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Case Details (Sorted by Age)

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VAERS ID:530325 (history)  Vaccinated:2014-04-16
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:2014-05-07
Location:Massachusetts  Entered:2014-05-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vasotec; Atenolol; Folic acid; Hydrochlorothiazide; Metformin; Omeprazole; Pravastatin
Current Illness: Autologous Hematopoietic Stem Cell Transplant without Purging; Depression; Diabetes mellitus type 2; Hodgkin lymphoma; Hyperlipidemia; Hypertension; Myofascial pain syndrome; Pulmonary embolism
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Chest pain, Herpes zoster, Rash vesicular
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Dx''ed with herpes zoster 5/6/14. Tx with Valtrex 1 gm TID 7 days. Pt was seen in ER previous to PCP visit due to chest pain where vesicular rash later errupted.

VAERS ID:531309 (history)  Vaccinated:2014-05-15
Age:45.0  Onset:2014-05-16, Days after vaccination: 1
Gender:Female  Submitted:2014-05-19, Days after onset: 3
Location:California  Entered:2014-05-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: WELLBUTRIN; ZYRTEC; ADVAIR; LEVOXYL; DIOVAN; Triamterene
Current Illness: Asthma; Depression; HTN
Preexisting Conditions: Asthma; Depression; HTN; Pollen allergy
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH899AE IMRA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS793JR0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0087990SCLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30007400PO 
Administered by: Public     Purchased by: Public
Symptoms: Chills, Fatigue, Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth, Lymph node pain, Lymphadenopathy, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Client experienced redness (8" x 6") tenderness, warmth, swelling on upper (L) arm at the site on her arm where she received her PNEUMOVAX about 1d after receiving the vaccination. 2 days after she had swollen tender lymph nodes in neck, aches, fever (102 degrees)/chills, extreme fatigue. She still has silver dollar size hard tender bump at inj site - most is clearing by today 5/19/14.

VAERS ID:531564 (history)  Vaccinated:2014-04-17
Age:45.0  Onset:2014-04-17, Days after vaccination: 0
Gender:Male  Submitted:2014-05-21, Days after onset: 34
Location:Alabama  Entered:2014-05-21
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: SINGULAIR; BIAXIN; VERAMYST; BACTROBAN
Current Illness: Recurrent sinusitis
Preexisting Conditions: Allergic rhinitis; GERD; HTN; Conjunctivitis
Diagnostic Lab Data: Lumbar puncture; CT brain
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J010396 IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Computerised tomogram head, Headache, Injection site erythema, Injection site pain, Lumbar puncture, Pyrexia, Vaccination complication
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Received PNEUMOVAX Thurs A.M. - Developed redness and pain at injection site. Developed headache and fever. Treated with over counter Ibupro, TYL. No relief in 3 days. Went to E.R. Checked for meningitis. Was treated next day with prednisone by primary (Monday). Redness and fever diminished by Tues.

VAERS ID:531591 (history)  Vaccinated:2013-10-27
Age:45.0  Onset:2013-10-27, Days after vaccination: 0
Gender:Female  Submitted:2014-05-21, Days after onset: 206
Location:Missouri  Entered:2014-05-21
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium and Prozac
Current Illness: No
Preexisting Conditions: I was hard of hearing.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 0SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Cochlea implant, Deafness, Hypoacusis
SMQs:, Hearing impairment (narrow)
Write-up: Sounds started sounding muffled and then the next day I was completely deaf. I went to Hearing Specialist that Monday and they sent me to facility that next week and I received cortisone shot in ear drum and it did not help. I now have a cochlear implant.

VAERS ID:532498 (history)  Vaccinated:2014-05-14
Age:45.0  Onset:2014-05-14, Days after vaccination: 0
Gender:Unknown  Submitted:2014-05-29, Days after onset: 15
Location:Unknown  Entered:2014-05-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1405USA007890
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a 45 years old patient. On 14-MAY-2014 the 45 years old patient was vaccinated with ZOSTAVAX, 0.65 ml (lot# and route were unknown). No adverse effects reported. Additional information has been requested.

VAERS ID:532710 (history)  Vaccinated:2014-05-18
Age:45.0  Onset:2014-05-18, Days after vaccination: 0
Gender:Female  Submitted:2014-05-27, Days after onset: 9
Location:Wisconsin  Entered:2014-06-02, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV370A5UNRA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal discomfort, Cold sweat, Headache, Influenza like illness, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient received Anthrax vaccine on 5/18/14. Experienced cold sweats, nausea and headache. Also stated an upset stomach. Went to hospital ER on 5-19-14. Was treated for flu like symptoms and released. Given TYLENOL, ibuprofen and ZOFRAN.

VAERS ID:532959 (history)  Vaccinated:2014-06-03
Age:45.0  Onset:2014-06-03, Days after vaccination: 0
Gender:Female  Submitted:2014-06-05, Days after onset: 2
Location:Michigan  Entered:2014-06-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSN45BR0IMLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J0081530SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4688AA0IMRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0123760SCRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Pain, Sensation of heaviness, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: RED, SWOLLEN, WARM TO TOUCH, VERY SORE, HEAVY FEELING.

VAERS ID:533181 (history)  Vaccinated:2014-05-30
Age:45.0  Onset:2014-05-30, Days after vaccination: 0
Gender:Female  Submitted:2014-06-07, Days after onset: 8
Location:California  Entered:2014-06-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Unknown     Purchased by: Private
Symptoms: Abdominal discomfort, Diarrhoea, Fatigue, Headache, Nausea, Pain, Pyrexia, Tinnitus
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hearing impairment (narrow), Noninfectious diarrhoea (narrow)
Write-up: Nausea, headache, body aches, extreme fatigue, ringing in ears, tight knot in stomach, diarrhea, fever.

VAERS ID:533460 (history)  Vaccinated:2014-03-08
Age:45.0  Onset:2014-04-08, Days after vaccination: 31
Gender:Female  Submitted:2014-06-10, Days after onset: 63
Location:Pennsylvania  Entered:2014-06-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Had a tetanus shot given at the same time. Not sure of the type. 1 mg of Lorazapan and 10 mg of valium taken alternately per day.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Had a Dr. Appt on 05/08/14 with a Follow up on 7/8/14.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site atrophy, Injection site bruising, Injection site erythema, Injection site reaction, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Indentation at site of shot started out small and is now the size of a golf ball scaling, red and now bruising.

VAERS ID:533847 (history)  Vaccinated:2014-06-09
Age:45.0  Onset:2014-06-10, Days after vaccination: 1
Gender:Female  Submitted:2014-06-13, Days after onset: 3
Location:West Virginia  Entered:2014-06-13
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: Allergic to ibuprofen -$g hives
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4804AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Body temperature increased, Chills, Injection site erythema, Injection site warmth, Malaise, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Received TDaP vaccine at Employee Health on 6/9/2014 by Employee Health RN in (L) deltoid. Had chills, temperature of 103 and hot, red (L) arm with hives on arm the next day. Still feels a little sick but better.

VAERS ID:533880 (history)  Vaccinated:2014-02-28
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:2014-06-13
Location:California  Entered:2014-06-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH920AC1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Immune system disorder
SMQs:
Write-up: Patient claims that flu shot caused his immune system to attack his own body.

VAERS ID:534611 (history)  Vaccinated:2014-05-16
Age:45.0  Onset:2014-06-07, Days after vaccination: 22
Gender:Female  Submitted:2014-06-23, Days after onset: 16
Location:Texas  Entered:2014-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: strept test x 2; EKG, CT of the sinuses. Unknown if LFTs were done.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.J0085050IMLA
Administered by: Other     Purchased by: Private
Symptoms: Computerised tomogram head normal, Electrocardiogram normal, Fatigue, Oropharyngeal pain, Pyrexia, Streptococcus test negative, X-ray normal
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: went to urgent care facility after the first does of HBV vaccine for symptoms of sore throat, fever, extreme fatique. Did not aassocate symptoms with vaccine so recieved the second dose on 6/13/14. symptoms increased and employee returned to urgent on 6/14/14 and then to ER on 6/19/14. All xrays and labwork were negative.

VAERS ID:534827 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:2014-06-01
Gender:Female  Submitted:2014-06-24, Days after onset: 23
Location:Unknown  Entered:2014-06-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1406USA009847
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Eyelid disorder, Injection site erythema, Injection site reaction, Skin lesion
SMQs:, Extravasation events (injections, infusions and implants) (broad), Periorbital and eyelid disorders (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 45 year old female patient. Patient''s medical history and concurrent condition was none. On 16-JUN-2014 the patient was vaccinated with ZOSTER, 65 ml, subcutaneous. Patient''s concomitant medication was reported was reported as none. On an unknown date approximately in June 2014 the patient developed a reddened injection site the size of a silver dollar with one lesion at its border the size of the head of a pencil and that her eyelids felt heavy, but she was not tired. The reporter stated that the patient reported that she had seen an unspecified physician who prescribed prednisone and Loratidine. PQC was not filed. The outcome of the event was reported as not recovered/not resolved. Reporter's causality assessment was not provided. Additional information has been requested.

