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Case Details (Sorted by Age)

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VAERS ID:394933 (history)  Vaccinated:2010-08-06
Age:33.0  Onset:2010-08-06, Days after vaccination: 0
Gender:Female  Submitted:2010-08-10, Days after onset: 4
Location:California  Entered:2010-08-11, 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: UTI
Preexisting Conditions: Anemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3049AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia, Induration, Injection site pain, Skin discolouration, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad)
Write-up: 8-6-10 day of injection pain at injection site. On 8/7/10 very painful swelling the color was red to purple and very hard to the touch. On 8/8 and 8/9/10 swelling and numbness that radiated down to the elbow. 8/10/10 swelling minimal no redness but still very painful and still experiencing numbness of upper arm.

VAERS ID:395923 (history)  Vaccinated:2009-10-01
Age:33.0  Onset:2009-10-01, Days after vaccination: 0
Gender:Female  Submitted:2009-10-16, Days after onset: 15
Location:Minnesota  Entered:2010-08-16, Days after submission: 304
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: MEDI0009101
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500756P IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: A non-serious spontaneous report of a pregnant "women" receiving FLUMIST was received from a registered nurse concerning a 33-year-old female. The patient''s medical history and obstetrical history were not provided. Early Oct-2009, the patient received FLUMIST. One week after vaccination she realized she missed her period and was pregnant. There was no adverse event associated with this pregnancy. Treatment and reporter/sponsor causality assessments are not applicable.

VAERS ID:395947 (history)  Vaccinated:2009-10-12
Age:33.0  Onset:2009-10-12, Days after vaccination: 0
Gender:Female  Submitted:2009-10-14, Days after onset: 2
Location:Texas  Entered:2010-08-16, Days after submission: 306
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: MEDI0009075
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: A non-serious, spontaneous report of FLUMIST administered to a nursing mother has been received from a consumer concerning a 33-year-old female patient. The patient''s medical history and concomitant medications were not provided. The subject received FLUMIST on 12-Oct-2009. The subject came into close contact of her five-month-old infant (MEDI-0009076) by way of breastfeeding. The subject stated "the pharmacist did not read my form to see that I was breastfeeding and I did not know I was not a candidate." There was no adverse event associated with this medication error for the subject; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved.

VAERS ID:395956 (history)  Vaccinated:2009-10-05
Age:33.0  Onset:2009-10-05, Days after vaccination: 0
Gender:Male  Submitted:2009-10-05, Days after onset: 0
Location:Virginia  Entered:2010-08-16, Days after submission: 315
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Exercise induced asthma [10015649]
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0008998
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Military     Purchased by: Military
Symptoms: Dysphagia, Flushing, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (broad)
Write-up: A non-serious, spontaneous report of tingling in upper extremities, flushing and dysphagia has been received from a physician on concerning a 33-year-old male patient subsequent to FLUMIST. The patient''s medical history included exercises induced asthma. The patient was not receiving any concomitant medications. The patient received FLUMIST, intranasal on 05-Oct-2009. On 05-Oct-2009, immediately after receiving FLUMIST, the patient experienced tingling in both upper extremities, facial flushing and dysphagia. The patient was seen in the emergency department and was noted to have a normal exam. The patient was considered recovered from the events of tingling in upper extremities, flushing and dysphagia on 05-Oct-2009. On 06-Oct-2009 the patient was seen as an outpatient and was asymptomatic.

VAERS ID:396028 (history)  Vaccinated:2009-09-01
Age:33.0  Onset:2009-09-01, Days after vaccination: 0
Gender:Female  Submitted:2009-11-12, Days after onset: 72
Location:Rhode Island  Entered:2010-08-16, Days after submission: 276
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: MEDI0009545
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A non-serious spontaneous report of Flu-like symptoms has been received from a 33-year-old female consumer, subsequent to FLUMIST. The patient''s past medical history and concomitant medications were not reported. About two months ago in approximately September 2009, the patient received FLUMIST. The same night after the vaccine was administered, the patient experienced a fever and other mild flu-like symptoms. The event resolved within 24 hours of onset.

VAERS ID:396079 (history)  Vaccinated:2009-10-27
Age:33.0  Onset:2009-10-27, Days after vaccination: 0
Gender:Male  Submitted:2009-11-04, Days after onset: 8
Location:California  Entered:2010-08-16, Days after submission: 284
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: MEDI0009394
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: A non-serious spontaneous report of headache has been received from a consumer, the patient''s wife, concerning an 33-year-old male subsequent to FLUMIST. The patient''s medical history and concomitant medications were not provided. The patient received FLUMIST on 27-Oct-2009. He received a total of one dose of FLUMIST before the onset of the event. After FLUMIST administration on 27-Oct-2009, the patient experienced a headache. The event resolved within one day on 27-Oct-2009.

VAERS ID:396152 (history)  Vaccinated:2009-09-15
Age:33.0  Onset:2009-09-15, Days after vaccination: 0
Gender:Female  Submitted:2009-10-27, Days after onset: 42
Location:Indiana  Entered:2010-08-16, Days after submission: 293
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: MEDI0009238
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (broad)
Write-up: A non-serious spontaneous report of FLUMIST administration to a pregnant 33-year-old female was received from a registered pharmacist. FLUMIST was administered on 15-Sep-2009. The patient''s expected date of delivery was May 2010. There was no adverse event associated with this pregnancy. Treatment and reporter/sponsor causality assessments are not applicable. The reporter was asked to inform when the pregnancy has ended and also to inform if the patient experiences any adverse events during the pregnancy.

VAERS ID:396539 (history)  Vaccinated:2009-09-21
Age:33.0  Onset:2009-09-21, Days after vaccination: 0
Gender:Female  Submitted:2009-09-21, Days after onset: 0
Location:Missouri  Entered:2010-08-16, Days after submission: 329
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0008913
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug exposure during pregnancy, No adverse event
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: A non-serious spontaneous report of FLUMIST administration to pregnant female (14 weeks pregnant) was received from a physician concerning herself, a 33-year-old female. FLUMIST was administered on 21-Sep-2009. There was no adverse event associated with this pregnancy. Treatment and reporter/sponsor causality assessments are not applicable. The reporter was asked to inform when the pregnancy has ended and also to inform if the patient experiences any adverse events during the pregnancy.

VAERS ID:396114 (history)  Vaccinated:2010-08-16
Age:33.0  Onset:2010-08-17, Days after vaccination: 1
Gender:Female  Submitted:2010-08-20, Days after onset: 3
Location:California  Entered:2010-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: THIS WAS MY SECOND HEP B SHOT.
Diagnostic Lab Data: I visited my nurse today on 8/20/10 she said to go to ER if I was not feeling better. I have chills and upset stomach still. I might go to hospital if I don''t get better.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1  
Administered by: Public     Purchased by: Public
Symptoms: Abdominal discomfort, Chills, Diarrhoea, Dyspnoea, Hypoaesthesia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)
Write-up: I felt these symptoms around 7:30 PM. Chills, fainting, hard time breathing, diarrhea and my body went numb. It is day five since I got the shot, and I have chills. And upset stomach.

VAERS ID:396479 (history)  Vaccinated:2010-07-12
Age:33.0  Onset:2010-07-12, Days after vaccination: 0
Gender:Female  Submitted:2010-08-25, Days after onset: 44
Location:California  Entered:2010-08-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3488AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Unable to use rt arm due to severe pain and soreness for 2 days

VAERS ID:396560 (history)  Vaccinated:2010-08-20
Age:33.0  Onset:2010-08-21, Days after vaccination: 1
Gender:Female  Submitted:2010-08-23, Days after onset: 2
Location:North Carolina  Entered:2010-08-26, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0155Z0SCLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B043BA0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1447Y0SCRA
Administered by: Public     Purchased by: Public
Symptoms: Hypersensitivity, Injection site erythema, Injection site pruritus, Injection site swelling, Injection site urticaria, Injection site warmth
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: "4 huge whelps" raised, red, warm, itching area at injection site. Pt took OTC children''s BENADRYL, visited Dr. advised to take CLARITIN. Reaction began at 1 am 8/21/10 and continued to 8/23/10. At 8/23/10 pt stated MD told her that it was an allergic reaction and to report to Health Dept.

VAERS ID:396748 (history)  Vaccinated:2010-08-26
Age:33.0  Onset:2010-08-26, Days after vaccination: 0
Gender:Female  Submitted:2010-08-29, Days after onset: 3
Location:Pennsylvania  Entered:2010-08-30, 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 noted
Preexisting Conditions: None noted
Diagnostic Lab Data: None to date
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU655AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)
Write-up: Telephone call with complaints of chest pain. Pt urged to go to ER.

