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Case Details (Sorted by Age)

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VAERS ID:250118 (history)  Vaccinated:2005-11-09
Age:54.0  Onset:2005-11-09, Days after vaccination: 0
Gender:Female  Submitted:2005-11-23, Days after onset: 14
Location:Massachusetts  Entered:2006-01-06, Days after submission: 44
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: NONE
Preexisting Conditions: Euthyroid
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1854AA  LA
Administered by: Public     Purchased by: Public
Symptoms: Bronchitis, Conjunctivitis, Cough, Myalgia, Pharyngolaryngeal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: 11/9/05 received Fluzone. 1st got very sore arm. Then got sore throat next day very achy. No fever. Very sore throat and got worse. Aches continued and cough, bronchitis & conjunctivitis

VAERS ID:250178 (history)  Vaccinated:2005-11-15
Age:54.0  Onset:2005-11-18, Days after vaccination: 3
Gender:Male  Submitted:2006-01-04, Days after onset: 47
Location:Massachusetts  Entered:2006-01-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Benicar, Lipitor, Viagra
Current Illness: Hypertension, hyperlipidemia
Preexisting Conditions: NONE
Diagnostic Lab Data: Sed rate-c/o
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1872AA IMRA
Administered by: Private     Purchased by: Public
Symptoms: Myalgia, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Right deltoid muscle pain with associated polymyalgia of neck, shoulders, lower back and proximal thighs

VAERS ID:250356 (history)  Vaccinated:2006-01-06
Age:54.0  Onset:2006-01-07, Days after vaccination: 1
Gender:Female  Submitted:2006-01-09, Days after onset: 2
Location:Alabama  Entered:2006-01-13, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: N/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1617GA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red streaks down arm, red at site. Keflex.

VAERS ID:250515 (history)  Vaccinated:2005-12-06
Age:54.0  Onset:2005-12-06, Days after vaccination: 0
Gender:Male  Submitted:2005-12-07, Days after onset: 1
Location:Illinois  Entered:2006-01-18, Days after submission: 42
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1854AA0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Cough, Eye irritation, Lacrimation increased
SMQs:, Anaphylactic reaction (broad), Corneal disorders (broad), Lacrimal disorders (narrow)
Write-up: At 2pm patient experienced watery itchy eyes, runny nose and chop cough. Resolved with over the counter antihistamine and symptoms were gone next morning.

VAERS ID:250660 (history)  Vaccinated:2004-10-25
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2006-01-06
Location:Kansas  Entered:2006-01-20, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: The patients medical history, concurrent conditions, and concurrent medications were not reported. The nurse reported that three other patients did not respond to immunization with Engerix B. Please see cases A0553276A, A0553278A, and A0553279A.
Diagnostic Lab Data:
CDC 'Split Type': A0553277A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 2 UN
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a nurse and described a 54 year old patient who did not respond to immunization with hepatitis B vaccine recombinant (Engerix B). On 04/22/2004, the patient received the first dose of Engerix B (lot ENG5553B2). On 04/25/2004, the patient received the second dose of Engerix B (lot ENG5553B) On 10/25/2004 the patient received the third dose of Engerix B. On an unspecified date after 10/25/2004 and on or before April 7 2005, a hepatitis B surface antibody titer was negative.

VAERS ID:250712 (history)  Vaccinated:2005-06-08
Age:54.0  Onset:2005-08-24, Days after vaccination: 77
Gender:Male  Submitted:2006-01-06, Days after onset: 135
Location:Pennsylvania  Entered:2006-01-20, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: U
Preexisting Conditions: Asthma, Hypertension, social alcohol drinker.
Diagnostic Lab Data: Hepatitis B surface antibody 8/24/2005 negative.
CDC 'Split Type': A0579432A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB125AA2 LA
Administered by: Private     Purchased by: Private
Symptoms: Drug ineffective, Medication error
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a nurse and described a 54 year old male subject who did not respond to immunization with hepatitis B vaccine recombinant Engerix B for prophylaxis. The subjects medical history included hypertension, asthma and social alcohol consumption. On 11/10/2004 the subject received 1st dose of Engerix B. On 12/10/2005, the subject received 2nd dose of Engerix B. On 6/8/2005, the subject received 3rd dose of Engerix B (lot AHBVB125AA). The represents an interval of seven months between the 1st and 3rd doses of Engerix B which is longer than the recommended interval of six months between the 1st and 3rd doses. On 08/24/2005, 77 days after vaccination with the 3rd dose of Engerix B, a hepatitis B surface antibody titer was negative. The nurse considered the negative antibody titer to possibly be related to vaccination with Engerix B.

VAERS ID:250732 (history)  Vaccinated:2005-11-14
Age:54.0  Onset:2005-11-14, Days after vaccination: 0
Gender:Female  Submitted:2005-11-15, Days after onset: 1
Location:Tennessee  Entered:2006-01-23, Days after submission: 69
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': TN05061
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0748P1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swollen from shoulder to elbow- red and warm to touch. Encourage to apply cold compress and follow up with PMD.

VAERS ID:250833 (history)  Vaccinated:2005-12-28
Age:54.0  Onset:2005-12-30, Days after vaccination: 2
Gender:Male  Submitted:2006-01-24, Days after onset: 25
Location:California  Entered:2006-01-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: HEP C
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION613212IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1044P1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: PATIENT DEVELOPED CELLULITIS AT THE SITE REQUIRING ANTIBIOTICS APPROXIMATELY TWO DAYS AFTER INJECTION.

VAERS ID:250932 (history)  Vaccinated:2005-07-08
Age:54.0  Onset:2005-07-18, Days after vaccination: 10
Gender:Male  Submitted:2005-09-19, Days after onset: 63
Location:Minnesota  Entered:2006-01-27, Days after submission: 130
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: Patient developed a red itchy rash on the right lower leg and ankle after receiving immunizations on 7/1/2005. It was reported that the patient has no known allergies.
Diagnostic Lab Data:
CDC 'Split Type': 20501693
Vaccination
Manufacturer
Lot
Dose
Route
Site
JEV: JAPANESE ENCEPHALITIS (JE-VAX)SANOFI PASTEUREJN213A1SCUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURW13443 IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Oedema, Rash pruritic, Urticaria, Vaccine positive rechallenge
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: initial report received from a health care professional on 08/30/2005. A 54 year old male patient received a subcutaneous injection of JE VAX vaccine, lot number EJN213A, site not reported, an intramuscular injection of Typhim VI vaccine, lot number W13443 in the left deltoid muscle on 7/8/2005. Then days later he developed large welty itchy areas like hives on both shoulders, arms and legs with right ankle swelling. The patient self medicated with antihistamines and recovered from this event. This patient experienced an adverse event on 7/4/2005 of red itchy rash following a previous injection of JE VAX on 7/1/2005 and that adverse event is detailed in case number 200501842.

VAERS ID:251119 (history)  Vaccinated:2005-12-01
Age:54.0  Onset:2005-12-02, Days after vaccination: 1
Gender:Female  Submitted:2006-01-17, Days after onset: 46
Location:California  Entered:2006-01-31, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prozac, Amitriptyline, Xanax, Glucotrol XL
Current Illness: Follow up visit
Preexisting Conditions: DM II, Depression, Obesity
Diagnostic Lab Data: NONE
CDC 'Split Type': CA050090
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0967P0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Arthralgia, Injection site hypersensitivity, Injection site oedema, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Injection site red, tender, swollen arthralgia left arm. F/U visit 01/11/2006 pt C/O tenderness, slight redness.

VAERS ID:251204 (history)  Vaccinated:2005-10-31
Age:54.0  Onset:2005-10-31, Days after vaccination: 0
Gender:Female  Submitted:2006-01-30, Days after onset: 91
Location:Massachusetts  Entered:2006-02-03, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: Normal temp, blood pressure, heart rate, etc.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0  
Administered by: Other     Purchased by: Public
Symptoms: Eye irritation
SMQs:, Corneal disorders (broad)
Write-up: Eyes became itchy 1 1/2-2 hours after flu shot. During night yellow discharge from eyes and puffy lids. Eyelashes were stuck together. This lasted for about 24 hours.

VAERS ID:251904 (history)  Vaccinated:2006-01-16
Age:54.0  Onset:2006-01-17, Days after vaccination: 1
Gender:Female  Submitted:2006-02-07, Days after onset: 21
Location:Iowa  Entered:2006-02-24, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prometrium 200 mg, Mennest 0.625mg, Paxil 20mg.
Current Illness: NONE
Preexisting Conditions: DLE
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Injection site induration, Muscular weakness, Nausea, Pain, Pyrexia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Vaccine given 1-16-06 thru (treatment) 1-23-06. Area below injection site very hard, red and swollen. Morning after had 101.8 temp. Saw Dr. Prescribed Augmentin 500mg. Said early cellulitis. Meds caused nausea-changed to Keflex 500mg. Next day symptoms were worse. Dr gave IV Rocefyn. Patient believes the last antibiotic she was given was Levaquin by mouth. Redness is gone. Still have weak and tired painful muscle.

VAERS ID:251993 (history)  Vaccinated:2006-01-19
Age:54.0  Onset:2006-01-19, Days after vaccination: 0
Gender:Male  Submitted:2006-01-19, Days after onset: 0
Location:Nevada  Entered:2006-02-24, Days after submission: 36
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lotrel;HCTZ;Lipitor
Current Illness: NONE
Preexisting Conditions: Hypertension;Allergic to seafood - some preservations
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB171AA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Ear discomfort, Flushing, Lacrimation increased, Rhinitis
SMQs:, Anaphylactic reaction (broad), Lacrimal disorders (narrow), Hypersensitivity (broad)
Write-up: Hep B vaccine was administered IM left deltoid at approx 10:00 am. At 1:15 pm patient developed coryza, eyes watery, plugged ears, flushed face.