VAERS ID:534940 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:2014-06-25
Location:Unknown  Entered:2014-06-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Rubber sensitivity; Allergy to chemicals
Preexisting Conditions:
Diagnostic Lab Data: 2002, Mumps antibody test, tested negative; 2011, Mumps antibody test, tested negative
CDC Split Type: WAES1406USA008681
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Mumps antibody test negative
SMQs:
Write-up: This spontaneous report was received from a 45-year-old nurse practitioner (also a patient). No pertinent medical history reported. Drug allergies include Sulpha and latex allergy. The nurse reported that on an unknown date in 1970 (reported as early 70''s) she was vaccinated with MMR II human serum albumin (HSA), subcutaneous (dose not reported). The nurse stated that she had titres drawn in 2002 (exact date not reported) and tested negative for mumps. On an unknown date in 2002 the nurse reported that she was given a booster dose of MMR II subcutaneous. On an unknown date in 2011 she again had titres drawn and again tested negative. There was no significant disability or incapacity. There was no hospitalization required. The event was not life-threatening. No PQC involved. The outcome of the events was unknown. The causality of the event was unspecified. The case has been linked with the cases (same reporter link) # 1406USA012141 and 1406USA012138. Additional information has been requested.

VAERS ID:535133 (history)  Vaccinated:2013-09-24
Age:45.0  Onset:2013-09-24, Days after vaccination: 0
Gender:Female  Submitted:2014-06-06, Days after onset: 255
Location:California  Entered:2014-06-27, Days after submission: 21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: There were no other vaccinations administered on the same date. At the time of reporting, there were no concomitant medications, no allergies and medical history was unknown. The subject had received flu shots previously with no reactions to previous flu shots.
Diagnostic Lab Data: UNK
CDC Split Type: A1043815A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSJ2B320SCRA
Administered by: Public     Purchased by: Private
Symptoms: Extensive swelling of vaccinated limb, Incorrect route of drug administration, Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: This case was reported by a healthcare professional (nurse) and described the occurrence of extensive swelling of vaccinated limb in a 45-year-old female subject who was vaccinated with FLUARIX (GlaxoSmithKline). On 24 September 2013 the subject received 1st dose of FLUARIX (.5 ml, unknown route, right deltoid). On 24 September 2013, less than one day after vaccination with FLUARIX, the subject experienced extensive swelling of vaccinated limb, injection site redness, injection site pain and injection site warmth (described as fever on right arm). The nurse reported that the edema on the subject''s right arm at the injection site was 4 inches by 3 inches in size (75 by 101.6 millimeters). The nurse reported that the injection site pain as "pain, achy." At the time of reporting the events were unresolved. The healthcare professional considered the events were probably related to vaccination with FLUARIX. Follow-up information was received on 01 November 2013 via healthcare professional who reported the subject received FLUARIX via subcutaneous injection on 24 September 2013 and experienced an additional event of intramuscular formulation administered by other route. The healthcare professional did not attribute the events to medical history/ concurrent illness, lack of efficacy, erroneous administration or suspected transmission of an infectious agent via medicinal product, and considered the events not serious. On 1 October 2013, the extensive swelling of vaccinated limb, injection site redness, injection site pain and injection site warmth were resolved.

VAERS ID:535191 (history)  Vaccinated:2014-06-25
Age:45.0  Onset:2014-06-26, Days after vaccination: 1
Gender:Female  Submitted:2014-06-27, Days after onset: 1
Location:Maryland  Entered:2014-06-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Same~Varicella (no brand name)~1~44.33~Patient
Other Medications: Loestrin, Actonel
Current Illness: No
Preexisting Conditions: Allergic to cephalosporins
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Itchy, red, swollen area warm to the touch at injection sight.

VAERS ID:535394 (history)  Vaccinated:2014-06-16
Age:45.0  Onset:2014-06-16, Days after vaccination: 0
Gender:Male  Submitted:2014-06-30, Days after onset: 14
Location:Washington  Entered:2014-06-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHH139950IMLA
Administered by: Private     Purchased by: Public
Symptoms: Fatigue, Local reaction, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: He apparently had a severe local reaction to his Prevnar vaccine at our last appointment and developed a rash on his back that improved with topical steroids. He also was extremely fatigued for 5 days but is now feeling back to his baseline. I think his symptoms were all due to Prevnar and he will continue to monitor and let us know if he starts feeling different to his baseline.

VAERS ID:535860 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:2014-07-04
Location:Unknown  Entered:2014-07-04
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: BENLYSTA; Prednisone; PLAQUENIL; Methotrexate
Current Illness: Systemic lupus erythematosus
Preexisting Conditions: 07/2013, Herpes zoster
Diagnostic Lab Data:
CDC Split Type: WAES1407USA001423
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: This spontaneous report as received from a health professional via a medical science liaison, described the occurrence of shingles in a 45-year-old female patient with systemic lupus erythematosus. In 2013 the patient was vaccinated with a dose of VARIVAX (Merck). Other suspect therapies included BENLYSTA. Concomitant therapies included prednisone (manufacturer unknown), PLAQUENIL and methotrexate (manufacturer unknown). The patient received her first infusion of BENLYSTA (Variable dose) for systemic lupus erythematosus in July 2013. She received her second infusion of BENLYSTA as scheduled 2 weeks later (date was unknown) and 48 hours later in July 2013 she had a shingles outbreak. The outbreak was treated with antiviral medication and resolved (date was unknown). One month after, in August 2013, the outbreak resolved she received the VARIVAX (Merck) (lot#, dose, frequency were unspecified). Six weeks after she received the vaccine she had her third infusion of BENLYSTA. Within 24 to 36 hours she had another shingles outbreak. The outbreak was treated again and resolved. She experienced shingles after 4-5 infusions total. She received the VARIVAX (Merck) after only the first outbreak of shingles. Every time the outbreak was treated and resolved before trying the next infusion. After a total of 5-6 infusions of BENLYSTA (there was no shingles after the first infusion) the decision was made to discontinue her from BENLYSTA. The shingles that occurred after her last infusion of BENLYSTA was still in the process of resolving, but it had improved. The patient never made it out of the loading phase for BENLYSTA because they would have to wait for her shingles to resolve before another dose was administered. Treatment with BENLYSTA was discontinued on an unknown date. The health professional considered the event to be probably related to BENLYSTA. The health professional considered the event to be disabling and clinically significant (or requiring intervention). Additional information has been requested.

VAERS ID:536058 (history)  Vaccinated:2013-09-19
Age:45.0  Onset:2013-09-19, Days after vaccination: 0
Gender:Female  Submitted:2013-12-17, Days after onset: 89
Location:Unknown  Entered:2014-07-08, Days after submission: 202
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
DTP: DTP (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash.

VAERS ID:536421 (history)  Vaccinated:2014-06-10
Age:45.0  Onset:2014-06-10, Days after vaccination: 0
Gender:Female  Submitted:2014-07-11, Days after onset: 31
Location:Georgia  Entered:2014-07-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1406USA006120
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0170271IMLA
Administered by: Public     Purchased by: Public
Symptoms: Incorrect route of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a patient of unknown age and gender. On 10-JUN-2014 the patient was vaccinated with MMR II (one dose, 0.5ml, lot# and expiry date were not reported) that was administered intramuscularly. No adverse effect was reported. Follow up information as received from the registered nurse refers to the 45 year old female patient. The patient had no pre-existing allergies, birth defects or medical conditions. On an unknown date, the patient was vaccinated with the second dose of MMR II (lot number, dose, route, strength and indication were not reported). On 10-JUN-2014 the patient was vaccinated with the second dose of MMR II (lot # H017027, expired date 14-SEP-2014) (0.5 ml, in the left arm) intramuscularly instead of subcutaneously (S.Q.). The patient had no illness at time of vaccination. There was no relevant diagnostic tests or lab data reported. The outcome was reported as recovered by the reporter. Additional information is not expected.

VAERS ID:536470 (history)  Vaccinated:2014-06-03
Age:45.0  Onset:2014-06-03, Days after vaccination: 0
Gender:Female  Submitted:2014-07-12, Days after onset: 39
Location:North Carolina  Entered:2014-07-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No illness
Preexisting Conditions: None
Diagnostic Lab Data: Saw orthopedic Dr. on 07/08/2014. He recommended MRI.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Injected limb mobility decreased, Local swelling, Paraesthesia, Tenderness
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, tenderness loss of motion in left arm, burning and slight tingling.

VAERS ID:536732 (history)  Vaccinated:2014-06-26
Age:45.0  Onset:2014-06-26, Days after vaccination: 0
Gender:Unknown  Submitted:2014-07-15, Days after onset: 19
Location:Unknown  Entered:2014-07-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1407USA000236
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H011898 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse refers to a 45 year old patient of unknown gender. No information on their medical history, concurrent conditions or concomitant drugs was provided. On 26-JUN-2014 the patient was vaccinated with a dose of expired MMR II, lot # H011898, expiration date 25-JUN-2014 (dose, site and route of injection not reported). The patient did not report or demonstrate any adverse effects. Additional information has been requested.