VAERS ID:397547 (history)  Vaccinated:2010-06-21
Age:33.0  Onset:2010-06-22, Days after vaccination: 1
Gender:Female  Submitted:2010-06-28, Days after onset: 6
Location:Georgia  Entered:2010-09-07, Days after submission: 71
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: GA10028
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB8800AA0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU2969BA0UNLA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Dermatitis contact, Pruritus, Rash generalised, Scab
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received vaccines 6/21/10 3PM. On morning of 6/22/10 started breaking out in rash that slowly spread all over her body. Denies SOB or swelling around mouth. Denies taking any other meds. Pt c/o itching and rash has blisters and scabs. Pt denies wheezing or fever. Referred MD/ER for evaluation. 6/28/10 Pt seen at Clinic-diagnosed with poison ivy.

VAERS ID:397723 (history)  Vaccinated:2010-08-30
Age:33.0  Onset:2010-09-01, Days after vaccination: 2
Gender:Female  Submitted:2010-09-08, Days after onset: 7
Location:Alabama  Entered:2010-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: HIV, VDRL, GC/CT
CDC Split Type: AL1022
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB880AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3353AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Bacterial test, HIV test, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth, Skin tightness, Treponema test
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt. reports that she awake yesterday AM with upper rt. arm sore, slightly swollen and tight with knot @ injection site and hot to touch. Denies any difficulty breathing N/V or diarrhea. No MD or ER visit. Pt. states doing much better today.

VAERS ID:399307 (history)  Vaccinated:2009-08-19
Age:33.0  Onset:2009-08-19, Days after vaccination: 0
Gender:Female  Submitted:2010-08-04, Days after onset: 350
Location:Texas  Entered:2010-09-08, Days after submission: 35
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: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0910USA02841
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.0670Y0UNUN
Administered by: Private     Purchased by: Private
Symptoms: Anogenital warts, Wart excision
SMQs:
Write-up: Information has been received from a physician and a medical assistant concerning a 33 year old female patient who on 19-AUG-2009 was vaccinated with the first 0.5 ml doe of GARDASIL (lot # 0670Y). Subsequently, the patient was diagnosed with a single, pinpoint condyloma on the perineum on 20-OCT-2009. The condyloma was excised in the office on that date. Since July 2009 the patient had a new sexual partner. The patient sought unspecified medical attention. At the time of the report, the patient had not recovered. Follow up information has been received from the physician concerning the 33 year old female patient with no illness at the time of vaccination and no known allergies, birth defects or medical conditions reported, who on 19-AUG-2009 was vaccinated with the first 0.5 ml dose of GARDASIL (route unknown, lot # 0670Y) at the private doctor''s office with private funds. The physician reported that the patient broke out with condyloma shortly after GARDASIL. The physician stated that it was confirmed Condyloma acuminatum on 20-OCT-2009. Additional information has been requested.

VAERS ID:399513 (history)  Vaccinated:0000-00-00
Age:33.0  Onset:2010-02-09
Gender:Male  Submitted:2010-08-04, Days after onset: 175
Location:California  Entered:2010-09-08, Days after submission: 35
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Induration
Preexisting Conditions: Genital wart
Diagnostic Lab Data: None
CDC Split Type: WAES1002USA03605
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Anogenital warts, Blister
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Information has been received from a 33 year old male consumer with "multiple sclerosis" and a history of genital warts, and no allergies who "a couple of years ago" was vaccinated with 0.5 ml dose of GARDASIL three times. Concomitant therapy included insulin and "medicine for multiple sclerosis". "With in the last 2 weeks" on approximately 09-FEB-2010 the consumer experienced a genital wart. There was not laboratory studies performed. When asked if the adverse event improved and about his present status, the consumer stated that his doctor froze the genital warts on 22-FEB-2010 and on 23-FEB-2010 there was a blister where the wart was. Additional information has been requested.

VAERS ID:397871 (history)  Vaccinated:2010-09-08
Age:33.0  Onset:2010-09-08, Days after vaccination: 0
Gender:Female  Submitted:2010-09-09, Days after onset: 1
Location:Georgia  Entered:2010-09-10, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Mild cold - no fever
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB891DA0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0255Z1SCRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B041BA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal discomfort, Convulsion, Dizziness, Feeling hot, Loss of consciousness, Muscle rigidity, Nausea, Pupil fixed, Tremor, Unresponsive to stimuli, Vertigo, Visual impairment, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Parkinson-like events (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Write-up: Ct here for MMR, TDA, PPD, and HBV. Talked with client prior to administration of vaccines. States mild cold symptoms. No fever. Brought pt back at approx 9:00AM after vaccines given. Pt states she feels hot and thinks she is going to pass out. I stood up and positioned myself beside the pt. Pt passed out and leaned to the side. I sat pt upright and began attempting to lay pt down. Pt''s body became very rigid. Head went back, eyes fixed and open, head and arms shaking. Pt unresponsive to voice. I walked pt down to floor, opened door and called for assistance from nurses. I assessed pulse and elevated legs. Nurse responded with crash cart. Due to lack of pt response, decision was made to call 911. B/P via nurse (120/80). Seizure like condition lasted approximately 45 seconds to one plus minutes. Once seizure condition subsided pt passed out for approximately 15 seconds. Pt stated her head was spinning and she was having difficulty with her vision. Advised pt to continue lying down. Kept pt in supine position for approx. 2 minutes at which time pt stated she was feeling better. Orange drink offered to pt. EMS arrived and assessed pt. All vitals signs were WNL. Pt stated she continued to feel hot. Fan positioned on pt. At approx 9:30, pt states she is feeling sick to stomach. Advised pt that she could rest in exam room. Pt accepted. In route to exam room pt vomited in trash can. Pt stated she thought her nausea was caused by the orange drink that was given earlier. Pt rested for approx. 30 min. At 10:00 AM pt stated she was okay. States she lives 5 miles away and she would be fine. Advised pt to call clinic once she arrived home. Pt called back to let us know she had gotten home safely. Will submit VAERS.

VAERS ID:398517 (history)  Vaccinated:2009-10-30
Age:33.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Female  Submitted:2010-09-16, Days after onset: 321
Location:Texas  Entered:2010-09-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Chills, Dizziness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Light headed, very weak, chills & fever.

VAERS ID:398582 (history)  Vaccinated:2004-06-20
Age:33.0  Onset:2004-12-01, Days after vaccination: 164
Gender:Male  Submitted:2010-09-16, Days after onset: 2114
Location:New York  Entered:2010-09-16
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: See attached notes
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV076 UNUN
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Bronchitis, Defaecation urgency, Diarrhoea, Dyspepsia, Epistaxis, Erythema, Fatigue, Foreign travel, Headache, Myalgia, Nonspecific reaction, Oedema peripheral, Pneumonia, Rash, Sinus headache, Sinusitis, Skin exfoliation, Swelling, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific dysfunction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 39 year-old (current age) ARNG WM who was in his usual state of good health prior to deployment to foreign country in 2004. Based on patient recall, he received 9 anthrax vaccines over a 28-month period due to lack of documentation of immunizations in medical records. He reports receipt of doses 1-3 over a 3-month period in early 2002; receipt of doses 4-6 over a 3-month period around March 2003, and receipt of his last 3 doses (doses 7-9) over a 3-month period between June and August 2004 (documented), within 3 months of deployment to foreign country. Starting the day of his "second doses" (#2, 5 and 8), he noted headaches, joint aches, fatigue and urgency to have bowel movement following meals. He denies worsening of these symptoms with subsequent doses and denies occurrence of these symptoms following doses #3, 6 and 9. These symptoms resolved after 3 days. He denies any unusual local reactions at anthrax vaccination sites until his last dose (#9) of anthrax vaccine in Aug 2004; he noted an area of about 2-3'' of redness, swelling and tenderness, which lasted < 1 week. SM reports that he was told after receipt of his smallpox vaccine in July 2004, he did not have "a good reaction", so he was given a 2nd dose. SM reports he had a robust response to the second dose with normal site progression and no prolonged systemic or local symptoms. He denies rashes or other systemic symptoms (other than those symptoms listed above) within 30 days of anthrax and smallpox vaccine receipt. He denies prior history of, or subsequent history of vaccine reactions. He was well on the days of vaccine receipt, without recent antecedent illnesses. He denies antecedent travel, animal or tick exposure, food, insect or latex allergies. At that time, his past medical history was negative and he was not taking any prescription or OTC medications on a routine basis. He was smoking a cigar or pipe about once per week and drank about 2 drinks daily. Family history is significant for diabetes, sarcoidosis, and hyperlipidemia. At that time, his exposure history included working at 9/11 site x 3 week activation. During his deployment to foreign country between Nov 2004 and Nov 2005, SM reports the onset of a number of symptoms, but due to mission priority, he did not seek evaluation, or if he was evaluated and treated, there are no records accessible. He is unable to recall the exact timeline or details of symptom onset. The following symptoms occurred during SM''s deployment to foreign country: 1) Joint pain and generalized muscle aches 2) Swelling of extremities 3) Fatigue 4) Diarrhea, dyspepsia 5) Bronchitis, episode of pneumonia 6) Sinus infections, with associated headaches 7) Nosebleeds 8) Rashes, skin peeling