VAERS ID:251999 (history)  Vaccinated:2006-01-27
Age:54.0  Onset:2006-01-28, Days after vaccination: 1
Gender:Female  Submitted:2006-01-30, Days after onset: 2
Location:North Carolina  Entered:2006-02-27, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin, Celexa, Singulair, Prilosec, Atrovent, Allegra, Ambien, Advair, Ribavirin, Pegasys, MVI
Current Illness:
Preexisting Conditions: Hepatitis, asthma, HTN, GERD.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0529P0 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, Hepatitis C virus, Injection site erythema, Injection site reaction, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Upper left arm cellulitis with erythematous area about 20cm x 15cm, increased temp at site with palpation. Pneumovax administered on 1/27/2006. Pt started pegasys and ribavirin treatment same day for hepatitis C virus Pegasys injection site was right below abdomen.

VAERS ID:252257 (history)  Vaccinated:2005-10-27
Age:54.0  Onset:2005-10-31, Days after vaccination: 4
Gender:Male  Submitted:2006-03-02, Days after onset: 122
Location:Idaho  Entered:2006-03-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: COPD, bronchitis, Ethohism
Preexisting Conditions:
Diagnostic Lab Data: All labs within normal limits
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1903AA0 RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0748P0 LA
Administered by: Public     Purchased by: Public
Symptoms: Amnesia, Asthenia, Dizziness, Myalgia, Nausea, Vision blurred, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Vestibular disorders (broad)
Write-up: Developed severe nausea, vomiting and muscle aches 3-4 days after vaccine. ~1 week after developed severe dizziness, inability to focus, memory loss. Over the next months symptoms have improved slowly. Still complained of severe weakness and fatigue. Can only work 4 hrs day then has to rest.

VAERS ID:252699 (history)  Vaccinated:2006-03-02
Age:54.0  Onset:2006-03-04, Days after vaccination: 2
Gender:Female  Submitted:2006-03-13, Days after onset: 9
Location:Florida  Entered:2006-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthyroid, Evista, fish oil supplements
Current Illness:
Preexisting Conditions: Breast Cancer survivor. Cancer free since 1994
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE667AB0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Two days after receiving the yellow fever vaccine, the patient experienced severe generalized pruritus. There was no rash or swelling. The same symptoms recured 2 days later. She reported to the ER and was given benadryl. Symptoms subsequently resolved.

VAERS ID:252704 (history)  Vaccinated:2006-02-11
Age:54.0  Onset:2006-02-11, Days after vaccination: 0
Gender:Male  Submitted:2006-02-21, Days after onset: 10
Location:North Carolina  Entered:2006-03-14, 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: Recovering from CABG on 2/6/06
Preexisting Conditions: Hypertension, hyperlipidemia, borderline diabetes, SP CABG (CAD), Smoker
Diagnostic Lab Data: Blood cultures;sputum culture- All negative 2/15 WBC 18000;2/16 16,000;2/17 13,000
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.   UN
Administered by: Public     Purchased by: Unknown
Symptoms: Pyrexia, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Patient admitted 2/6-2/13 for coronary bypass surgery. On 2/10 patient received pneumovax vaccine. On 2/11 the patient developed fevers of unknown origin. Fevers treaded downward and patient discharged 2/13. Patient re-hospitalzied 2/15 for fevers of unknown origin up to 102. Infectious disease consult obtained and it was felt that most probable cause of fevers was pneumovax - no other suspected source. All cultures negative. Fever resolved and patient discharge home on 2/17/06.

VAERS ID:253173 (history)  Vaccinated:2006-02-21
Age:54.0  Onset:2006-02-21, Days after vaccination: 0
Gender:Female  Submitted:2006-03-23, Days after onset: 30
Location:Colorado  Entered:2006-03-23
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: allergies to environmental
Diagnostic Lab Data:
CDC 'Split Type': CO06003
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEUR1341AA6IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Neuritis, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Eosinophilic pneumonia (broad)
Write-up: On 3/1, patient called to report a rx she was having to the Td vaccine given on 2/21. She said she felt it was something to do with the nerve in her left are where the vaccine was given. She plans to see her Dr. on 3/2. On 3/7 patient said the Dr. said the nerve was inflammed, ordered Relafen to be started on 3/7 and told her it might take a while to heal - maybe as long as a month. She said she felt a burning sharp pain shoot down her arm when the nurse put the needle in her arm on 2/21 when she got the vaccine. The sensation calmed down by the time she stopped to check out of the clinic. There was muscle soreness for the next 2-3 days and the burning nerve pain came and went. 3/13 - patient is improving. Taking only ibuprofen.

VAERS ID:253303 (history)  Vaccinated:2004-11-23
Age:54.0  Onset:2006-01-24, Days after vaccination: 427
Gender:Female  Submitted:0000-00-00
Location:Alabama  Entered:2006-03-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE (required for employment)
Preexisting Conditions:
Diagnostic Lab Data: Electronystagmography;Auditory Brainstem Response;Auditory;Electrocochleography
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.076440  
Administered by: Public     Purchased by: Unknown
Symptoms: Balance disorder, Disturbance in attention, Dizziness, Hearing impaired, Laboratory test, Otitis media, Stress
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Depression (excl suicide and self injury) (broad), Hearing impairment (narrow), Vestibular disorders (broad)
Write-up: Beginning Jan/24/06 pt woke in middle of night with dizziness, continued each day with increasing dizziness. Eye could not focus, felt like they were drawing to center. This lasted approximately 3 weeks - went to 2 - eye, ear, nose and throat Drs as well as ophthalmologist - was put on acyclovir, still taking. Unable to concentrate - stressful. Was put on acylcoivr 21 day. Still taking. Pt still has dizziness at night -sometimes day- Prescribed 2nd prescription was diagnosed with viral inner ear infection on 3/14/06 for 6 wks. Unable to concentrate-stressful. Took acyclovir 21 day. Prescribed 2nd prescription was diagnosed with viral inner ear infection. On 5/14/06 for 6 wks.

VAERS ID:254067 (history)  Vaccinated:2006-03-22
Age:54.0  Onset:2006-03-23, Days after vaccination: 1
Gender:Female  Submitted:2006-03-28, Days after onset: 5
Location:Texas  Entered:2006-04-13, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': TX06019
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1619AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Dyspnoea, Malaise, Rash
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Pt called and said she had a rash on face, chest and shoulder, Thursday morning that lasted until Sunday. She went to ER on Monday because she felt sick and couldn''t breath. Said she was told by ER Dr not to take another one.

VAERS ID:254165 (history)  Vaccinated:2005-07-22
Age:54.0  Onset:2005-09-01, Days after vaccination: 41
Gender:Female  Submitted:2006-02-03, Days after onset: 155
Location:Idaho  Entered:2006-04-17, Days after submission: 72
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fall
Preexisting Conditions: DM, Hyperlipidemia, CAD, HTN, Blind, CHF,ESRD, Pituitary adenoma.
Diagnostic Lab Data:
CDC 'Split Type': ID06006
Vaccination
Manufacturer
Lot
Dose
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Site
TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Public
Symptoms: Injection site abscess
SMQs:
Write-up: Abscess formation at site.

VAERS ID:254230 (history)  Vaccinated:2006-04-13
Age:54.0  Onset:2006-04-14, Days after vaccination: 1
Gender:Female  Submitted:2006-04-18, Days after onset: 4
Location:Massachusetts  Entered:2006-04-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HCT, Lipitor.
Current Illness: None; just had a yearly physical that day.
Preexisting Conditions: Post polio syndrome, hypertension, high cholesterol, over weight, degenerative joint disease.
Diagnostic Lab Data: x-rays, O2s and other vitals
CDC 'Split Type':
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthma, Choking, Cough, Dizziness, Dyspnoea, Injection site pain, Nasal congestion, Nausea, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (narrow), 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), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Extreme pain in arm of injection site, 5 hours later pain caused nausea and dizziness. Next day, heavy nasal and sinus congestion. On the third, I reported to the local walk-in clinic because it was a Sat and my doctor''s office was closed. I could not breath through my nose, had post nasal drip that choked me. I was very wheezy, doctor gave me a breathing treatment with a nebulizer for 10 minutes that lasted for 3 hr. He also prescribed albuteral air chamber. This treatment lasted only 30 minutes. I went to the ER of the local hospital on Sunday, April 16 due to much more wheezing and very difficulty breathing. O2 was 94,usually 99 - 100) xrays showed fluid in small airways of the lungs. I received three breathing treatments and, although I had some wheezing in upper right lung small air ways and the Dr. initially recommended admission, I was able instead to go home with three inhalers, 2 nose sprays, cough syrup and zpack. It is Tues and I am still wheezing and coughing, but i am better. drs dx was Asthmatic bronchitis. I do not have asthma.

VAERS ID:254369 (history)  Vaccinated:2006-04-17
Age:54.0  Onset:2006-04-18, Days after vaccination: 1
Gender:Female  Submitted:2006-04-20, Days after onset: 2
Location:Wisconsin  Entered:2006-04-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MULTIVITAMIN ONE DAILY ASA 81MG DAILY ESTROVEN OTC 2 DAILY
Current Illness: NONE
Preexisting Conditions: MORPHINE--PT UNSURE OF REACTION. HCTZ--HEART PALPITATIONS. BLADDER CANCER. HTN.
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2340AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Injection site erythema, Injection site induration, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: LEFT DELTOID INJECTION SITE REDDENED AREA--APPROX 4" IN DIAMETER, HARD TO TOUCH, INCREASED PAIN WITH ANY MOVEMENT AND TOUCH.

