lab Data: UNK
CDC 'Split Type': A1024625A
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS432TJ IMLA
Administered by: Private     Purchased by: Other
Symptoms: Body temperature increased, Cold sweat, Erythema, Extensive swelling of vaccinated limb, Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site warmth, Local swelling, Nausea, Pain, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of sore (nos) in a 55-year-old female subject who was vaccinated with BOOSTRIX (GlaxoSmithKline). Concurrent medical conditions included allergy to DURAGESIC, codeine allergy and sulfa allergy. Concurrent medications included Lisinopril, Furosemide, Potassium, Pravastatin and Estradiol vaginal cream. On 9 May 2013 at 10:30 the subject received unspecified dose of BOOSTRIX (intramuscular, left arm); Lot number was reported as 432TJ. On 10 May 2013, 1 day after vaccination with BOOSTRIX, the subject experienced "feeling a little sore". On 11 May 2013 the subject had nausea and a temperature of 102 degrees. On 12 May 2013, the subject was feeling sore and clammy. On 13 May 2013, her left arm started to get red. On 14 May 2013 her left arm had become swollen and painful. it was warm to the touch, and she had decreased range of motion. The subject was started on a five day course of Cephalexin 500 mg on the night of 14 May 2013. On the morning of 15 May 2013, after one dose of Cephalexin, the subject was seen at the office. Her reaction, described as red, warm and significantly swollen had expanded to nearly the top of the shoulder and was 22x18 centimeters in size. Compared to the previous day, it had already started clearing at this point. The reporting healthcare professional found it strange that the location of the actual shot was where it began clearing first, described as a big band of red around the shot area. On 16 May 2013, the healthcare professional had not yet spoken to the subject but described the reaction as improving based on the subject''s last visit. At the time of reporting the sore (nos), nausea, increased temperature, clamminess, arm swollen, arm pain, warm to touch, decreased range of motion, injection site pain, injection site redness, injection site warmth, extensive swelling of vaccinated limb and red around injection site were improved. The healthcare professional considered the events were possibly related to vaccination with BOOSTRIX.

VAERS ID:505430 (history)  Vaccinated:2013-09-27
Age:55.0  Onset:2013-09-27, Days after vaccination: 0
Gender:Female  Submitted:2013-10-03, Days after onset: 6
Location:Virginia  Entered:2013-10-03
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: Hypothyroid, allergy to E-Mycin
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED09149211A2IMRA
Administered by: Other     Purchased by: Private
Symptoms: Lip swelling, Pruritus, Swelling face, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Friday night had mild hives itching to abdomen. Those symptoms were resolved by Sat. morning, however EE noted mild swelling to the lip left corner of her mouth. Saturday afternoon her entire lip surface was swollen. Sunday 09/29/13 noted sweiing to her periorbital area. Monday am entire face swollen and she sought care at an Urgent Care. She was given Hydrocortisone and placed on a Prednisone dose pack.

VAERS ID:505433 (history)  Vaccinated:2013-09-17
Age:55.0  Onset:2013-09-17, Days after vaccination: 0
Gender:Male  Submitted:2013-10-03, Days after onset: 16
Location:New York  Entered:2013-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA, HTN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH906AC0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Decreased appetite, Feeling abnormal, Feeling cold, Insomnia, Local swelling
SMQs:, Angioedema (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Arm swollen, red, patient cold all night couldn''t sleep, felt terrible. Patient went to work next day for a brief time, back home slept all day, chilled, decreased appetite. Somewhat better 2 days later but not 100%.

VAERS ID:505683 (history)  Vaccinated:2013-09-25
Age:55.0  Onset:2013-09-26, Days after vaccination: 1
Gender:Female  Submitted:2013-10-03, Days after onset: 7
Location:South Carolina  Entered:2013-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH894AA1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Rash that developed about 2 inches around injection site and persisted for 3 days, is now resolving. No other adverse effects/complications.

VAERS ID:505707 (history)  Vaccinated:2013-09-28
Age:55.0  Onset:2013-09-29, Days after vaccination: 1
Gender:Male  Submitted:2013-10-04, Days after onset: 5
Location:Pennsylvania  Entered:2013-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillins; Ace inhibitor; Calcium Channel Blocker
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR55408 UNLA
Administered by: Other     Purchased by: Public
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: Warmth and red swelling at site developing over 2 days. Pt hs hx of other allergies. TX was Benadryl PO and topical. Pt has Epi Pen available if needed. Pt records updated to poss. allergic rxn to Neomycin or Poly mix.