VAERS ID:537003 (history)  Vaccinated:2014-07-11
Age:45.0  Onset:2014-07-12, Days after vaccination: 1
Gender:Female  Submitted:2014-07-18, Days after onset: 6
Location:California  Entered:2014-07-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: Blood test was done and patient had high white cell count. She was put on wide spectrum antibotics.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K004483 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU40804AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Blood test, Local swelling, Pyrexia, White blood cell count increased
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen left arm and fever. Husband took patient to hospital and was treated there.

VAERS ID:538045 (history)  Vaccinated:2014-07-17
Age:45.0  Onset:2014-07-17, Days after vaccination: 0
Gender:Male  Submitted:2014-07-29, Days after onset: 12
Location:Pennsylvania  Entered:2014-07-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Shoulder joint pain in arm that was vaccinated. Large area of pain around the injection site. Reddening of the skin 5-6cms around the injection site. 1st sign persisted for a week and half. The second two signs persisted for 4 days.

VAERS ID:538053 (history)  Vaccinated:2011-04-23
Age:45.0  Onset:2011-05-02, Days after vaccination: 9
Gender:Female  Submitted:2014-07-29, Days after onset: 1184
Location:Washington  Entered:2014-07-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No medication was taken at the time of vaccine
Current Illness: None
Preexisting Conditions: Tetracycline, penicillin
Diagnostic Lab Data: X-ray of neck region; MRI of the neck region
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PER: PERTUSSIS (NO BRAND NAME)EMERGENT BIOSOLUTIONS 1SYRRA
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER 2SYRRA
Administered by: Unknown     Purchased by: Private
Symptoms: Acupuncture, Muscle tightness, Musculoskeletal stiffness, Nuclear magnetic resonance imaging normal, X-ray normal
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: I had stiff neck muscles for about 3 months that started approx a week after tetanus shot. I had physical therapy, massage therapy, acupuncture followed by muscle relaxant and pain reliever (ibuprofen 800mg and acetaminophen+hydrocodone) prescribed. All the tests done including x-ray and MRI did not indicate any underlying illness. The symptoms (tight muscles in the neck region) were finally resolved after 3-4 months of the above treatments. I have been without symptoms since.

VAERS ID:538509 (history)  Vaccinated:2014-08-01
Age:45.0  Onset:2014-08-01, Days after vaccination: 0
Gender:Female  Submitted:2014-08-01, Days after onset: 0
Location:North Carolina  Entered:2014-08-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole; Viorele; Iron; Meloxicam; Vitamins
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Local swelling, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Arm burning and swelling. Hives. Returned to office where monitored and Benadryl administered. Ice pack helped swelling subside. Was given doctor contact info if problems occur later. Physician called later in the evening. Feeling better. Swelling slowly subsiding.

VAERS ID:540045 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:2014-08-10
Location:Virginia  Entered:2014-08-15, 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 known
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBUC220BA0IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS793JR0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt passed out after receiving vaccines. Sometime had passed, then pt passed out.

VAERS ID:540154 (history)  Vaccinated:2014-08-07
Age:45.0  Onset:2014-08-08, Days after vaccination: 1
Gender:Male  Submitted:2014-08-18, Days after onset: 10
Location:Unknown  Entered:2014-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Alprazolam; CRESTOR; INVOKANA; LANTUS; COZAAR; LUNESTA; Metformin; Metoprolol; Niacin; Omeprazole; Trasodone hydrochloride; VIIBRYD
Current Illness: Immunodeficiency; Major depression; Hypertension; Hyperlipidemia; Type 2 Diabetes mellitus
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1408USA007812
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K004930 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a nurse refers to a 45 year old male patient. The patient''s current conditions included Type 2 diabetes, hyperlipidemia, hypertension and major depressive disorder. The patient had no drug reactions/allergies. On 07-AUG-2014 the patient was vaccinated with a dose of PNEUMOVAX23, injection (lot # K004930, expired date: 06-MAR-2015) 0.5ml, intramuscularly in his right deltoid for immunocompromised patient. Concomitant therapies included alprazolam, CRESTOR, INVOKANA, LANTUS, losartan potassium (manufacturer unknown), LUNESTA, metformin, metoprolol, niacin, omeprazole, trazodone hydrochloride, VIIBRYD and "LAVASA". On 08-AUG-2014, the patient experienced redness around the injection site that had spread to two thirds of his upper arm. The patient came to office on 11-AUG-2014 to seek medical attention. The patient was diagnosed with cellulitis on 11-AUG-2014. The outcome of adverse event was reported as not recovered/not resolved. The relationship between adverse event and PNEUMOVAX23 was not reported. Additional information has been requested.

VAERS ID:541820 (history)  Vaccinated:2013-12-03
Age:45.0  Onset:2013-12-03, Days after vaccination: 0
Gender:Male  Submitted:2013-12-04, Days after onset: 1
Location:Arizona  Entered:2014-08-25, Days after submission: 263
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: 2013SE88696
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BH2029 IN 
Administered by: Other     Purchased by: Other
Symptoms: Expired drug administered
SMQs:
Write-up: A report has been received from a Pharmacist concerning a 45 year old, Male subject, who had been receiving Nasal FLUMIST QUADRIVALENT (Intranasal). FLUMIST QUADRIVALENT (Intranasal) started on 03-Dec-2013. The patient was administered expired FLUMIST on 03-Dec-2013. The outcome of the event of administration of expired FLUMIST is unknown. The report was considered to be non-serious.

VAERS ID:541125 (history)  Vaccinated:2014-08-25
Age:45.0  Onset:2014-08-26, Days after vaccination: 1
Gender:Female  Submitted:2014-08-26, Days after onset: 0
Location:North Carolina  Entered:2014-08-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra, Protonix, Lexapro, Advair, doxepin ibuprofen, Vivelle dot
Current Illness: Abrasion on right leg from treadmill accident
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4902BA SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Headache, Muscle tightness
SMQs:, Dystonia (broad)
Write-up: I am experiencing jaw joint tightness along with a headache. NP at pharmacy said I should report it since she has never heard of jaw pain with the Tdap shot.

VAERS ID:541442 (history)  Vaccinated:2014-08-24
Age:45.0  Onset:2014-08-25, Days after vaccination: 1
Gender:Female  Submitted:2014-08-27, Days after onset: 2
Location:Pennsylvania  Entered:2014-08-27
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
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS011011A0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red circle at administration site about 3" in circumference, itchy.

VAERS ID:542386 (history)  Vaccinated:2014-09-01
Age:45.0  Onset:2014-09-02, Days after vaccination: 1
Gender:Female  Submitted:2014-09-04, Days after onset: 2
Location:Iowa  Entered:2014-09-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1452041IM 
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient had injection site reaction (injection site became red, enlarged, and warm). She took ZYRTEC, BENADRYL and never decreased by 9-3-14, so she went to doctor. Swelling hasn''t gotten any larger, but it hasn''t gone down. Dr told her it is an injeciton site reaction and continue BENADRYL.

VAERS ID:542950 (history)  Vaccinated:2013-10-27
Age:45.0  Onset:2013-10-28, Days after vaccination: 1
Gender:Female  Submitted:2014-09-04, Days after onset: 311
Location:Unknown  Entered:2014-09-08, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NEXIUM; PROZAC
Current Illness: Unknown
Preexisting Conditions: Hypoacusis; Cochlea implant
Diagnostic Lab Data:
CDC Split Type: PHHY2014US090181
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Condition aggravated, Deafness, Hypoacusis
SMQs:, Hearing impairment (narrow)
Write-up: Case number PHHY2014US090181 is an initial spontaneous report received from a consumer via the Vaccine Adverse Event Reporting System (VAERS reference number: 531591) website on 22 Jul 2014 and a follow up report received from the consumer via VAERS on 27 Aug 2014 and a follow up report from the VAERS received on 03 Sep 2014. This report refers to a 45-year-old female patient. Her medical history included hard of hearing. Concomitant medications included NEXIUM and PROZAC. She was vaccinated with FLUVIRIN, (batch number: not reported) in the left arm on 27 Oct 2013. On the same date after vaccination, sounds starting sounding muffled and then next day she was completely deaf. She went to a hearing specialist and she received cortisone shot in the ear drum which did not help. She had a cochlear implant. The final outcome of the event was reported as condition unchanged. The consumer reported the events as serious due to permanent disability. The causality of the event was not reported. Follow up report received from the consumer via VAERS on 27 Aug 2014: Updated suspect vaccine coding from Seasonal Influenza vaccine to FLUVIRIN. Follow up report received from the consumer via VAERS on 03 Sep 2014: Added concomitant medications.

VAERS ID:543580 (history)  Vaccinated:2014-09-09
Age:45.0  Onset:2014-09-10, Days after vaccination: 1
Gender:Male  Submitted:2014-09-11, Days after onset: 1
Location:California  Entered:2014-09-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Metformin; Atorvastatin
Current Illness: No
Preexisting Conditions: Diabetes; hyperlipidemia
Diagnostic Lab Data: WBCs, 19.2; 12%, bands; UA, (-); CXR, (-)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14126012UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0096890UNRA
Administered by: Private     Purchased by: Private
Symptoms: Band neutrophil percentage increased, Chest X-ray normal, Loss of consciousness, Pneumonia, Pyrexia, Urine analysis normal, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Patient received influenza and pneumococcal vaccine on 9/9/14. Yesterday, 9/10/14, patient had a fever of 102 and then passed out this morning after having a BM. Patient''s wife called 911. Pt went to ER and diagnosed with pneumonia.