VAERS ID:254661 (history)  Vaccinated:2006-04-21
Age:54.0  Onset:2006-04-23, Days after vaccination: 2
Gender:Female  Submitted:2006-04-23, Days after onset: 0
Location:Michigan  Entered:2006-04-27, 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: NONE
Preexisting Conditions: Health, HTN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER   UN
Administered by: Public     Purchased by: Private
Symptoms: Injection site hypersensitivity, Injection site oedema, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Arm red, hot, swollen, fever

VAERS ID:254934 (history)  Vaccinated:2005-11-17
Age:54.0  Onset:2005-11-17, Days after vaccination: 0
Gender:Female  Submitted:2006-04-25, Days after onset: 158
Location:California  Entered:2006-05-02, Days after submission: 7
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Developed flu like symptoms within hours of receiving the vaccine.
Preexisting Conditions:
Diagnostic Lab Data: Culture from infection came back as Serratia Marcescens.
CDC 'Split Type':
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION615010 UN
Administered by: Other     Purchased by: Other
Symptoms: Anorexia, Bacterial infection, Cough, Headache, Infection, Influenza like illness, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Experienced flu like symptoms (body ache, headache, low grade fever, lose of appetite), within hours of receiving vaccination. Symptoms persisted to varying degrees over the next 3 months. Developed a persistent dry cough after a couple of weeks. Developed a large (tennis ball size) infection in lower back area at site of a previous surgery (performed in 2002). The culture came back as Serratia Marcescens. Required emergency surgery to clean site of infection and use of antibiotics.

VAERS ID:255014 (history)  Vaccinated:2006-04-05
Age:54.0  Onset:2006-04-06, Days after vaccination: 1
Gender:Male  Submitted:2006-05-03, Days after onset: 27
Location:Maryland  Entered:2006-05-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: LACERATED RIGHT THUMB
Preexisting Conditions:
Diagnostic Lab Data: THROAT CULTURE NEGATIVE FOR ABNORMAL FLORA
CDC 'Split Type':
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysphonia, Face oedema, Pharyngeal oedema, Pharyngolaryngeal pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: 4-6-2006 THE MORNING AFTER THE TD SHOT IN HIS LEFT ARM, MY HUSBAND HAD INCREASING FEVER TO 101F, LEFT FACIAL SWELLING, LEFT THROAT PAIN AND SWELLING AND GRADUAL LOSS OF VOICE. THIS CONTINUED AND HE WENT BACK TO THE EMERGENCY ROOM ON 4-10-06. HIS SYMPTOMS DID NOT FULLY SUBSIDE UNTIL 4-18-06. HE HAD HX OF SEVERE DIPHTHERIA CONTRACTED AT AGE 5 YRS OLD.

VAERS ID:255036 (history)  Vaccinated:2006-04-24
Age:54.0  Onset:2006-04-25, Days after vaccination: 1
Gender:Male  Submitted:2006-05-04, Days after onset: 9
Location:Minnesota  Entered:2006-05-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, multivitamins, fish oil, coral calcium
Current Illness: MPME
Preexisting Conditions: MPME
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2455AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Malaise, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, warmth, redness at injection site which began on 4/25/06 about 24 hrs after vaccination, worsened over next 2 days, he also felt ill, generally achy on 4/25/06. Band of induration of skin measured 10cm wide by 30cm in length.

VAERS ID:255381 (history)  Vaccinated:2006-04-18
Age:54.0  Onset:2006-04-19, Days after vaccination: 1
Gender:Female  Submitted:2006-05-11, Days after onset: 22
Location:Colorado  Entered:2006-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: swollen arm~Td Adsorbed, Adult (no brand name)~1~0~In Patient
Other Medications: levoxyl (thyroid) toprol (BP) zocar(cholesterol)
Current Illness:
Preexisting Conditions: has pace maker
Diagnostic Lab Data:
CDC 'Split Type': CO0605
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)AVENTIS PASTEUR2340 AA2IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Chills, Erythema, Musculoskeletal stiffness, Myalgia, Oedema, Pain, Pyrexia, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad)
Write-up: On awakening at 4:30 am on 4/19 left arm was sore and muscles in upper body and back were sore like when recently exercised - worsened all day. Started to have fever about 2:30 with chills. Took temp. at 6pm was 100.6 degrees. Felt so cold and muscles in legs, feet, hands were sore and stiff. Hips hurt so she could not lie down. Unable to sleep at night. Started to take Advil every 4 hours, at 6pm on 4/19/06. Highest temp was 100.8 degrees on 4/20/06. Advil 4 tabs every 4 hours during the day took edge off body discomfort. Took advil before sleep with ambian and slept thru the night 4/20/06. Returned to work 4/21/06 with less soreness but 2.5cm x 3cm red swollen area on left deltoid.

VAERS ID:255537 (history)  Vaccinated:2006-05-05
Age:54.0  Onset:2006-05-05, Days after vaccination: 0
Gender:Female  Submitted:2006-05-08, Days after onset: 3
Location:Hawaii  Entered:2006-05-16, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD, Lexapro, Tums, Vit D,
Current Illness: Allergies Sinuses
Preexisting Conditions: Rheumatoid arthritis, allergic rhinitis.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1008P0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Hypokinesia, Injection site oedema, Injection site pain, Rheumatoid arthritis
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: Swelling and pain in arm just distal to injection unable to move arm for 2 days due to pain. Swelling and pain slowly resolving without treatment. pt has rheumatoid arthritis.

VAERS ID:255548 (history)  Vaccinated:2006-05-01
Age:54.0  Onset:2006-05-10, Days after vaccination: 9
Gender:Female  Submitted:2006-05-11, Days after onset: 1
Location:Wisconsin  Entered:2006-05-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Penicillin, sulfa drug.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0027R0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Rash papular
SMQs:
Write-up: Localized papular rash to inner left upper arm.

VAERS ID:255832 (history)  Vaccinated:2006-05-11
Age:54.0  Onset:2006-05-12, Days after vaccination: 1
Gender:Female  Submitted:2006-05-16, Days after onset: 4
Location:Nebraska  Entered:2006-05-19, 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: Inderal, Prempro, Boniva, Buspar
Current Illness: NONE
Preexisting Conditions: Hx migraines, hx stroke age 24, anxiety, osteoporosis
Diagnostic Lab Data: BP 112/76; temp 98.2F
CDC 'Split Type':
Vaccination
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Site
MU: MUMPS (MUMPSVAX II)MERCK & CO. INC.1113R0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure increased, Flushing, Headache
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypersensitivity (broad)
Write-up: Headaches, flushing of cheeks, had daily since getting vaccine. Has been taking Migraine Strength Excedrin. HX of migraines on Inderal. Last migraine 6-7 years ago. Gets headaches a lot before this but they were always relieved by

VAERS ID:256031 (history)  Vaccinated:2006-05-11
Age:54.0  Onset:2006-05-11, Days after vaccination: 0
Gender:Female  Submitted:2006-05-15, Days after onset: 4
Location:Kansas  Entered:2006-05-22, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Earlier that day felt lightheaded.
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB268CA0 LA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Rec''d 1st dose Hep B at 4:00 pm on May 11th. At 5:30 pm began to itch and soon after broke out in rash on arms and legs. Phoned her physician advised to take Benadryl. On May 12th some urticaria continued and rash continued. May 15th follow up still rash primary upper arm and lower leg.

VAERS ID:256559 (history)  Vaccinated:2006-05-06
Age:54.0  Onset:2006-05-06, Days after vaccination: 0
Gender:Male  Submitted:2006-05-19, Days after onset: 13
Location:D.C.  Entered:2006-05-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Pt admitted to hospital for chest pain and CHF.
Diagnostic Lab Data: Basic metabolic panel within normal limits. Albumin 3.0. BNF, a CHF marker, highly elevated at 328.
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0001F   
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood albumin decreased, Cardiac failure congestive, Injection site erythema, Injection site pain, Malaise
SMQs:, Cardiac failure (narrow), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)
Write-up: Pt administered Pneumovax 0.5mL SC x 1. Pt experienced local reactions outside of normal. Pt experienced malaise in addition to severe redness and pain at injection site. Temp was not recorded.

VAERS ID:257688 (history)  Vaccinated:2006-06-01
Age:54.0  Onset:2006-06-02, Days after vaccination: 1
Gender:Female  Submitted:2006-06-02, Days after onset: 0
Location:Washington  Entered:2006-06-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: L-Thyroxine
Current Illness: none
Preexisting Conditions: ciproflaxin iodine dyes penicillin
Diagnostic Lab Data:
CDC 'Split Type':
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HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: moderate headache severe nausea and vomiting severe diarrhea

VAERS ID:258256 (history)  Vaccinated:2006-05-17
Age:54.0  Onset:2006-05-17, Days after vaccination: 0
Gender:Female  Submitted:2006-05-18, Days after onset: 1
Location:Alaska  Entered:2006-06-12, Days after submission: 25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Erythromycin; Penicillin; Septra; Cipro; Motrin
Diagnostic Lab Data: NONE
CDC 'Split Type': AK200624
Vaccination
Manufacturer
Lot
Dose
Route
Site
MEN: MENINGOCOCCAL (MENOMUNE)AVENTIS PASTEURUE162AB0SCLA
Administered by: Other     Purchased by: Private
Symptoms: Hot flush
SMQs:
Write-up: Feeling flushed but no fever, headache, pressure/aching of eyes, nausea. Symptoms not relieved with aspirin or Benadryl.

VAERS ID:258577 (history)  Vaccinated:2006-06-05
Age:54.0  Onset:2006-06-05, Days after vaccination: 0
Gender:Female  Submitted:2006-06-12, Days after onset: 7
Location:Texas  Entered:2006-06-20, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium; Nasacort; Singulair; Reglan; Flexeril; Relpax
Current Illness: NONE
Preexisting Conditions: Sulfa; Seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
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HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0029F0IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)AVENTIS PASTEURZ057220IMLA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE813AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt reported blotchy redness at site of injection of Yellow Fever vaccine. No swelling or bumps. Approx. size 4.5cm wide, 2-3cm long. Pt noticed site on same day of vaccination 6/5/06. No general ill feelings noted. F/U on 6/14/06, no s/s present.

VAERS ID:258659 (history)  Vaccinated:2005-12-21
Age:54.0  Onset:2005-12-22, Days after vaccination: 1
Gender:Female  Submitted:2006-02-23, Days after onset: 63
Location:Minnesota  Entered:2006-06-21, Days after submission: 117
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Enalapril; Piroxicam
Current Illness: NONE
Preexisting Conditions: Celebrex; Vioxx
Diagnostic Lab Data: Blood cultures negative; WBC 16.9.
CDC 'Split Type':
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.    
Administered by: Private     Purchased by: Unknown
Symptoms: Cellulitis, Injection site reaction
SMQs:
Write-up: Cellulitis - large area of local reaction - arm. Seen in ER 3 times. She saw me on 12/27 when it was resolving.