VAERS ID:398840 (history)  Vaccinated:2010-09-09
Age:33.0  Onset:2010-09-09, Days after vaccination: 0
Gender:Female  Submitted:2010-09-09, Days after onset: 0
Location:Nevada  Entered:2010-09-20, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None known; allergic to Penicillin & Sulfa
Diagnostic Lab Data: Acute asthma exacerbation.
CDC Split Type:
Vaccination
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB162BA IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1222Y SCRA
Administered by: Private     Purchased by: Private
Symptoms: Asthma, Erythema, Oedema peripheral, Respiratory distress, Throat tightness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Acute Respiratory Distress, throat tightened up erythema & swelling bilateral upper/outer arms extending to elbows.

VAERS ID:399128 (history)  Vaccinated:2010-09-21
Age:33.0  Onset:2010-09-21, Days after vaccination: 0
Gender:Male  Submitted:2010-09-21, Days after onset: 0
Location:Tennessee  Entered:2010-09-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NO
Diagnostic Lab Data: STEROID SHOT
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS111772P10IMLA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Cough, Dyspnoea, Erythema, Throat irritation
SMQs:, Anaphylactic reaction (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: FACE TURNED RED-STARTED COUGHING, SHIVERING AND DIFFICULTY BREATHING-PATIENT STATES THAT SHE FELT LIKE FISHBONE STUCK IN HER THROAT

VAERS ID:399203 (history)  Vaccinated:2010-09-14
Age:33.0  Onset:2010-09-16, Days after vaccination: 2
Gender:Male  Submitted:2010-09-22, Days after onset: 6
Location:Florida  Entered:2010-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: CBC ABD X-Ray UA
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (CSL)CSL LIMITEDM511070IMRA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal X-ray, Abdominal discomfort, Abdominal pain, Body temperature increased, Chills, Diarrhoea, Full blood count, Nausea, Urine analysis, Viral infection, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 16 SEP-started to get upset stomach 17 SEP- upset stomach 18 SEP- lwr abd cramps, nausea, vomiting, diarrhea, chills, elev temp 19 SEP- lwr abd cramps, nausea, diarrhea, chills, 20 SEP- lwr abd cramps, some diarrhea, seen by doc with dx of viral syndrome- sick in quarters x 1 day. 21 SEP- back to normal 22 SEP- 1st solid stool -AM

VAERS ID:400190 (history)  Vaccinated:2010-09-22
Age:33.0  Onset:2010-09-22, Days after vaccination: 0
Gender:Male  Submitted:2010-09-24, Days after onset: 2
Location:California  Entered:2010-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Possible Iodine Allergy. However, not confirmed.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Military     Purchased by: Military
Symptoms: Headache, Injection site erythema, Injection site swelling, Injection site warmth, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling at local site up to six inches in diameter, redness, and hot to touch. Had a mild headache following day. Not sure if it was dehydration or from reaction.

VAERS ID:400197 (history)  Vaccinated:2010-09-23
Age:33.0  Onset:2010-09-23, Days after vaccination: 0
Gender:Female  Submitted:2010-09-24, Days after onset: 1
Location:California  Entered:2010-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH181AB0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Arthralgia, Burning sensation, Chest discomfort, Chest pain, Chills, Conjunctival hyperaemia, Eye swelling, Headache, Hot flush, Muscular weakness, Palpitations
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conjunctival disorders (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Employee felt heart racing, chest pain, heaviness in her chest, head felt like it was in a vice, severe joint pain in all extremities with muscle weakness, face felt like it was burning, experienced hot flashes and chills, eyes injected and swollen. No shortness of breath or dyspnea. Pt felt like going to the ED and decided not to. Took a shower, and a dose of night time Nyquil (OTC) and went to slept through the night.

VAERS ID:400416 (history)  Vaccinated:2010-09-26
Age:33.0  Onset:2010-09-26, Days after vaccination: 0
Gender:Female  Submitted:2010-09-26, Days after onset: 0
Location:Massachusetts  Entered:2010-09-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3620CB5UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient received injection and within 3 minutes had large (6 inch) redness and swelling over injection site. Very itchy. No throat swell. No difficulty breathing. Watched patient for any worsening - over 15 minute period swelling went down. Patient advised to take Loratadine 10 mg. Still no hives, no tongue swell, no difficulty breathing.

VAERS ID:400705 (history)  Vaccinated:2010-09-15
Age:33.0  Onset:2010-09-17, Days after vaccination: 2
Gender:Male  Submitted:2010-09-21, Days after onset: 4
Location:Maryland  Entered:2010-09-27, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cellulitis finger
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURC3476AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Local axillary swelling post vaccine 2 days later.

VAERS ID:400753 (history)  Vaccinated:2010-09-22
Age:33.0  Onset:2010-09-23, Days after vaccination: 1
Gender:Female  Submitted:2010-09-24, Days after onset: 1
Location:Maryland  Entered:2010-09-27, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: KEFLEX
Diagnostic Lab Data: None
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.073930UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Severe (L) deltoid pain 1 day after PNEUMOVAX.

VAERS ID:400964 (history)  Vaccinated:2010-09-24
Age:33.0  Onset:2010-09-24, Days after vaccination: 0
Gender:Female  Submitted:2010-09-28, Days after onset: 4
Location:Nevada  Entered:2010-09-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
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HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site reaction, Local swelling, Musculoskeletal stiffness, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash, small bumps first on my R hand 9/25/10 rash started on R arm, then on 9/26/10 R leg, then L leg. It was worse the evening of 9/27/10 and seems to be going away today 9/28/10. I had stiffness in my arm, neck, and shoulder on side of injection and swelling of the neck near my jaw on the R side the first two days after the injection.

VAERS ID:400973 (history)  Vaccinated:2010-09-28
Age:33.0  Onset:2010-09-28, Days after vaccination: 0
Gender:Female  Submitted:2010-09-28, Days after onset: 0
Location:Colorado  Entered:2010-09-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH181AB UNLA
Administered by: Public     Purchased by: Other
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: About 4 hours after vaccine - patient lying down with daughter felt fluid in lungs, chest tightness, shortness of breath -$g to Urgent Care- give Epinephrine -$g HA, vomiting, IM PHENERGAN, IM TORADOL. Observed 1 hr -$g then sent home.

VAERS ID:401222 (history)  Vaccinated:2010-09-24
Age:33.0  Onset:2010-09-28, Days after vaccination: 4
Gender:Female  Submitted:2010-09-29, Days after onset: 1
Location:Florida  Entered:2010-09-29
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: Biopsy of lymph node pending
CDC Split Type:
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Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJLA
Administered by: Other     Purchased by: Private
Symptoms: Biopsy lymph gland, Dizziness, Headache, Lymphadenopathy, Oedema peripheral, Pain in extremity, Pruritus, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Swollen painful and itchy arm. Dizziness, headache, fever and swollen lymph nodes.

VAERS ID:401397 (history)  Vaccinated:2010-09-29
Age:33.0  Onset:2010-09-30, Days after vaccination: 1
Gender:Female  Submitted:2010-09-30, Days after onset: 0
Location:Michigan  Entered:2010-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none noted
Preexisting Conditions: none noted
Diagnostic Lab Data: none
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH182AC IMRA
Administered by: Public     Purchased by: Other
Symptoms: Lip swelling, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: facial and lip swelling

VAERS ID:401406 (history)  Vaccinated:2010-09-15
Age:33.0  Onset:2010-09-18, Days after vaccination: 3
Gender:Male  Submitted:2010-09-30, Days after onset: 12
Location:California  Entered:2010-09-30
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: none
Diagnostic Lab Data: none
CDC Split Type:
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TDAP: TDAP (ADACEL)SANOFI PASTEURC3491AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Nasopharyngitis, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever and cold symptoms that were transient and resolved quickly- note that I do not know the time his illness started on 9/18- no box for "unknown".