VAERS ID:543521 (history)  Vaccinated:2014-09-02
Age:45.0  Onset:2014-09-03, Days after vaccination: 1
Gender:Female  Submitted:2014-09-05, Days after onset: 2
Location:New York  Entered:2014-09-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID; PRILOSEC
Current Illness: None
Preexisting Conditions: PCN allergy; Hypothyroidism; GERD
Diagnostic Lab Data: No testing
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4965AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness and swelling 1st with pruritus. Onset mild pain day 3 post administration no fever or chills; no wheezing or dysphagia.

VAERS ID:543788 (history)  Vaccinated:2014-09-12
Age:45.0  Onset:2014-09-12, Days after vaccination: 0
Gender:Female  Submitted:2014-09-15, Days after onset: 3
Location:Missouri  Entered:2014-09-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 100mg daily; Maxalt 10mg prn migraine; Mucinex D BID; Excedrin extra strength prn; MVI
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Seen at PCP office to confirm on 9/15/14 - area is pale red 3"x4" in size, no further induration.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI172AB2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Injection site erythema, Pallor
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Erythema surrounding injection site and then on 9/13/14 erythema worsened and induration noted. Put ice on it immediately.

VAERS ID:543804 (history)  Vaccinated:2014-07-21
Age:45.0  Onset:2014-07-24, Days after vaccination: 3
Gender:Female  Submitted:2014-09-15, Days after onset: 53
Location:Connecticut  Entered:2014-09-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.K007177 SCLA
Administered by: Other     Purchased by: Private
Symptoms: Cellulitis
SMQs:
Write-up: Cellulitis.

VAERS ID:543848 (history)  Vaccinated:2014-08-21
Age:45.0  Onset:2014-08-21, Days after vaccination: 0
Gender:Female  Submitted:2014-08-31, Days after onset: 10
Location:Kentucky  Entered:2014-09-15, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT576060UNRA
Administered by: Other     Purchased by: Military
Symptoms: Dizziness, Eye movement disorder, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow)
Write-up: Dizziness, vomiting, involuntary rapid movement side to side in both eyes.

VAERS ID:543980 (history)  Vaccinated:2014-09-16
Age:45.0  Onset:2014-09-16, Days after vaccination: 0
Gender:Female  Submitted:2014-09-17, Days after onset: 1
Location:Rhode Island  Entered:2014-09-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.CH20612IN 
Administered by: Military     Purchased by: Military
Symptoms: Eye pruritus
SMQs:, Anaphylactic reaction (broad)
Write-up: Patient had itchiness of the eyes shortly after receiving Flumist until the time the patient took some Benadryl at around 9PM the same day.

VAERS ID:544454 (history)  Vaccinated:2014-09-15
Age:45.0  Onset:2014-09-16, Days after vaccination: 1
Gender:Male  Submitted:2014-09-18, Days after onset: 2
Location:Indiana  Entered:2014-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: May give on site. Patient requests this due to 4 episodes of herpes zoster ophthalmicus. He''s aware it is off-label for his age group.
Preexisting Conditions: Pt has shingles previously x 4 episodes zoster ophthalmicus
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.K0003260SCLA
Administered by: Other     Purchased by: Private
Symptoms: Drug administered to patient of inappropriate age, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left arm 6" x 4" oblong circle of red, warm, swollen, painful around site of injection.

VAERS ID:544696 (history)  Vaccinated:2014-09-18
Age:45.0  Onset:2014-09-18, Days after vaccination: 0
Gender:Female  Submitted:2014-09-19, Days after onset: 1
Location:North Carolina  Entered:2014-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril
Current Illness: None besides allergies - sore throat.
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1456030UNLA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Eye discharge, Ocular hyperaemia, Pain
SMQs:, Anaphylactic reaction (broad), Glaucoma (broad)
Write-up: Both of patients eyes turned "bloodshot" red. There were yellow residues in the corner of eyes. Patient also experienced some full body aches and chills. Patient took some Ibuprofen, 1/2 BENADRYL, Vitamin C.

VAERS ID:544764 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:2014-09-20
Location:Ohio  Entered:2014-09-22, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT59907 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K010016 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4695AA IMRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Immediate post-injection reaction, Induration, Local swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Arm immediately hard/red swollen. No other issues. Went home. Took BENADRYL. Arm swelled shoulder to elbow. Went to ER. Given steroid tx. Pt ok, swelling down.

VAERS ID:544773 (history)  Vaccinated:2014-09-17
Age:45.0  Onset:2014-09-17, Days after vaccination: 0
Gender:Female  Submitted:2014-09-20, Days after onset: 3
Location:Virginia  Entered:2014-09-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.K000455 IMAR
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Pain, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Right upper arm/deltoid, redness, very painful swelling, area is hot to touch, approximately 8cm x 7cm.

VAERS ID:545137 (history)  Vaccinated:2014-09-22
Age:45.0  Onset:2014-09-23, Days after vaccination: 1
Gender:Female  Submitted:2014-09-25, Days after onset: 2
Location:Minnesota  Entered:2014-09-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: SINUS ISSUES
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS7LE2S IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0044830IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Local swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: PATIENT''S LEFT ARM BECAME VERY RED, SWOLLEN, AND TENDER.

VAERS ID:545220 (history)  Vaccinated:2014-09-23
Age:45.0  Onset:2014-09-24, Days after vaccination: 1
Gender:Female  Submitted:2014-09-25, Days after onset: 1
Location:Minnesota  Entered:2014-09-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: High blood pressure medication; Atorvastatin; Metformin; Luvox
Current Illness: No
Preexisting Conditions: Type II Diabetes; High Blood Pressure
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS7LE2S IMRA
Administered by: Other     Purchased by: Public
Symptoms: Body temperature increased, Chills, Headache, Pain
SMQs:, Neuroleptic malignant syndrome (broad)
Write-up: Severe Chills. Temperature of 101. Severe body aches. Severe headache.

VAERS ID:545310 (history)  Vaccinated:2014-09-24
Age:45.0  Onset:2014-09-25, Days after vaccination: 1
Gender:Female  Submitted:2014-09-26, Days after onset: 1
Location:Texas  Entered:2014-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1452230IMLA
Administered by: Private     Purchased by: Private
Symptoms: Feeling abnormal, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: "Don''t feel right", red, warm, swollen at injection site.

VAERS ID:545323 (history)  Vaccinated:2014-09-23
Age:45.0  Onset:2014-09-24, Days after vaccination: 1
Gender:Female  Submitted:2014-09-24, Days after onset: 0
Location:Vermont  Entered:2014-09-26, 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: Oxycodone; Ropinirole; Morphine ER; Perphenazine; Cyclobenzaprine; Ondansetron; Perphenazine
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Pt was seen at ER then discharfed home same day.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14113010IMAR
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0041960IMAR
Administered by: Other     Purchased by: Private
Symptoms: Chills, Injection site reaction, Rash macular
SMQs:, Hypersensitivity (narrow)
Write-up: Patient''s husband reported that pat experienced chills and had a series of red blotches around the site where the injection occurred. Symptoms occurred approx 24 hrs after vaccine.

VAERS ID:545740 (history)  Vaccinated:2014-09-24
Age:45.0  Onset:2014-09-24, Days after vaccination: 0
Gender:Female  Submitted:2014-09-26, Days after onset: 2
Location:New Jersey  Entered:2014-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DIOVAN; ARMOUR Thyroid
Current Illness: None Known
Preexisting Conditions: Dx: Hypothyroidism, Fabry''s disease; Allergies: BACTRIM, aspirin, ADVIL
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT58306 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dysphagia, Dyspnoea, Hypoaesthesia, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: 9/24/14 2:30 pm sx: dizziness, difficulty breathing and swallowing, felt like "throat was closing", nausea, numbness in both hands (Lt worse than Rt); no hives/rash, no audible wheezing. TX: O2, 1.5L face mask, BENADRYL 25mg IM, Rt delt at 2:30 pm. EPIPEN 0.3 mg, IM (left thigh) at 2:53 pm. 3:05 pm to ER, via ambulance.

VAERS ID:545475 (history)  Vaccinated:2014-09-26
Age:45.0  Onset:2014-09-27, Days after vaccination: 1
Gender:Male  Submitted:2014-09-28, Days after onset: 1
Location:Oregon  Entered:2014-09-28
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: HTN
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14515P IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J015868 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4939AA IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Influenza like illness, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Flu like symptoms -fever, bodyaches.