VAERS ID:258781 (history)  Vaccinated:2006-06-08
Age:54.0  Onset:2006-06-09, Days after vaccination: 1
Gender:Female  Submitted:2006-06-23, Days after onset: 14
Location:Utah  Entered:2006-06-26, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2456AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Lymphadenopathy
SMQs:
Write-up: Developed "softball size" lump under arm (arm pit) vaccine was given IM. Lymph node swelling.

VAERS ID:259064 (history)  Vaccinated:2006-04-20
Age:54.0  Onset:2006-04-27, Days after vaccination: 7
Gender:Male  Submitted:2006-06-30, Days after onset: 64
Location:Oregon  Entered:2006-06-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: See previous determination of anthrax vaccine VAERS.
Preexisting Conditions: Auto immune compromised from previous anthrax vaccine shots from military. Also old VAERS.
Diagnostic Lab Data: blood tests, MRIs,
CDC 'Split Type':
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Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU1911AA PO 
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB166AB IMUN
Administered by: Military     Purchased by: Military
Symptoms: Condition aggravated, Depression, Dizziness, Fatigue, Muscular weakness, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (narrow), Vestibular disorders (broad)
Write-up: Sore muscles in arm for two weeks. Soreness increasing from day of shot for weeks. Muscles throughout body became sore and weak. Fatique increasingly becoming worse within days of shots and continued to worsen to severe fatigue within 1 week of shots and continues to remain today. Dizziness & nausea within 2 weeks of shots. Continues off & on regularly. Mind cloudy and memorory fadding within 1 month of shot. Continued to worsen and effect daily routine to point of missing work, unable to function as normal causing and to the point of depression. All symptoms continue now. Seeing various doctors to treat symptoms. Various tests and treatment of symptoms continue to date. Cause possibly due to previous Anthrax Vaccine the effected immune sysmtem and was complicated and compromised health by recent vaccines. There is a previous Vaers for Anthrax Vaccine on filed in previous years.

VAERS ID:259337 (history)  Vaccinated:2006-06-16
Age:54.0  Onset:2006-06-19, Days after vaccination: 3
Gender:Female  Submitted:2006-06-23, Days after onset: 4
Location:California  Entered:2006-07-10, Days after submission: 17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Flonase, asthma medication
Current Illness: NONE
Preexisting Conditions: UNK
Diagnostic Lab Data: At time of call on 6/23/06 Appt made with her MD
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR814AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Crying, Nausea, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: On 6/19/06 reported Hives on neck and chest c/o nausea. On 6/23/06 continues to have hives now all over described as weeping sores and itchy.

VAERS ID:259369 (history)  Vaccinated:2006-06-30
Age:54.0  Onset:2006-07-05, Days after vaccination: 5
Gender:Female  Submitted:2006-07-10, Days after onset: 5
Location:Georga  Entered:2006-07-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0488R0SCRA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2454AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Feeling hot, Hypokinesia, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Complaining of muscle pain on right side of neck. Pain extends from back of jaw on right side of neck down to shoulder. Also has a warm sensation on right side of neck in painful area. Pain worsens with movement of area.

VAERS ID:259501 (history)  Vaccinated:2005-11-01
Age:54.0  Onset:2005-11-02, Days after vaccination: 1
Gender:Female  Submitted:2006-07-10, Days after onset: 249
Location:Unknown  Entered:2006-07-13, 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: 5/17/06: C K Enzyme 204 N=<165
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA151AA  LA
Administered by: Private     Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Injection site pain, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient feels pain at the injection site, left arm deltoid region, with tenderness to the "touch or pressure" and weakness of elevation of the left arm. No atrophy. Presented on 05/17/06; improving on Diclofenac 75 mg twice daily.

VAERS ID:259533 (history)  Vaccinated:2006-07-11
Age:54.0  Onset:2006-07-12, Days after vaccination: 1
Gender:Female  Submitted:2006-07-13, Days after onset: 1
Location:Oklahoma  Entered:2006-07-13
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
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2341AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Pain
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: client came to heath department with compliant of left arm hurting and not able to raise left arm up more than a couple of inches. client taking ibuprofen and putting warm compact on arm.

VAERS ID:259802 (history)  Vaccinated:2006-06-29
Age:54.0  Onset:2006-06-30, Days after vaccination: 1
Gender:Female  Submitted:2006-07-20, Days after onset: 20
Location:Oklahoma  Entered:2006-07-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: none
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)AVENTIS PASTEURU1596BA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Infection, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Adult Td shot was given on 6-29-06 to the Left Deltoid. One 7-3-06 client stated he saw doctor and he dx with an infection from the shot and was give Cipro and medrol. Arm was red, swollen, warm to touch and painful reported by pt.

VAERS ID:259853 (history)  Vaccinated:2006-07-14
Age:54.0  Onset:2006-07-19, Days after vaccination: 5
Gender:Female  Submitted:2006-07-21, Days after onset: 2
Location:Pennsylvania  Entered:2006-07-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS109AA0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURZ001 SCRA
TDAP: TDAP (ADACEL)AVENTIS PASTEURC2492BA IMLA
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEUR805AA0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Diarrhoea, Dizziness, Headache, Lethargy, Stomach discomfort
SMQs:, Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: In taking the oral typhoid medication, by the third pill pt felt weak, lethargic, dizzy, headache, queasy stomach and diarrhea.

VAERS ID:259985 (history)  Vaccinated:2006-07-13
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2006-07-24
Location:Texas  Entered:2006-07-24
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: PER PT, HE IS TAKING BENADRYL, PRESCRIBED BY THE ER.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB058CA IMRA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU1731CA IMLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUE601AA SCRA
Administered by: Military     Purchased by: Military
Symptoms: Oedema, Throat tightness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: PT VACCINATED IN OUR CLINIC ON 7/13/06. PT RETURNED HOME AND STARTED TO EXPERIENCE SWELLING OF THE MOUTH AND FEELING OF A CLOSING AIRWAY. PT WENT TO THE ER AND WAS TX''D ON 3 VISITS AND RELEASED FROM THE HOSPITAL YESTERDAY 7/23/06. PT CALLED CLINIC AND SPOKE WITH NURSE TO LET HER KNOW THAT THE REACTION OCCURRED. PT WAS TOLD TO RETURN TO THE ER TO BE REEVALUATED DUE TO PROLONGED FEELING OF AIRWAY CLOSURE.

VAERS ID:260031 (history)  Vaccinated:2005-10-24
Age:54.0  Onset:2005-10-24, Days after vaccination: 0
Gender:Female  Submitted:2006-07-21, Days after onset: 270
Location:Wisconsin  Entered:2006-07-25, 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: UNK
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES0511USA00025
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0055R0 UN
Administered by: Private     Purchased by: Other
Symptoms: Cellulitis, Erythema, Injection site erythema, Injection site induration, Injection site pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Information has been received from a registered nurse concerning a 54 year old female who on 10/24/05 at 4:30 pm was vaccinated with a first dose of Pneumococcal 23v polysaccharide vaccine (lot 647661/0055R), in the right deltoid. Subsequently, she called the physician complaining of pain at injection site. The patient was seen in the office on 10/26/05 for cellulitis to right shoulder, induration, erythema in linear area below injection site and running medially around anterior aspect of shoulder and into axilla. It was also reported that the patient had developed erythema around injection site and a red line to the axillary area. The patient was treated with azithromycin (Zithromax) for 5 days and warm compresses. The patient recovered. The reporter considered the patients adverse experience to be an other medical event (OMIC). It was also reported that two other patients had an adverse experience following vaccination with Pneumococcal 23v polysaccharide vaccine WAES0511USA00419 and WAES0511USA00420.

VAERS ID:260036 (history)  Vaccinated:2005-11-07
Age:54.0  Onset:2005-11-07, Days after vaccination: 0
Gender:Female  Submitted:2006-07-21, Days after onset: 255
Location:Unknown  Entered:2006-07-25, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES0511USA02279
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0747P UNUN
Administered by: Other     Purchased by: Other
Symptoms: Cellulitis, Injection site hypersensitivity, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a registered nurse concerning a 54 year old female with unspecified medical history who on 11/7/05 was vaccinated with Pneumococcal 23v polysaccharide vaccine 0.5 ml (lot 650329/0747P) Concomitant therapy included unspecified medication. Subsequently, the patient developed a swollen, red arm. The patient was seen in the doctors office. The patient was diagnosed with cellulitis and was treated with oral antibiotics. The patient was reportedly doing well. The reporting nurse considered cellulitis to be disabling. It was also reported that two other patients experienced cellulitis after being vaccinated with Pneumococcal 23v polysaccharide vaccine WAES0511USA01525 and WAES0511USA02280. the reporting nurse requested a lot check. Additional information has been requested.

VAERS ID:260369 (history)  Vaccinated:2005-10-24
Age:54.0  Onset:2005-10-24, Days after vaccination: 0
Gender:Male  Submitted:2006-07-21, Days after onset: 270
Location:California  Entered:2006-07-25, 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: NONE
Current Illness:
Preexisting Conditions: Sarcoidosis; general symptom
Diagnostic Lab Data: Body temp 10/28/05 96F
CDC 'Split Type': WAES0510USA09399
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0SC 
Administered by: Other     Purchased by: Other
Symptoms: Body temperature decreased, Cellulitis, Feeling hot, Injection site erythema, Spleen disorder
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Information has been received from a physician concerning a 54 yr old Caucasian male pt with sarcoidosis, thrombocy, and no known drug reactions/allergies, who on 24Oct2005 was vaccinated SC with a first dose pneumococcal 23v polysaccharide vaccine. There was no concomitant medication. On 24Oct05 the pt developed a local reaction. The left tricep and upper arm of the pt had warmth and erythema. It was reported that the doctor gave the pt a shot of methylprednisone sodium succinate (Solumedrol) and gave cefdinir (Omnicef) (300g) to take for 7 days for cellulitis. The physician also reported that the pt was scheduled for a splenectomy. The pt reported the area affected had increased each day. On 28Oct05 the pt was seen for a follow up visit. The pt felt better. The pt had a temp of 96F. The pt recovered. No product quality complaint was involved. Additional information is not expected.