VAERS ID:505725 (history)  Vaccinated:2013-10-03
Age:55.0  Onset:2013-10-04, Days after vaccination: 1
Gender:Male  Submitted:2013-10-04, Days after onset: 0
Location:Minnesota  Entered:2013-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Diabetes, type II, diabetic neuropathy
Diagnostic Lab Data: NA
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR53407 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Nausea, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Upon awakening: 5:15AM-soreness in R arm, nausea, vomiting and headache which continue through 10:30AM (time of report). Ate usual bkft-inc. water/coffee and is now leaving work early.

VAERS ID:505906 (history)  Vaccinated:2013-09-30
Age:55.0  Onset:2013-10-01, Days after vaccination: 1
Gender:Female  Submitted:2013-10-04, Days after onset: 3
Location:Iowa  Entered:2013-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No acute illness
Preexisting Conditions: Chronic airway obstruction; Hypothyroid; HTN; GERD; Depression; Low back pain
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSXE2940IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Injection site erythema, Injection site pain, Injection site swelling, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Redness swelling pain left upper arm - site of flu injection. Also increased shortness of breath, wheezing.

VAERS ID:505957 (history)  Vaccinated:2013-09-23
Age:55.0  Onset:2013-09-23, Days after vaccination: 0
Gender:Female  Submitted:2013-10-04, Days after onset: 11
Location:Unknown  Entered:2013-10-07, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2013038302
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR54307 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Ocular hyperaemia, Odynophagia, Pharyngeal erythema
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad)
Write-up: This medically confirmed spontaneous report (initial receipt 24-Sep-2013) concerns a 55-year-old female patient with no allergies. Concomitant medication included levothyroxine. On 23-Sep-2013, the patient was administered intramuscular AFLURIA (batch number R54307) at a dose of 0.5ml. On 23-Sep-2013, within 8-12 hours post-vaccination, the patient developed severe redness of the eyes, throat and uvula along with discomfort swallowing. There was no evidence of swelling. That evening, on the 23-Sep-2013, the patient attended an emergency room and was treated with an unspecified injectable steroid and an unspecified non-narcotic analgesic. As of the 24-Sep-2013, the redness in the eyes was greatly diminished, some of the redness in the throat had diminished and the patient still had some difficulty swallowing. Outcome was reported as recovering.

VAERS ID:505990 (history)  Vaccinated:2013-09-27
Age:55.0  Onset:2013-09-27, Days after vaccination: 0
Gender:Female  Submitted:2013-10-02, Days after onset: 5
Location:New York  Entered:2013-10-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: Diabetes
Diagnostic Lab Data: Diabetes
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13082018IMLA
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Diabetes mellitus
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow)
Write-up: None stated.

VAERS ID:506097 (history)  Vaccinated:2013-10-04
Age:55.0  Onset:2013-10-05, Days after vaccination: 1
Gender:Female  Submitted:2013-10-07, Days after onset: 2
Location:Maryland  Entered:2013-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSDF3413 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Meralgia paraesthetica
SMQs:
Write-up: Meralgia

VAERS ID:506204 (history)  Vaccinated:2013-10-03
Age:55.0  Onset:0000-00-00
Gender:Female  Submitted:2013-10-08
Location:Michigan  Entered:2013-10-08
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: On Cardizem for atrial fibrillation (1 episode).
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives on forearms, thigh, lower back for several days duration.

VAERS ID:506441 (history)  Vaccinated:2013-09-29
Age:55.0  Onset:2013-09-29, Days after vaccination: 0
Gender:Female  Submitted:2013-10-03, Days after onset: 4
Location:Vermont  Entered:2013-10-08, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Temperature and BP - WNL
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH908AA UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4617AA UNLA
Administered by: Other     Purchased by: Other
Symptoms: Contusion, Erythema, Local swelling, Nausea, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: 9-29-13 in evening had a swollen and sore arm. On Mon. 9-30-13 in the AM there was a large bruise (quarter size) continued to swell and hurt. Went to urgent care on 10/2/13 temperature and BP were OK. Was given Cephalexin 500mg for 1 week. Continues to have nausea, but the redness and swelling are decreasing.

VAERS ID:506504 (history)  Vaccinated:2013-10-07
Age:55.0  Onset:2013-10-08, Days after vaccination: 1
Gender:Female  Submitted:2013-10-08, Days after onset: 0
Location:Florida  Entered:2013-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMLA
Administered by: Public     Purchased by: Other
Symptoms: Chills, Decreased appetite, Headache, Lethargy, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Fever, chills, malaise, loss of appetite, aches, headache, lethergy.