VAERS ID:545945 (history)  Vaccinated:2014-03-03
Age:45.0  Onset:2014-03-06, Days after vaccination: 3
Gender:Male  Submitted:2014-09-29, Days after onset: 206
Location:Unknown  Entered:2014-09-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Computered tomography (CAT scan) (in approximately June 2014 reported also as: 2 to 3 months ago): results unknown.
CDC Split Type: WAES1409USA011933
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC. 1IMUN
Administered by: Other     Purchased by: Other
Symptoms: Computerised tomogram, Dizziness, Immediate post-injection reaction, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a 45 male patient refers to himself. There was no pertinent medical history and drug reaction or allergies. On 31-JAN-2014 the patient was vaccinated by his physician with the first dose of RECOMBIVAX HB (injection, strength: 10mcg/l ml, intramuscular, dose: 1 ml, lot#: J006511 expiration date: 26-JAN-2016) for prevention of infection caused by all known subtypes of the hepatitis B virus. On 03-MAR-2014 the patient was vaccinated by his physician with the second dose of RECOMBIVAX HB (injection, strength: 10mcg/1 ml, intramuscular, dose: 1 ml, lot# reported as: J012565, expiration date reported as: 03-FEB-2016) also for prevention of infection caused by all know subtypes of the hepatitis B virus. There was no concomitant medications. On 31-JAN-2014 the patient experienced dizziness for "about a week" (reported also as: starting immediately after the injection). On 06-MAR-2014, the patient experienced muscle pain and weakness throughout his whole body (reported also as beginning "about three days" after the second injection). The patient reported that muscle pain felt like "after heavy workout" describing it as pain was felt more intensely while moving his arms and legs. The patient also stated that "any normal muscle pain would last longer than normal like upwards of a week". There was computered tomography (CAT) scan performed in approximately June 2014 (reported as: "2 to 3 months ago") but the results were not provided. The therapy with RECOMBIVAX HB was discontinued on 03-MAR-2014 and the patient did not recover from the events of muscle pain and weakness throughout his whole body. The patient''s condition did not improve. The outcome of he experienced dizziness for about a week starting immediately after the injection was recovered/resolved. There was no treatment given for the reported events. The patient sought medical attention in approximately September 2014 (reported also as "about week ago") by returning to his physician who referred him to the rheumatologist. The relatedness between the events and the therapy with RECOMBIVAX HB was not reported. Additional information has been requested.

VAERS ID:546130 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:2014-09-30
Location:Unknown  Entered:2014-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Selective IgA immunodeficiency
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1409USA010192
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Antibody test negative
SMQs:
Write-up: This spontaneous report as received from medical assistant via other company refers to a 45 year old female adult patient. Patient''s concurrent conditions included low IgA levels. On an unknown date the patient was vaccinated with PNEUMOVAX 23 (dose and route unspecified). Concomitant medications were unknown. The patient had no antibody response. The medical assistant reported that the immunologist recommended PREVNAR 13. The reporter asked the appropriate dose of PREVNAR 13 for the patient and whether they get an repeat dose at a later time. The outcome of the events was unknown. The causality of the events with PNEUMOVAX 23 was not reported. Additional information has been requested.

VAERS ID:546040 (history)  Vaccinated:2014-09-26
Age:45.0  Onset:2014-09-26, Days after vaccination: 0
Gender:Female  Submitted:2014-10-01, Days after onset: 5
Location:Arizona  Entered:2014-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1412121 IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: 2hrs following vaccination myalgias began, getting progressively worse, eventually severe, resolved 10/1/14.

VAERS ID:546674 (history)  Vaccinated:2012-08-03
Age:45.0  Onset:2012-08-06, Days after vaccination: 3
Gender:Female  Submitted:2012-11-16, Days after onset: 102
Location:Florida  Entered:2014-10-01, Days after submission: 683
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Estrogens conjugate; Lorazepam; Topiramate; Hydroxyzine HCL; Albuterol; Flunisolide; Hydroxypropyl ME cellulose; Polyvinyl alcohol; Simvastatin; Bupropion HCL; Meloxicam; Azelastine
Current Illness: No acute illness
Preexisting Conditions: Osteoarthrosis involving the knee; Cough; Dysphonia; Chronic laryngitis; Positive PPD; Migraine, unspecified, without ment; Chondromalacia of patella; Ulnar neuropathy; Depression; Allergies; Hyperlipidemia; Memory loss; Other disorders of menstruation; and Spasms; Allergies/ADRs: DARVOCET-N, Tramadol, Nortriptyline, VICODIN, NSAIDS, Eggs, Sweet potatoes, Beans, Chocolate, Aspartame, Monosodium Glutamate
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU3867DA UNLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Back pain, Body temperature increased, Chills, Hypoaesthesia, Local swelling
SMQs:, Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Pt states she had a reaction to the TD shot. She states she was achy in all her joints, back, numbness in all extremities, arm was swollen and continues but not as bad, Temp of 101.4 with chills and she has never had a reaction before. Pt still doesn''t feel well but is improving.

VAERS ID:546121 (history)  Vaccinated:2014-09-26
Age:45.0  Onset:2014-09-26, Days after vaccination: 0
Gender:Female  Submitted:2014-10-02, Days after onset: 6
Location:New York  Entered:2014-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None reported
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI188AA0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Cough, Face oedema, Periorbital oedema
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow)
Write-up: Barking cough relieved with Albuterol Nebulizer treatment then next morning facial and peri-orbital edema reported.

VAERS ID:546186 (history)  Vaccinated:2014-10-02
Age:45.0  Onset:2014-10-02, Days after vaccination: 0
Gender:Female  Submitted:2014-10-02, Days after onset: 0
Location:D.C.  Entered:2014-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None.
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Cough, Dizziness, Immediate post-injection reaction, Injection site swelling, Throat irritation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Immediately developed swelling at site of injection; twenty minutes later developed lightheadedness, scratchy throat, emesis, and coughing. Received IM epinephrine, prednisone, diphenhydramine, ranitidine, prednisone. Symptoms resolved within minutes of receiving epinephrine.

VAERS ID:546244 (history)  Vaccinated:2013-10-10
Age:45.0  Onset:2013-10-14, Days after vaccination: 4
Gender:Female  Submitted:2014-10-02, Days after onset: 353
Location:New Hampshire  Entered:2014-10-02
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Migraines since 2003
Diagnostic Lab Data: Thorough blood work including Lyme, gluten, thyroid and every general test. Only thing not right was vitamin D levels were low. MRIs of brain and spinal cord, x rays,
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR56108 IMAR
Administered by: Other     Purchased by: Private
Symptoms: Blood test normal, Borrelia test negative, Fatigue, Hypoaesthesia, Joint stiffness, Muscle fatigue, Myalgia, Nuclear magnetic resonance imaging brain normal, Nuclear magnetic resonance imaging spinal normal, Pain in extremity, Paraesthesia, Periarthritis, Somnolence, Thyroid function test normal, Tremor, Vitamin D decreased, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Eosinophilic pneumonia (broad), Arthritis (narrow)
Write-up: First, shock-like pains in leg for almost a month, then in same side developed numbness, tingling, other parasthesias, muscle pain, muscle fatigue, muscle shaking, general fatigue, sleepiness. After a couple of months I gradually developed a severe frozen shoulder, same side and other joint stiffness worsened as well. Almost a year later I continue to suffer and left side is also developing some symptoms now. Have had loads of tests done including MRIs, xrays, blood work, and they have not found any disease they (neurologist, rheumatologist, primary care) can diagnose, but I still suffer. This is not a complete list of symptoms -too long to remember them all.

VAERS ID:546894 (history)  Vaccinated:2014-08-25
Age:45.0  Onset:2014-08-25, Days after vaccination: 0
Gender:Female  Submitted:2014-10-02, Days after onset: 38
Location:Unknown  Entered:2014-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Drug hypersensitivity
Preexisting Conditions: Mycobacterium avium complex infection; SULFA, Drug hypersensitivity
Diagnostic Lab Data: Blood test (August 2014): normal
CDC Split Type: WAES1409USA001530
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K004148 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Blood test normal, Chills, Dyspnoea, Headache, Hyperhidrosis, Hypersensitivity, Local swelling, Pain, Pyrexia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 45 year old female patient with allergy to sulfa. The patient''s medical history included Mycobacterium avium complex (MAC) infection. The patient''s past drug included SULFA. On 25-AUG-2014 the patient was vaccinated with a dose of PNEUMOVAX 23 (lot # K004148, expiration date: 10-MAY-2015, 0.5 ml, intramuscular in the right upper arm for vaccination). On 25-AUG-2014, the patient experienced adverse effects. By evening of 25-AUG-2014 the patient had body aches, headache, sweats, chills, shortness of breath, fever, right arm swelling. The patient also vomited once. On 26-AUG-2014, the patient sought medical attention by going to the emergency room of a different hospital. Blood work drawn (unspecified date in August 2014) was normal. The patient was diagnosed as severe allergic reaction to PNEUMOVAX 23. It was specified what type of treatment was given and the patient was not hospitalized. The outcome of the event was unknown. This is one of several reports received from the same reporter. Additional information has been requested.

VAERS ID:547125 (history)  Vaccinated:2014-09-26
Age:45.0  Onset:2014-09-27, Days after vaccination: 1
Gender:Male  Submitted:2014-10-02, Days after onset: 5
Location:Arkansas  Entered:2014-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14504 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0078240SCLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Injection site nodule, Local swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient developed a big knot, size of a baseball at the injection site. The whole arm was swollen and red starting day ! after injection. Patient received antibiotics from his PCP two days after injection. Swelling is subsiding as of day 5.