VAERS ID:260569 (history)  Vaccinated:2005-11-17
Age:54.0  Onset:2005-11-17, Days after vaccination: 0
Gender:Female  Submitted:2006-07-21, Days after onset: 245
Location:North Carolina  Entered:2006-07-25, 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: hydrochlorothiazide Zocor
Current Illness:
Preexisting Conditions: hypertension hyperlipidemia rhinitis allergic
Diagnostic Lab Data: None
CDC 'Split Type': WAES0601USA00720
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.650329/0747P1  
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Feeling hot, Oedema peripheral, Pain, Swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Erythema; Pain in extremity; Skin warm; Edema peripheral Information has been received from a health care professional and a 54 year old female white consumer with hypertension, hyperlipidemia, allergic rhinitis and no allergies who on 17-NOV-2005 at 1)30 PM was vaccinated with a second dose of pneumococcal 23v polysaccharide vaccine (lot #650329/0747P). Concomitant therapy included HCTZ/triamterene and simvastatin (MSD). Subsequently on 17-NOV-2005 the patient''s right arm was swollen ("size of baseball"), hot, red, and also created a great deal of pain. There were no relevant diagnostic tests or laboratory data. Unspecified medical attention was sought. The patient recovered after several days over 2 days. Additional information is not expected.

VAERS ID:260733 (history)  Vaccinated:2005-10-23
Age:54.0  Onset:2005-10-24, Days after vaccination: 1
Gender:Male  Submitted:2006-07-21, Days after onset: 270
Location:Michigan  Entered:2006-07-25, 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: LIPITOR
Current Illness:
Preexisting Conditions: Concurrent conditions: Cholesterol high
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0605USA04619
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0791P1SC 
Administered by: Other     Purchased by: Other
Symptoms: Joint range of motion decreased
SMQs:, Arthritis (broad)
Write-up: Initial and follow up information has been received from a physician and a health care worker concerning a 54 year old male with high cholesterol, who in approximately the year 2000 was vaccinated with pneumococcal 23v polysaccharide vaccine with reportedly, no adverse reaction. On 23-OCT-2005, the patient was vaccinated, subcutaneously in the right arm, with a 0.5 ml dose of pneumococcal 23v polysaccharide vaccine on (Lot#650453/0791P). Concomitant therapy included atorvastatin calcium (LIPITOR). The physician reported that the next day (24-OCT-2005), the patient was not able to move the arm. The patient was to be seen in the physician''s office on 24-MAY-2006. The patient sought unspecified medical attention. At the time of the report, the patient had not recovered. The physician reported that this patient is the second of two patients. Additional information has been requested.

VAERS ID:260813 (history)  Vaccinated:2006-07-14
Age:54.0  Onset:2006-07-21, Days after vaccination: 7
Gender:Female  Submitted:2006-07-21, Days after onset: 0
Location:California  Entered:2006-07-28, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~~~0~In Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEUR  IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site inflammation, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pain, inflammation at injection site

VAERS ID:260966 (history)  Vaccinated:2006-07-03
Age:54.0  Onset:2006-07-04, Days after vaccination: 1
Gender:Female  Submitted:2006-07-19, Days after onset: 15
Location:Missouri  Entered:2006-08-02, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB107AA0IMRA
IPV: POLIO VIRUS, INACT. (IPOL)AVENTIS PASTEURY1050 SCLA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1596CA IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD30009740PO 
YF: YELLOW FEVER (YF-VAX)AVENTIS PASTEURUE805AA0SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Diarrhoea, Fatigue, Injection site hypersensitivity, Injection site mass, Injection site reaction, Nasal congestion, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Client report mild problems on 07/10/06 including lump and redness with yellow fever injection site, fever less than or equal to 100 which began 24 hours after vaccination and then recurred on 7/7/06. Also reported fatigue and nasal congestion. Client instructed to continued to cold pack injection site and take Ibuprofen and Tylenol for fever and discomfort. 07/12/06 F/U call to client. Stated she feel better, denied fever states redness et lump at yellow fever injection site was subsiding. Stated she now had diarrhea. Stated she had not yet begun taking the oral typhoid vaccine. 07/13/06 F/U call re: oral typhoid. Stated she feels good , denies fever. Stated she took the first dose of Oral Typhoid that morning. 7/17/06 no further messages from or phone contact with client.

VAERS ID:261206 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2006-08-04
Location:Unknown  Entered:2006-08-07, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Antihypercholesterolaomic
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Hepatic Enzyme elevated.
CDC 'Split Type': A0615174A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS   UN
Administered by: Other     Purchased by: Other
Symptoms: Blood creatine phosphokinase increased, Hepatic enzyme abnormal, Laboratory test abnormal, Myopathy
SMQs:, Rhabdomyolysis/myopathy (narrow), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad)
Write-up: This case was reported by a physician and a nurse and described the occurrence of myopathy in a 54 year old male subject who was vaccinated with Lyme disease vaccine recombinant Lymerix for prophylaxis. On an unspecified date years ago the subject received unspecified doe of Lymerix unknown. Previously the subject had taken cholesterol and medications but they were discontinued. On an unspecified date after vaccination with Lymerix, the subject experienced elevated liver enzymes, myopathy, elevated creatinine phosphokinase and an abnormal electromyography. The nurse considered that these events were life threatening. At the time of reporting the outcome of the events was unspecified. The nurse considered that the events were probably related to treatment with Lymerix.

VAERS ID:261977 (history)  Vaccinated:2006-08-05
Age:54.0  Onset:2006-08-05, Days after vaccination: 0
Gender:Male  Submitted:2006-08-09, Days after onset: 4
Location:Unknown  Entered:2006-08-23, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: Environmental allergies.
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2491AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Cough, Fatigue, Feeling hot, Malaise, Pain
SMQs:, Anaphylactic reaction (broad)
Write-up: Received vaccine Sat sore arm that night and 24 hours later felt very tired, felt warm and body aches, was unable to get up for work Monday morning and had cough.

VAERS ID:262467 (history)  Vaccinated:2006-07-25
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2006-08-28
Location:Indiana  Entered:2006-09-01, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (DAPTACEL)SANOFI PASTEURC2407AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Medication error
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Soreness at injection site and mild redness.

VAERS ID:262568 (history)  Vaccinated:2006-08-01
Age:54.0  Onset:2006-08-15, Days after vaccination: 14
Gender:Female  Submitted:2006-09-01, Days after onset: 17
Location:California  Entered:2006-09-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Neg- West Nile Virus. Neg-Anti-Nuclear AB Screen. CBC WNL Neg-Rheumatoid factor Uric Acid-neg
CDC 'Split Type':
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0154R SCLL
Administered by: Unknown     Purchased by: Unknown
Symptoms: Joint stiffness, Musculoskeletal stiffness, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Neck stiffness. Shoulder pain. Joint stiffness.

VAERS ID:262678 (history)  Vaccinated:2004-10-05
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Puerto Rico  Entered:2006-09-07
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:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV088   
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR    
SMALL: SMALLPOX (DRYVAX)PFIZER/WYETH4030013   
Administered by: Military     Purchased by: Military
Symptoms: Dry skin, Hypertension, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: Rash, itches and dry skin, left neck side surgery, high pressure.

VAERS ID:263009 (history)  Vaccinated:2006-09-11
Age:54.0  Onset:2006-09-11, Days after vaccination: 0
Gender:Male  Submitted:2006-09-13, Days after onset: 2
Location:Louisiana  Entered:2006-09-13
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: NKDA
Diagnostic Lab Data:
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TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD1572IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Patient report nausea, vomiting and diarrhea that started approx 5 hours after immunization administered.

VAERS ID:263198 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:Puerto Rico  Entered:2006-09-19
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:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Unevaluable event
SMQs:
Write-up: see attachment at shots record

VAERS ID:263383 (history)  Vaccinated:2006-09-08
Age:54.0  Onset:2006-09-08, Days after vaccination: 0
Gender:Male  Submitted:2006-09-20, Days after onset: 12
Location:D.C.  Entered:2006-09-21, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: See attached summary
Diagnostic Lab Data: See attached report for ECHO normal and ECG
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TDAP: TDAP (ADACEL)SANOFI PASTEURC2556AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Cardiac disorder, Cardiac flutter, Fatigue, Feeling hot, Hyperhidrosis, Nausea, Palpitations
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tachyarrhythmia terms, nonspecific (narrow)
Write-up: After vaccine receipt in the morning, he ran his usual 9 miles before lunch. Later that night, he felt fatigued and experienced diaphoresis with no associated symptoms. His vaccine site was a little tender, but he did not note any significant redness, warmth or lymphadenopathy. He was afebrile. He continued to experience episodes of felling hot and sweaty throughout the week end. He also noted palpitations that started on Friday Pm (around 2200) felt like fluttering in my chest. AT first he noted 1-2 extra beats every 3-5 minutes, on Sunday, the palpitations seemed to be associated with the diaphoresis and he also noted a little bit of nausea associated with the diaphoresis. Service member went to the ER on Sunday pm 9/10/06. He was seen by cardiology on a1 of 9/14/06n He has no previous history of palpitations or arrhythmias. He is non smoker, He notes an increase in stress over the last 3 months, however, the week of vaccine receipt had not been very stressful. No recent changes in medications, supplements or caffeine intake (drinks 1-2 cups of coffee day). No aggravating or alleviating factors identified. At appointment on 9/14/06, service member reported a couple palpitations since getting up that morning. He noted the palpitations seemed to be a lot less an the am and tended to increase in frequency in the evening. The palpitations peaked Monday night when they were coming every minute to two, and have been decreasing frequency since then. He has not experienced any diaphoresis since Monday night. He ahs not run since 9/8/06. He reports generally feeling fine except for being tired. He ahs been working fewer hours than normal (6-7 hours per day), but has been feeling more tired at the end of the day. He reports he has no disruption of his sleep pattern related to palpitations or diaphoresis. He states that if he had a fever he would think that he had a virus. Service member denies personal history of hypertension, diabetes, dyslipidemia, valvular disease ( he was told he has a mild murmur for the first time today), coronary artery disease, obesity, heart failure, peripheral vascular disease, gastrointestinal disease, or lung disease. He does not use tobacco. He denies any personal history of heart attacks, strokes or TIAs, or thrombosis. Service member GF M, who was a heavy smoker, died from a heart attack at age 62. Also his grandfathers son/pt uncle died from a heart attack at around age 70 and he was also a smoker. Other wise no family history of coronary artery disease, drowning, motor vehicle accidents, Seizures, or sudden death.