VAERS ID:401584 (history)  Vaccinated:2010-09-29
Age:33.0  Onset:2010-10-01, Days after vaccination: 2
Gender:Male  Submitted:2010-10-02, Days after onset: 1
Location:Maryland  Entered:2010-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUTA564BA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Discomfort, Local swelling, Muscle tightness, Nasal congestion, Neck pain, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: SEVERE SWELLING IN BOTH CHEEKS AND NECK AREA. ACHES IN NECK, CHEEKS AND EARS. EXTREME DISCOMFORT, STUFFINESS, AND TIGHTNESS IN NECK AREA.

VAERS ID:401592 (history)  Vaccinated:2010-09-30
Age:33.0  Onset:2010-10-01, Days after vaccination: 1
Gender:Female  Submitted:2010-10-02, Days after onset: 1
Location:Illinois  Entered:2010-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: 14 wks pregnant
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site haematoma, Oropharyngeal pain, Tonsillar hypertrophy
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Badly swollen right tonsil the day after receiving a flu shot in the left shoulder. Started late that evening with continued tonsil swelling and sore throat the next day (10/02/1010) as well. No other symptoms other than minor bruising-type pain at the site of injection so far.

VAERS ID:401622 (history)  Vaccinated:2010-10-03
Age:33.0  Onset:2010-10-03, Days after vaccination: 0
Gender:Male  Submitted:2010-10-03, Days after onset: 0
Location:California  Entered:2010-10-04, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB834BA IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Ear discomfort, Rash, Rash erythematous, Throat irritation
SMQs:, Anaphylactic reaction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Hepatitis vaccine given + within one hour service member returned with the following symptoms: rash-red face & neck; c/o "ears on fire," "scratchy throat." No signs of SOB, wheezing, swelling, no reaction observed over injection site.

VAERS ID:401804 (history)  Vaccinated:2010-09-29
Age:33.0  Onset:2010-09-29, Days after vaccination: 0
Gender:Female  Submitted:2010-10-04, Days after onset: 5
Location:Ohio  Entered:2010-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ?
Preexisting Conditions: unknown
Diagnostic Lab Data: X-rays
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDM52308 IMAR
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Injection site pain, Mobility decreased, Pain, Paraesthesia, X-ray
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: Vaccine painful, unable to move arm, shooting pains, tingling, numbness in arm. Pt went to urgent care, then ER. Given X-rays, sling, and pain medication.

VAERS ID:401788 (history)  Vaccinated:2010-09-20
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2010-10-05
Location:Wisconsin  Entered:2010-10-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR    
Administered by: Other     Purchased by: Private
Symptoms: Musculoskeletal pain, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Tendinopathies and ligament disorders (broad)
Write-up: worsening left shoulder/upper arm pain since shot, can''t lift above head without severe pain, severe pain with lifting or moving

VAERS ID:402020 (history)  Vaccinated:2010-10-05
Age:33.0  Onset:2010-10-05, Days after vaccination: 0
Gender:Female  Submitted:2010-10-06, Days after onset: 1
Location:Michigan  Entered:2010-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: EKG
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA6077AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dyspnoea, Electrocardiogram, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Shortness of Breath Hives Swollen Tongue Treated at ER. Received IV Benadryl and Solu-Medrol

VAERS ID:402332 (history)  Vaccinated:2010-10-05
Age:33.0  Onset:2010-10-06, Days after vaccination: 1
Gender:Female  Submitted:2010-10-07, Days after onset: 1
Location:Illinois  Entered:2010-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Pregnancy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED11049111A0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Drug exposure during pregnancy, Dyspnoea, Palatal oedema, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pharyngeal and uvular edema, Difficulty breathing

VAERS ID:402358 (history)  Vaccinated:2010-10-05
Age:33.0  Onset:2010-10-06, Days after vaccination: 1
Gender:Male  Submitted:2010-10-07, Days after onset: 1
Location:Wisconsin  Entered:2010-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: seen for Physical concern of tendonitis and joint pain also has sinus symptoms
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0930Z0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Cellulitis, Chills, Dizziness, Injection site rash, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash at site, fever, chills, dizziness, body ache and cellulitis

VAERS ID:402468 (history)  Vaccinated:2009-10-30
Age:33.0  Onset:2009-11-01, Days after vaccination: 2
Gender:Female  Submitted:2010-10-04, Days after onset: 337
Location:Connecticut  Entered:2010-10-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3563BA IMUN
Administered by: Private     Purchased by: Private
Symptoms: Chills, Pain
SMQs:
Write-up: Chills, bodyaches.

VAERS ID:402523 (history)  Vaccinated:2010-09-16
Age:33.0  Onset:2010-09-23, Days after vaccination: 7
Gender:Male  Submitted:2010-10-08, Days after onset: 15
Location:Unknown  Entered:2010-10-08
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: PHHY2010DE67070
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA100440UNUN
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Ear pain, Eyelid ptosis, Facial paresis, Headache
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow)
Write-up: Initial report received from a consumer (who was a physician) on 27 Sep 2010: This patient with an unknown medical history was vaccinated first time with MENVEO (batch number A10044) on 16 Sep 2010. After vaccination, the patient developed facial paresis (no side reported), ptosis, dizziness (recurrent), headache, and otalgia on 23 Sep 2010. No hospitalization took place. Outcome of the events was reported as condition unchanged.

VAERS ID:402530 (history)  Vaccinated:2010-10-06
Age:33.0  Onset:2010-10-07, Days after vaccination: 1
Gender:Female  Submitted:2010-10-08, Days after onset: 1
Location:West Virginia  Entered:2010-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA531AA IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Day after vaccine was red, warm to touch, but not sore. No streaking, no fever.

VAERS ID:402739 (history)  Vaccinated:2010-09-29
Age:33.0  Onset:2010-09-30, Days after vaccination: 1
Gender:Female  Submitted:2010-10-04, Days after onset: 4
Location:California  Entered:2010-10-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data: Observation
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA528BA0UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0978Z0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness, swelling, pain at injection site with associated fevers. SX for 4-5 days post vaccine.

VAERS ID:402779 (history)  Vaccinated:2010-10-07
Age:33.0  Onset:2010-10-07, Days after vaccination: 0
Gender:Female  Submitted:2010-10-11, Days after onset: 4
Location:Idaho  Entered:2010-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED10049121A6IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Erythema, Nodule, Skin warm, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: SWELLING, KNOT, REDNESS, HOT TO TOUCH, PAIN IN SHOULDER JOINT, TENDER TO THE TOUCH - TREATED WITH ZYRTEC 10MG ORALLY

VAERS ID:402807 (history)  Vaccinated:2010-09-27
Age:33.0  Onset:2010-09-27, Days after vaccination: 0
Gender:Female  Submitted:2010-10-06, Days after onset: 9
Location:Wisconsin  Entered:2010-10-11, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS111794P1 UNLA
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pruritus, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness, swelling, itching, warmth.

VAERS ID:402978 (history)  Vaccinated:2010-10-11
Age:33.0  Onset:2010-10-11, Days after vaccination: 0
Gender:Female  Submitted:2010-10-12, Days after onset: 1
Location:Ohio  Entered:2010-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3653AA IM 
TDAP: TDAP (ADACEL)SANOFI PASTEURC3490AA IM 
Administered by: Private     Purchased by: Private
Symptoms: Malaise
SMQs:
Write-up: Felt ill hours after the vaccination. Went to Emergency Department and treated & released.

VAERS ID:403089 (history)  Vaccinated:2010-10-07
Age:33.0  Onset:2010-10-08, Days after vaccination: 1
Gender:Female  Submitted:2010-10-13, Days after onset: 5
Location:Virginia  Entered:2010-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: eczema
Diagnostic Lab Data: unknown at this time
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA591BA4IMRA
Administered by: Military     Purchased by: Other
Symptoms: Blister, Erythema, Pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: redness initially the next day around area on Saturday 10/09/10 multiple blisters formed around area with drainage noted- very itchy

VAERS ID:403228 (history)  Vaccinated:2010-10-11
Age:33.0  Onset:2010-10-11, Days after vaccination: 0
Gender:Female  Submitted:2010-10-13, Days after onset: 2
Location:Ohio  Entered:2010-10-13
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: Latex
Diagnostic Lab Data: ECG normal; Chest CAT scan normal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3700AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Computerised tomogram normal, Cough, Dyspnoea, Electrocardiogram normal, Heart rate increased, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Difficulty breathing, chest tightness, coughing, wheezing, increased heart rate.