VAERS ID:546575 (history)  Vaccinated:2014-09-30
Age:45.0  Onset:2014-10-01, Days after vaccination: 1
Gender:Female  Submitted:2014-10-03, Days after onset: 2
Location:Kentucky  Entered:2014-10-03
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) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS14135010UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0066810UNLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient reported redness, swelling, paiin, and fever after getting a flu and pneumonia shot in the left arm.

VAERS ID:546648 (history)  Vaccinated:2014-10-03
Age:45.0  Onset:2014-10-04, Days after vaccination: 1
Gender:Female  Submitted:2014-10-06, Days after onset: 2
Location:Arizona  Entered:2014-10-06
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
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI191AA IM 
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K007826 IM 
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Injection site rash, Injection site swelling, Night sweats, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Localized rash and swelling at site of injection. Patient reports fever and night sweats over the weekend. Patient also reports soreness at site of injection, too.

VAERS ID:546749 (history)  Vaccinated:2014-10-04
Age:45.0  Onset:2014-10-04, Days after vaccination: 0
Gender:Male  Submitted:2014-10-06, Days after onset: 2
Location:Maine  Entered:2014-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS1602340IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Pain, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, swelling, hot to the touch, painful. Advised ice pack and appointment with PCM for further care.

VAERS ID:547332 (history)  Vaccinated:2003-02-13
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:2014-10-02
Location:D.C.  Entered:2014-10-06, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Activities of daily living impaired, Arthralgia, Back pain, Chronic fatigue syndrome, Fatigue, Fibromyalgia, Myalgia, Neck pain, Poor quality sleep
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: Patient reports she received 5 of the 6-shot vaccine series in 2002. After the 2nd or 3rd dose she began to develop aching in the muscles and joints. The symptoms continued and she evolved to experiencing pain in the upper and lower back, hips, SI joints, and neck, as well as fatigue interfering with functioning, and unrefreshing sleep. She reports she was evaluated by rheumatology in 2011 and diagnosed with fibromyalgia. In the course of this evaluation multiple other conditions were ruled out including autoimmune disease, ankylosing spondylitis, psoriatic arthritis (employee has psoriasis), and Ehlers Danlos syndrome (which is in her family history). Fibromyalgia syndrome continues today. Patient also meets the 2012 International case Definition for Chronic Fatigue Syndrome.

VAERS ID:548517 (history)  Vaccinated:2014-10-07
Age:45.0  Onset:2014-10-08, Days after vaccination: 1
Gender:Female  Submitted:2014-10-08, Days after onset: 0
Location:Texas  Entered:2014-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI185AA0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Local swelling, Tenderness
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling to (R) side of neck with tenderness at and just above collar bone.

VAERS ID:547347 (history)  Vaccinated:2014-10-05
Age:45.0  Onset:2014-10-06, Days after vaccination: 1
Gender:Male  Submitted:2014-10-09, Days after onset: 3
Location:Florida  Entered:2014-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1411601 IMRA
Administered by: Other     Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient developed a rash all over arms and chest the morning after receiving the shot. He took 2 doses of Benadryl and the rash subsided.

VAERS ID:547399 (history)  Vaccinated:2013-01-15
Age:45.0  Onset:2013-01-19, Days after vaccination: 4
Gender:Female  Submitted:2014-10-10, Days after onset: 628
Location:Michigan  Entered:2014-10-10
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benadryl; Lyrica; Baclofen; Wellbutrin
Current Illness: No
Preexisting Conditions: Allergies to multiple medications; codeine, Flexeral, Bactrim, e-mycin, prednisone, Singulair
Diagnostic Lab Data: Blood work, EMG, pulmonary function testing. Muscle biopsy. Referral to another facility for 2nd opinion.
CDC Split Type:
Vaccination
Manufacturer
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FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSAFLUA690AA0SYRLA
Administered by: Public     Purchased by: Other
Symptoms: Biopsy muscle, Blood test, Dyspnoea, Electromyogram, Headache, Local swelling, Muscular weakness, Myalgia, Pulmonary function test, Swelling face, Urticaria
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Hives, headache, muscle pain. 5 days later, Face and neck swelling. Followed by shortness of breath and muscle weakness. Continuing still 21 months later.

VAERS ID:547448 (history)  Vaccinated:2014-10-06
Age:45.0  Onset:2014-10-06, Days after vaccination: 0
Gender:Female  Submitted:2014-10-10, Days after onset: 4
Location:Pennsylvania  Entered:2014-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hydrochlorothiazide and simvastatin
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Other     Purchased by: Public
Symptoms: Activities of daily living impaired, Dizziness, Dysphonia, Fatigue, Oropharyngeal pain, Pain
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Vestibular disorders (broad)
Write-up: I felt achy and fatigue on Monday evening, the night of the shot. I felt achy, fatigue and my throat began to hurt on Tuesday. On Wednesday (three days after the shot,) my throat hurt and my voice started to become horse. Thursday, my voice was so horse it hurt to talk. Friday, I stayed home from work because I couldn''t really talk at all. I felt fatigue, dizziness and achy.

VAERS ID:547450 (history)  Vaccinated:2014-10-09
Age:45.0  Onset:2014-10-09, Days after vaccination: 0
Gender:Male  Submitted:2014-10-10, Days after onset: 1
Location:Ohio  Entered:2014-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Back pain, Headache, Influenza like illness, Injection site pain, Mobility decreased, Muscular weakness, Neck pain, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Extreme soreness at injection site (right arm) no redness was visible. As the evening progressed this developed into extreme weakness in the right arm, almost complete inability to lift the arm. This then developed into overall body soreness in all joints but especially lower back, neck and knees along with fever and headache. Basically extreme flu like symptoms with the extreme soreness and weakness of the right arm.

VAERS ID:549546 (history)  Vaccinated:2014-10-07
Age:45.0  Onset:2014-10-07, Days after vaccination: 0
Gender:Female  Submitted:2014-10-10, Days after onset: 3
Location:Ohio  Entered:2014-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDT518081IMAR
Administered by: Unknown     Purchased by: Other
Symptoms: Eye swelling, Night sweats, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient states that her arm was itching, she feels aching, her eye was itching and sweat at night. She woke up with swollen eyes and went to emergency room.

VAERS ID:547510 (history)  Vaccinated:2014-10-12
Age:45.0  Onset:2014-10-12, Days after vaccination: 0
Gender:Female  Submitted:2014-10-12, Days after onset: 0
Location:North Carolina  Entered:2014-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None acknowledged
Preexisting Conditions: Nnone disclosed
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI197AC IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Eye movement disorder, Injection site erythema, Injection site swelling, Injection site warmth, Opisthotonus
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Ocular motility disorders (narrow)
Write-up: Injection site became swollen, red and hot. Patient was questioned about reactions to injections before. Patient discussed being treated for hives related to allergic reaction when having infections. Patient then said they felt faint. I retrieved Epi-Pen and 0.3mg was administered. Patient then bucked back and her eyes rolled back in head. Patient then started to speak, but had no recollection of the possible seizure. She was very relaxed but speaking when the EMS arrived. They took her vitals, that were low but normal. She was referred to go to the emergency room by the EMS.

VAERS ID:549615 (history)  Vaccinated:2014-10-11
Age:45.0  Onset:2014-10-11, Days after vaccination: 0
Gender:Female  Submitted:2014-10-11, Days after onset: 0
Location:Idaho  Entered:2014-10-12, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS160234 UNUN
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSN45BR0UNUN
Administered by: Military     Purchased by: Military
Symptoms: Incorrect dose administered
SMQs:
Write-up: None.

VAERS ID:547639 (history)  Vaccinated:2014-10-10
Age:45.0  Onset:2014-10-11, Days after vaccination: 1
Gender:Female  Submitted:2014-10-13, Days after onset: 2
Location:New Mexico  Entered:2014-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Had a bad headache 24 hrs after the vaccine. 48 hrs after vaccine had bad diarrhea and hives all over my arms and legs.
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRRA
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Headache, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Bad headache. Diarrhea. Hives.

VAERS ID:550614 (history)  Vaccinated:2014-10-07
Age:45.0  Onset:2014-10-08, Days after vaccination: 1
Gender:Female  Submitted:2014-10-10, Days after onset: 2
Location:Pennsylvania  Entered:2014-10-13, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Laceration
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
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Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURC4695AA UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site induration, Injection site pain, Injection site swelling, Injection site warmth, Nausea
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: Left arm swelling, pain, induration, tenderness and warmth in 7.5 cm x 6 cm area on left upper arm lateral aspect, also had nausea.

VAERS ID:550637 (history)  Vaccinated:2014-10-02
Age:45.0  Onset:2014-10-02, Days after vaccination: 0
Gender:Female  Submitted:2014-10-09, Days after onset: 7
Location:Maryland  Entered:2014-10-13, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Latex (latex free vaccine)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED1064922A0UNLA
Administered by: Public     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Facial hives - requiring ED visit -$g IV steroids, IV BENADRYL and IV PEPCID. Was monitored for 2 hours in ED.