VAERS ID:506545 (history)  Vaccinated:2013-09-30
Age:55.0  Onset:2013-10-01, Days after vaccination: 1
Gender:Female  Submitted:2013-10-08, Days after onset: 7
Location:South Carolina  Entered:2013-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J006242 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Hypersensitivity, Infection, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Had allergic reaction, redness, soreness, high fever, then got infected.

VAERS ID:506701 (history)  Vaccinated:2013-10-04
Age:55.0  Onset:2013-10-04, Days after vaccination: 0
Gender:Female  Submitted:2013-10-09, Days after onset: 5
Location:Missouri  Entered:2013-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Denied any
Preexisting Conditions: Denied
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4788AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Apathy, Asthenia, Lip swelling, Nausea, Oedema mouth, Oral discomfort
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (narrow), 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), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: Nauseated and felt terrible. Burning and Swelling inside mouth and lips No energy or motivation for 3 days. Fine on the 4th day

VAERS ID:506734 (history)  Vaccinated:2013-09-16
Age:55.0  Onset:2013-09-16, Days after vaccination: 0
Gender:Female  Submitted:2013-10-09, Days after onset: 23
Location:Wisconsin  Entered:2013-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Depression; High blood pressure; Colitis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH898AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Cardiovascular evaluation, Dyspnoea, Heart rate increased, Intensive care, Laboratory test normal, Malaise
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Got shot on 9-16-13 at approx 8:00AM. Started to feel ill in afternoon 9-17-13 went to ER with shortness of breath, rapid heart rate. Was admitted to hospital, went to ICU for 2 days. Had heart tests done, everything came back fine. Been feeling fine ever since.

VAERS ID:507049 (history)  Vaccinated:2013-09-28
Age:55.0  Onset:2013-10-01, Days after vaccination: 3
Gender:Male  Submitted:2013-10-01, Days after onset: 0
Location:Arizona  Entered:2013-10-10, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
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Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J003796 SCAR
Administered by: Other     Purchased by: Unknown
Symptoms: Skin reaction
SMQs:, Hypersensitivity (narrow)
Write-up: Skin reaction to ZOSTAVAX inj. 10-1-13. Went to doctor for other issues, doctor prescribed KEFLEX 500 mg (1 TIX x 7D) for skin infection site of ZOSTAVAX injection.

VAERS ID:507588 (history)  Vaccinated:2013-10-10
Age:55.0  Onset:2013-10-10, Days after vaccination: 0
Gender:Female  Submitted:2013-10-11, Days after onset: 1
Location:Colorado  Entered:2013-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Stated history asthma in past
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH900AC IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Dyspnoea, Eye swelling, Flushing, Hyperhidrosis, Nausea, Restlessness, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Akathisia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Went home from work and 4 hours after vaccine began with throat tightening, shortness of breath. Wheezing, eyes swelling. Use inhaler for history of asthma, Ibuprofen went to bed, restless all night and at 2 pm felt nausea and chest tightness remained, at 9:30 AM evaluated Temp 99.2 BP 136/85 general flushing, slight diaphoresis. Seen by occupational health physician.

VAERS ID:507165 (history)  Vaccinated:2013-10-08
Age:55.0  Onset:2013-10-10, Days after vaccination: 2
Gender:Female  Submitted:2013-10-13, Days after onset: 3
Location:North Carolina  Entered:2013-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Chills, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Severe chills x2 hours, fever, nausea.

VAERS ID:507187 (history)  Vaccinated:2013-10-10
Age:55.0  Onset:2013-10-11, Days after vaccination: 1
Gender:Female  Submitted:2013-10-14, Days after onset: 3
Location:Louisiana  Entered:2013-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Dizziness, Fatigue, Headache, Lacrimation increased, Nasal congestion, Pain, Sinus disorder
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Lacrimal disorders (narrow)
Write-up: Dizziness, weakness, fatigue, aches and pains, headache, sinus problems - runny eyes, stuffy nose.

VAERS ID:507232 (history)  Vaccinated:2013-09-24
Age:55.0  Onset:2013-09-26, Days after vaccination: 2
Gender:Female  Submitted:2013-10-14, Days after onset: 18
Location:Georga  Entered:2013-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NOT KNOWN
Diagnostic Lab Data: NOT YET
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13392P IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: INTENSE PAIN IN UPPER LEFT SHOULDER. DIFFICULTY IN MOVING ARM AROUND. PAIN IN DELTOID MUSCLE.

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