VAERS ID:263429 (history)  Vaccinated:2006-08-10
Age:54.0  Onset:2006-08-13, Days after vaccination: 3
Gender:Female  Submitted:2006-09-21, Days after onset: 39
Location:California  Entered:2006-09-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: naprosyn, estroven, calcium, vitamin C, multivitamin
Current Illness:
Preexisting Conditions: Hypercholesterolemia, Osteoarthritis, Insulin Resistance NKDA
Diagnostic Lab Data:
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2492BA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cellulitis, Chills, Diabetes mellitus, Feeling hot, Injection site erythema, Injection site induration, Injection site pain, Pyrexia
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Vaccine was administered 8/10/06, patient was subsequently admitted to MC 8/13/06-8/16/06 with cellulitis requiring IV antibiotics. 9/25/06 Received medical records from hospital which revealed patient admitted 8/13/06-8/16/06 w/final Dx: left shoulder cellulitis, diet controlled diabetes, dyslipisemia. Left shoulder pain, swelling & erythema began day after tetanus injection with fever & chills. Exam on admit revealed LUE & shoulder erythema, induration & tenderness w/increased warmth. WBC 6900. LUE/shoulder X-ray was WNL. Blood cultures were neg. Improved significantly & was d/c to home on oral antibiotics./ss

VAERS ID:263485 (history)  Vaccinated:2006-08-07
Age:54.0  Onset:2006-08-13, Days after vaccination: 6
Gender:Female  Submitted:2006-09-19, Days after onset: 37
Location:Minnesota  Entered:2006-09-25, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Upper resp concerns since early 8/06
Preexisting Conditions:
Diagnostic Lab Data: Diagnosed with Miller Fisher Syndrome by neurologist. Labs: WBC 8.1, Hgb 16.1. CSF: RBC 1.058, WBC 1, glucose 60, protein 33. Chemistry, sodium 135, glucose 103, ALT 35, TSH 5.50, Immuno Elp serum Beta 1.31and no monoclonal protein detected. serology negative. Elisa IgG 1:400. EMG: axonal sensory polyneuropathy with subdemyelinating components. Labs: cholesterol 256, triglyceride 278 Echocardiogram and Doppler: Normal left ventricular size with hyperdynamic function left ventricular wall thickness at the upper limits of normal to mildly hypertrophied with borderline Doppler evidence of abnormal left ventricular relaxation (diastolic dysfunction). Aortic valve thickening without stenosis or insufficiency. Trace pulmonic insufficiency. Poss
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1730FA1IMLA
Administered by: Private     Purchased by: Other
Symptoms: Activities of daily living impaired, Alanine aminotransferase normal, Antinuclear antibody positive, Back pain, Blood cholesterol increased, Blood glucose normal, Blood sodium normal, Blood thyroid stimulating hormone normal, Blood triglycerides increased, CSF glucose normal, CSF protein normal, CSF white blood cell count negative, Coordination abnormal, Diplopia, Echocardiogram, Echocardiogram abnormal, Electromyogram abnormal, Encephalopathy, Fatigue, Gait disturbance, Haemoglobin normal, Hyperlipidaemia, Hypertensive crisis, Hypoaesthesia, Immunology test, Impaired work ability, Labile hypertension, Laboratory test, Miller Fisher syndrome, Neck pain, Neuropathy, Paraesthesia, Red blood cell count decreased, Red blood cells CSF positive, Serology negative, Vision blurred, Visual impairment, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Dyslipidaemia (narrow), Haematopoietic erythropenia (narrow), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Glaucoma (broad), Hypertension (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Lipodystrophy (broad), Ocular motility disorders (narrow), Chronic kidney disease (broad), Arthritis (broad)
Write-up: The day of the immunization I had a sharp, zinging stabbing in my neck and back that flashed and was gone on 8/13/06 upon waking I walked to the side, could not feel my hands or feet normally, my feet, hands, legs and arms were tingly and numb, my teeth felt like they were being pushed out, face tingly, sore back. 10/3/06-records received for 2 hospitalizations DOS 8/14-8/15/06- DC DX: Hypertensive Urgency Hypertensive encephalopathy Hyperlipidemia Upper respiratory infection Summary: admitted with hypertensive urgency/mild encephalopathy. BP 170/118, Sensory intact throughout, though she complained of some paresthesia on the extremities. Gait, is somewhat unsteady and unable to perform the linear walking. Treated with Cozaar 50 mg and hydrochlorothiazide. Once blood pressure was controlled her paresthesia, confusion and gait difficulty rapidly improved. DOS 8/19-8/24/06- DC DX: Probably Miller-Fisher syndrome with ataxia, diplopia and sensory neuropathy. Labile hypertension Positive antinuclear antibody of uncertain significance. History of cholecystectomy. MRI of brain: normal MRA of neck and head showed some mild irregularities with the distal two thirds of the basilar artery and moderate narrowing at the distal portion of the right posterior cerebral artery probably no related to recurrent symptoms. Present illness: light sensitivity, blurriness at distance and near in both eyes, eyelids somewhat sore to touch and eyes hurting in up gaze for approximately 1 1/2 weeks. After she reads for a while her vision tends to get blurry. Review of systems negative except for gastrointestinal significant for gastro esophageal reflux disease. PE: Applanation tonometry yields pressures of 14 bilaterally. Pupils re 5.5 mm in the dark bilaterally and react to 4mm in light bilaterally slightly sluggish reaction bilaterally. Ocular motility is full. On confrontation visual fields are full. Tear lake appears decreased bilaterally. Optic nerves normal. Attempted visual field testing with a 120 point screening exam, the patient was unable to even complete the right eye because of discomfort, she felt test made her dizzy. What there was of the test basically showed a few nonspecific depressed points, certainly noting to indicate a neurologic vision deficit. HX of present illness: symptoms began one week ago with increasing numbness, paresthesias in somewhat of glove-stocking distribution in bilateral upper and lower extremities, feeling of great difficulty. Hard time walking, falling towards the wall. After discharge on 8/16/06 symptoms improved until morning of this admission when not only paresthesias but also some visual changes with images on top of one another. Present to a lesser degree yesterday. She apparently had been having a viral infection. Since end of July she had been on antibiotics and that was discontinued. Now having recurrent cough and upper respiratory infection like symptoms. Intermittent palpitations and some atypical chest pain mostly on her right side. Husband noticed some halting thoughts last week. 1/11/2010 Automatic dysfunction and symptonatology visual disturbances. Gait disturbance that make it difficult to even perform daily activities of living due to an excess amount of generalized fatigue. 02/01/2010 Vision remains poor-has autonomic nervous system problems-fatigue continues-not able to work due to GBS-gastro problems-hearing problems-balance problems-unable to drive.

VAERS ID:263615 (history)  Vaccinated:2006-09-16
Age:54.0  Onset:2006-09-20, Days after vaccination: 4
Gender:Female  Submitted:2006-09-26, Days after onset: 6
Location:Wyoming  Entered:2006-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEURU1637CA  LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Red, hot, a Knot in muscle of left deltoid.

VAERS ID:264180 (history)  Vaccinated:2006-10-03
Age:54.0  Onset:2006-10-05, Days after vaccination: 2
Gender:Female  Submitted:2006-10-09, Days after onset: 4
Location:Florida  Entered:2006-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: see chronic medications
Current Illness: 10/03/2006 physical examination V70.0
Preexisting Conditions:
Diagnostic Lab Data: NONE
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1008P0 RA
Administered by: Private     Purchased by: Other
Symptoms: Headache, Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: (+) rash neck, arms, chest, back and legs, body aches, headache, fever.

VAERS ID:264214 (history)  Vaccinated:2006-09-29
Age:54.0  Onset:2006-09-30, Days after vaccination: 1
Gender:Female  Submitted:2006-10-03, Days after onset: 3
Location:California  Entered:2006-10-10, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2341AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swollen and redness at injection site right deltoid, warm to touch.

VAERS ID:264260 (history)  Vaccinated:2006-10-06
Age:54.0  Onset:2006-10-07, Days after vaccination: 1
Gender:Male  Submitted:2006-10-10, Days after onset: 3
Location:New Jersey  Entered:2006-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Lipitor, Triamterene
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER70736 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 24 hours after flu shot got chills and 96.5F body temp. Slept for 4 hours. Awoke with 101.3 body temp. Spent rest of day and most next day in bed with fever around 101. Fever subsided in evening. Following day body temp back to normal. Feel fine today...4 days later.