VAERS ID:552106 (history)  Vaccinated:2014-10-10
Age:45.0  Onset:2014-10-11, Days after vaccination: 1
Gender:Female  Submitted:2014-10-14, Days after onset: 3
Location:Ohio  Entered:2014-10-15, 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: Metformin; Aldactone; Effexor XR
Current Illness: None
Preexisting Conditions: Penicillin; codeien; latex; diabetic/3 sinus surgeries
Diagnostic Lab Data: None; Oral temp =98.2 10/14/14 (9 AM)
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI189AC IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Low grade temperature, rash on arms/chest, injection site red swollen and warm to touch.

VAERS ID:552139 (history)  Vaccinated:2014-10-13
Age:45.0  Onset:2014-10-14, Days after vaccination: 1
Gender:Female  Submitted:2014-10-14, Days after onset: 0
Location:Virginia  Entered:2014-10-15, 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: Iodine; shellfish; penicillin; sulfa drugs; clindamycin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS145305 UNLA
Administered by: Other     Purchased by: Private
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Woke up about 12 hours after receiving vaccination with hives covering the trunk of the body. Took BENADRYL to help with the hives.

VAERS ID:548407 (history)  Vaccinated:2014-10-13
Age:45.0  Onset:2014-10-13, Days after vaccination: 0
Gender:Female  Submitted:2014-10-16, Days after onset: 3
Location:Missouri  Entered:2014-10-16
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: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J014399 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site cellulitis, Injection site erythema, Pain in extremity, Vaccination site inflammation, Vaccination site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patients arm started hurting evening of administration. The next morning, patient was starting to have some pain extending down to elbow. Upon examination, area where vaccination was administered was red, swollen, and starting to flare. Patient was advised to take diphenhydramine and apply cold to area. Injection site continued to flare, upon which patient proceded to see physician, where she was diagnosed with cellulitis and prescribed antibiotics for treatment.

VAERS ID:550767 (history)  Vaccinated:2014-10-15
Age:45.0  Onset:2014-10-15, Days after vaccination: 0
Gender:Female  Submitted:2014-10-15, Days after onset: 0
Location:D.C.  Entered:2014-10-16, 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: Sinus tachycardia
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS57CG30IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Heart rate increased, Hyperhidrosis, Nausea, Visual impairment
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: Seeing white spots, sweats, rapid heartbeat, difficulty breathing, nausea (within one minute).

VAERS ID:552179 (history)  Vaccinated:2014-10-10
Age:45.0  Onset:2014-10-11, Days after vaccination: 1
Gender:Male  Submitted:2014-10-16, Days after onset: 5
Location:Unknown  Entered:2014-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin
Current Illness: Diabetes mellitus
Preexisting Conditions: Cellulitis
Diagnostic Lab Data:
CDC Split Type: WAES1410USA007932
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Erythema, Local swelling, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: This spontaneous report as received from a registered nurse refers to a 45 year old male patient with diabetes. The patient''s medical history included cellulitis. There were no other drug reactions/allergies. On 10-OCT-2014 the patient was vaccinated with PNEUMOVAX 23 (lot# reported as J015860), 0.5 ml, intramuscular in the left arm. Concomitant therapies included FLUZONE and insulin. It was reported that the patient developed a fever, redness, swelling, and warmth of the left arm on 11-OCT-2014. The patient was evaluated at an unspecified urgent care facility on 13-OCT-2014. He was diagnosed with cellulitis and was prescribed LEVOQUIN. The outcome of cellulitis was reported as not recovered/not resolved. The patient sought medical attention by urgent care facility. Additional information has been requested.

VAERS ID:548525 (history)  Vaccinated:2014-07-18
Age:45.0  Onset:2014-07-18, Days after vaccination: 0
Gender:Male  Submitted:2014-10-02, Days after onset: 76
Location:Indiana  Entered:2014-10-17, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: States no further ED visits or doctors visits - symptoms resolved after ED visit.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J008534 SCRA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain upper, Hypersensitivity, Lip swelling, Pain, Rash generalised
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)
Write-up: Body rash, right upper quadrant pain, lip swelling, seen ED 7/18/14 rx with prednisone, famotidine and hydroxyzine. Dx by ED with allergic reaction and atypical pain.

VAERS ID:548678 (history)  Vaccinated:2014-10-08
Age:45.0  Onset:2014-10-08, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2014-10-17
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: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS196604 UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K009106 UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4870BA UNLA
Administered by: Public     Purchased by: Other
Symptoms: Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Received 3 vaccines Flu, Tdap, PNEUMOVAX about 3 pm. Later that evening woke up sweating went to bathroom and fainted. Husband called 911 for ambulance.

VAERS ID:550759 (history)  Vaccinated:2014-09-29
Age:45.0  Onset:2014-09-30, Days after vaccination: 1
Gender:Male  Submitted:2014-10-14, Days after onset: 14
Location:Illinois  Entered:2014-10-17, 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: Multiple
Current Illness:
Preexisting Conditions: M.S.; Chronic low back pain
Diagnostic Lab Data: 09/29/2014
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS014021A UNLA
Administered by: Private     Purchased by: Other
Symptoms: Injection site pain, Myalgia, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Pain at injection site, (Lt) deltoid, (Lt) trapezius and neck starting 24 hours after injection -$g lasting $g 2 weeks +.

VAERS ID:553300 (history)  Vaccinated:0000-00-00
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2014-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No allergies
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0073500SCUN
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site reaction - induration/redness/swelling at site of injection.

VAERS ID:549051 (history)  Vaccinated:2014-09-04
Age:45.0  Onset:2014-09-04, Days after vaccination: 0
Gender:Female  Submitted:2014-10-16, Days after onset: 42
Location:Minnesota  Entered:2014-10-21, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions: INFLUENZA, Prophylaxis, No adverse event
Diagnostic Lab Data:
CDC Split Type: US2014GSK005298
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS7LE2S UNRA
Administered by: Private     Purchased by: Other
Symptoms: Joint range of motion decreased, Middle insomnia, Pain, Pain in extremity
SMQs:, Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: This case was reported by a other health professional and described the occurrence of arm was sore in a 45-year-old female patient who received FLUARIX QUADRIVALENT (batch number 7LE2S, expiry date 30th June 2015). Previously administered products included influenza vaccine with an associated reaction of no adverse event. On 4th September 2014, the patient received FLUARIX QUADRIVALENT. On 4th September 2014, less than a day after receiving FLUARIX QUADRIVALENT, the patient experienced arm was sore (serious criteria disability), limited range of motion (serious criteria disability), waking up at night (serious criteria disability) and pain (serious criteria disability). On an unknown date, the outcome of the arm was sore, limited range of motion, waking up at night and pain were not recovered/not resolved. The reporter considered the arm was sore, limited range of motion, waking up at night and pain to be probably related to FLUARIX QUADRIVALENT. Additional information received: The reporter was a nursing student. She reported that her nursing class (a total of 30-35 students) received Flu vaccines at a local hospital about a month ago. About 5 of the students experienced adverse events. She reported that this patient received the vaccine and experienced pain, her arm was sore, is experiencing a limited range of motion, and wakes up at night from the pain. The reporter reported that this patient''s events were worse.

VAERS ID:553431 (history)  Vaccinated:2014-10-06
Age:45.0  Onset:0000-00-00
Gender:Female  Submitted:2014-10-15
Location:Missouri  Entered:2014-10-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Pending CBC, ESR, CMP
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4955AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Fatigue, Full blood count, Local reaction, Metabolic function test, Pain, Red blood cell sedimentation rate, Serum sickness
SMQs:, Hypersensitivity (narrow), Arthritis (broad)
Write-up: Serum sickness reaction with local reaction, arthralgia, pain, fatigue in multiple joints.

VAERS ID:549765 (history)  Vaccinated:2014-10-21
Age:45.0  Onset:2014-10-21, Days after vaccination: 0
Gender:Female  Submitted:2014-10-22, Days after onset: 1
Location:Missouri  Entered:2014-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI173AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Four to five hours after receiving influenza vaccine IM in left deltoid, developed scattered hives on left arm and left side of neck, had pruritis of scalp. She took a dose of BENADRYL and symptoms subsided.

VAERS ID:549369 (history)  Vaccinated:2012-10-24
Age:45.0  Onset:2012-11-18, Days after vaccination: 25
Gender:Female  Submitted:2014-02-05, Days after onset: 444
Location:Missouri  Entered:2014-10-23, Days after submission: 259
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: None stated.

VAERS ID:549801 (history)  Vaccinated:2014-10-11
Age:45.0  Onset:2014-10-14, Days after vaccination: 3
Gender:Female  Submitted:2014-10-23, Days after onset: 9
Location:California  Entered:2014-10-23
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
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI188AB1UNLA
Administered by: Other     Purchased by: Private
Symptoms: Activities of daily living impaired, Asthenia, Mobility decreased, Pain, Pain in extremity
SMQs:, Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: Pt report unable to lift arm past a certain point. Dull pain in left arm. Has been taking Ibuprofen 200mg - Reports weakness. Dull aching pain that stays the same. Trouble putting on clothes.