VAERS ID:403436 (history)  Vaccinated:2010-10-14
Age:33.0  Onset:2010-10-14, Days after vaccination: 0
Gender:Male  Submitted:2010-10-14, Days after onset: 0
Location:Colorado  Entered:2010-10-14
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) (AFLURIA)CSL LIMITED10849111A0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Generalised erythema
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red all over the body

VAERS ID:403611 (history)  Vaccinated:2010-10-08
Age:33.0  Onset:2010-10-08, Days after vaccination: 0
Gender:Male  Submitted:2010-10-08, Days after onset: 0
Location:Georgia  Entered:2010-10-15, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None stated
Preexisting Conditions: none-no allergies
Diagnostic Lab Data: None performed 911 and paramedics called
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDM52808 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Patient stated that he could faint from shots. Administer shot, had patient wait 5 minutes. No visible ill effects and patient said fine. Patient fainted at customer service desk, attended by nursing student and pharmacist, call 911 - patient signed and refused treatment or transport.

VAERS ID:403853 (history)  Vaccinated:2010-10-14
Age:33.0  Onset:2010-10-14, Days after vaccination: 0
Gender:Female  Submitted:2010-10-18, Days after onset: 4
Location:Texas  Entered:2010-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: n/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJLA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJRA
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJLA
Administered by: Private     Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site pain, Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: Excrutiating shoulder (right) pain, radiating down to just below elbow, which is severely limiting movement at best; Symptoms have not ceased or decreased. 800 mg Ibuprofen & 1000 mg Tylenol taken up to 4x a day for pain.

VAERS ID:403979 (history)  Vaccinated:2010-09-21
Age:33.0  Onset:2010-09-21, Days after vaccination: 0
Gender:Female  Submitted:2010-10-18, Days after onset: 27
Location:Montana  Entered:2010-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, seasonal allergies on immunatherapy
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3697AA2UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1426Y0UNRA
Administered by: Private     Purchased by: Private
Symptoms: Local reaction, Lymphadenopathy, Oedema peripheral, Pain in extremity, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Large local reaction, pain and swelling of right arm, lymphadenopathy and fever of 101 degrees, started about 1 hour after injection and lasted 5-6 days.

VAERS ID:403987 (history)  Vaccinated:2010-10-12
Age:33.0  Onset:2010-10-15, Days after vaccination: 3
Gender:Female  Submitted:2010-10-15, Days after onset: 0
Location:Florida  Entered:2010-10-18, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Chronic sinusitis
Preexisting Conditions: Seizure disorder; Chronic sinusitis $g5 yrs. of symptom
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0933Z0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: (L) deltoid area red, swollen, tender just below injection site.

VAERS ID:404026 (history)  Vaccinated:2010-09-28
Age:33.0  Onset:2010-09-30, Days after vaccination: 2
Gender:Female  Submitted:2010-10-18, Days after onset: 18
Location:Colorado  Entered:2010-10-19, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: ZITHROMAX; ALDOMET; TOPAMAX; Ibuprofen; morphine; oxycodone; steroids; saccharin; aspartame
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB891CA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3281CA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pruritus, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Hives and severe itching all around the injection site down to the elbow of right arm.

VAERS ID:404162 (history)  Vaccinated:2010-10-11
Age:33.0  Onset:2010-10-12, Days after vaccination: 1
Gender:Female  Submitted:2010-10-13, Days after onset: 1
Location:Pennsylvania  Entered:2010-10-19, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3719AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red warm, swelling at injection site. Started 1 day after injection. Also fever to 102 - 103 degrees orally day after inj. No fever today. Eight, induated, warm 7 X 4 cm area Rt deltoid.

VAERS ID:404454 (history)  Vaccinated:2010-10-14
Age:33.0  Onset:2010-10-15, Days after vaccination: 1
Gender:Female  Submitted:2010-10-18, Days after onset: 3
Location:Unknown  Entered:2010-10-20, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA579AA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site urticaria, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was given FLULAVAL on 10/14/2010 on 10/15/2010 started w. hives around vaccine site on right deltoid, hives then spread to rest of body.

VAERS ID:404459 (history)  Vaccinated:2010-10-04
Age:33.0  Onset:2010-10-04, Days after vaccination: 0
Gender:Male  Submitted:2010-10-13, Days after onset: 9
Location:Unknown  Entered:2010-10-20, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3580CA IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blindness transient, Headache, Malaise, Photosensitivity reaction, Vision blurred
SMQs:, Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)
Write-up: The patient temporarily had blurred vision and loss of his central and peripheral vision. He had a headache, photosensitivity, and felt too ill to drive himself home from work. The following day, the patient was back to normal without any symptoms.

VAERS ID:404689 (history)  Vaccinated:2010-09-17
Age:33.0  Onset:2010-10-12, Days after vaccination: 25
Gender:Female  Submitted:2010-10-21, Days after onset: 9
Location:Iowa  Entered:2010-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Has allergies to cephalexin and nitrofurantion, ragweed, and diphenhydramine. Has Factor II blood mutation,
Diagnostic Lab Data: Lumbar Puncture was negative, however diagnosed as possible Guillain Barre
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA576AA UNRA
Administered by: Private     Purchased by: Private
Symptoms: Dysphagia, Immunoglobulin therapy, Lumbar puncture normal, Muscular weakness, Paraesthesia, Speech disorder
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Progressive weakness and tingling of both legs and arms and difficulty in speaking and swallowing. Dr.''s question that it may be Guillain Barre. Treated with Gammagard x3 days. Lumbar Puncture was negative however. Stayed from 10-12 to 10-15.

VAERS ID:404696 (history)  Vaccinated:2010-10-12
Age:33.0  Onset:2010-10-19, Days after vaccination: 7
Gender:Female  Submitted:2010-10-21, Days after onset: 2
Location:Alabama  Entered:2010-10-21
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: Allergic to CIPRO; Hx Herpes Complex Type I
Diagnostic Lab Data: When questioned further patient states she noticed some tingling sensations in face 2 weeks prior to Mist.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.50100P IN 
Administered by: Private     Purchased by: Public
Symptoms: Ear pain, Headache, Hypoaesthesia oral, Paraesthesia oral, VIIth nerve paralysis
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: FLUMIST 10/12. 10/19- woke up with H/A posterior head & behind (R) ear. H/A throughout day. 10/20-AM-felt numbness & tingling in (R) jaw, lips & tongue. Then noticed has right facial droop.

VAERS ID:404700 (history)  Vaccinated:2010-10-19
Age:33.0  Onset:2010-10-19, Days after vaccination: 0
Gender:Female  Submitted:2010-10-21, Days after onset: 2
Location:New Jersey  Entered:2010-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: pcn allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Unknown     Purchased by: Public
Symptoms: Burning sensation, Erythema, Paraesthesia, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approx 20 mins after shot, started itching/burning over arms, back, abdomen. Felt burning sensations through out body. Decreased by night time. Next morning right index finger started to burn and turn pink/red. Warm to touch. Burning and Tingling sensation continued to travel down finger to wrist to elbow to remaining fingers. Dr visit on 10/21/10. Course of steroids administered. Started at approx 05:30 PM on 10/21/10. Final outcome pending.

VAERS ID:404797 (history)  Vaccinated:2010-10-15
Age:33.0  Onset:2010-10-17, Days after vaccination: 2
Gender:Female  Submitted:2010-10-22, Days after onset: 5
Location:Michigan  Entered:2010-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH184AB0IMRA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB894AA0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3353AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Hypoaesthesia, Injected limb mobility decreased, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: DEVELOPED 2 INCH AREA OF ERYTHEMA, WARM TO TOUCH WITH DIFFUCLTY MOVING LEFT ARM. C/O NUMBNESS IN LEFT FINGERS

VAERS ID:404961 (history)  Vaccinated:2010-10-15
Age:33.0  Onset:2010-10-15, Days after vaccination: 0
Gender:Female  Submitted:2010-10-22, Days after onset: 7
Location:New Hampshire  Entered:2010-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: environmental allergies, hypothyroidism
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC3382AA IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site mass, Injection site pain, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: hard lump size of egg at injection site, mild erythema, itching, sore to touch, continued swelling at injection site for 6 days

VAERS ID:405133 (history)  Vaccinated:2010-09-15
Age:33.0  Onset:2010-09-19, Days after vaccination: 4
Gender:Male  Submitted:2010-10-25, Days after onset: 36
Location:Texas  Entered:2010-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE STATED
Preexisting Conditions: ALLERGIC TO PENICILLIN
Diagnostic Lab Data: none.
CDC Split Type:
Vaccination
Manufacturer
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB275BA IMRA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1778Y2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Cough, Dyspnoea, Lymphadenopathy, Sneezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: "On 9-19-10 pt started sneezing and coughing and which got progressively worse with shortness of breath, stomach cramps and swollen lymph nodes etc. "Patient called me with these symptoms on 10-21-10. Informed him that it may not be related issue to the vaccinations but his symptoms needs to evaluated to rule out the causes. Urged him to seek medical help ASAP by calling 911 or going to the nearest ER. He called me and left me a message on 10-22-10 that he looked things up online and got some over the counter meds and slept well the night before. Attempted to reach him on 10-25-10. Lefft message to call back. # provided.