VAERS ID:264413 (history)  Vaccinated:2006-10-11
Age:54.0  Onset:2006-10-11, Days after vaccination: 0
Gender:Female  Submitted:2006-10-11, Days after onset: 0
Location:California  Entered:2006-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 10/11/06:Cortisone injection in foot;PPD TST Macrodantin (UTI)x1wk Salagen X 5yrs;Tramadol X 27mos Tylenol PRN Pain
Current Illness: No contraindication to vaccine reported.
Preexisting Conditions: Arthritis, Fibromyalgia, Sojren Syndrome, Plantar Fascitis, Carpal Tunnel Both Hands, Hx of neck and Back Surgeries
Diagnostic Lab Data: Employee was referred for further Medical Evaluation
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2240AA1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: On 10/11/2006 at approximately 08:30 a.m, the above named employee received the Inactivated Influenza Vaccine (Right Deltoid) and a PPD SKIN Test (Left Arm). She states that approx. 1 hour post vaccination she developed on LUE fine raised red rash on the LUE spreading to BUE''s and back. Other symptoms include generalized pruritis. Denies respiratory symptoms, Chest pains, or SOB at time of report. 10/11/06 Approx.12:00 Noon: The employee report that she recieved a Cortisone Injection from her treating physician for a plantar fascitis problem. 10/11/06 @ 16:30: The employee presented to the Employee Health Office to report a possible vaccine adverse reaction to the flu shot based on the above symptomology reported. - Employee self medicated with 2 Benadryl (50mg total) with little relief at time of report. -Employeee reports a history of multiple medical conditions. -Denies adverse reactions with previous Flu vaccine given in 2005. - Employee was referred for further medial evaluation.

VAERS ID:264722 (history)  Vaccinated:2006-10-13
Age:54.0  Onset:2006-10-13, Days after vaccination: 0
Gender:Female  Submitted:2006-10-13, Days after onset: 0
Location:Texas  Entered:2006-10-17, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLU-IMUNE)LEDERLE LABORATORIES 1IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0619F1IMRA
TDAP: TDAP (ADACEL)AVENTIS PASTEURU1217DB1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Injection site warmth, Pyrexia, Sleep disorder, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Friday evening right arm swollen, hot, and red. Could not sleep. Got up Sturday morning with chills and 102.4 fever. Took aspirin. Called school nurse. She called back in afternoon and told me to call my doctor. I called him and he told me to take 600 mg ADVIL every six hours and to continue the fluids. I have been doing this since Saturday evening. My are is still red, tender, and a little warm.

VAERS ID:265128 (history)  Vaccinated:2006-10-10
Age:54.0  Onset:2006-10-11, Days after vaccination: 1
Gender:Female  Submitted:2006-10-17, Days after onset: 6
Location:Texas  Entered:2006-10-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: 2 pack
Diagnostic Lab Data: NONE
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION694808IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0877R0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt received pneumococcal Immunization 10/10/06 left arm 10/12/06 c/o 3 red spots on left deltoid. States sore touch. No treatment. Resolved 10/14/2006.

VAERS ID:265587 (history)  Vaccinated:2006-10-11
Age:54.0  Onset:2006-10-11, Days after vaccination: 0
Gender:Female  Submitted:2006-10-26, Days after onset: 15
Location:Nebraska  Entered:2006-10-30, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Crestor, Calcium, Mypolene, Vitamin Supp
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2557AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Headache, Retching
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Caused headache with Dry heaves, vomited twice about 15 minutes after leaving clinic.

VAERS ID:265657 (history)  Vaccinated:2006-10-01
Age:54.0  Onset:2006-10-03, Days after vaccination: 2
Gender:Female  Submitted:2006-10-03, Days after onset: 0
Location:New York  Entered:2006-10-30, Days after submission: 27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data:
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)AVENTIS PASTEUR206691IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Client reports redness, swelling right arm 2 days after TD given. Swelling, redness under admission site to elbow top of arm.

VAERS ID:265879 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2006-11-02
Location:Iowa  Entered:2006-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data:
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TDAP: TDAP (ADACEL)AVENTIS PASTEURC2556AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypokinesia, Musculoskeletal stiffness, Myalgia, Pain, Thermal burn
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad)
Write-up: Pt had burning sensation of stabbing and tightness. PT feels this was muscular in nature and perhaps irritated the tendon. she had limited ROM at injection site and had Physical therapy to increase range of motion and decrease pain. This has taken approx 3 months.

VAERS ID:266112 (history)  Vaccinated:2006-10-31
Age:54.0  Onset:2006-11-01, Days after vaccination: 1
Gender:Female  Submitted:2006-11-06, Days after onset: 5
Location:Kentucky  Entered:2006-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, Singulair, Altace
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: none
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2245AA9IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: I am an RN in a pediatric practice and take the Influenza Vaccine yearly. Approximately 32 hours after receiving the Influenza Vaccine, I had severe vomiting and fever of 102 degrees. I used Phenergan and Tylenol for symptoms. These same adverse symptoms have been reported verbally to me by several other people in the community after they had received the Influenza vaccine in less than a 48 hour period.

VAERS ID:266113 (history)  Vaccinated:2006-11-03
Age:54.0  Onset:2006-11-03, Days after vaccination: 0
Gender:Female  Submitted:2006-11-06, Days after onset: 3
Location:Pennsylvania  Entered:2006-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Tyleon Arthritis 650MG Voltarin 30mg Cymbalta 30mg
Current Illness: none
Preexisting Conditions: Sulpha, Floxin, Iodine
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2254AA5IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Influenza like illness, Injection site erythema, Injection site swelling, Injection site warmth, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Flu like symptoms. Tired, swelling, redness, hot, sore arm and muscle. Place warm clothes.

VAERS ID:266125 (history)  Vaccinated:2006-10-28
Age:54.0  Onset:2006-10-29, Days after vaccination: 1
Gender:Female  Submitted:2006-11-06, Days after onset: 8
Location:Virginia  Entered:2006-11-06
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:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU22133A0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Eye swelling, Pruritus, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Approximately 27 hours after the shot patient developed splotchy face, continued over the next few hours to develop into redness and itching over entire face. Went to bed, then woke in the morning with eyes swollen shut due to swelling.

VAERS ID:266130 (history)  Vaccinated:2006-10-27
Age:54.0  Onset:2006-10-27, Days after vaccination: 0
Gender:Female  Submitted:2006-11-06, Days after onset: 10
Location:Missouri  Entered:2006-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: breast cancer
Diagnostic Lab Data: ***Several employees and community members have had gastroenteritis**** Unrelated to the Influenza vaccine
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA204BA2IMLA
Administered by: Military     Purchased by: Other
Symptoms: Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Employee received vaccine on 10/27/06 after having a bone scan with contrast. She reports becoming extremely ill 3 hours after administration of the vaccine. Began vomiting and was examined in ED--received IV fluids and Magnesium. Her PCP examined employee and states the illness may have been caused by the Influenza vaccine.

VAERS ID:266315 (history)  Vaccinated:2006-10-25
Age:54.0  Onset:2006-10-26, Days after vaccination: 1
Gender:Male  Submitted:2006-10-31, Days after onset: 5
Location:Colorado  Entered:2006-11-08, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NKDA
Diagnostic Lab Data: NONE
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION69427 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0881F IMLA
Administered by: Private     Purchased by: Private
Symptoms: Anorexia, Fatigue, Myalgia, Shoulder pain
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Myalgias, headache, fatigue, loss of appetite, left shoulder pain, left arm pain.

VAERS ID:266441 (history)  Vaccinated:2006-11-07
Age:54.0  Onset:2006-11-07, Days after vaccination: 0
Gender:Female  Submitted:2006-11-09, Days after onset: 2
Location:Wyoming  Entered:2006-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Was told "heart beat is irregular" several years ago.
Diagnostic Lab Data: BP 166/88 P 104
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION716390IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Dizziness, Heart rate increased, Hypertension, Nausea, Palpitations
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: C/O weakness, dizzyness, nausea, and heart pounding ~30 minutes after shot given. Shot was given at outside clinic. Client presented to Public Health office 2 hours later were PHN took vitals. BP and Pulse above normal range. Advised to see Primary MD.

VAERS ID:266488 (history)  Vaccinated:2006-11-07
Age:54.0  Onset:2006-11-08, Days after vaccination: 1
Gender:Female  Submitted:2006-11-10, Days after onset: 2
Location:Maryland  Entered:2006-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Diabetes, asthma
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Injection site erythema, Injection site pain, Injection site warmth, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Severe pain and redness/heat at site, fever, nausea, headache, body aches.

VAERS ID:266615 (history)  Vaccinated:2006-10-17
Age:54.0  Onset:2006-10-17, Days after vaccination: 0
Gender:Female  Submitted:2006-11-06, Days after onset: 20
Location:Ohio  Entered:2006-11-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lasix, Lisinopril, Metag, Lovastatin, Plavix, Restoriz, aspirin
Current Illness: None
Preexisting Conditions: Diabetes, heart disease
Diagnostic Lab Data: None
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)CHIRON CORPORATION70279   
Administered by: Private     Purchased by: Other
Symptoms: Chest discomfort, Injection site erythema, Injection site swelling, Pruritus
SMQs:, Anaphylactic reaction (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: About 1-1.5 hrs after getting flu shot developed itching, and tightness in chest. Site of injection red and swollen. Treated with Epi 0.3ml SQ which relieved symptoms and then Zyrtec 10mg prescribed.

VAERS ID:266841 (history)  Vaccinated:2006-11-13
Age:54.0  Onset:2006-11-14, Days after vaccination: 1
Gender:Female  Submitted:2006-11-15, Days after onset: 1
Location:Wisconsin  Entered:2006-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levothyroxin, Wellbutrin, Paxil,
Current Illness: None
Preexisting Conditions: Exercise induced asthma, Hypothyroidism, prior ablation and surgery.
Diagnostic Lab Data: None at this time
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU1267AA4IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthritis, Injection site erythema, Injection site swelling, Pain in extremity
SMQs:, Systemic lupus erythematosus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow)
Write-up: First noted signs at 6:00 AM, when she got out of bed. Felt arthritic. Aches in feet, ankles, all joints of hands and wrist. Swelling at injection site. site was puffy for about 1 inch in diameter. Red in center. No treatment. Still feels symptoms in feet and hands today. Particularly in proximal thumb joint. When standing whole foot hurts.