VAERS ID:549538 (history)  Vaccinated:2014-09-24
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:2014-10-24
Location:Michigan  Entered:2014-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1410901 IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Underdose
SMQs:
Write-up: Under-dosage was given. Administered .05mL of Fluvirin instead of 0.5mL.

VAERS ID:549912 (history)  Vaccinated:2014-09-30
Age:45.0  Onset:0000-00-00
Gender:Male  Submitted:2014-10-24
Location:Michigan  Entered:2014-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1309001 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Expired drug administered
SMQs:
Write-up: Expired vaccine administered to patient inadvertently.

VAERS ID:550054 (history)  Vaccinated:2014-10-23
Age:45.0  Onset:2014-10-25, Days after vaccination: 2
Gender:Male  Submitted:2014-10-26, Days after onset: 1
Location:California  Entered:2014-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergies to morphine, aspirin, latex, cilantro. Cervical disc degeneration disease in neck.
Diagnostic Lab Data: None yet
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1SYRLA
Administered by: Public     Purchased by: Private
Symptoms: Axillary mass
SMQs:
Write-up: Lump found in left armpit, lymph node.

VAERS ID:550231 (history)  Vaccinated:2014-10-23
Age:45.0  Onset:2014-10-23, Days after vaccination: 0
Gender:Female  Submitted:2014-10-27, Days after onset: 4
Location:California  Entered:2014-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unkn.
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI197AB IMRA
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Approximately 2 hours after Flu shot her RD area began to hurt & swell with "arthritis-like" symptoms in Rt wrist and Rt hand following. She treated with Tylenol and ibuprofen. Pt thinks it might be preservative reaction.

VAERS ID:553917 (history)  Vaccinated:2014-10-14
Age:45.0  Onset:2014-10-15, Days after vaccination: 1
Gender:Female  Submitted:2014-10-16, Days after onset: 1
Location:California  Entered:2014-10-27, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None known
Preexisting Conditions: Allergy to amoxicillin and FLAGYL; PMH - HTN, hyperlipidemia, low back pain, congenital absence right leg lymph nodes
Diagnostic Lab Data: Had urine culture done to evaluate fever -$g negative
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4965AA UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Culture urine negative, Injection site erythema, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Left shoulder approximately 5 cm redness and tenderness around immunization site. In addition fever/chills 24-36 hours after vaccination - but may be due to possible UTI (mild sx).

VAERS ID:550867 (history)  Vaccinated:2014-10-06
Age:45.0  Onset:2014-10-06, Days after vaccination: 0
Gender:Female  Submitted:2014-10-29, Days after onset: 23
Location:Illinois  Entered:2014-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: METFORMIN / GLIPIZIDE combo; LOSARTAN; PROPANOLOL; LOW DOSE ASPRIN
Current Illness: No
Preexisting Conditions: Type 2 Diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI200AB1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Injected limb mobility decreased, Injection site pain, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: At the time of the needle stick (prior to the serum being injected) I stated to the nurse that she must have hit a nerve. She asked if I was in pain and I said, "Not pain, but there is an achey feeling from my shoulder to my fingertips." She continued with the injection and withdrew the needle and at that time asked if it was still hurting. I stated no, not at the time. Later that evening, the left shoulder and arm was in severe pain and I was not even able to lift my arm away from my body. I treated myself with over the counter Tylenol and was still in severe pain the next day so I sought treatment from the Occupational Health doctor on 10/7/2014. DX was Left deltoid pain after annual flu vaccination. I was told to ice as I could for 15 minutes at a time and to take Aleve as directed on the bottle. I returned on 10/9/14 for the scheduled follow up and was feeling better and range of motion was improving as I was using Aleve and ice to treat. I was told to follow up as needed. I never improved beyond that point and the following week the pain began to get worse. I called to see Dr. again on 10/21/14 and was told the next available appointment was on 10/23/14. I again saw Dr. that afternoon and was given the same instructions and was recommended therapy, which was denied by Workers Compensation. As of 10/29/14 I am still experiencing pain in my left shoulder and upper arm. I am scheduled to follow up on 11/6/14 if allowed by workers compensation.

VAERS ID:550901 (history)  Vaccinated:2014-10-13
Age:45.0  Onset:2014-10-13, Days after vaccination: 0
Gender:Female  Submitted:2014-10-24, Days after onset: 11
Location:Unknown  Entered:2014-10-29, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: 10/13/2014-10/15/2014, Activities of daily living impaired
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PHEH2014US021025
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS161211 SYRAR
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Hypoaesthesia, Impaired driving ability, Impaired work ability, Injection site anaesthesia, Malaise, Vertigo
SMQs:, Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)
Write-up: Case number PHEH2014US021025, is an initial spontaneous report from a consumer (patient''s spouse) received on 19 Oct 2014. This report refers to a 45-year-old female patient. Her medical history and concomitant medications were not reported. She was vaccinated with 0.5 ml of FLUCELVAX, (batch number: 161211) into deltoid on 13 October 2014 at 12:15 hours. On the same day, post vaccination, she experienced vertigo at 12:45 hours and injection site whole arm numbness at 14:00 hours. It was reported that she could not go to work or drive from 13 Oct 2014 at 23:45 hours till 15 Oct 2014 at 07:15 hours. On 14 Oct 2014, she experienced malaise at 6:00 hours. Event of numbness was resolved on 13 Oct 2014 at 17:30 hours, malaise on 15 Oct 2014 at 5:45 hours and vertigo on 19 Oct 2014 at 12:00 hours. The reporter assessed the events as serious (significant disability). Causality assessment of the events was not reported.

VAERS ID:550990 (history)  Vaccinated:2013-10-09
Age:45.0  Onset:2013-10-09, Days after vaccination: 0
Gender:Male  Submitted:2014-10-29, Days after onset: 385
Location:Illinois  Entered:2014-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, Singulair, Allegra
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH899AD0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Mobility decreased, Musculoskeletal pain, Periarthritis, Rotator cuff syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Arthritis (narrow)
Write-up: Dull shoulder pain at onset - intensified overnight limiting mobility in shoulder - severe shoulder pain by following morning and very limited mobility - pain intensity lessened over the following month, but mobility remained restricted. Doctor diagnosis was rotator cuff injury and adhesive capsulitis.

VAERS ID:551079 (history)  Vaccinated:2014-10-29
Age:45.0  Onset:2014-10-29, Days after vaccination: 0
Gender:Female  Submitted:2014-10-30, Days after onset: 1
Location:California  Entered:2014-10-30
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: Pollen, mold, dogs, cats, anemia
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRRA
Administered by: Public     Purchased by: Private
Symptoms: Chest pain, Dyspnoea, Feeling cold, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Shortness of breath, chest pains, extreme cold, vomiting.

VAERS ID:551192 (history)  Vaccinated:2014-10-29
Age:45.0  Onset:2014-10-29, Days after vaccination: 0
Gender:Male  Submitted:2014-10-30, Days after onset: 1
Location:Michigan  Entered:2014-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin 81mg; Hydrochlorothizide; Lisinopril; Simvastatin; Zoloft
Current Illness: No
Preexisting Conditions: Acute Maxillary Sinusitis; Anemia; Hypercholesterolemia; Hypertension; Vasomotor Rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Other
Symptoms: Asthenia, Chills, Dizziness, Injection site erythema, Injection site pain, Injection site reaction, Myalgia, Pyrexia, Respiratory tract congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Severe muscle pain in area of injection, soreness and redness around injection site, fever above 100F, weakness, dizziness, chills, the following day (10/30/2014) developed respiratory congestion. Ibuprofen for pain...

VAERS ID:554530 (history)  Vaccinated:2014-10-10
Age:45.0  Onset:2014-10-12, Days after vaccination: 2
Gender:Male  Submitted:2014-10-28, Days after onset: 16
Location:California  Entered:2014-10-31, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None Reported
Preexisting Conditions: Unknown
Diagnostic Lab Data: Varicella Zoster Virus AB < or = 0.90 (obtained on 10/3/14)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0020360SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.K0061350SCRA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Rash macular, Skin lesion, Viral test
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Generalized malaise, unbroken erythemic lesions on face, neck, body and extremities; over the course of 2 weeks.

VAERS ID:551420 (history)  Vaccinated:2014-10-31
Age:45.0  Onset:2014-11-01, Days after vaccination: 1
Gender:Female  Submitted:2014-11-02, Days after onset: 1
Location:Texas  Entered:2014-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Progesterone Armor Thyroid Aspirin Testosterone cream
Current Illness: No
Preexisting Conditions: Bee stings Bee pollen Mold Sulpha drugs lot about
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Dyspnoea, Fatigue, Headache
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Lightheaded. Fatigued. Out of breath with very light activity. Headache.

VAERS ID:551758 (history)  Vaccinated:2014-10-22
Age:45.0  Onset:2014-10-22, Days after vaccination: 0
Gender:Male  Submitted:2014-11-04, Days after onset: 13
Location:Texas  Entered:2014-11-04
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: No...
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Injection site swelling, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Slight swelling and soreness at place of shot...next day...swelling of lymph nodes under left arm down to elbow...last over a week.

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