VAERS ID:405209 (history)  Vaccinated:2010-10-24
Age:33.0  Onset:2010-10-25, Days after vaccination: 1
Gender:Female  Submitted:2010-10-25, Days after onset: 0
Location:Massachusetts  Entered:2010-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no, except for my regular Fibromyalgia and Rheumatoid Arthritis Symptoms acting up with the rainy cold weather. no other symptoms
Preexisting Conditions: Fibromyalgia, Rheumatoid Arthritis, Depression, Anxiety, HBP, Type 1 Diabetes, Splenectomy (2 spleens removed 01-10), Gynecological complications, fertility issues, PolyCystic Ovarian Syndrome, Previous Car Accident injuries (age 12-14) Ulcerative Colitis, Diabetic Neuropathy...I always know how I am feeling.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Abdominal distension, Blood glucose, Chills, Diarrhoea, Feeling of body temperature change, Heart rate increased, Hypertension, Insomnia, Lethargy, Nausea, Pain, Pyrexia, Restlessness, Supraventricular tachycardia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Dementia (broad), Pseudomembranous colitis (broad), Akathisia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 7:20 AM instantaneously vomiting while driving vehicle, cold/hot, HIGH PULSE rate, HBP, Blood Sugar (unknown-no batteries), SVT, Low Grade Fever, Chills, restless, high abdominal bloating, overall Body Aches and severe lethargy...now 12:51 PM small-amount watery diarrhea, nausea, HBP, restless, all previous symptoms listed, cannot sleep/rest, am able to keep down sips of liquids at a time (from vomiting).

VAERS ID:405434 (history)  Vaccinated:2010-10-20
Age:33.0  Onset:2010-10-21, Days after vaccination: 1
Gender:Female  Submitted:2010-10-26, Days after onset: 5
Location:Nebraska  Entered:2010-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: Latex sensitive, Codeine, Sulfa
Diagnostic Lab Data: C-reactive protein elevated 145
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS111797P10IMRA
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS111797P1 IMRA
Administered by: Private     Purchased by: Private
Symptoms: C-reactive protein increased, Chills, Fatigue, Influenza like illness, Pain, Pain of skin, Pyrexia, Rash erythematous, Urine analysis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccine given 10/20 afternoon. Flu-like symptoms started 10/21 afternoon. Chills, aches, fever, extreme fatigue. Worse on 10/22 and 10/23 woke with rash that attacked all scar tissue area on body, old scars and any area that had ever had blood drawn or IV started. Raised, red, painful. Seen at ER and was given IV fluids, blood and urine drawn. C-reactive protein was only elevated lab at 145. Medrol dose pack given. Symptoms improved with meds and rest.

VAERS ID:405592 (history)  Vaccinated:2010-10-13
Age:33.0  Onset:2010-10-14, Days after vaccination: 1
Gender:Female  Submitted:2010-10-19, Days after onset: 5
Location:Maine  Entered:2010-10-27, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA; None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3653AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.088Z0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Erythema, Myalgia, Pain, Pruritus, Skin warm, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received vaccine 10/13/10. 12 hours later noticed burning, itching, very painful, red, hot to touch, swollen, muscle pain.

VAERS ID:405603 (history)  Vaccinated:2010-10-26
Age:33.0  Onset:2010-10-27, Days after vaccination: 1
Gender:Female  Submitted:2010-10-27, Days after onset: 0
Location:Ohio  Entered:2010-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: slight runny nose
Preexisting Conditions: Septra
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJLA
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJLA
Administered by: Other     Purchased by: Private
Symptoms: Abnormal behaviour, Loss of consciousness, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Write-up: woke up throwing up and passed out; husband found me lying on bathroom floor after passing out; totally NOT normal for me

VAERS ID:405626 (history)  Vaccinated:2010-10-15
Age:33.0  Onset:2010-10-15, Days after vaccination: 0
Gender:Female  Submitted:2010-10-20, Days after onset: 5
Location:Washington  Entered:2010-10-27, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: PMD diagnosed Bell''s Palsy
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.501006P0IN 
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Blepharospasm, Fatigue, Headache, Lip swelling, Myalgia, Nasal congestion, Swollen tongue, VIIth nerve paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hearing impairment (broad), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 hours after vaccine given pt experienced basilar h/a. Next morning had twitch in (L) eye, swollen lips & tongue, muscle ache in shoulders & upper back, tiredness/weakness, nasal congestion.

VAERS ID:405932 (history)  Vaccinated:2010-10-25
Age:33.0  Onset:2010-10-26, Days after vaccination: 1
Gender:Female  Submitted:2010-10-28, Days after onset: 2
Location:Illinois  Entered:2010-10-28
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 PASTEURU3700AA IMRA
Administered by: Private     Purchased by: Public
Symptoms: Hypersensitivity, Injection site erythema, Injection site induration
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt. had red, raised area to injection site. Approx. 2 in induration. Dr diagnosed pt with hypersensitivity to flu shot. Pt treated with prednisone.

VAERS ID:405955 (history)  Vaccinated:2010-10-27
Age:33.0  Onset:2010-10-29, Days after vaccination: 2
Gender:Female  Submitted:2010-10-29, Days after onset: 0
Location:Georgia  Entered:2010-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: denied
Preexisting Conditions: unknown
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3488BA1IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURD10871IMLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUF85AA1SCLA
Administered by: Military     Purchased by: Military
Symptoms: Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: swollen glands in throat fever

VAERS ID:406266 (history)  Vaccinated:2010-10-28
Age:33.0  Onset:2010-10-29, Days after vaccination: 1
Gender:Female  Submitted:2010-11-01, Days after onset: 3
Location:Missouri  Entered:2010-11-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS111775P10IMLA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Decreased appetite, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Nausea, Pain
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Large-hard-warm-red-swollen area where vaccine was given, aches-chills-nausea-anorexia

VAERS ID:406475 (history)  Vaccinated:2010-10-13
Age:33.0  Onset:2010-10-13, Days after vaccination: 0
Gender:Female  Submitted:2010-11-02, Days after onset: 20
Location:Kentucky  Entered:2010-11-02
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: None except Asthma Severe Environmental Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH223AC2IMRA
Administered by: Other     Purchased by: Public
Symptoms: Cough, Status asthmaticus
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Nagging cough that proceeded to status asthmaticus

VAERS ID:406537 (history)  Vaccinated:2010-10-20
Age:33.0  Onset:2010-10-20, Days after vaccination: 0
Gender:Female  Submitted:2010-10-26, Days after onset: 6
Location:Georgia  Entered:2010-11-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH224AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1427Y IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3082AA IMRA
Administered by: Other     Purchased by: Public
Symptoms: Erythema, Headache, Neck pain, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red streaks, hot to touch, headache, neck ache, fever 102 (LD) Tx with KEFLEX.

VAERS ID:406560 (history)  Vaccinated:2010-10-20
Age:33.0  Onset:2010-10-21, Days after vaccination: 1
Gender:Female  Submitted:2010-10-25, Days after onset: 4
Location:Georgia  Entered:2010-11-02, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH224AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1427Y IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU3082AA IMRA
Administered by: Other     Purchased by: Public
Symptoms: Flushing, Injection site streaking, Injection site warmth, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever 102, red streaks, hot to to touch (LD), flushed face. Tx with KEFLEX.

VAERS ID:406674 (history)  Vaccinated:2010-10-27
Age:33.0  Onset:2010-10-30, Days after vaccination: 3
Gender:Male  Submitted:2010-11-01, Days after onset: 2
Location:North Carolina  Entered:2010-11-03, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS112946P1 UNLA
Administered by: Other     Purchased by: Private
Symptoms: Dysgeusia, Eye irritation, VIIth nerve paralysis
SMQs:, Taste and smell disorders (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Corneal disorders (broad), Hearing impairment (broad)
Write-up: 10/30 facial drop (L); altered taste? 11/1 (L) eye irritation.

VAERS ID:406736 (history)  Vaccinated:2010-10-22
Age:33.0  Onset:2010-10-30, Days after vaccination: 8
Gender:Male  Submitted:2010-11-03, Days after onset: 4
Location:Unknown  Entered:2010-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED1084911A IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Cough, Influenza like illness, Injection site pain, Injection site vesicles, Pain, Rash, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Blistering at site of injection. Site appeared to have peeled where blister erupted. No itching, but burning at site. Also complaints of flu-like symptoms, cough, and body aches. No treatment administered.