VAERS ID:266987 (history)  Vaccinated:2005-10-26
Age:54.0  Onset:2006-10-26, Days after vaccination: 365
Gender:Female  Submitted:2006-03-28, Days after onset: 211
Location:Michigan  Entered:2006-11-15, Days after submission: 232
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: Patient had Fluzone since 1995 every year. Allergy to cats and intravenous iodine. Gastroesoophageal reflux disease.
Diagnostic Lab Data:
CDC 'Split Type': 200502277
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEUR    
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Cough, Influenza like illness, Nausea, Ocular hyperaemia, Visual acuity reduced
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad)
Write-up: Initial report received on 01 Nov 2005 from a patient. A 53 year old female patient with a medical history of allergy to cats and intravenous iodine developed coughing for 15 minutes and her eyes began to feel gritty and turned blood shot red around 3:00pm following the influenza vaccine (Fluzone SV ''2005-''2006) administration on 26 Oct 2005 at 11:00am. It was reported that, by 6:00pm she had a hard time seeing. Lather in the evening, she reported to have flu like symptoms with nausea and feeling weak. She was on prevacid from an unspecified time for gastroesophaeal reflux disease. She went to bed at an unspecified time and next day she was fine. Follow up information received on 27/Mar/2006 from the patient. There was no illness at the time of vaccination, and the patient was on no other medications. Additional information was not provided.

VAERS ID:267180 (history)  Vaccinated:2006-11-16
Age:54.0  Onset:2006-11-16, Days after vaccination: 0
Gender:Female  Submitted:2006-11-19, Days after onset: 3
Location:California  Entered:2006-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: diverticulosis. no allergies, defects, no prescription medications
Diagnostic Lab Data: None
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Chills, Hyperhidrosis, Hypokinesia
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Within 6 hours of the injection, chills and shivering, sweats, general weakness and inability to stand. Stayed in bed for the entire day after the injection.

VAERS ID:267550 (history)  Vaccinated:2006-09-27
Age:54.0  Onset:2006-09-27, Days after vaccination: 0
Gender:Female  Submitted:2006-11-08, Days after onset: 42
Location:West Virginia  Entered:2006-11-21, Days after submission: 13
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
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HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB050AA0 LA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0498F0 RA
Administered by: Public     Purchased by: Private
Symptoms: Agitation, Amnesia, Confusional state, Depressed level of consciousness, Ear disorder, Encephalopathy, Feeling hot, Head discomfort, Paraesthesia, Personality disorder, Sensation of pressure, Syncope, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Hostility/aggression (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Chronic kidney disease (broad)
Write-up: Encephalopathy, decreased consciousness, immediate warm rush sat. Syncope, (Slow moving, pressure on ears, unable to focus on task on hand, easily confused, short term memory loss, trouble focusing eyes, left whole let and foot tingling, personality change, agitated, back of head felt like it smacked hard as in a fall. Symptoms very bad x2 days, third better, ok in one week.

VAERS ID:267637 (history)  Vaccinated:2006-11-15
Age:54.0  Onset:2006-11-15, Days after vaccination: 0
Gender:Female  Submitted:2006-11-17, Days after onset: 2
Location:New York  Entered:2006-11-22, 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: ASA, Niacin
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2272AA2IMLA
Administered by: Public     Purchased by: Other
Symptoms: Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Itching arms legs progressed 11/17/06 arms cleared, to left scapula and down hands. Prednisone.

VAERS ID:267982 (history)  Vaccinated:2006-11-28
Age:54.0  Onset:2006-11-28, Days after vaccination: 0
Gender:Female  Submitted:2006-11-29, Days after onset: 1
Location:Alabama  Entered:2006-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: "Felling well" no complaint of illness
Preexisting Conditions: Allergies; Monopril (fosinopril sodium)
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2259AA5IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Injection site reaction, Pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Administer .5ml Fluzone IM Left deltoid. After 15 minutes pt expressed that she was having some itching above the injection site on left arm. Upon observation the upper portion of her arm at the junction of the shoulder was erythematous as well at the inner aspect of the upper arm. The site was not warm to touch and there was noted central clearing with redness only at the inner and upper portion of arm. Pt complained of slight pain. She stated that she had many allergies and had PO benadryl in purse. She took two 25mg Benadryl by mouth. denies any difficulty breathing or other complaints. Pt observed for 15 additional minutes without incident. redness, pain and itching decreased. Pt released with instruction to seek medical attention if symptoms worsened. PT left Alert and oriented x3.

VAERS ID:268123 (history)  Vaccinated:2006-11-13
Age:54.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Female  Submitted:2006-12-01, Days after onset: 18
Location:Michigan  Entered:2006-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None given
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2247AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Husband called to report client experienced nausea, severe headache after flu shot, lasting approximately 3 days.

VAERS ID:268140 (history)  Vaccinated:2006-11-29
Age:54.0  Onset:2006-11-29, Days after vaccination: 0
Gender:Female  Submitted:2006-12-02, Days after onset: 3
Location:Massachusetts  Entered:2006-12-02
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:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Conjunctivitis, Pharyngitis, Rhinitis
SMQs:, Severe cutaneous adverse reactions (broad), Agranulocytosis (broad), Oropharyngeal infections (narrow), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (broad)
Write-up: Within 6 hours, sore throat; 24 hours conjunctivitis, then full blown head/chest cold.

VAERS ID:268185 (history)  Vaccinated:2006-11-14
Age:54.0  Onset:2006-11-14, Days after vaccination: 0
Gender:Female  Submitted:2006-11-20, Days after onset: 6
Location:South Carolina  Entered:2006-12-04, Days after submission: 14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS69897 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site oedema, Injection site pain, Injection site warmth, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Local Swelling 2" diameter local fever, arm sore, ache.

VAERS ID:268221 (history)  Vaccinated:2006-11-20
Age:54.0  Onset:2006-11-20, Days after vaccination: 0
Gender:Female  Submitted:2006-12-04, Days after onset: 14
Location:Virginia  Entered:2006-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Neurontin
Current Illness: None
Preexisting Conditions: Headaches Peanut allergies
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain
SMQs:
Write-up: Pt c/o arm soreness that travels down the arm continuing for time following vaccine. Worsenes over time.

VAERS ID:268227 (history)  Vaccinated:2006-11-29
Age:54.0  Onset:2006-11-30, Days after vaccination: 1
Gender:Male  Submitted:2006-12-04, Days after onset: 4
Location:Connecticut  Entered:2006-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2260AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: 11/30/06 Called PDDH to report he started at noon today feeling nauseated, dizzy. No fever. Sx came on suddenly. Instructed to call MD.

VAERS ID:268374 (history)  Vaccinated:2006-11-02
Age:54.0  Onset:2006-11-02, Days after vaccination: 0
Gender:Female  Submitted:2006-12-05, Days after onset: 33
Location:Michigan  Entered:2006-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2213AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Lump at injection site immediately following injection.

VAERS ID:268441 (history)  Vaccinated:2006-12-01
Age:54.0  Onset:2006-12-01, Days after vaccination: 0
Gender:Female  Submitted:2006-12-06, Days after onset: 5
Location:Wyoming  Entered:2006-12-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: I have allergies to various things such as trees and weeds. CFS
Diagnostic Lab Data:
CDC 'Split Type':
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Dizziness, Dysphonia, Dyspnoea, Injection site hypersensitivity, Nausea, Pruritus, Rash
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Shot area itched. The second day I had chills and a rash. The third day in the pm I experienced dizziness, difficulty breathing, nausea, and hoarseness. The fourth day in the am I still experienced dizziness and nausea. It finally went away in the afternoon. The next couple of days I have still had a feeling of lightheadedness but am able to work. I took Benedryl for the rash.

VAERS ID:268531 (history)  Vaccinated:2006-11-13
Age:54.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Female  Submitted:2006-12-07, Days after onset: 24
Location:Michigan  Entered:2006-12-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2256AA1IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: Nurse administered 1 cc of inactivated flu vaccine. No adverse effects reported.

VAERS ID:268534 (history)  Vaccinated:2006-11-13
Age:54.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Male  Submitted:2006-12-07, Days after onset: 24
Location:Michigan  Entered:2006-12-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2256AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: Nurse administered 1 cc of inactivated flu vaccine. No adverse effects reported.

VAERS ID:268560 (history)  Vaccinated:2006-11-13
Age:54.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Female  Submitted:2006-12-08, Days after onset: 25
Location:Michigan  Entered:2006-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2256AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: Nurse administered 1 cc inactivated flu vaccine. No adverse effects reported.

VAERS ID:268562 (history)  Vaccinated:2006-11-13
Age:54.0  Onset:2006-11-13, Days after vaccination: 0
Gender:Female  Submitted:2006-12-08, Days after onset: 25
Location:Michigan  Entered:2006-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: No
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2213AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Medication error
SMQs:
Write-up: Nurse administered 1 cc inactivated flu vaccine. No adverse effects reported.

VAERS ID:268852 (history)  Vaccinated:2006-11-29
Age:54.0  Onset:2006-12-11, Days after vaccination: 12
Gender:Female  Submitted:2006-12-13, Days after onset: 2
Location:Maryland  Entered:2006-12-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: injection site sore
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)AVENTIS PASTEURU2186AA2IMLA
Administered by: Public     Purchased by: Private
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Flu shot was given on November 29, 2006 at 10:30am. She comes on December 11, 2006 complaining of arm being numb.

VAERS ID:268860 (history)  Vaccinated:2006-12-06
Age:54.0  Onset:2006-12-07, Days after vaccination: 1
Gender:Female  Submitted:2006-12-13, Days after onset: 6
Location:Minnesota  Entered:2006-12-14, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atenolol, Ibuprofen, aspirin, Tylenol.
Current Illness: NONE
Preexisting Conditions:
Diagnostic Lab Data: Blood test increased white blood count
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 2 RA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1006P  LA
Administered by: Other     Purchased by: Private
Symptoms: Cellulitis, Chills, Injection site erythema, Injection site oedema, Injection site warmth, Malaise, Pyrexia, White blood cell count increased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 24 hours after receiving pneumovax. I felt sick chilled, my left arm swelled and was red and hot. Over nite my fever was 101.3. I called telephone nurse, she said to put warm compress, antibiotic cream and report to Dr in am. Urgent care diagnosed cellulitis and put me on Amoxicillin after a shot of antibiotic.

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