VAERS ID:406747 (history)  Vaccinated:2010-09-23
Age:33.0  Onset:2010-09-25, Days after vaccination: 2
Gender:Male  Submitted:2010-11-03, Days after onset: 39
Location:Kansas  Entered:2010-11-03
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: N/A
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0 LA
Administered by: Unknown     Purchased by: Private
Symptoms: Joint stiffness, Lethargy, Mass, Pain in extremity
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Lump in the arm. Steadily growing to around 5 inches long. Painful. Stiffness in joint. Lethargy.

VAERS ID:406878 (history)  Vaccinated:2010-11-02
Age:33.0  Onset:2010-11-02, Days after vaccination: 0
Gender:Female  Submitted:2010-11-04, Days after onset: 2
Location:South Carolina  Entered:2010-11-04
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: Allergies to Penicillin and Cephalosporins
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
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Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDM516080IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Pain, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Began having chills and felt achy around 5:00 PM. Took some Motrin and Benadryl and began to feel better between 7:30 and 8:30 that night. Next day (11/3/2010) noticed a non-itchy red rash on torso and forearms around 11:00 AM. At unknown time on 11/3 noticed the rash was also on her lower back. She continuted with Benadryl. On 11/4/2010 contacted me (vaccine provider) and the rash was no longer on her back and was beginning to look less red.

VAERS ID:407102 (history)  Vaccinated:2010-10-29
Age:33.0  Onset:2010-10-31, Days after vaccination: 2
Gender:Female  Submitted:2010-11-04, Days after onset: 4
Location:Massachusetts  Entered:2010-11-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pt pregnant
Preexisting Conditions: Allergies: Erythromycin - pt pregnant
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3581CA0UNLA
Administered by: Private     Purchased by: Public
Symptoms: Drug exposure during pregnancy, Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow)
Write-up: 10/29/10 - Administered flu shot, & pt went to Hosp emerg room bec of red, swollen lt up arm (site of injection) on 10/31/10. Pt is pregnant, EDC -02/19/11. Pt was given KEFLEX & discharged.

VAERS ID:407126 (history)  Vaccinated:2010-11-03
Age:33.0  Onset:2010-11-03, Days after vaccination: 0
Gender:Male  Submitted:2010-11-05, Days after onset: 2
Location:Tennessee  Entered:2010-11-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Extreme redness the size of a baseball swelling hot to the touch pain at the site.

VAERS ID:407206 (history)  Vaccinated:2010-10-02
Age:33.0  Onset:2010-10-03, Days after vaccination: 1
Gender:Male  Submitted:2010-10-18, Days after onset: 15
Location:Ohio  Entered:2010-11-05, Days after submission: 18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA594BA UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1427Y UNLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Influenza like illness, Muscular weakness, Pain in extremity, Skin warm
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received Flu-pneumonia shots on 10/2/10 Tuesday at store. Next day (L) arm weakness noted. He felt fluish and arm hurt. Pr. to Sat it was red and hot and this increased to all around the arm - went to Urgent Care on Sunday and was started on antibiotics. Now is less swollen but still hurts.

VAERS ID:407154 (history)  Vaccinated:2010-11-02
Age:33.0  Onset:2010-11-03, Days after vaccination: 1
Gender:Female  Submitted:2010-11-06, Days after onset: 3
Location:California  Entered:2010-11-06
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) (NO BRAND NAME)UNKNOWN MANUFACTURER  IJLA
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJLA
Administered by: Private     Purchased by: Other
Symptoms: Dysaesthesia, Erythema, Injection site erythema, Injection site pain, Injection site rash, Pain in extremity, Pruritus, Rash papular, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Started with itching at my left wrist (same arm where vaccine given). The itchy area became a papular rash. Several patches of papular rash measuring up to 3-4 cm then appeared over the next 24 hours in the C5 and C6 dermatomal distribution. Then the rash became more sensitive/painful, with pain and dysesthesia throughout my left arm and hand. The rash is now becoming more vesicular with spreading erythema.

VAERS ID:407295 (history)  Vaccinated:2010-10-01
Age:33.0  Onset:0000-00-00
Gender:Male  Submitted:2010-11-08
Location:Florida  Entered:2010-11-08
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS111795P1 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: No adverse effects noted, report being filed on advise of physician advisor that pt mistakenly thought he was to get two shots like last year and came to office two times and recieved vaccination twice.

VAERS ID:407412 (history)  Vaccinated:2010-09-01
Age:33.0  Onset:2010-09-01, Days after vaccination: 0
Gender:Male  Submitted:2010-11-08, Days after onset: 68
Location:Unknown  Entered:2010-11-08
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: PHHY2010US72913
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Depression, Dizziness
SMQs:, Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad)
Write-up: Initial report received from a consumer (patient''s wife) on 25 Oct 2010: This patient received FLUVIRIN (batch number: not reported), intramuscularly in Sep 2010 (date unspecified). On an unspecified date in Sep 2010, the patient felt light headed within 24 hours which was persisted at the time of report also. The patient stated that his emergency room doctor has reported these symptoms were related to a depressive episode. Final outcome of the patient was reported as condition unchanged.

VAERS ID:407467 (history)  Vaccinated:2010-10-29
Age:33.0  Onset:2010-10-29, Days after vaccination: 0
Gender:Female  Submitted:2010-11-09, Days after onset: 11
Location:Puerto Rico  Entered:2010-11-09
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: DIABETES MELLITUS
Diagnostic Lab Data:
CDC Split Type: PR1037
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA531AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: REDNESS IN THE INSERTION AREA: LEFT DELTOID.

VAERS ID:407532 (history)  Vaccinated:2010-10-25
Age:33.0  Onset:2010-10-25, Days after vaccination: 0
Gender:Female  Submitted:2010-11-09, Days after onset: 15
Location:Idaho  Entered:2010-11-09
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3621GA0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Eye discharge, Eye swelling, Feeling hot, Lip swelling, Ocular hyperaemia, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Symptoms started around 2:30 - 3:00 PM. Throat swelling, eyes red and swollen, felt hot all over, eyes draining, lips swollen. Took Benadryl about 7 PM and in AM 10/26. Symptoms gone within 24 hrs.

VAERS ID:407817 (history)  Vaccinated:2010-11-09
Age:33.0  Onset:2010-11-09, Days after vaccination: 0
Gender:Female  Submitted:2010-11-10, Days after onset: 1
Location:Colorado  Entered:2010-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: N/A Still sick, feverish, bruse at injection site about the size of half of a doller bill. Bleeding occured immediately after injection, pain durring injection (not usual for me)
CDC Split Type:
Vaccination
Manufacturer
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Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Back pain, Chills, Immediate post-injection reaction, Injection site haematoma, Injection site haemorrhage, Injection site pain, Malaise, Pyrexia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: started feeling sick, started feeling feverish, back ache, weak, chills

VAERS ID:407825 (history)  Vaccinated:2010-10-30
Age:33.0  Onset:2010-11-04, Days after vaccination: 5
Gender:Female  Submitted:2010-11-10, Days after onset: 6
Location:Indiana  Entered:2010-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: no
Diagnostic Lab Data: Ultrasound
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3560CA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Abortion spontaneous, Ultrasound scan
SMQs:, Termination of pregnancy and risk of abortion (narrow)
Write-up: Missed Miscarriage

VAERS ID:407931 (history)  Vaccinated:2010-10-15
Age:33.0  Onset:2010-11-01, Days after vaccination: 17
Gender:Female  Submitted:2010-11-11, Days after onset: 10
Location:Maine  Entered:2010-11-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3575FA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abortion spontaneous, Drug exposure during pregnancy, Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (narrow)
Write-up: Pt suffered from vaginal bleeding - went to MD''s office & it was confirmed she had a miscarriage. They said the baby had been dead for a while. Patient''s fiance called the Rx concerned it was from flu shot.

VAERS ID:408135 (history)  Vaccinated:2009-11-02
Age:33.0  Onset:0000-00-00
Gender:Female  Submitted:2010-11-14
Location:Arizona  Entered:2010-11-12, 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: Hepatitis B
Preexisting Conditions: Hepatitis B
Diagnostic Lab Data: Liver - ultrasound are normal; CBC - normal; Urine - normal; Blood work for liver - normal (low virus); CT Scan - clear (normal)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP015AA0UNLA
Administered by: Private     Purchased by: Public
Symptoms: Blood test normal, Computerised tomogram normal, Diarrhoea, Full blood count normal, Neuralgia, Paraesthesia, Skin warm, Steatorrhoea, Ultrasound liver normal, Urine analysis normal, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (narrow), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tingling - everywhere on the body: one spot to the next. Heat Nerve pain everywhere on the brain spread from legs, arms, and other parts of the body. Diarrhea. Oil floated on the water when its time to go poo. Hives.

VAERS ID:408504 (history)  Vaccinated:2009-10-22
Age:33.0  Onset:2009-10-22, Days after vaccination: 0
Gender:Female  Submitted:2009-10-26, Days after onset: 4
Location:Pennsylvania  Entered:2010-11-12, Days after submission: 382
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: MEDI0009278
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Accidental exposure, Chills, Cough, Fatigue, Headache, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)
Write-up: A non-serious spontaneous report of accidental exposure, cough, chills, headache, fatigue, and nausea has been received from a consumer concerning herself, a 33-year-old female, involving H1N1. The patient''s past medical history and concomitant medications were not reported. The patient was exposed to H1N1 on 22-Oct-2009. The patient did not receive the vaccine. On 22-Oct-2009, the patient''s daughter was administered H1N1. The patient was holding her, and as the syringe was pulled from her daughter''s nose, her daughter took a deep breath and blew it into the patient''s face. The next day, 23-Oct-2009, the patient experienced a cough. That evening, the patient was "very ill" with chills, headache, fatigue, and nausea. The event of headache was resolved on 10/24/2009. The outcome for the other events was not reported. The patient indicated she did not receive the vaccine "but thinks the virus was transmitted from her daughter''s vaccination".

VAERS ID:408517 (history)  Vaccinated:2009-10-30
Age:33.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Female  Submitted:2010-09-09, Days after onset: 314
Location:Indiana  Entered:2010-11-12, Days after submission: 64
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: MEDI0009301
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500763P IN 
Administered by: Other     Purchased by: Other
Symptoms: Vaccination error
SMQs:, Medication errors (narrow)
Write-up: A non-serious report of "eye exposure to mist" was received from a licensed practical nurse concerning a 33-year-old female. The patient''s medical history was not reported. On 30-Oct-2009, some of the administered H1N1, Intranasal went in the patient''s eye. The eye was immediately flushed with water. There was no adverse event associated with this vaccination error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved.

VAERS ID:408652 (history)  Vaccinated:2009-10-27
Age:33.0  Onset:2009-10-29, Days after vaccination: 2
Gender:Female  Submitted:2009-11-04, Days after onset: 6
Location:California  Entered:2010-11-12, Days after submission: 373
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Anaemic
Preexisting Conditions: Patient never gets headache
Diagnostic Lab Data:
CDC Split Type: MEDI0009388
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Dizziness, Fatigue, Headache, Oropharyngeal pain, Throat irritation
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad)
Write-up: A non-serious spontaneous report of chest pressure, dizzy, tiredness, sore throat, tickle in throat and headache has been received from a 33-year-old female patient, subsequent to H1N1, Intranasal. The patients medical history included anemia. The patient denies history of headache. No concomitant medications were reported. On 27-Oct-2009, the patient received H1N1, Intranasal for an unspecified indication. On 29-Oct-2009, the patient experienced chest pressure, sore throat, tickle in her throat and tiredness. On 03-Nov-2009, patient experienced a headache on the right side of her head that persists. As stated by reporter most of the other symptoms had resolved but she was still tired. At the time of report she was feeling dizzy when she gets up. The patient recovered from the events of chest pressure, sore throat, tickle in her throat and headache. The events of dizzy and tiredness were not resolved.

VAERS ID:409629 (history)  Vaccinated:2010-03-30
Age:33.0  Onset:2010-03-30, Days after vaccination: 0
Gender:Female  Submitted:2010-03-31, Days after onset: 1
Location:Michigan  Entered:2010-11-12, Days after submission: 226
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: MEDI0010896
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500890P IN 
Administered by: Public     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: A non-serious spontaneous report of administration of expired product was received from a registered nurse/health professional concerning a 33-year-old female. Neither relevant medical history nor concomitant medications have been reported for this patient. The product expired on 29-Mar-2010. On 30-Mar-2010, the patient received expired H1N1, Intranasal for an unknown indication. There was no adverse event associated with this medication error; therefore, treatment and reporter causality assessments are not applicable and the event was considered to be resolved.

VAERS ID:409939 (history)  Vaccinated:2010-03-31
Age:33.0  Onset:2010-03-31, Days after vaccination: 0
Gender:Female  Submitted:2010-04-01, Days after onset: 1
Location:Ohio  Entered:2010-11-12, Days after submission: 225
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: MEDI0010934
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500890P0IN 
Administered by: Public     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: A non-serious spontaneous report of inadvertent administration of expired H1N1 was received from a registered nurse/health professional concerning a 33-year-old female. Neither relevant medical history nor concomitant medications have been reported for this patient. The original expiration date was 08-Apr-2010, which was reassigned to 29-Mar-2010. On 31-Mar-2010, the patient received the expired H1N1, Intranasal for an unknown indication. There was no adverse event associated with this medication error; therefore, treatment and reporter causality assessments are not applicable and the event was considered to be resolved.

VAERS ID:410486 (history)  Vaccinated:2009-10-27
Age:33.0  Onset:2009-10-27, Days after vaccination: 0
Gender:Female  Submitted:2009-11-16, Days after onset: 20
Location:Pennsylvania  Entered:2010-11-12, Days after submission: 361
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: MEDI0009529
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500779P IN 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: A non-serious spontaneous report of inadvertently given half dose of H1N1 was received from a nurse/health professional concerning a 33-year-old female. The patient''s medical history and concomitant medications were not reported. On 27-Oct-2009, the patient was inadvertently given half dose (0.1 ml) of H1N1, Intranasal. There was no adverse event associated with this medication error; therefore, treatment and reporter causality assessments are not applicable, and the event was considered resolved.

VAERS ID:410684 (history)  Vaccinated:2009-10-27
Age:33.0  Onset:2009-10-27, Days after vaccination: 0
Gender:Female  Submitted:2009-11-16, Days after onset: 20
Location:Pennsylvania  Entered:2010-11-12, Days after submission: 361
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: MEDI0009524
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500779P IN 
Administered by: Other     Purchased by: Other
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: A non-serious spontaneous report of inadvertently given half dose of H1N1 LAIV was received from a registered nurse/health professional concerning a 33-year-old female. The patient''s medical history and concomitant medications was not reported. On 27-Oct-2009, the patient was inadvertently given half dose of H1N1, Intranasal. There was no adverse event associated with this medication error; therefore, treatment and reporter causality assessments were not applicable, and the event was considered resolved.

VAERS ID:408265 (history)  Vaccinated:2010-11-08
Age:33.0  Onset:2010-11-09, Days after vaccination: 1
Gender:Male  Submitted:2010-11-13, Days after onset: 4
Location:Arizona  Entered:2010-11-13
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: Had surgery on Oct. 18th, 2010 on lung. resulted in doctor having to embolize part of his right lung which led to an infarction.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IJRA
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IJRA
Administered by: Unknown     Purchased by: Other
Symptoms: Adverse reaction, Arthralgia, Erythema, Injection site erythema, Injection site pain, Pain, Pain in extremity, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Body aches, joint pain, soreness at site, small red spot (size of a nickel) beginning around 8-10pm. Temp of 100.1F next morning (11/10) at 8am. Severe pain in arm in morning of 11/10 with continued body aches. Redness at site approximately 2 inches in diameter. Notified doctor and she told me what to be on the lookout for. Still in severe pain all over body through the night. Morning of 11/11, redness at site now covers the entire width of upper arm. Fever of 102.5F at 8am. Notified doctor. She called in prescription for cephalexin 250mg and took first pill at 4pm. Patient also had a previously scheduled CT Scan on 11/11 and pre medicates with Prednisone to combat a sensitivity to contrast dye. The Prednisone taken at 12pm actually helped alleviate symptoms from vaccine reaction. Cephalexin taken every 8 hrs along with Advil 600mg. Still sore during 11/12. Now it is 2:45pm on Saturday, 11/13. Pain somewhat less. Site is still red across the width of upper arm. Redness has been warm to the touch ever since symptoms began.

VAERS ID:408586 (history)  Vaccinated:2010-10-19
Age:33.0  Onset:2010-10-19, Days after vaccination: 0
Gender:Female  Submitted:2010-11-03, Days after onset: 15
Location:Illinois  Entered:2010-11-15, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS111809P1 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain radiating from immunization site down arm.

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